Category Archives: Euthanasia

Noel Conway should not have the right to die

As with all notable assisted suicide cases that crop up in the news, the story of Noel Conway is an extraordinarily move one. Mr Conway seeks the right to die, and two judges reviewed his plea at the High Court on Tuesday. A judgement is to be made next week.

I wish him every moment of pain relief, the support of his medical supervisors and the emotional strength of his closest relatives, but cannot bring myself to support a change in the current law.

I appreciate that today’s case is a refined one. Specific legal changes and safeguards have been proposed (more information on his case can be read here), and it is two of those points, drawn up by Mr Conway’s legal team, listed clearly in the ‘Legal background’ section, that I will be addressing in this post.

Any assisted suicide case such as this has to be taken extremely seriously because a change in the law for one is a change in the law for all, and so proposals for legal change must be specific and rigorous.

Notice that, unlike Mr Conway and the ‘Dignity in Dying’ campaign, I refer to his case an assisted ‘suicide’ one, as opposed to an assisted ‘dying’ case, which I regard as a propaganda term designed to normalise the process and mask what it involves.

The first of the two aforementioned quotations calls for a similar change in the law as did the Assisted Dying Bill debated in the House of Commons back in September 2015: “that the adult is suffering a terminal illness diagnosed with six months or less to live.”

On the face of things, it sounds reasonable, but the important logistical flaw to consider, first and foremost, is that many medical diagnoses are not especially accurate, with some proving hopelessly wrong.

It is not as rare an occurrence as you might think it is, and even incidents of terminal illness do not prevent misdiagnoses. Doctors are not saintly prophets and cannot hope to faultlessly predict the length of the remainder of any sufferer’s life.

As such, any exemption added to the 1961 Suicide Act that includes provisions for patients with (according to doctors) six months to live will inevitably lead to the killing of patients who might otherwise have lived for longer periods or seen dramatic improvements to their health.

But this is not the only logistical difficulty. In Oregon, so often cited as a euthanasia success story (George Pitcher’s useful book A Time to Live thoroughly negates this suggestion), a 2007 Department for Human Services report revealed that the time between a prescription written for lethal drugs and the death of a “terminally ill” patient ranged from 0 to 698 days.[1]

This suggests that even if those few individuals seeking a change in the law get their way, many will not benefit in time, their agony will continue until death (provided that their relevant diagnosis is correct) and that the six month time frame provided in law will stand not as a safeguard for the dying, but as nothing more than an arbitrary figure that does not allow for anomalies in the accuracy of a medical diagnosis nor for an extended period of time between prescription and receipt of a life-ending drug.

I appreciate that with some diseases, a point of death may be more easily predicted by doctors than with others. Not being Mr Conway’s doctor, I can’t tell if his current diagnosis (he has been given no longer than a year to live) will prove correct or not, and I am not comfortable making any predictions of my own, given my notable lack of medical experience.

The issue, though, is not whether Mr Conway should be allowed to choose whether or not he dies, rather it is whether a change in the law is sustainable and good for wider society. Which leads me to my second contention with his legal team’s proposal.

Dignity in Dying summarise quite clearly, that Mr Conway’s legal team argue that a change in the law ought to be acceptable in situations where there is “evidence of the person’s wishes and that they were informed, clear, settled and voluntary.”

I will pay Mr Conway the compliment of acknowledging that his request for physician-assisted suicide meets all of the above criteria. He will no doubt know about the suffering that accompanies MND far better than I hope to.

But, again, thinking in a wider context, many thinking about the possibility of physician-assisted suicide will not be so certain. The reality, according to Baroness Finlay, a professor of palliative medicine at Cardiff University, is that the terminally ill bounce constantly between feelings of optimism and hopelessness.

Those living with chronic or terminal illness will undoubtedly experience just as much mental and emotional discomfort as they do physical pain. But it is misleading to suggest that most in such a position overwhelming support the right to die.

Due to the hesitation and consequences on family involved, most opt to die naturally in a hospice or at home, and some select individuals move to Switzerland. The picture that is painted is nowhere near as black or white as one would imagine.

The use of the word ‘voluntary’ is also crucial in this argument. Alongside legal change comes the huge risk of sufferers feeling like a burden on their families, whether as a result of active pressuring or individual guilt.

In Oregon, between 1998 and 2008, the number of suicide patients that cited ‘feeling like a burden on relatives, friends and carers’ skyrocketed from one in eight in 1998 to one in three ten years later[2].

In particular, religious families or families in which the ill relative enjoys a concentration of wealth may be profoundly affected. It is worth noting that splits and feuding of this kind – inevitable in many families – are an extension of suffering for the ill person.

It can thus be argued that the current state of the law prevents the spread of emotional suffering that may otherwise be goaded out and exploited by cynical or opportunistic family members, who may stand to gain from the death of an ill relative.

These points should stand notice for those who succumb to Mr Conway’s reasonable, but emotional appeal for the right to die. The case examined by the High Court this week wasn’t about him; it was about whether a change in the law is congruent with the public interest.

And my very strong view, with some reluctance and sympathy, is that Mr Conway’s proposed  changes to the Suicide Act of 1961 are not so.

 

Notes

[1] See ‘Timing of PAS Event’, Table 1: https://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year10.pdf

[2] George Pitcher, A Time to Live, p58