The welcome spread of assisted dying
Euthanasia or ‘assisted dying’ as it is called these days is becoming legal in more and more countries. Liberals believe that freedom should also include one’s choice of the manner and timing of their death as well. Whilst many countries are legalising it, the debate is far from over, argues this piece in The Economist, which historically has advocated ‘assisted dying’ but with riders.
“Assisted dying is now legal in one form or another in a dozen countries, and the trend seems likely to continue. Last week New Zealand enacted a euthanasia law for the terminally ill after 65% of voters backed it in a referendum. The same week Portugal’s parliament passed a broader law. Assisted dying is still illegal in Britain, but the House of Lords is debating a bill to allow it.
…Many people object to assisted dying on religious grounds: some faiths deem suicide a sin. Others worry that safeguards will prove insufficient, or that legalisation is a slippery slope. Critics have long predicted that families exhausted by the demands of caring for sick, elderly relatives will place undue pressure on them to end their lives, or that cash-strapped states will encourage the most expensive terminally ill patients to hurry up and die.
Yet such horrors do not seem to have come to pass. In places with the longest experience of assisted dying, charities that represent the elderly or disabled have not reported any abuse. It is conceivable that some has taken place unobserved, but scrutiny has been intense and in most countries permission to help someone die is revoked if there is even a hint of coercion. Fears that the poor and marginalised might be hastened to their ends have also proved to be unfounded. In America, the Netherlands and Switzerland the overwhelming majority of those who choose an assisted death are educated and middle-class.
…Canada offers a better model, because it provides more leeway for individuals to make their own choices. Anyone whose suffering is unbearable can choose an assisted death. They do not have to be terminally ill. And, uniquely, the question of what constitutes “unbearable” suffering is for the patients themselves to decide, so long as they are of sound mind. There is a cooling-off period of 90 days for those whose deaths are not reasonably foreseeable, in case they have second thoughts. In many cases, simply having the option of an assisted death gives people a sense of comfort and control. In Oregon a third of those people who receive the prescribed lethal medication ultimately choose not to take it.
Even as more societies accept the principle of assisted dying, hard questions remain. Some people worry that its availability may prompt health services to skimp on palliative care. But that is not ordained. Canada’s assisted-dying bill was explicitly linked to increased funding for palliative and long-term care.
…The trickiest questions arise when an individual’s capacity to make an informed choice is in doubt. Some people with mental disorders have suicidal thoughts that come and go. For them, the bar should be very high. Doctors must be sure they can distinguish between a temporary mental-health crisis and a sustained, considered wish to die. If in doubt, they should offer treatment aimed at helping the patient to live.”
“Assisted dying is now legal in one form or another in a dozen countries, and the trend seems likely to continue. Last week New Zealand enacted a euthanasia law for the terminally ill after 65% of voters backed it in a referendum. The same week Portugal’s parliament passed a broader law. Assisted dying is still illegal in Britain, but the House of Lords is debating a bill to allow it.
…Many people object to assisted dying on religious grounds: some faiths deem suicide a sin. Others worry that safeguards will prove insufficient, or that legalisation is a slippery slope. Critics have long predicted that families exhausted by the demands of caring for sick, elderly relatives will place undue pressure on them to end their lives, or that cash-strapped states will encourage the most expensive terminally ill patients to hurry up and die.
Yet such horrors do not seem to have come to pass. In places with the longest experience of assisted dying, charities that represent the elderly or disabled have not reported any abuse. It is conceivable that some has taken place unobserved, but scrutiny has been intense and in most countries permission to help someone die is revoked if there is even a hint of coercion. Fears that the poor and marginalised might be hastened to their ends have also proved to be unfounded. In America, the Netherlands and Switzerland the overwhelming majority of those who choose an assisted death are educated and middle-class.
…Canada offers a better model, because it provides more leeway for individuals to make their own choices. Anyone whose suffering is unbearable can choose an assisted death. They do not have to be terminally ill. And, uniquely, the question of what constitutes “unbearable” suffering is for the patients themselves to decide, so long as they are of sound mind. There is a cooling-off period of 90 days for those whose deaths are not reasonably foreseeable, in case they have second thoughts. In many cases, simply having the option of an assisted death gives people a sense of comfort and control. In Oregon a third of those people who receive the prescribed lethal medication ultimately choose not to take it.
Even as more societies accept the principle of assisted dying, hard questions remain. Some people worry that its availability may prompt health services to skimp on palliative care. But that is not ordained. Canada’s assisted-dying bill was explicitly linked to increased funding for palliative and long-term care.
…The trickiest questions arise when an individual’s capacity to make an informed choice is in doubt. Some people with mental disorders have suicidal thoughts that come and go. For them, the bar should be very high. Doctors must be sure they can distinguish between a temporary mental-health crisis and a sustained, considered wish to die. If in doubt, they should offer treatment aimed at helping the patient to live.”
