Is assisted suicide a dangerous idea?

Issue 
Helen Joyce at the Festival of Dangerous Ideas.

As part of The Festival of Dangerous Ideas, journalist Helen Joyce presented a talk titled, “The Right to Die”.

Joyce is the international editor of The Economist, which, despite sounding like something millionaire bankers read on the way to work, has a long history of campaigning on issues. It has fought for equal marriage and the decriminalisation of prostitution and drugs — and now it is throwing its considerable weight behind the issue of assisted suicide.

Assisted suicide is a complex debate. At first glance it seems like a turf war between right and left, between the secular and the religious. But, it crosses all boundaries, and you would be hard pressed to find someone who has lost a loved one to a terminal illness who is not in favour of assisted suicide.

But to Joyce it is much more than this. She defines the issue as the most complex of the modern age, one that silences politicians in an act she calls “political cowardliness”.

In one of several nuances in the debate, Joyce used the term “assisted suicide”, rather than “euthanasia” or “voluntary euthanasia”. And with good reason.

Vets euthanase old or sick cats and dogs. Euthanasia is linked to the notion of putting something “out of its misery”. The term “assisted suicide” however, makes us face the argument head on —it is about an individual’s choice to end their life. And now that individual choice is blocked by the state.

Laws on suicide have been used to prosecute the families of those who have taken their own lives. Indeed they have been used to charge an individual when a suicide attempt fails.

In the Oscar winning German film The Lives Of Others Georg, a socialist playwright, says: “The state office for statistics on Hans-Beimler Street counts everything; knows everything: how many pairs of shoes I buy a year: 2.3, how many books I read a year: 3.2 and how many students graduate with perfect marks: 6347. But there's one statistic that isn't collected there, perhaps because such numbers cause even paper-pushers pain, and that is the suicide rate.” Even for the soulless Stasi, suicide is too much to comprehend.

Debate aimed at government

Those arguing for the Right to Die say that assisted suicide needs to be sanctioned by the government so people have control over their exit from the world.

Shayne Higson, State Convener of the Voluntary Euthanasia Party (NSW) said: “I can see why some people consider giving people ‘the right to die’ to be a ‘dangerous idea’ but I don't share that view. In a secular society, like ours, individuals do not want to be told, by the church or the state, how they should die.
“As long as there are safeguards, there is no sound reason why people should not be given real end-of-life choices and be allowed a peaceful and dignified death at a time and place of their choosing.”

The concept of dignity is a common thread on both sides of the argument about assisted suicide.

Melissa Schmidt spent 15 years working as a palliative care nurse. She knows first-hand, what the last stages of life are like.

“When I first started working in a palliative setting,” she said, “the drugs given to keep a patient comfortable would be given at different times, orally or intramuscularly. Most of the time, the drugs would wear off and a patient would have to wait for their next dose.

“Now pain medication is given as a continuous administration over a 24-hour period. These usually provide a much more controlled and comfortable existence for a patient, allowing them to die with some dignity towards the end…

“But when you've watched a lot of people die in this way, euthanasia does seem like the kinder thing to do.”

Anyone who has witnessed a loved one in the final stages of a terminal illness will say they only wanted their loved one to be free of the intolerable suffering.

However, Joyce said her research indicated that sick people not only wanted to stop the pain, but to end, what she called, their “existential suffering”.

She said people, when they know their lives were ending, want to trim “that bit at the end”, the bit that was flanked with hopelessness, indignity, loneliness, exhaustion and loss of bodily functions.

Abuse of power

But is “existential suffering” enough of an argument to change the law? What are the arguments against assisted suicide? Abuse of power is one.

Vice chair of the Euthanasia Prevention Coalition International Paul Russell says: “Whether by overt or subtle coercion we see that euthanasia or assisted suicide puts vulnerable people at risk.”

The Australian Catholic Bishops Conference used a similar argument. “Euthanasia is not just an issue of personal choice, because it always involves at least one other person. Allowing someone to cause the death of another is always an issue of public concern because it is a power that can so easily be abused. The evidence from countries that have legalised euthanasia, like Belgium and the Netherlands, is that some people are being given a lethal dose even when they have not asked for euthanasia.”

But Higson says: “Religious leaders see voluntary euthanasia as a 'dangerous idea'; however, as polling has shown, the majority of practicing Christians actually support its legalisation and believe it to be consistent with their message of love and compassion.”

Arguments against assisted suicide explore a concern Joyce also raised in her talk — the administration of the lethal medicine. Often, even with those in favour of assisted suicide, when asked to explore how a lethal dose should be administered, recoil. Should it be doctor assisted or self-administered?

Macabre it may be, but these are the logistics of legislative change in favour of assisted suicide.

In her talk, Joyce identified three main areas requiring discussion — children, mental suffering and “difficult lives”.

She argued that terminal illness had to be a certainty for children — but not adults — to even consider assisted suicide.

She also argued that assisted suicide was not the answer to mental suffering. Depression can be overcome and those who had once wished to no longer live can end up glad their wish was not fulfilled.

Joyce also quickly touched on other mental health issues, such as schizophrenia. She said that assisted suicide was also not an option in those cases because the choice had to be available only to those with mental and cognitive clarity.

As for assisted suicide for those with “difficult lives” — lives where there is no terminal illness but where suffering is great — she quoted Stephen Hawking: “To keep someone alive against their will is the ultimate indignity.” Hawking, the world’s most prominent physicist, suffers from motor neurone disease.

According to the British Telegraph, Hawking said that he would consider assisted suicide “if I were in great pain or felt I had nothing more to contribute but was just a burden to those around me.”

Is the right to die a dangerous idea? Well, it is a subject that sends lawmakers into silence, says Joyce, and one they wish “would just go away”.

In this country, the topic is central to some political parties. The Greens have an assisted suicide campaign, Dying With Dignity, which saw them put a motion in the Upper House of Victoria's Parliament in April this year.

And there is the Voluntary Euthanasia Party, headed by our very own “Dr Death” — Dr Philip Nitschke. Nitschke, also the founder of Exit International (formerly the Voluntary Euthanasia Research Foundation), was able to provide lethal injections to four of his terminally ill patients while assisted suicide was legal in the Northern Territory in 1996 and 1997.

“You need to lobby, you need to talk, you need to get your politicians to pay attention” said Joyce.

Topical; yes. Sensitive; most definitely. But dangerous? Perhaps the biggest danger is having no choice at all.

[See Helen Joyce’s talk “The Right To Die” here.]

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