Over the last 20 years I have had a few close shaves that made me think about death, including a quadruple bypass, a burst colon, lung cancer and an aortic aneurysm. None of these were conditions that involved more than temporary pain and a fairly low risk, though as Hamlet’s mother says:
‘All that lives must die
Passing through nature to eternity.’
But then in August 2011 I was diagnosed with myelofibrosis, an incurable form of blood cancer, that ultimately leads to various unpleasant and painful symptoms, needing frequent blood transfusions to prevent the arteries seizing up with fibres. Would I then want to carry on with a Golgotha of suffering, affecting the family and carers, or would I sooner forego the last few weeks of misery?
More and more people are going to confront that dilemma, as medical science enables them to live fairly normal lives well beyond Psalm 90’s expectation that
‘the days of our years are three score years and ten….’.
But remember the rest of the verse:
‘….and if by reason of strength they be fourscore years, yet is their strength labour and sorrow’.
The final stages may be a crescendo of pain and suffering, from which death is the only release. How can we say that the law should deny people in this situation access to the exit door?
Terminally ill patients who are mentally competent ought surely to be able to get medical help to end their lives. Unless they are absolutely desperate, refusing medication or ceasing to eat or drink are not to be contemplated. A relative of mine who died in a care home not long ago used to say every time I visited her that she wished she could die, but it never occurred to her to do either.
It is estimated that one in ten suicides in England are by people with a terminal or chronic condition, and this implies that some 500 suicides a year are by people with a serious physical illness. The true number is probably higher because coroners are aware of the social stigma of a suicide verdict.
If those people had been able to consult their doctor about assisted dying, they could have been referred for expert counselling and might have decided to soldier on with life.
Ultimately, though, a patient has the right to make this decision, and to be helped to carry it out, relying on J S Mill’s principle that an individual’s freedom should only be restricted to prevent harm to others. This is the bedrock of Liberal thinking on personal liberty.
I reach this conclusion even though as a Buddhist I recognise the precept against the taking of life. But the Buddha taught the virtue of karuna, an active form of compassion which involves the alleviation of suffering, an intrinsic characteristic of the human condition.
This suffering may be not only the patient’s, but his immediate family’s as well. They may be physically, mentally or financially exhausted by the duty of care.
It remains the case that a patient can refuse treatment or refrain from eating and drinking without breaking the precept, but these are not pleasant ways to die,
The practical difficulty of deciding whether an illness is terminal are not insuperable. When I was first diagnosed with myelofibrosis, a consultant estimated that I had one year left of useful life and I’m still in reasonable shape 18 months later.
Finally, is it not inhuman to force a person who is determined to end his life to travel to Switzerland, with his carers, for the purpose? This is surely a matter on which the whole of Europe should adopt the same law, so that terminally ill patients are not forced to undertake long journeys across international frontiers as they approach death.
* Eric Lubbock, Lord Avebury, is a working peer, and Vice-Chair, Parliamentary Human Rights Group. He blogs here.