The last rights

SOCIETY II
Kris Anderson defends assisted dying

My grandmother died a good death. It dragged on for a week. She was comatose, which was partly induced by a steady stream of morphine, and she was starving, as her feeding tube had been removed. To me, it was a horrible death – drugged, emaciated, rasping…a death of attrition. But it was a good death, because she died as she had wanted, surrounded by her family, content in her faith.
     Two years before, she had been diagnosed with motor neurone disease, a rapidly progressive and fatal condition wherein muscle after muscle would atrophy, disintegrating until she could no longer walk, eat, or, most frightening of all, speak.
     However, she was lucky – relatively, of course – to have been diagnosed with MND in Oregon State. In 1997, Oregon passed an assisted dying law which gave terminally ill people the option to end their lives when their suffering became unbearable. There, the law is heavily safeguarded and very restrictive: assisted dying is only available to those who have been certified by at least two doctors as terminally ill and mentally competent, and who have proved that they are acting autonomously. This isn't suicide as such: these people are already dying and want some control over the process.
     I mention this because Oregon's law provides the model for the proposed UK law, which was voted down in the House of Lords in 2006 but which will be re-introduced soon. And it's about time, too. Assisted dying isn't new to European politics: several countries have already passed such laws. Nor is it unfamiliar to Britain – in the 16th century, Thomas More wrote of a utopia where those who lived with 'torturing and lingering pain' were helped to have a good death. Modern opinion polls routinely find that about 80% of Britons would like to have an assisted dying law here. So why the delay?
     Unfortunately, a vocal minority are mounting a bellowing, if contrafactual, fight. Most opposition is faith-based, such as Care Not Killing, whose director is also president of the Christian Medical Fellowship – although he seldom admits the latter in his editorials. Most opposition groups dress up religious beliefs as scientific truths. Although easily refuted by hard evidence, such rhetoric is nevertheless attention grabbing and recognisable to anyone who's read a newspaper in the last 10 years: it's fear-mongering, war-on-terror stuff. An assisted dying law could jeopardise our democracy, they say. Vulnerable people might feel coerced into killing themselves, or, worse yet, they would have the choice removed from them entirely – death without consent, like (whispers the voice) what the Nazis did.
     This is the 'slippery slope' argument, and if the proposed UK law was more permissive and the safeguards less rigorous, it might be a valid worry. But it isn't and they aren't.
     In Oregon, after a decade of rigorous scrutiny, there have been no – zero – credible reports of abuse. Rather, such laws protect the vulnerable: a report last year found that over 2,500 people in the UK die annually with help from their doctor. The legalisation of assisted dying would bring the practice out of the back alley, preventing abuse while providing doctors and patients with legal recourse. Oregon's number of assisted deaths declined once they passed the bill. Now, while half of terminally-ill Oregonians said that they seriously consider using the law and felt comforted by the option, assisted deaths account for a minute 0.2% of actual mortalities – surely the antithesis of the slippery slope.
     Moreover, an assisted dying law doesn't just benefit individuals in extremis: it benefits wider society, too.
     For one, such legislation exposes the end-of-life healthcare system to further scrutiny: in every country and state with assisted dying laws, access to palliative care improved dramatically once the law was enacted. Last year, 98% of those who had an assisted death in Oregon did so from within a hospice, and Oregon is now rated the 'second-best place to die' in the US.
     More broadly, an assisted dying law in Britain would mean that, as individuals, as a culture, we could start to discuss death as an ordinary, rather than an extraordinary, part of life. That's what happened in our family: my grandmother discussed dying with her hospice nurses, with her doctors, and with us. In the end, she opted out: she felt that assisted dying contravened her Catholic faith. Those of us without faith, or with a different interpretation of faith, might choose to avoid the starving, the rasping, the coma. But merely having the option reinforced my grandmother's autonomy: she died affirmed in her faith and empowered by her choice.
     Similar legislation here is long overdue. I've corresponded with hundreds of terminally-ill Britons who want to know how to get to Dignitas, how much it costs, if the law here will change soon. It's awful to have to say to them, 'I'm sorry, I can't help you: for me to provide you with any information of that sort would, under current UK law, be a crime. We're trying to change that; meanwhile, please speak to your doctor about pain management options.' These aren't vulnerable people: they're strong, assertive individuals who want to die as they've lived – as themselves, not as a prognosis. Allowing terminally-ill people a dignified death presents no threat to wider society, while refusing them this curtails their basic right to self-determination and is fundamentally anti-democratic.
     Ultimately, this isn't a revolutionary call to arms. An assisted dying law won't end hunger or inequality; it won't halt climate change. But it will make existence more bearable for those nearing death, and it's easily accomplished. Why does it matter to young, vivacious people? It doesn't – but that doesn't mean it won't. Meanwhile, I think we have a social obligation to pass assisted dying legislation on behalf of those that do need it, not least because one day we or someone we love might join their ranks.

This was the winning paper in the 2009 Third Sector Young Thinker of the Year. Kris Anderson works for Dignity in Dying