Assisted dying is a human right

Said the professor of education with a Distinguished Service Order from the war: "I would like to see accepted… and established by law, the right of the individual at his own request to be helped out of life in such a way that this last act could be performed in the most humane, civilised and considerate way possible.”

So is this from a submission made to the All-Party Parliamentary Group on Choice at the End of Life, which has been producing a draft Bill which Lord Falconer will take to the Lords? Or perhaps it comes from a recent debate in the newsletter of Dignity in Dying, or maybe from their more cutting-edge sister organisation Health Professionals for Assisted Dying? Or maybe it is from the Society for Old Age Rational Suicide, which aims with low-profile discretion to carry the debate further?

Actually, no. It is from an AGM address to the Voluntary Euthanasia Society in 1973, and no one then present regarded these views as particularly advanced, let alone unacceptable. VES was founded in 1935; its emphasis was firmly on the voluntary, with human rights at the heart of the movement, though these were a much less fashionable topic then than they are today. In the 1980s I was on the VES committee, and I contributed articles on the subject to national newspapers, typically when some high-profile person had decided to take his dying into his own hands or when a court case about the act of a kindly doctor or a devoted spouse was making news.

We have moved on from there: the Director of Public Prosecutions made the decision in 2010, recently endorsed by parliament, that it is not in the public interest to prosecute someone who assists in a suicide for compassionate reasons. This has brought some common sense and honesty into a legal trap that should never have been set in the first place.

We have not, however, moved toward the concept of it being a human right to determine your own end—rather, we have retreated on the matter. Today, Dignity in Dying is a mainstream organisation, and in its desire to be respectable and not frighten anyone it has tended to favour an intellectually downmarket approach. Some members, feeling that the newsletters contained little but tales to touch your heart, have suggested that rather more principle should come back into the campaign. No one, after all, has ever managed to formulate a philosophical argument as to why an individual should not be able to renounce his own right to life. Could this discussion point perhaps be mentioned in a newsletter?

But the idea was vetoed on the grounds that it might alarm the Opposition. What is meant by this is a small but highly visible body of self-styled “pro-lifers” who seem constantly on the lookout for grounds, however far-fetched, for declaring that we are on the slippery slope to the gas chambers. One might feel that the ambition not to alarm them could serve only to drive them into ever more tenuous pretexts for prophecies of doom.

Dignity in Dying is well respected, and it is encouraging to see the amount of wide-ranging consultation and heartfelt discussion that has attended the drawing up of the draft Bill. Evidence has been gathered from countries and states that have already taken some step in the same direction and enormous thought has gone into proper safeguards against abuse (which aren't actually difficult to erect). With over 80 per cent of the population in favour of a revision in the law, this Bill really ought to succeed.

But Dignity in Dying's persistent emphasis on help for those already terminally ill is not addressing a more fundamental moral issue. Whatever one feels about the desirability of allowing a terminally sick person to die quickly rather than lingeringly, the word “allow” pulls me up short. We don't attempt to make restrictive rules today about other major areas of life, including marriage and child-bearing. We let people, in the decent name of free will, lead unhealthy or dangerous lives if that is that they want. Should the discourse around dying really be about “allowing” an individual to decide that enough is enough? Should we really have stringent tests for “eligibility,” which risk creating a restrictively narrow window between “not ill enough yet” and “too ill to take a competent decision”? Doesn't the focus on the terminally ill sidestep the central issue about personal autonomy? It certainly excludes all those who, for sane reasons, do not wish to go on living in a dilapidated state deprived of most of life's worth. And anyway, must we really adopt such a negative, defensive approach to the Great Imponderable we are all eventually going to meet?

In the Times in 1983 I wrote, “I am willing to bet that, within my own lifetime, ordinary people will look back with as much disapproval on the days when there were no proper arrangements for a timely death as we now look back on the dark ages before contraception.”

A generation has passed, and “within my lifetime” has a very different dimension. My contemporaries confide their fears about old age—which are never, contrary to “pro-life” myth, about being bumped off too soon but about being forced by well-intentioned but ill-advised doctors to go on too long. The elderly murmur to one another about stocking up on sleeping pills—and whether hypothermia might be worth bearing in mind? Anyone who has seen Michael Haneke's darkly brilliant film Amour, about an old couple imprisoned in a life worse than death, will understand the desperation engendered. A little kindly tinkering, along the lines of the Liverpool Care Pathway, with people already on their way out, does not address this problem. All social adjustments change the landscape. But while we are so afraid of allowing people to decide about their own death that we do not even want to examine the idea, the problem will only grow bigger.