Molly Meacher, whose Bill to allow assisted dying gets its further reading in the Lords today, gave an interesting interview on BBC radio today – there was no other speaker to counter her arguments; an exchange of views came later in the programme. She explained that her engagement with the cause had been prompted by the lonely death of an aunt who had a terminal illness; she went on to describe the unpleasant conditions that could not be dealt with by palliative care. But then the interviewer, Martha Kearney, went on to ask about the problem that old people might be made to feel a burden. Baroness M said that she had four children, whom she loved more than anything, and went on to observe that while some old people may want to die because they are suffering, ‘they might also not want to be a burden on their families.’ This was, she felt, a valid reason. And she went on to ponder how it was that she’d like her children to remember her.
In other words, the argument segued from the safeguards and the very-worst-case scenarios to the more imprecise and more emotive question of quality of life and whether old and sick people should be asking themselves whether they are a burden to their families and society.
And that’s exactly how it works out in practice. What starts out as a measure for extreme cases with apparently impregnable safeguards – the original abortion legislation was very tightly framed – ends up in astonishingly short order becoming a matter of personal autonomy and individual preference.
The thing is, this is one area where the whole argument about individual choice doesn’t work because the very fact of the availability of assisted suicide changes the way everyone dies; all of a sudden there’s a choice that wasn’t there before that people with unpleasant conditions have to engage with.
Many people who support the Meacher Bill mention Oregon as an example of how to do it. Well, a study there last year suggested that 53 per cent of people seeking assisted suicide reported feeling like a ‘burden on families, friends or caregivers.’ Many would qualify for a diagnosis of depression. These are not autonomous rational individuals exercising free choice in the way Baroness Meacher would suggest. As Gordon Brown observed in his moving intervention on the subject, people can be made to feel a burden. People may in fact choose to die from altruism; they shouldn’t even have to make that choice.
And that notion of free, autonomous individuals exercising rational choice at the very end of their lives, it doesn’t last over time. A study this year of the operation of the euthanasia law in Belgium, introduced in 2002, found that the safeguards didn’t stand up to scrutiny, especially where the euthanasia was justified by multiple conditions (fatigue, vision loss etc). In 2014, Belgium extended euthanasia to children.
In the Netherlands, the Supreme Court extended euthanasia in 2018 to the old, that is, people qualified on account of the ‘normal degenerative conditions that accompany ageing.’ And indeed old age is a condition from which there is no prospect of improvement; old age is an inescapable condition. Last year, the Netherlands allowed patients with dementia who’d given advance consent to be euthanised. As for Canada, the legislation there was amended this year to allow for people with non-terminal illnesses to be assisted to die.
Those safeguards, in fact, about which Baroness Meacher sets such store… they haven’t worked out to be terribly robust in other liberal jurisdictions. You think that the UK is somehow different? This is one case where British exceptionalism would be proved illusory in very short order. But by then, it would be too late to turn back to the status quo now, where people die without having to face the burden of choice about whether to continue their lives or not.
The Bill today is going nowhere. But there’ll be other attempts. Molly Meacher’s arguments show exactly where this is going.