Assisted Suicide — A Moral Case

Ross Douthat plays fast and loose in his New York Times column today, “Dr. Kervorkian’s Victims.” One moment he says there isn’t a moral case for assisted suicide—just one based on an “impulse toward mercy” – and then he suggests there might be one. But then argues that if we acknowledge such a right to suicide, then what’s to stop anyone from deciding to die, even if they are not suffering from a terminal illness.

Of course, there IS nothing to stop anyone deciding to end their life, and most sensible countries long ago decriminalized attempted suicide – India’s Supreme Court two months ago urged the Indian Parliament to “delete” a law that seeks to punish failed suicides, saying it was anachronistic and lacking in compassion.

But suicide is one thing – the person committing it or attempting to do it — is involved in a self-sufficient action. Assisted suicide is something else: others are being asked to help. And so a case has to be made.

My late mother, Barbara Dettmer, who underwent assisted suicide in Switzerland nearly six years ago, would have scorned Douthat’s arguments against assisted suicide. She would have insisted emphatically that it was up to her to decide when and how to go. She would have said it was a matter of civil liberties, common decency as well as compassion. She would have said her physical suffering had earned her the right to ask for assistance to end her life.

She chose assisted suicide after struggling for more than three decades very bravely with crucifying pain. Her multiple, progressive and incurable diseases were not helped by palliative care and her quality of life had been reduced to an appalling existence. Her body was wrecked. She was not terminal but chose to be. Modern medicine has shifted many out of the terminal category and they linger in the incurable one, condemned to a life of suffering prolonged. Some would call it torture.

The Swiss organization, Dignatas, who Douthat sneers at, allowed her to regain her dignity. My mother’s last moments were peaceful – two very sympathetic nurses were in attendance. She had no doubts about what she was doing. My family and I supported her “right” to die because she asked us to and because we accepted the civil liberties case for assisted suicide while also sharing at the same time an “impulse toward mercy.” None of us have had any time, by the way, for the rather suspicious Jack Kervorkian, who is the main target of the Douthat’s NYT column.

Douthat worries that there is too much arbitrariness in deciding who should have the right to undergo assisted suicide and predictably he talks about slippery slopes. But many of the biggest human dilemmas can’t be subject intelligently to a black-and-white mindset. When it comes to assisted suicide it must come down to a matter of individual choice. And we should be humble when someone decides that they want to go through assisted suicide, however painful it is for us.

Obviously, there need to be practical checks and balances and the UK’s Director of Public Prosecutions, Keir Starmer, outlined a couple of years ago some fine guidelines for when his department would not seek a prosecution against those assisting others to commit suicide. The emphasis and focus of the guidelines were spot-on and seek to protect the vulnerable from manipulation, coercion and trickery. Factors against prosecution include: the expression of a clear, settled and informed wish by the person electing suicide, who has to be terminally ill or suffering from a severe and incurable disability and degenerative condition.

See Assisted Suicide category for other posts on this subject.

 

BBC Man in Mercy Killing

The BBC’s Ray Gosling has admitted in an interview that he smothered a former lover who was suffering from AIDS and was dying. Gosling has refused to cooperate with police and is unwilling to name the man or where and when the smothering took place.

No doubt, opponents of assisted suicide will jump on the case — and, despite being a committed advocate of the assisted laws in the UK being changed, I, too, am disturbed by Gosling’s action and his behaviour now.

But it needs to be stressed: assisted suicide is not the same thing as mercy killing. Gosling has not indicated whether his former lover made clear his wish to die and the method of death.

Any intelligent advocate of legalising assisted suicide understands a couple of major points: there must be transparency and clear evidence that the wishes of the dying or incurably sick are being carried out and that they, if possible, are the ones who “pull the trigger.” And when, or if, there is an investigation there must be evidence that there has been no trickery or cajoling. Obviously, if there is a change in the law there should be checks and balances and procedure — in the absence of a change of law, it is, surely, the responsibility of anyone involved in an assisted suicide to ensure a “procedure” involving others (family and friends) is followed and that they are prepared to be questioned by authorities.

I suspect, Gosling may have put back the assisted suicide cause by his high-handed and rather casual attitude since announcing his involvement in a mercy killing.

British Back Change In Assisted Suicide Law: Don’t Prosecute

The Daily Telegraph splashed this morning on a very significant poll conducted by YouGov. More than 80 percent of those polled agreed that relatives of terminally ill people, who had made it clear they wanted to die, should not be prosecuted for assisting in their deaths.

Three quarters of those polled said the law should be amended to allow assisted suicide.

The Telegraph also reports on the upcoming lecture by  author Sir Terry Pratchett, an Alzheimer sufferer, who will call for assisted suicide “tribunals” that would give the terminally ill permission to end their lives. In this week’s Richard Dimbleby Lecture, he will offer himself as a test case for just such a tribunal.

One hopes that Sir Terry will also take into account the plight of those who are desperately and incurably sick.

The Gilderdale Case: The Right To Die

Is there one law to be followed, if Britons assist their relatives to undergo suicide overseas and another to be applied when the assisted suicide takes place at home? That would seem to be one conclusion to be drawn from the Crown Prosecution Service’s prosecution on an attempted murder charge of a mother who provided a cocktail of drugs allowing her bedridden daughter to end her life.

The case of Kay Gilderdale, who was found this week by a Sussex jury not guilty of attempted murder, is a dismaying indication that the Director of Public Prosecutions, Keir Starmer, is unlikely to follow with consistency his own breakthrough guidelines on assisted suicide that he issued last year.

Yet again it remains unclear where people stand when it comes to assisting the terminally ill – or desperately sick – to end their suffering. Clarity is what Mr. Starmer offered with his guidelines but apparently they are not worth the paper they were written on for they do not clarify the situation but muddy it. What are we to make of such a harsh prosecution? Mrs Gilderdale wasn’t even prosecuted for assisting a suicide but was charged with the even graver offence of attempting murder.

When Mr Starmer unveiled his guidelines I for one applauded them. Three years earlier my mother, Barbara Dettmer, had committed suicide in Switzerland with the assistance of Dignitas, and the loving support of my sister, myself and our father.

My sister, Anne, and I remain furious that our mother was unable to end her life in her own home surrounded by family and friends but had to drag her pained and wrecked body to a foreign country to do as she wished. She had been virtually house-bound for years, had suffered greatly with no end to her pain in sight and she believed passionately that no one – governments or churches – had the right to tell her that she could not select the moment and means of her death (see earlier blog posting).

Along with the decades-long crucifying pain she suffered she was made by the law to go through another crucifixion — to seek death in a foreign country far from the familiar and from her husband of 55 years.

When Mr. Starmer issued his guidelines I wrote: “Despite his cautious wording and assurances that the law in England and Wales against assisted suicide has not changed, he has in effect advanced civil liberties when it comes to the right to die.” I did note I was troubled that the law itself hadn’t been altered and I highlighted the odd situation of having guidelines that in spirit and humanity pulled in one direction while the law against assisted suicide pulls in another. “That is a recipe for trouble down the road and there remains a lack of certainty. The guidelines could be changed later,” I warned.

I did not think the problem would come from Mr. Starmer, who gave the go-ahead for the prosecution of Mrs. Gilderdale. The DPP’s guidelines, which detailed when the UK authorities will prosecute a spouse, relative or friend who assists in a suicide, emphasised that a prosecution would be unlikely as long as those who assisted the suicide do not maliciously encourage the act of suicide or stand to profit and assisted only a “clear, settled and informed wish” to end life.

Mrs. Gilderdale had sought to dissuade her bedridden daughter, Lynn, from wanting to end life. She was a reluctant participant. But her 31-year-old daughter, who had been suffering from Myalgic Encephalomyelitis for 17 years and whose body was wrecked, was determined. She made her views clear both verbally and in writing – the writing took her weeks and months to pull off – that she had had enough.

“Imagine being imprisoned inside the miserable existence that is your life,” she wrote. “I don’t have to imagine that. My body and mind is broken. I am so desperate to end the never-ending carousel of pain and sickness and suffering. I love my family. I have nothing left and I am spent.”

Another passage from Lynn: “I really, really, really want to die and have had enough of being so sick and in so much pain every second of every day…This is something I have thought long and hard about…I’m sure it’s what I want. I have discussed and continued to discuss with my parents at great length. Although they obviously desperately don’t want me to go.”

The emphasis and focus of the Starmer guidelines were spot-on: the DPP stressed that he wanted to protect the vulnerable from manipulation or coercion or trickery. There was none of that involved in the suicide of Lynn – the prosecution showed no evidence to the contrary.

Under the guidelines Mrs. Gilderdale should not have even been prosecuted for assisting the suicide. Despite the fact she had pleaded guilty to assisted suicide, she was brought to court for attempted murder. A charge that irritated the trial judge, and two other judges previously who sought to persuade the CPS to cease prosecution. Mr. Justice Bean, who oversaw the trial, praised the jury for “common sense, decency and humanity” on acquitting Mrs. Gilderdale of attempted murder.

The guidelines were issued after the Law Lords backed in July a call from Debbie Purdy, who suffers from multiple sclerosis, for a policy statement on whether people who help someone commit suicide should be prosecuted. Purdy wanted a clear policy on whether her husband would be prosecuted for helping her travel to Switzerland to go through assisted suicide at a Dignitas clinic.

More than 100 Britons have ended their lives at Dignitas clinics, but, until the Starmer guidelines friends or relatives could not be sure whether they would face prosecution for assisting. Can they now, in the light of the Gilderdale prosecution? No prosecutions have been mounted of those who have helped Britons to commit suicide overseas. Hence the initial question of this posting: are you free from the dangers of prosecution, if it is an overseas suicide, but will face the full weight of prosecution, if the act takes place in the UK?

According to UK Conservative MP Ann Widdecombe, Mr. Starmer turned the Gilderdale case into a “showpiece” to promote the legalization of assisted suicide.  I don’t believe that Mr. Starmer is as Machiavellian as Mrs. Widdecome supposes – he could not know that the jury would acquit and I doubt he would have been as cruel as to risk the imprisonment of a woman he thought was innocent. No, what we have here is a mess and one that is going to add to the suffering of those who want to die.

The Right to Die: Sense and Sensibility

Britain’s Director of Public Prosecutions, Keir Starmer, has revealed himself today to be a humane and sensible man and, despite his cautious wording and assurances that the law in England and Wales against assisted suicide has not changed,  he has in effect advanced civil liberties when it comes to the right to die. He has issued new guidelines detailing when the authorities will prosecute a spouse, relative or friend who assists a terminally ill or incurably sick person to travel overseas to undergo assisted suicide. Prosecution is unlikely as long as people do not maliciously encourage the act of suicide and assist only a “clear, settled and informed wish” to end life, the DPP says.

Today’s guidelines were issued after the Law Lords backed in July the call by Debbie Purdy, who suffers from multiple sclerosis, for a policy statement on whether people who help someone commit suicide should be prosecuted. Purdy wanted a clear policy statement on whether her husband would be prosecuted for helping her to travel to Switzerland to go through assisted suicide at a Dignitas clinic there.

More than 100 Britons, including my mother, Barbara Dettmer, have ended their lives at the Dignitas clinic in Switzerland, but, until now, friends or relatives who have accompanied them have not known if they will face prosecution — although no prosecutions have as yet been mounted.

Barbara Dettmer

A Few Years Before

My mother went through assisted suicide three years ago after struggling for three decades very bravely with crucifying pain. Her multiple, progressive and incurable diseases were not helped by palliative care or drug therapies and her quality of life had been reduced to a shambling and appalling existence. My mother was not terminal – but she chose to be, and she made it clear that she believed she had the right to die when she chose to exercise it. My family and I supported her right to die because she asked us to and, although we all arrived at our support through different intellectual routes, none of us had any doubts about backing her when she requested that backing. Her courage was astonishing.

The DPP’s has certainly clarified what factors will be taken into account when the authorities consider whether to prosecute or not. The emphasis and focus of the guidelines are spot-on: the DPP wants to protect the vulnerable from manipulation and coercion and trickery.

Factors against prosecution include: there was a clear, settled and informed wish to commit suicide and that the person who went through the suicide indicated unequivocally that they wished to commit suicide. The person who went through the suicide personally asked for help and they were terminally ill or suffered from a severe and incurable disability and degenerative condition.

While welcoming the DPP’s guidelines I remain troubled that the law itself  hasn’t been changed. What is bizarre is that there are now guidelines that in spirit and humanity pull in one direction while the the law against assisted suicide pulls in another. That is a recipe for trouble down the road and there remains a lack of certainty. The guidelines could be changed later or an appeal could be mounted against the guidelines in the courts to have them struck down because they don’t enforce the law in place. It is a good holding position but Parliament has got to have the courage and humanity the DPP has shown and alter the law. The DPP has had to almost usurp Parliament because the parliamentarians have not done their jobs and they have failed to respond to public opinion and common sense.