Myles’ Blog: Euthanasia and assisted suicide

My name is Myles. I am forty years old and have suffered with depression for thirty-three years. My fondest wish is for someone to help me end my life, to put me out of the cycle of misery and pain in which I am trapped, to release me from the hell in which I live.

Unfortunately, in most countries, helping someone end their life is a crime so the list of volunteers is non-existent. I must, therefore, continue to suffer but I will no longer suffer in silence. The law in England needs to be changed so that I and others like me who have tried and failed in the past, can finally get the peace we want and so desperately need.

The debate about euthanasia and assisted suicide, where it exists at all, is led by, or influenced by, the sensationalist media who want to sell papers or get viewers or listeners rather than having a well thought out, rational debate between all the different interest groups, both for and against. There are, however, many good and rational arguments on the subject and now is the time to listen, in a calm and reasonable manner, to all these arguments with open minds and compassionate hearts, with a view of the larger picture of the potential benefits for society of legalising euthanasia and assisted suicide.

The world we live in is constantly evolving, changing to meet the needs of the individuals who constitute the whole of humanity and this debate must be held now, as part of this process of societal change and evolution, for it will not go away, will not die until it has been held in a constructive and non-judgmental way and the voices of those in favour of changing the law are heard, loud and clear.

Defining the types

Part of the problem with debating the subject of euthanasia and assisted suicide is that it is not always completely understood what is meant by and the differences between the different terms used to identify the actions involved so we should begin by looking at the terms, setting out exactly what types we will be covering in this article.

We shall begin with the various terms relating to euthanasia.

Euthanasia, the grounding for all the other terms on this subject, simply refers to the act of one person killing another, or permitting their death, for the benefit of the latter. For example, Jim kills Martin, or permits Martin’s death to reduce his suffering.

Active euthanasia refers to a person taking action that results in the cessation of another person’s life. To follow our example from above, Jim giving Martin a lethal dose of morphine is an act of active euthanasia; this will become an important distinction when we start to discuss the ethics and the legality of the various forms of euthanasia.

Passive euthanasia refers to one person simply allowing someone to die by withdrawing or withholding life-prolonging treatment. To use Jim and Martin’s example, Jim asking for Martin’s medication to be stopped thus allowing Martin to die falls under this category.

Voluntary euthanasia refers to a legally competent adult requesting his or her own death therefore, if Martin is capable of rationally making such a decision, any action thus taken to end his life is considered a voluntary act of even euthanasia.

Non-voluntary euthanasia refers to euthanasia upon a person who is unable to express his or her own preference, such as a severely disabled newborn baby.

Involuntary euthanasia refers to euthanasia that is performed on an individual that is against his or her own personal wishes even though the death permitted or imposed is for the patient’s benefit; thus, Martin does not agree to euthanasia, but Jim permits an act of euthanasia in order to reduce Martin’s suffering.

Now we must look at the terms used in conjunction with suicide.

Suicide refers to the act of an individual who intentionally kills him or herself; therefore, if Martin kills himself with no other person involved, he has simply committed suicide.

Assisted suicide refers to one individual intentionally acting to help another person kill him or herself; thus, if Jim helps Martin to obtain or assist in the method that Martin has chosen to end his own life, the act committed becomes an act of assisted suicide.

Physician assisted suicide is the same as an assisted suicide with the exception being that the person assisting in the act is a qualified medical practitioner.

For the purposes of this discussion, we shall be covering only the active, passive and voluntary acts of euthanasia and both types of assisted suicide.

Euthanasia – a problem in medical ethics and morals

There is a great deal of controversy in the medical profession on the subject of euthanasia, which is strange given that passive euthanasia has been widely accepted as morally acceptable given the right set of circumstances and has been protected by the law in England, provided it is voluntary and in the patient’s best interests. Many countries including the United States and Canada also hold this moral viewpoint.

Countries such as Belgium and the Netherlands have gone a step further, having legalised active euthanasia within certain rigidly defined parameters whilst physician-assisted suicide has been legalised in both the US state of Oregon and in Switzerland with similar restrictions.

Euthanasia is, however, sometimes required, on the basis of morality, when it aligns itself to the widely held principles of patient autonomy and promoting the best interests of the patient.

Patient autonomy is a matter of the patient’s right to individual liberty. If, for instance, the patient wishes to die then that is their human right. If, on the other hand, the patient’s religious conviction stands in the way of treatment, even life-saving treatment, then that is also their human right to reject it. Legally, if treatment is given against a patient’s expressed wishes, the physician involved may open themselves up to charges of battery

Promoting the best interests of a patient is a question of their quality of life – will their quality of life be lower if they are kept alive to suffer more discomfort and pain? Passive euthanasia is the most commonly used form when confronted by a patient whose life is endangered by a relatively harmless illness that has become life threatening because of an incurable underlying condition that will end their life in a short time anyway. The rationale is that it would be in the patient’s best interest to die from the relatively minor illness rather than extend their life and, in turn, their suffering. The lower the patient’s quality of life will become if they are treated, the higher the moral imperative is for their suffering to be ended.

The controversy around active euthanasia hinges on the intention of the physician involved – taking actions with the intention of ending a patient’s life is a million miles away from simply withdrawing or withholding treatment and allowing them to die, which is a legal and normal part of medical practice.

One of the first things a physician who opposes active euthanasia will say upon being asked a question on why they take their stance will be to fall back on the old and tired line that it is against the Hippocratic Oath, which many believe states as one of its first principles that a doctor should “first, do no harm”. This argument against euthanasia is based on a fallacy as doctors are not required to take the Hippocratic Oath, although some take a modern version, of which there are several, and the line “first, do no harm” actually comes from another part of Hippocrates writing, not from the Oath at all. The original Oath contains many promises that would be impractical in today’s medical profession; such as not to cut anyone (perform surgery). Supporters, on the other hand, take the position that active euthanasia is, in fact, a form of mercy killing, a term that brings with it its own controversy.

Mercy Killing

To examine the controversy around the terminology of mercy killing, a number of thought experiments have been undertaken, most of which involve relatively unlikely situations to highlight the two sides of the argument. We will now look at one such thought experiment, which takes us away from the medical setting for a moment, to look at the moral question alone, and discuss the arguments involved.

Imagine that a beloved family member is trapped in a burning house and that they are pinned down so that escape is impossible; you cannot reach them even if you could move the object that is pinning them down. You do have a gun, however, and are a good shot. The trapped loved one asks you to shoot them to reduce their suffering.

The case for shooting the loved one is clear – it is in accordance with not only their expressed wishes but also it will be a mercy, as it will reduce their overall suffering. The case against shooting the loved one is rather more involved but boils down to approximately seven main arguments, in no particular order, that form the counter-arguments to the ‘for’ case although further counter-arguments that are thrown up will be included for the sake of thoroughness.

The first argument against an act of mercy killing is a very well-worn one stating that the person performing the act by performing such an act is interfering in the natural order of things, which is a morally wrong thing to do because it is ‘unnatural’, whereas passive methods of euthanasia allows nature to take its proper course. A problem with this argument is defining what is actually meant by ‘unnatural’; homosexuality happens in nature but there are differing views on whether it is natural or unnatural. This same argument can also be used as an argument against any form of treatment with any number of modern pharmaceuticals or medical and surgical methods. Why do people who use this argument against mercy killing believe that just because something is ‘unnatural’ that it is also inherently morally wrong. Medications may have a basis on certain natural compounds but a significant amount are synthetically made by man and are therefore not natural – are we therefore to stop all treatments based on the ‘unnatural’ origins of the drugs? Should we also stop using medical or surgical methods that have similar ‘unnatural’ origins? Some may suggest that helping couples conceive using IVF is also interfering with nature because of the medical procedures are unnatural even if the biological processes involved are not – does that mean that helping the couple in question is morally wrong? The argument against nature is a double-edged sword that cannot be wielded in favour of one case without it having to be applied equally to the opposing case, to do so allows bias to take hold and a biased argument is no argument at all.

The second argument is very similar to the first but, instead of claiming that the act is interfering in nature, claims that the act is ‘playing God’, which is morally wrong. This argument depends very much on an individual’s views regarding God. If the individual believes that God has a plan for all of us then, surely, any acts carried out by an individual are part of that plan as everything that happens is pre-determined by divine intelligence and free will is nothing but an illusion. If, however, free will exists then the only way to decide if it is against God’s will is to first decide which acts are right or wrong before you make that determination. The question this raises is – under what criteria do we make the determination on what is considered right or wrong. People who follow the Judeo-Christian God might invoke the commandment ‘thou shalt not kill’ as their basis for considering a mercy killing as morally wrong, which is indeed their right; however, this raises a further objection from the opposition. The commandments also state that you should honour your father and mother so where would that leave an individual who believes in the Judeo-Christian God if faced with a situation where a parent asks to be helped to die? Whatever their decision, it will be breaking a commandment and therefore will be usurping God’s will.

The third argument deals with a more practical consideration – if you shoot the loved one, you may simply wound them and thereby increase their suffering rather than decrease it. This is a valid argument but hinges on a matter of probabilities and, whilst it is true that you can never be 100 percent sure of a particular outcome, if the odds are in favour of a positive outcome (i.e. less suffering for the loved one), then a merciful killing is morally justified. If, however, the situation was that the loved one was pinned down in a burning hospital and the person acting was a medically trained professional, this argument becomes meaningless, as the person acting would be able to ensure a relatively painless death.

The fourth argument against shooting the loved one is that it is not right for an individual to impose a lifetime of guilt on someone for ending a life. This argument fails to take into account the lifetime of guilt a person may face for failing to act at all. It also fails to take into account that a determination must first be made as to whether the act is right or wrong before deciding whether a person should feel guilty for acting. Not only may there not be time to make the initial determination of the correctness of acting but also guilt may be the result either way.

The fifth argument raises the thorny issue of allowing one act of mercy killing may be the start of a slippery slope, which will end in people not just killing an individual in their best interests but instead killing someone in the best interests of the actor or other interested parties. This argument can take one of two forms, the logical or the empirical. The logical form of the argument states that each small infraction will make a small, if imperceptible, moral difference so a barrier should be placed to stop the moral state from declining too far and while drawing a line along the downward slope is not arbitrary, the precise limits imposed by the drawing of the line are arbitrary. Looking at the argument logically, one has to acknowledge that while clear policies and laws cut a precise line through the concepts although there may be a gradual change in the moral landscape. Another view may be to place a barrier that is in agreement with a principled reason so that supporters of euthanasia can distinguish between active euthanasia and the other types so that moral decline can be halted, making the slippery slope more like a more like a moral staircase. The empirical form, however, believes that although there is no logical reason for sliding down a moral slope, it will, in fact, happen in practice therefore it would be wrong to legitimise voluntary active euthanasia. A proponent of the empirical form would not, however, view mercy killing as wrong in principle; precise wording outlining the legitimacy of an act and enforcement of policies would be needed to counter this argument.

The sixth argument against this act of mercy killing takes us back into the realm of probabilities by stating that the loved one may not burn to death and may indeed survive the fire. This argument amounts to saying that it is morally wrong to kill the loved one if their chances of survival outweigh the chances of greater suffering. If the reverse were true, the moral choice would be to shoot the loved one. Some people who use this argument as a reason against mercy killing believe that even if there is the remotest possibility of rescue then that possibility must be given infinite weight and that a mercy killing is therefore not justified. However, a supporter of mercy killing may counter this argument by saying that the shot may, perhaps, miss its intended target but provide the target with the means to escape, i.e. the bullet may hit a gas line, causing an explosion that removes the object that is pinning the target down. If this were to be the case, the remote possibility of creating a means of escaping from the situation should also be given infinite weight; both the argument and its counter-argument cancel each other out. This argument also provides a convincing argument for the rejection of passive methods of euthanasia, leaving us in the same position as the first argument in that it is a double-edged sword.

Our final argument against this act of mercy killing is that killing is fundamentally wrong because it involves a conscious act to end someone’s life. The argument hinges on the moral distinction between acts and omissions and the differences between intending and foreseeing death. So what is meant by acts and omissions and by intending and foreseeing death? This is most easily explained by the following situation – a doctor gives a dying patient high doses of morphine with the intention of relieving the patient’s suffering; the doctor foresees that the high doses of morphine will have the added effect of hastening death, in essence omitting to act to prevent death. In this situation, the doctor has acted within the boundaries of good medical practice and within the law. If, however, the doctor gave the dying patient an overdose of morphine with the express intent of ending the patient’s life to relieve their suffering, the doctor has acted illegally, having killed the patient with a conscious, intentional act. Although this is an impressive argument, it has its deficiencies it that it ignores certain facts such as the only person benefiting from the death is the patient, for whom it is in the best interests, and the doctor has the ultimate duty of care to the patient.

Having concluded our exploration of the controversy around mercy killing, we will look at one final argument against voluntary active euthanasia and assisted suicide…

The Nazi argument

As a final attempt at trying to convince people of the wrongness of voluntary active euthanasia and assisted suicide, opponents will try to alarm people with the idea that support for them is aligning them with the morality shown by the Nazis. This could not be further from the truth as, although during World War II, the Nazis were certainly very actively involved in a horrendous programme of active euthanasia, the programme was not voluntary on behalf of the victims. Indeed, the mass euthanasia programme had no benefits to the victims whatsoever but, in their own twisted minds, had benefits for Nazi society and it is this that separates them from the supporters of voluntary active euthanasia and assisted suicide.

Other points to consider
As we can see, the debate on the subject of voluntary active euthanasia and assisted suicide has many facets when viewed from a medical ethics viewpoint. There is, however, very little that truly forms a cast-iron case against it, especially when we take into account the lack of due consideration given to what is in the patient’s best interests and what their expressed wishes are on the subject.

There are also other points to consider in this debate such as what do we mean by ‘quality of life’ and who is to determine what is a good quality of life compared to a poor one? Should voluntary active euthanasia and assisted suicide be available exclusively to those with terminal or untreatable degenerative conditions or should people with mental health problems be allowed a dignified exit, providing they have come to the decision logically?

Before we look at some of the other points for and against voluntary active euthanasia and assisted suicide, it would be in our best interests to look at the debate surrounding these very points…

The ‘quality of life’ debate

The broadest definition for ‘quality of life’ is, perhaps, an individual’s ability to live life to the fullest, to participate fully in what it is to be a social, creative and intelligent being and to be able to fully explore the full range of emotions that all humans are capable of. This is not to say, however, that a person’s quality of life is necessarily made poorer by a surfeit of negative effects on their health or made better by a surfeit of positive effects on their life.

The problem with the ‘quality of life’ debate is that it concerns something that can only truly be measured by the individual concerned. for example, a wealthy person may have little quality of life due to poor health or a lack of companionship, whereas a disabled person may have a good quality of life based purely on their own outlook on life being positive and being supported by loving family. Quality of life is not something that can be decided upon by a third party so – who can decide what is good or poor quality of life when a decision needs to be made regarding the premature termination of life?

A great deal of controversy has raged over this very point with supporters in both camps giving valid points on what ‘quality of life’ means and who the best judge is of an individual’s quality of life; perhaps though, we should go back to our definition for a starting point. Is the individual concerned living life to the fullest, giving due consideration to the negative influences on their life, and is the individual satisfied with their lot? Professor Stephen Hawking has a great deal of negative influences on his quality of life due to his physical disability but his mind is as active as it was before his physical health deteriorated. His ability to carry out the activities that make him happy and world famous has not been diminished by his physical condition and, therefore, it can be said that, although he may not be fully content with his life, he is living it to the best of his abilities. If Professor Hawking’s mind had been affected his quality of life may be seen in a different light.

Moving along to our second point, we must then ask the question – is the individual concerned able to participate fully in what it is to be a social, creative and intelligent being, giving due consideration to the negative influences on their life, and is the individual satisfied with their lot? A person suffering from agoraphobia may only see the odd visitor to their home but may have an active social life on the internet with a social networking website with the ability to exercise their creativity on any number of forums. Physically isolated they may be but, perhaps, their online life keeps them happy enough to maintain a lower than average but still respectable quality of life.

Our final measure of ‘quality of life’ begs the question – is the individual concerned able to fully explore their emotions, giving due consideration to the negative influences on their life, and is the individual satisfied with their lot? This is, perhaps, a harder question to answer than at first glance for can anyone truly say that they have experienced every emotion fully? A sociopath may never be able to experience emotions – does that necessarily mean that their quality of life is low or that they are not as satisfied with their lot as they can be?

The debate around the notion of ‘quality of life’ will always come back to the individual’s own measurement of whether they are meeting a certain standard of living and whether or not they are satisfied with that standard. This being the case, however, how will it be possible to rule on the legality of an act of voluntary active euthanasia or assisted suicide? How can one truly legislate on what is or is not ‘quality of life’?

One law for the…

Some would argue that people with terminal or untreatable degenerative conditions should have the option of a dignified exit through an act of voluntary active euthanasia or assisted suicide, providing it is in their best interests and in accordance with their wishes, but that others should not have that option. For example, an individual who suffers from depression may wish to die but may be refused on the grounds that their condition is neither terminal nor untreatably degenerative. The question we have to ask ourselves is – is that fair? Surely, this becomes a question of ‘quality of life’ again.

The issue is neatly side-stepped by denying voluntary active euthanasia and assisted suicide to both sets of individuals but that also means people with terminal or untreatable conditions are left to suffer so that people who are merely “weary of life” cannot avail themselves of a dignified exit on a whim. Supporters of voluntary euthanasia and assisted suicide for all would jump on the fact of a ‘one law for some, another law for the rest’ situation and milk it for all its worth to force a change in the law which is why the legalising of voluntary active euthanasia and assisted suicide is being avoided at all costs.

The problem of having a ‘one law for some, another for the rest’ situation is that it devalues the effect depression, for instance, can have on a person’s quality of life. Indeed, a person with a terminal illness may have a better quality of life in their final months than a person with severe depression because their condition is better understood and they may get more support from family and friends. The only sensible solution, therefore, would be to grant both groups of individuals the option to a dignified exit, something that would be difficult to justify to the public with such sensationalist debate raging on the subject.

Euthanasia – beyond medical ethics

Having thoroughly covered the subject from the medical ethics viewpoint, let us turn our attention to the wider debate…

The Universal Declaration of Human Rights
In December 1948, the General Assembly of the United Nations adopted the Universal Declaration of Human Rights and, as such, all the member countries are bound by its edicts. This document has been used by both opponents of and supporters of voluntary active euthanasia and assisted suicide to support their cases; for the sake of brevity, however, we shall look at just two points.

The opponents of euthanasia tend to look towards Article 3 of the declaration, which states, “everyone has the right to life, liberty and security of person”, to support their case. They would put great emphasis on the fact that it reads “right to life” and says nothing about a person’s right to die. Perhaps this was an oversight when the Declaration was written or perhaps the UN did not want to open that particular can of worms. The counter-argument, however, is that it also reads that an individual should have the right to liberty and that ‘liberty’ should include the right to choose the manner of their death. Indeed, surely the ‘right to die’ is the implicit counter-point to the ‘right to life’ and does not really need to be explicitly stated. Unfortunately, the debate becomes a vicious circle of argument and counter-argument over the precise meanings of the ‘right to life’ and the ‘right to liberty’, which will only be resolved by amendments to the Declaration, something the UN may try to avoid on the basis of the slippery slope argument (previously mentioned in the section on medical ethics).

Opponents of euthanasia have also used Article 29.2 of the Declaration, which states, “in the exercise of his rights and freedoms, everyone shall be subject only to such limitations as are determined by law solely for the purpose of securing due recognition and respect for the rights and freedoms of others and of meeting the just requirements of morality, public order and the general welfare in a democratic society”, to support their case. Supporters have, however, been able to partially counter this argument by referring to the fact that the statement takes no account of the changing moral landscape and that, if one individual exercises his or her right to die and another willingly exercises their right to help them, it respects both parties rights and freedoms and has little effect on the general welfare of society except change the moral landscape fractionally. Fractional changes in the moral landscape are an inevitable consequence of a living vibrant society and can always be limited by sensible legislation.

The religious objections to euthanasia

We touched on the religious objections to mercy killing earlier in our examination of the medical ethics, we now return to that argument for a more in-depth look.

One argument put forward by Christian opponents of euthanasia is not that we cannot kill each other or ourselves but that, as God’s creations, our lives are not entirely ours to do with as we please. If we kill another, or ourselves, it denies God’s rights over our lives, to make the determination over how long we live and how we meet our end. The question becomes – if we should bow to God’s right over our lives, why did he give us free will in the first place? We must also consider that this argument precludes acts of voluntary passive euthanasia as well. Should we keep patients on life support machines alive until their body dies because to turn off the machine would be, effectively, to commit an act of involuntary active euthanasia? Our current definition of brain death could be found to be incorrect – so where should we draw the line?

Some also cite that suffering may be necessary to our lives in order that some may become closer to God in their suffering. Of course, if suffering is necessary, it may not be for the benefit of the sufferer but for the people who care for them, forging a bond stronger than one borne of any other circumstance.

The final argument, from a Christian point of view, that we shall look at that has been put forward is the idea that dying and the way we face death could be a test that God puts an individual through to test our faith in him and to offer an opportunity for spiritual development.

Some Eastern religions revolve around the concept of reincarnation and that the suffering we face in this life may affect the quality of our next life and that cutting short this life may have unforeseen consequences in the next. It would also follow that the person assisting in the suicide of an individual would be adding a lot of negative karma to their next life, causing a harsher existence for them to live through.

The main counter-argument to religious objections on this subject is that the arguments put forward to oppose euthanasia and assisted suicide are seemingly made to ensure that more weight is given to their spiritual beliefs at the cost of an individual’s right to choose. The question is – should such beliefs have any weight at all in an increasingly secularised society? Of course, with so many not subscribing to any form of religion, is it right that those with religious convictions should have any say on their secular counterpart’s lives and decisions?

We must also remember that religious arguments are put forward by people who may not be facing a terminal or untreatable degenerative condition or a poor quality of life. Would they change their minds if they were facing such circumstances? If they did change their minds, would they view their change of heart as the hypocrisy it would be?

The only way is ethics – ethical arguments against euthanasia
Ethical arguments take in some of the ideas covered by other groups, including religious, in that the main thrust is that allowing euthanasia and assisted suicide will lead to the weakening of respect for the sanctity of human life. The purely ethical argument, however, only views the sanctity of human life as an issue in its own right without subscribing it to an outside agency. While this may be a reasonable position, it may be argued that the right to self-determination should also be an inviolable attribute.

A further ethical consideration is that by accepting euthanasia and assisted suicide, society would have to accept attributing a lower value to the lives of the disabled and the sick in relation to the rest of the members of society. Some may say, however, that denying an individual’s right to choose the manner of their death devalues their life anyway.

A far more persuasive argument, from an ethical point of view, is that allowing euthanasia and assisted suicide affects the rights of not just the individual but also the people around them. Of course, if an individual can find someone who is willing to help them die, does this argument hold water? To accept this argument, however, you would be devaluing the rights of the individual in favour of the rights of others, not a decision that should be taken lightly. Some may argue that to deny the rights of an individual to an assisted death is to discriminate against them on the grounds of their mental or physical limitations, which would make an interesting case for a tribunal involving the Disability Discrimination Act.

Practical arguments against euthanasia

In such a secular society, people may well turn to the practical arguments to steer clear of the ethical and religious minefields but even practical considerations have their counter-arguments.

Some would argue that with proper palliative care made more accessible, euthanasia and assisted suicide are unnecessary evils. This may very well be true but to deny an individual the right to choose a dignified exit is to devalue their wishes and may be denying what is best for the individual concerned.

A more serious concern raised, from a practical perspective, is the fact that proper regulation of euthanasia and assisted suicide may well be difficult if not impossible. This is, indeed, a problem but the legislative framework for England and Wales is full of such difficult decisions that need to be made and yet the legal system works fairly well in handling such matters. It has to be remembered that the legal system has had to evolve over the years with certain acts that were once considered criminal becoming decriminalised whilst others have taken the opposite journey. The rise of new technologies have also brought with them the need for new laws and regulations so is it really too much to add one or two more?

Opponents of euthanasia and assisted suicide may argue that allowing them might undermine the commitment of medical professionals to saving lives or lead to a reduction of the quality of care received by the terminally ill. This argument side-steps the issue of the requirement of medical professionals to relieve suffering, which in some cases may well be to allow them the option of ending that suffering prematurely with their help and may be in the individual’s best interests. There is also the counter-argument that, allowing those individuals who wish to avail themselves of an assisted suicide, the quality of care for those who wish to fight their condition to the bitter end may well improve as money will be freed up to be spent on them. This will lead, of course, to a further objection in the form of arguing that euthanasia may become the more cost-effective way of treating the terminally ill; this is not necessarily true as it should only be used with the informed consent and expressed wishes of the individual concerned. As with all issues such as this, there should be adequate safeguards put in place to avoid abuse of any methods of euthanasia.

Another practical argument is that allowing euthanasia may stop research into new cures and treatments for terminal or untreatable degenerative conditions; this objection, however, fails to take into account the vast amount of money in medical and pharmaceutical research waiting for eager pharmaceutical companies looking for increased sales. There are some conditions that affect only a small number of individuals but the small gains in the discovery of cures and treatments for those conditions are more than out-weighed by the gains for ones that are more lucrative.

Some may argue that giving people the option of having an assisted death will give doctors too much power but it could be argued that doctors already have the power of life and death over their patients anyway, especially when you consider that voluntary passive euthanasia is already a legally acceptable medical practice. An assisted death or voluntary active act of euthanasia, however, gives the patient the power to decide his or her own fate and the best chance of a successful and dignified exit.

It may be argued that the most vulnerable individuals in society may find themselves being forced into accepting euthanasia by doctors as a means of cutting costs or by unscrupulous family members eager to inherit money or just to shed the burden of the person involved. There is certainly that danger but, with the right level of guidance as to who may or may not be considered for an assisted death, the number of incidents of abuse should be minimised or negated altogether.

Having now looked at the main arguments in the euthanasia/assisted suicide debate, in what is hoped to have been an unbiased way, we now come to what will surely be the most controversial part of this article…

Euthanasia and assisted suicide – my personal view

You may have noticed that, apart from my introduction and this final section, I have not used the personal pronoun in this article. I have done this deliberately so that I could try to keep an objective view of the debate whilst exploring the arguments and counter-arguments. I am not a religious man and hold no particular beliefs in that area so it was hard to cover that part of the debate with any great vigour. I did, however, try my best and that, I hope, will be good enough for now.

In my introduction, I stated that I would like to have an assisted suicide and so it will be clear that I am in favour of a change in the law of England and Wales but I will now outline my reasons for supporting such a stance.

My arguments go to the very heart of the spirit of the Universal Declaration of Human Rights which is the right to self-determination, the right to life and liberty and its implied right to die. The member countries of the United Nations pledged to uphold the articles of the Declaration and to deny an individual the right to choose an assisted death is to deny the whole spirit of the document and the rights of the individual.

I believe that the rights of the individual are paramount in importance and that those rights should be upheld, providing that they do not impinge on another individual’s rights. I believe that an individual should be the master of his or her own destiny and that they should have the right in deciding how they live and how they die as long as they can do so without adversely affecting society as a whole. Society’s ethical and moral landscape is a constantly evolving one, rising and falling to meet new challenges and obstacles, and while voluntary active euthanasia and assisted suicide are currently seen as ethically and morally suspect, I believe that that will and should change in time.

The rights of the many must never outweigh the rights of the few unless they impinge on or endanger the rights of the many. Society will not be brought to its knees by allowing voluntary active euthanasia and assisted suicide, providing there are safeguards in place to stop any abuse of the right to die. The tapestry of law has been woven over centuries and will change its patterns and colours to suit the needs of society, protecting the vulnerable and the weak and supporting those who wish to exercise their right to die.

Being a man of no religious conviction, I find it intolerable that religious objections are given as much weight as they are thereby impinging on my individual rights when I have gone out of my way to ensure that my beliefs do not impinge on theirs. I respect people who have deep religious convictions because I suppose I envy them their certainty but I do not wish to have my rights and beliefs ignored in return.

My wish for a dignified exit

Some people may wonder why I wish to have an assisted death and the answer is simple – I wish to die because I have no reason to live. I am forty years old and my marriage of eleven years is over. I have no children to miss me and I have achieved nothing in my life. I have suffered with depression for thirty-three years, with no respite from the darkness. I go to bed every night hoping not to wake up the following morning; I wake up each morning despising the fact that I have to face another day in darkness and despair. I look at each day with dread, knowing that no matter how hard I try to make something of myself, I will never be given the chance to fulfil the potential that lies within me.

I have attempted suicide three times in the last two years or so – two overdoses and an attempted hanging – and I know that I will continue to try until I either succeed or cause myself such physical harm that I will be unable to make another attempt, existing in a state of agony. I want to forgo the inevitable cycle of suicide attempts and hospital admissions. I want someone to assist me to die with a little bit of dignity and with the minimum of pain and discomfort. I cannot bear the thought of another forty years of this existence, knowing that I could be just two short drinks away from eternal rest.

At the present time, I know that my wish will go unfulfilled because the law says that it is illegal for someone to assist in my suicide. The law must change. My suffering is real and it is the duty of a doctor to relieve my suffering, not prolong it. My quality of life is, in my eyes, poor at best and intolerable at worst. The only way to end my suffering is to end my life now while I still have some dignity left.

My passing will not bring down society because the moral, ethical and legal landscape will change to accommodate the needs of society. My passing would, however, be a boon to the National Health Service who would not need to patch up my failing body following a series of failed suicide attempts. A physician-assisted suicide may even help preserve my organs for transplantation so that, in death, I may finally achieve something worthwhile.

I wrote this article because I want to change the law, to open the debate free from the hysteria and scare mongering, and because I want to die, peacefully and quickly.

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