The Royal College of Physicians (RCP) is polling its membership of doctors over their support for assisted suicide. The status of doctors in the UK is currently that they have voted ‘against’ but this is a bid to raise that to a ‘neutral’ or even supportive position.
This is a debate that might seem cerebral and make us think about what we would want if we were in pain but, for many disabled people, it is a frightening discussion about our very lives. It’s not a hypothetical discussion. The proposed changes may relate specifically to people described as terminally ill but the line between terminal illness and disability is a very thin one, if it exists at all.
What this discussion actually does is make us look at our doctors in a different way. Do they think we would be better off dead? Would they rather help us to die than help us to live?
I am not suggesting that doctors are murderous folks who can’t see how any disabled person wants to be alive. However, many people who are disabled do believe that it is a profession that, like any other, is mired in disablism. Doctors, as Baroness Jane Campbell wrote for the BMJ, “seldom see us at our best. You often see us when we are in crisis. Yet we depend on you to do all that you can for us.
“Many of us, myself included, are alive now because of the skill of the medical profession, advances in drug treatments, and improved devices. We are immensely grateful. We want you to keep asking yourselves, “How can I improve this person’s health and quality of life?””
Doctors see us when our pain is at its highest, when our desperation is showing and when our usual cool, calm, collectedness has exited the building. They don’t see us having fun and working hard and living our lives quite so much. So they can have a skewed perception of what disabled like is actually like. If you’d asked me on Saturday night, when I was writhing in pain, whether I would risk a dose of morphine that might finish me off, I might not have said no. That is not to say that that decision should have been offered to me, or my answer taken seriously.
Ask me again now, and I’m sore but pretty much fine. I’d say no. That degree of pain will recur in my life, many more times. I will want to do anything I can to make it end. I must be protected from myself at times when I wish for that!
Of course terminal illness is more serious than pain alone, and people give ending their own life a lot of thought. And yet even those who go through with it leave people behind who wished they had not made that choice.
Simon Binner’s death by suicide in a Swiss clinic in 2015 was recorded for a BBC documentary. His wife, Deborah Binner, told Victoria Derbyshire, “Simon’s death wasn’t bad – but when you open the gate, what happens next?. Older lonely people, or people sitting on lots of money, people already feel a burden – it’s something, how we value human life, that really worries me.”
People who are unwell often do feel burdensome, and this is a real risk where assisted suicide is concerned. Should we let someone die because they don’t like a fuss being made of them, or because they feel like they are an untolerable burden on their partner or children? That can combine with despair and lead to suicidal feelings, which should be treated as such, not validated by doctors who should be helping somebody to live.
When a non-disabled person is suicidal, steps are taken to help them to stay alive. Not uniformly, and not reliably perhaps, but the view of society is that things can get better and that they should fight the self-destructive urges they are feeling.
Why is that so different when a disabled or terminally ill person wants to die? Why is it acceptable to lean back and say “Well, yes, I can see why…”?
We are told by pro-assisted suicide campaigners that safeguards will be put in place to protect disabled and ill people who do not want to kill themselves, but studies show that these protections are unreliable and are routinely ignored. This is terrifying and Pereira’s work demonstrates that the “slippery slope” fears are frequently true:
“In 30 years, the Netherlands has moved from euthanasia of people who are terminally ill, to euthanasia of those who are chronically ill; from euthanasia for physical illness, to euthanasia for mental illness; from euthanasia for mental illness, to euthanasia for psychological distress or mental suffering—and now to euthanasia simply if a person is over the age of 70 and “tired of living.” Dutch euthanasia protocols have also moved from conscious patients providing explicit consent, to unconscious patients unable to provide consent. Denying euthanasia or pas in the Netherlands is now considered a form of discrimination against people with chronic illness, whether the illness be physical or psychological, because those people will be forced to “suffer” longer than those who are terminally ill. Non-voluntary euthanasia is now being justified by appealing to the social duty of citizens and the ethical pillar of beneficence. In the Netherlands, euthanasia has moved from being a measure of last resort to being one of early intervention. Belgium has followed suit 37, and troubling evidence is emerging from Oregon specifically with respect to the protection of people with depression and the objectivity of the process.”
This is why disabled campaigners like myself are calling for British doctors to vote in the RCP poll that they are against a position supporting assisted suicide. Even a vote for ‘neutral’ would make patients feel unsafe and untrusting of those we need to place the ultimate faith in. No organisation run by disabled people supports assisted suicide and many actively oppose it. We are the people at risk from these debates and our views must be centred, not overridden by the worried well.
Photo: Klesta