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Why Euthanasia doesn't equal "good death"

The recent vote in New Zealand has caused the debate to resurface

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Image Credit: Nick Youngson (Picpedia.org)

Euthanasia has risen to the fore once again. With the recent referendum in New Zealand passing with over 65% of the vote, there is a good chance that in all the hype about the good that this legislation will bring, the dangers will be overlooked. Nevertheless, euthanasia brings the capacity to do great harm to the most vulnerable of society.

Proposed euthanasia legislation in the UK – and actual legislation in countries such as Belgium and The Netherlands – requires only two doctors to approve most of the applications made. Furthermore, patients suffering from dementia are able to leave instructions for euthanasia should their suffering become too great. This policy has created a dangerous crack in the system, through which patients have fallen. Reports from February 2018 detail a case where a dementia patient underwent euthanasia treatment despite never formally requesting it, doctors instead acting upon the wishes of the family. That the system can be abused in such a way is alarming. Unlike other medical treatments people undergo, euthanasia is – of course – irreversible. Therefore, before any procedure is to take place, there must be absolute proof that it is being done on the patient’s wishes. Even if 99.9 per cent of cases are carried out in such a responsible way, that isn’t good enough because that other 0.1% involves patients with family, friends and children. Most importantly, they didn’t want to die.

And the margin for error only increases as more people become eligible. In Belgium, euthanasia has been on a slippery slope with ever-widening criteria. Policy changes in 2008 extended euthanasia so that those with mental illnesses and severe physical and learning difficulties gained access, and as of 2014 Belgium removed the age limit too (although not for psychological suffering).  This created a problem: how to rule that a patient has made the choice freely and with full mental capacity when at the same time the reason for their decision is severe mental suffering, at times because they lack said mental capacity. Therefore, those patients in this situation must also have consent from their parents or carers. Imagine making such a decision for a person in your care and the guilt you would feel afterwards. To put parents in such a position would surely leave them questioning their actions to no end.

But perhaps the area most dangerous way the eligibility requirements have slipped is that they now allow euthanasia on mental health grounds, also legalised in 2008. Belgium clarifies the grounds that the pain must be ‘constant and unbearable’ and ‘incurable.’ Unfortunately the road to recovery for many is a long and painful process, no person is the same and neither is the path or treatment plan that they will use. Therefore, it is impossible to know at what specific point someone’s mental illness is incurable. Moreover, even mentioning the idea of euthanasia to someone suffering from mental illness will mean that their treatment and all the work that they’d done up to that point might as well have not happened. It will confirm their worst fears, that there is no hope and that they can’t be cured. This is absolutely not the case at all.  The vast majority, up to 90 per cent according to the American Psychiatric Association,  feel better once undergoing treatment, and the vast majority of those who survive suicide attempts are glad they did so. The ineffectiveness of certain treatments for patients does not mean that they are incurable or that their pain can’t be reduced, it simply shows a need for innovation into the treatments currently available.

But returning to euthanasia solely for terminal patients, as this is what New Zealand voted on, being able to choose when and where you die doesn’t automatically translate to one’s dying in dignity. No, dying in dignity is about ensuring that, up to the point of death, a person can enjoy the highest possible quality of life, that they can enjoy themselves, do activities that they enjoy doing and spending time with their loved ones whilst giving them the time and comfort to say goodbye properly.  Human dignity doesn’t come from independence or having full control over what happens to your life, that would be an impossible notion. Instead, human dignity is found in the relationships we have and the love we are given by others. So to argue that dignity in death can only be found in controlling the “when” is to dismiss these key points about where our dignity and our worth truly come from.

Hence, end of life care – also known as palliative care – is a much better way of alleviating the suffering of those nearing the end of their lives. Palliative care, absent of all the dangers that can arise with euthanasia, promotes the preservation and fulfilment of life – a core belief of modern society since its foundation. Hospices and hospitals around the country do amazing work in providing care for those in huge amounts of distress. The holistic and palliative care methods that we have available to us is outstanding. They aren’t something that should be given up on, something I fear will happen should euthanasia ever be legalised here. Those with not long left to live need purpose and comfort to get the best out of the life they have left. Euthanasia, on the other hand, can steal people away too soon and can make the treatment for those suffering all the more difficult. Although its advocates are motivated by compassion, we should remember it isn’t inevitably the good death that its literal definition suggests.

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