It is the most natural impulse in the world to, when the time comes, wish for one’s own mother to have a peaceful death — but not by suicide. In that spirit, we urge the Parliament of the United Kingdom to reject the Terminally Ill Adults (End of Life) Bill when it comes to a vote, expected this Friday.
First, it is important to clarify what this bill is not. It is not a bill that allows people to discontinue extraordinary life-extending treatments or provides hospice care for those who know they are near death. This bill would allow doctors to prescribe lethal drugs to patients who meet certain criteria. It is a bill that allows doctors around the Hippocratic oath’s vow to “do no harm”; it allows them to purposely hasten death.
Even the bill’s own terms are problematic and corruptive of good medicine. As one condition to qualify for assisted suicide, the bill requires the patient to have a prognosis of six or fewer months to live. Such a prognosis is almost by definition unreliable; studies show that doctors get such predictions wrong more than half the time. By expanding the menu of treatments to include suicide under such conditions, the bill would radically incentivize medical pessimism, putting doctors and patients into a dynamic of mutually reinforcing demoralization.
But the best argument against the End of Life bill is the fearful example of other nations that have tried the same, namely Belgium and Canada.
People voting for such bills imagine that they are allowing a tiny handful of patients who are writhing and moaning in their final agony to die as they fall into a sleep, sedately and solemnly with a feeling of control and peace. Such cases are extraordinarily rare. Instead, excessive fear of such a terrible end is encouraged by the culture and eventually a corrupted medical community itself to gain the consent of people to submit to deaths long before their afflictions come, or while they’re still curable. Quickly, the nominal legal limits on suicide are tossed aside. Canada’s requirement that death be foreseeable was dropped in just five years. Belgium and the Netherlands expanded the availability of suicide to minors dealing with psychological problems. In Canada, one in every 20 deaths is now a medically assisted suicide. These have included scandals in which a patient whose condition was homelessness qualified for suicide. In other cases, patients who consented on their forms but verbally and physically resisted the death treatment at the time were restrained by nurses while doctors filled them with their lethal dose of “dignity.”
In a medical system like that of the National Health Service, the introduction of suicide as a treatment means that the queues for lifesaving surgeries or expensive treatments will no longer be a lottery for services but something more like a Hobbesian battle for survival. The zero-sum logic of expanding the availability of suicide for some, to free up resources for others, will take on a life of its own.
The legalization of suicide has become a disaster and scandal in every nation that has tried it. But worst of all, it is a societal inducement to despair among the disabled, the infirm, the mentally ill and elderly. It is an inversion of medical ethics and commits governments to the diabolical lie that only the most vigorous and successful lives are worth living, and that killing each other and ultimately ourselves is the kind thing to do.