Words By Rosie Burgess
This week’s referendum in New Zealand, in which euthanasia for people with
terminal illnesses was legalised by a landslide margin (62.5% to 33.8%), marked a very important landmark in the case for euthanasia and assisted suicide.
So, what is euthanasia and assisted suicide?
Euthanasia is the practice of ending someone’s life in order to relieve pain or suffering, without any active input from the person themselves. Assisted suicide, meanwhile, involves the person wishing to die and thus taking an active role in the ending of their life.
When you think of assisted suicide, Switzerland is probably the first country that springs to mind. With services offered primarily by Dignitas, Switzerland allows physician-assisted suicide without a minimum age requirement, diagnosis or symptom state. It is only illegal when the motivation can be deemed “selfish” – for example, if someone does not want to carry the burden of caring for a sick person.
In 2018, 221 people travelled to Switzerland to seek assisted suicide. 87 of those were from Germany, 31 from France and 24 from the UK.
Services offered by Dignitas are not cheap and can cost up to £3,380. Assisted suicide is therefore simply not an option for those without the financial means to pursue it.
Euthanasia and assisted suicide are also legal in the Netherlands, Belgium and Luxembourg, whereby there is ‘unbearable suffering and no prospect of improvement”. Various checks have to be undertaken before assisted suicide can be approved. Canada also allows euthanasia and assisted suicide for adults suffering from irremediable conditions.
Even in the USA, several states now offer legal assisted dying. Oregon, Washington, Vermont, California, Colorado, Washington DC, Hawaii, New Jersey, Maine and Montana all have laws or court rulings allowing doctor-assisted suicide for terminally ill patients. The doctors may write a prescription for fatal drugs, but a healthcare professional must be present when they are administered. All states require a 15-day waiting period between two oral requests and a two-day waiting period between a final written request and the fulfilment of the prescription. Palliative sedation in France is also legal, whereby someone can be asked to be deeply sedated until they die.
Meanwhile, in the UK a survey carried out by the campaign group My Death, My Decision (MDMD) discovered that 88% of respondents considered it acceptable for dementia sufferers to receive help to end their lives, provided they consented to do doing so prior to losing their mental capacity. A previous survey carried out by Dignity in Dying in 2015 found that 82% of people supported assisted dying. The data now shows that one person a week is now travelling from the UK to Switzerland to end their lives. Despite this, helping someone kill themselves is, in fact, a criminal offence that carries a maximum sentence of 14 years and is prohibited by section 1(1) of the suicide act 1962. Indeed, in the UK, euthanasia is considered murder in the eyes of the law.
For many, it is clear that it is time to change UK law. However, the most recent legal challenges to the UK ban have been dismissed by the supreme court by the lawyers for Noel Conway, a retired lecturer who is paralysed from the neck down by progressive motor neurone disease. At the moment, arranging an assisted death overseas is a long and arduous process. Making the journey to Switzerland requires health, creating an immense pressure to make the journey before becoming ill sacrificing quality time with friends and family. Another negative is that when you have an assisted suicide in Switzerland, you have to be cremated there to avoid legal problems so many people are denied a traditional funeral service. The dying are in need of the help of friends and family to make the arrangements for an assisted death, yet any assistance provided is against the law.
The threat of prosecution and the resulting anxiety for those seeking these treatments culminates often in a botched attempt to end their own lives. These horrendous and often unsuccessful circumstances tend to lead to even more suffering.
Around 53% of deaths in England take place in hospital despite the fact that this is often the least preferred by patients. According to a survey completed by Marie Curie, between 92,000 and 142,500 people in England each year have an unmet need for palliative care. With the addition of new euthanasia and assisted suicide laws as well as providing additional community services reducing hospital stays for the terminally ill, there could be millions of pounds of savings made to an already crumbling NHS.
The current laws in the UK are failing to help many vulnerable people in a system where palliative care in the country has its shortcomings. Longstanding underfunding of palliative care training and services is a major cause of a failure to provide sufficient care in the NHS. With the looming potential problem of an ageing population and changing demographics, longer chronic disease trajectories and more co-morbidities show just how urgent it is to revise the current laws in order to create a more sustainable, widely accepted, patient-centred and cost-effective model for euthanasia and assisted suicide.