So, as with many of my columns I have picked an absolute can of worms to open. I felt it pertinent to do an article on this while an excellent talk from Peter D Williams by the Life Matters Society is fresh in my mind. I have always been opposed to assisted suicide, but often have been dismissed as opposing it merely for my Christian faith. For me there is no better reason than that, but I have many secular reasons for my opposition as well, and indeed some of the most vocal opponents of assisted suicide in the UK are atheists and agnostics.
The first reason is the importance of palliative care. For those who do not know what this is, it’s basically end of life care, designed to lessen the pain of patients who are nearing the end of their lives. In the UK we have one of the best palliative care systems in the world, currently ranked in the top ten in the most recent studies. In my view, assisted suicide undermines palliative care and indeed there is evidence for this. In Belgium and the Netherlands, two countries that have brought in assisted suicide laws, in the same study of palliative care, they came very low indeed (the Netherlands was 42nd , Belgium was worse). Palliative care in these countries is in complete crisis, to the point at which it has become a more viable option to kill oneself than to suffer through a end of life care system that is woefully inadequate. It makes sense really, as there is less motivation for research into palliative care if suicide is considered a more viable option. Now, I’m not saying the British system is by any means perfect, but there is an excellent House of Lords bill currently being processed that will hopefully deal with the problems that lead to recent scandals.
This brings me to another critical medical service which is undermined by assisted suicide legislation: Suicide prevention. Belgium has a system that has led to people with depression (a very treatable condition) opting for assisted suicide instead of the vital mental health treatment they need. The Belgian law has also resulted in people with anorexia, borderline personality disorder ,chronic fatigue syndrome and other illnesses being euthanised. In one particularly harrowing case, a transgender individual opted for euthanasia after their reassignment surgery failed. Again, the implications of assisted suicide legislation make what has happened totally logical , if chilling. If we can say that it is legitimate for someone to allow the state to take their lives, then there is no logical reason for the state to try and prevent people from doing so. To quote one key representative of the assisted suicide lobby in the UK, Baroness Warnock ,we would be legislating to “put people down”. It’s not just Belgium. In Oregon (generally the model used by the assisted suicide lobby) , the majority (83%) of the patients who died under assisted suicide legislation were suffering from cancer, 46% of those that used assisted suicide legislation felt that part of the reason was that they felt like a burden on their families or society. Oregon (not including suicides by their legislation) has seen a 49.3% rise in suicide rates among those aged 35-64 (this compares to the national average rise of 28%). As harsh as this sounds, the statistics show that the culture assisted suicide promotes winds up in a society that does not value life as much to the point at which suicide prevention has clearly been undermined.
The conclusion of this is that being a libertarian is not necessarily the wish to allow anyone to do whatever they want. Ultimately the law is there to protect the vulnerable as well as defend the freedoms of others. The inherent problems with assisted suicide (including the lack of true patient-doctor relationships, which are crucial in ordinary safeguards) mean that there will never be sufficient safeguards to protect those who could be pressured into taking that option, due to the inherent issues with the confirmation of agency on the patient’s part. In the Netherlands , one of the strongest advocates for assisted suicide before the legislation (Professor Theo Boer) now calls for the euthanasia law to be repealed due to the problems with safeguards. As a Libertarian , I am forced to dismiss assisted suicide due to the effects that it has on the rights of others, the slow creep that such legislation has that makes it impossible for patient safety to be ensured.