Catholic Medical Quarterly Volume 71(4) November 2021

Editorial

Legalizing Assisted Suicide

Dr Adrian Treloar FRCP MRCPsych MRCGP

Author: Adrian TreloarLegalizing assisted suicide would place very many frail and vulnerable people at risk. We know that people fear illness and old age. We also know that people do not want to be a burden upon others. Especially in the elderly, that fear of being a burden has been one of the really important reasons why people ask to be killed or ask for help killing themselves. People do not want to be a burden on their children. Some also want to be able to pass on their inheritance etc.

If assisted suicide is legalised, then society will be making a clear statement that some people’s lives are not worth living. It is a hugely destructive thing to tell people who are sick, frail, weak and dying that their life is no longer worth living. The route of suicide becomes not only a legitimate route, but an easier route, and may in fact be the only option offered by the doctor or nurse. None of us can know what it will truly be like to be sick and dependant upon others until we are, ourselves, in that position. And yet, the reality is that being in such a situation MUST be a call for the care and support of people around us and NOT a call to offer death.

Christians passionately proclaim that all people’s lives are worthy and of value. But in fact, that view is widely held throughout society. On this matter, Christianity and other major faiths simply reflect good sense.

The legalisation of assisted suicide will make many people very vulnerable. It will place them at risk of being treated in such a way that they end up asking for their lives to be ended. That in turn risks making access to the best possible care more difficult:- especially for frail and vulnerable people. We know that fearing being a burden, concurrent depression, poorly treated pain, and social isolation have been shown to be key reasons why people request that they be killed.

Those in favour of assisted suicide promise safe­guards. But safeguards are impossible to put in place or to police. Those private conversations be­tween patients and their family members and also between patients and their doctors have so much opportunity for subtle and unspoken coercion etc. Finally, the legalisation of assisted suicide will also affect those who are not able to choose for them­selves. People who lack the mental capacity to ask to be killed, will find that the UK’s disability discrimination law holds that those who cannot choose must also have the same right of access (in their so-called “best interests”) to being killed. We have seen those who lack capacity being killed in Holland and also in Canada. Inevitably, the courts in this country will also open that path.

I believe that the legalisation of Assisted Suicide would be especially disastrous for frail, older and vulnerable people in this country. While I fully recognise that some people really want to be able to ask to be killed, I strongly believe that if that is allowed, many more innocent and vulnerable people will suffer greatly and will be killed.

Dr Treloar is a Consultant Old Age Psychiatrist. He works in a Memory Service with people with dementia. He pioneered the Palliative Care of Dementia and has lectured nationally and internationally on the care of older people.

Some resources

Mental Illness is the most powerful predictor of desire to die. Studies have shown that losing a sense of dignity and hope and taking on a sense of burden prompt some people to seek euthanasia and Physician Assisted Suicide. Desire for has­tened death among terminally ill cancer patients is not uncommon. Depression and hopelessness are the strongest predictors of desire for hastened death in this population [1-4]. Strategies to im­prove the sense of dignity, based on empirical studies that have explored the concept of dignity within palliative care, have been shown to work [5]. Similar strategies need to be developed in the areas of hope and burden.

References

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