Easing death

SINCE 1999, when an American court gave Jack Kevorkian a lengthy jail sentence after he admitted helping 130 patients to die, a big change has quietly taken place. Next month voters in Massachusetts will decide whether a terminally ill patient, with less than six months to live, will be able to ask for a doctor’s help in committing suicide. If, as expected, the vote goes in favour of the proposal, the state will become the third in America to liberalise its laws. Assisted suicide is already permitted in seven countries and states and is now being debated in New Zealand, Quebec, Australia and Britain (see article). It is to be hoped that the current wave of liberalisation will continue, for those who suffer at the end of their lives have been too long denied the right to an easeful death.

Liberalisation reflects a shift in public opinion. A growing belief in people’s right to self-determination over their life and death, secularisation and media coverage of hard cases have combined to shift opinion in favour of assisted suicide. Polls all over the Western world show strong public support for it. Yet among some groups of people, resistance remains strong. Religious bodies tend to maintain that only God, who has given life, has the right to take it. Although plenty of doctors are in favour of liberalisation, their trade associations by and large oppose it, on the ground that it runs against their profession’s traditional oath to “do no harm”. And there is a broader concern that allowing assisted suicide in the case of terminal patients is a slippery slope that will lead to large-scale killing.

There are answers to these objections. The views of particular religious groups should not be allowed to constrain the freedoms of those who do not share their faith. The definition of “harm” is debatable; and anyway these days the Hippocratic oath is not universally taken. Humankind sets out on many slippery slopes—abortion, for instance—without descending all the way down them. Nor, where assisted suicide is allowed, has there been an epidemic: in Switzerland, where it has been permitted since 1942, it accounts for around 300 deaths each year, or around 0.5% of all deaths in the country. And against those weak objections stands the huge benefit of allowing people in great suffering to get help in putting an end to the pain and misery when they are not strong enough, or do not have the resources, to do so themselves.

Most of the jurisdictions that allow assisted suicide make it available only for the terminally ill. Only Switzerland, Belgium and the Netherlands allows others—those in great psychological pain, for instance, or with “locked-in” syndrome—to take advantage of its rules. As a liberal newspaper, we sympathise with that approach. People should be free to determine the course of their life, and death is part of that. But there is a danger in making suicide easier than it already is for those who are not terminally ill. Mental anguish may make life seem unbearable for depressives, for instance, but depression can lift, and many ex-depressives are glad that suicide was not easily available when they were ill. Old people might succumb to pressure from impatient relatives who feel that the money wasted on care for the elderly would be better spent on the grandchildren’s education. And for those less keen to see their relatives pass on, suicide is devastating for friends, children, spouses and parents. Individual liberty matters greatly: but the welfare of others matters too.

Take into the air my quiet breath

For the families of the terminally ill, by contrast, as well as for the victims themselves, assisted suicide can greatly reduce suffering. Governments everywhere should therefore be inclined to liberalise their laws. For those near the end of their natural lives, knowing that they can cease upon the midnight with no pain is a great blessing.