Paul KeenanLegislators have been urged to proceed cautiously
“We were wrong – terribly wrong.” More than dry figures and statistics, perhaps more than the moral debates currently underway, a lone doctor’s words last week served to raise a warning flag for legislators on the thorny issue of assisted dying.
Delivered by Professor Theo Boer, a Dutch medical practitioner, the warning was deliberately timed to coincide with the July 18 debate in Britain’s House of Lords on the Assisted Dying Bill and was designed to prompt a rethink among peers considering their support for the proposed legislation.
Cognisant no doubt of the arguments around ‘compassion’ and ‘safeguards’ against abuses of such a law for the terminally ill, Prof. Boer’s cautionary message delved into the Netherlands’ own previous experience by way of illustrating the path ahead for Britain should the current Bill progress to law.
'Slippery slope'
Citing such safeguarding elements as assessment procedures and medical review committees which served to ease fears as his country became the first in the world, in 2001, to introduce euthanasia and assisted dying, Prof. Boer outlined how, with a stable death rate in the first five years of enactment, he and his fellow supporters of assisted dying felt satisfied with their campaigning success.
“In 2007 I wrote that ‘there doesn’t need to be a slippery slope when it comes to euthanasia. A good euthanasia law, in combination with the euthanasia review procedure, provides the warrants for a stable and relatively low number of euthanasia.’ Most of my colleagues drew the same conclusion.
“But we were wrong – terribly wrong, in fact.”
Prof. Boer went on to offer a picture where assisted suicide figures began to surge in 2008, by 15% annually. From a recorded figure of 1,800 in 2002, through 4,188 in 2012, Prof. Boer said: “I expect the 6,000 line to be crossed this year or the next.”
Most worrying, perhaps, Prof. Boer also pointed out that the category of patients being ‘assisted’ towards death has changed, with psychiatric patients and those with dementia now increasingly listed.
“Cases have been reported in which a large part of the suffering of those given euthanasia or assisted suicide consisted in being aged, lonely or bereaved,” he added.
To judge by the record of the subsequent House of Lords debate, the potential for a repeat of the ‘slippery slope’ described by Prof. Boer is keenly perceived by those faced with the British Assisted Dying Bill. As demonstrators gathered outside the Lords’ precincts, peers of the House argued back and forth on the topic, issuing their own warnings of money-grabbing relatives forcing decisions on ill relatives, of the Bill’s lack of adequate provision for psychiatric assessment of those to be given the right to access assisted suicide and the all-too-possible expansion of the legislation beyond the terminally ill.
Reversal
No less vocal then her fellow Lords, though prevented from attending the July 18 debate, was Baroness Nuala O’Loan, The Irish Catholic contributor who, on the BBC’s Sunday Sequence detailed her own objection to the Bill.
Quite aside from the volume of mail she has personally received on the issue, with “not one asking me to support the Bill”, Mrs O’Loan detailed two specific concerns: “Doctors are trained to do no harm and this would be a complete reversal of that because they would have to be trained how to kill people. And 77% of members of the Royal College of General Practitioners said they do not want to do this, they do not think it’s right and do not think there’s a need for a change of law.”
Acknowledging that “tragic cases need to be recognised”, Mrs O’Loan said the Bill should prompt a rethink on “how we supply palliative care, and how we resource that and train doctors”.
These concrete measures aside, Britain’s legislators would be well served by pausing at this point to consider the advice of Prof. Boer in looking to the experiences of those territories – The Netherlands, Belgium, Luxembourg and three US states – which allow for assisted suicide.
“At the very least, wait for an honest and intellectually satisfying analysis of the reasons behind the explosive increase in the [Netherlands] numbers,” he has urged.
“Is it because the law should have had better safeguards? Or is it because the mere existence of such a law is an invitation to see assisted suicide and euthanasia as a normality instead of a last resort? Before those questions are answered, don’t go there. Once the genie is out of the bottle, it is not likely to ever go back in again.”
