A new opinion poll, recent news stories and a TV programme here in the UK have brought the issue of Euthanasia back onto the media agenda. In the Scottish Parliament Margo MacDonald is introducing a Bill to allow assisted suicide in the case of a terminal illness. It’s worth noting that Mrs MacDonald has Parkinson’s Disease so this is a pertinent issue for her. MacDonald’s Bill has the following criteria for allowing euthanasia to take place.
- person must be terminally ill or “permanently physically incapacited”
- Request must be made to and approved by doctor and psychiatrist
- Both must be asked twice after 15-days cooling off period
- Assistance must be supervised by the approving doctor
- Close friends and relatives banned from administering drug
- Only over-16s qualify
- Applicants must be registered with Scottish GP for 18 months
- Bill does not apply to those with dementia or other degenerative mental condition
The problem with the debate at the moment is that it’s been conducted in an environment of emotion which does not to clarify the underlying issues. In some sense MacDonald’s Bill is useful because we can examine her criteria for euthanasia. Even before we explore the possibility that Euthanasia where it has been legalised in Europe has led to alarming rates of involuntary euthanasia, there are serious flaws with the approach of Macdonald.
Consider the criteria that person must be terminally ill or “permanently physically incapacited”. What is the definition of teminally ill? If someone is diagnosed with HIV/AIDS they are technically terminally ill, but may still have decades of quality life left with the right kind of treatment. Is MacDonald seriously suggesting that such a person may be allowed to undertake assisted suicide simply upon being diagnosed with HIV?
How does one decide what permanent physical incapacitation is? Quadriplegic? But then while some quadriplegics seek to end their life, others carry on with fulfilled lives. One has to question that when two people in exactly the same situation make completely different choices about whether to carry on living, how can one limit a subjective decision on whether an individual committing suicide is moral only to those in that specific situation? If it is perfectly acceptable for someone who could live for 50 years or more to commit suicide just because they are quadriplegic (which while debilitating is not necessarily painful), why should we prevent anybody in any position of health from doing the same? What then are the boundaries of permanent physical incapacitation? Fully paralysed? Partially? Blindness? Deaf? Cleft Lip?
In the UK at the moment we have a legal understanding of “Double Effect“. In terms of the Euthanasia debate this means that if the effect of a doctor validly trying to reduce someone’s pain causes a shortening of life, the courts will not view such an action as assisted suicide or murder. As long as the intent of the medication is not to cause death but rather to appropriately relieve pain (i.e. you cannot claim double effect if you overdose a patient) then there is a strand of orthodox Christian ethics that supports such an approach. Like many conservative pastors I have been with families as they have considered the side-effects of the appropriate level of pain relief for a loved one, and while it is hard to permit something to occur that will eventually cause a secondary result of death I’ve never once felt that an inappropriate moral boundary was crossed.
Introducing assisted suicide will tear up the notion of double effect and as we have seen above creates far more moral issues then it seeks to solve. Until the kind of questions that I have raised in this post can be satisfactorily answered by the advocates of euthanasia we should be highly sceptical of any attempt to liberalise the law in this area.