Helen Griffiths
22/01/2015
“Making someone die in a way that others approve, but he believes a horrifying contradiction of his life,
is a devastating, odious form of tyranny.”
Dworkin, Life’s Dominion (1993)
Should the law recognise a right to die?
The right to die is defined as “the right to refuse extraordinary medical measures to prolong one’s life” 1.
This right is already recognised by the law to a limited extent, with S1 of the Suicide Act 1961 removing
suicide from the bounds of criminal law: “The rule of law whereby it is a crime for a person to commit
suicide is hereby abrogated.” 2 However, the current law states that it is still a criminal offence to assist
another in ending his or her life; therefore a “right to die” is not fully acknowledged in the UK. The law
should recognise a right to die in all respects, including the right for others to assist the disabled and
terminally ill if they cannot physically take their own lives, thus allowing all individuals equal rights to selfdetermination and reflecting human rights. In exploring both sides of the case, opposition to legalising
assisted suicide must be discussed, including spiritual objections, problematic regulation, and difficulties in
determining the sufferer’s state of mind during the decision-making process. Whilst appreciating that
arguments against euthanasia are altogether reasonable, I contend that the rational case in favour of
allowing the terminally ill and relevant others assistance in ending their lives is stronger, as it is inhumane,
discriminatory and against fundamental rights of autonomy to prohibit this right.
The right to die should be fully granted in legislation, as those who request euthanasia are likely to be
enduring a poor quality of life; therefore disallowing death at their request can be considered inhumane,
causing the prolonging of their hardship. Denying somebody who is physically incapable of taking their own
life the right to be assisted (yet lawfully allowing self-inflicted suicide) can be interpreted as a form of
discrimination against those with disabilities, thus negating the Human Rights Act of 1998 that bestowed
everyone with “freedom from torture and inhuman or degrading treatment.” 3 The necessity for the law to
recognise this right is accentuated in the case of Tony Nicklinson who suffered from locked in syndrome
following a stroke in 2005, causing him to wish to end his life whilst being unfit to commit suicide
independently. Mr Nicklinson was unable to turn to family or doctors as assisting suicide remained an
offence under s. 2(1) of the Suicide Act 1961, and any assistance would have resulted in conviction of
murder or manslaughter for participants: a positively unjust punishment. Mr Nicklinson’s case, among
others, highlights a flaw in British legislation, as under the current system, somebody in Nicklinson’s
position would have to “resort to refusing food, water and life-preserving equipment” 4 in order to shorten
their life. This is an undignified and painful way to die, therefore it can be determined that the current law
regarding assisted suicide and euthanasia is unjustified and requires reform in order to acknowledge a
universal right to die.
British law should recognise the right to die by means of euthanasia to allow patient autonomy. It is widely
believed that an individual should have the right to control his life and body, and so should determine at
what time, in what way and by whose hand he or she will die: extending to the right of ownership, a
1
Dictionary.com. (2008). right-to-die. Available: http://dictionary.reference.com/browse/right-to-die. Last accessed 08/01/2015.
Cranmer, F. (2013). Is there a "right to die" in English law?. Available: http://www.lawandreligionuk.com/2013/08/02/is-therea-right-to-die-in-english-law-r-nicklinson-v-a-primary-care-trust/. Last accessed 17/12/2014.
3
Equality and Human Rights Commission. (2014). The Human Rights Act. Available: http://www.equalityhumanrights.com/yourrights/human-rights/what-are-human-rights/human-rights-act. Last accessed 18/12/2014.
4
Beel, V and Scorer, R. (2012). Who should have the right to a medically assisted death?. New Law Journal. 162 (1167).
2
Helen Griffiths
22/01/2015
concept that justifies freedom of individuals from the dominion of others. In the words of Paterson: “In
order to genuinely respect persons as autonomous persons, we must recognise that they are able to direct
their own lives and actions in accordance with their own plans.”5 The law as it presently stands forbids
those who request assisted suicide from attaining the right to determine their own life. Furthermore,
medical professionals have an ethical duty to do everything to help their patients; and hence doctors
should be able to carry out life-ending, as well as life-saving procedures to forestall suffering. In Paterson’s
Assisted Suicide and Euthanasia, David A.J. Richards challenges that: “By appealing to an extensive right of
non-interference… suicide and voluntary euthanasia should have immunity from state censure.”6 This
supports the contention that the law should recognise a right to die in order to comply with the right to
personal autonomy.
Other human rights imply that assisted dying should be made lawful, as it is declared in Article 5 of the
Universal Declaration of Human Rights that “everyone has the right to life”7. This includes a right to die, as
an individual’s dying moments are a crucial part of their life. The right to life comprises living with a sense
of quality and value, and if the process of dying is distressing for an individual, then he should be entitled
to shorten such affliction. Moreover, Article 8 of the Human Rights Act states that: “everyone has the right
to respect for his or her private and family life”8; as a result, those who request assisted suicide or
euthanasia should be entitled to spend the closing moments of their life however they choose. Assisted
suicide and euthanasia should be legalised since discriminating against those with disabilities is
unequitable, and their human rights are contradicted by current law; therefore legislation should be
adapted to advocate these rights.
Lastly, the pragmatic argument stands that euthanasia is already a widespread practice, thus legalisation
would merely allow for more efficient regulation. DNACPR orders (by which an individual requests not to
receive lifesaving medical treatment if their breathing or heart stops) can be interpreted as a form of
passive euthanasia, as patients are denied treatment that would otherwise perpetuate their life. A second
example of indirect euthanasia is palliative sedation, whereby a patient is put to sleep using sedative
medication in order to end extreme discomfort for which there is no effective treatment; subsequently
carrying the risk of hastening death. NHS Choices states that: “many of the practices used in end of life care
are a type of euthanasia in all but name”9, clarifying the interpretation that euthanasia is already in
occurrence; therefore it should be fully legalised in all its forms in order to ensure fuller control over the
process. The law should recognise a right to die, as those who cannot commit suicide themselves should be
granted equal opportunity to eradicate their suffering, in consideration of the right to self-determination
and in pursuance of true equality for all.
However, it can be debated that the sanctity of life makes one’s existence too valuable to deliberately
terminate, and as such, spiritual objections must be taken into account: from a religious perspective life
5
Paterson, C. (2008). Justifications for Suicide, Assisted Suicide and Euthanasia. In: Assisted Suicide and Euthanasia. Hampshire:
Ashgate. 24.
6
Paterson, C. (2008). Justifications for Suicide, Assisted Suicide and Euthanasia. In: Assisted Suicide and Euthanasia. Hampshire:
Ashgate. 26.
7
United Nations. (2014). The Universal Declaration of Human Rights. Available: http://www.un.org/en/documents/udhr/. Last
accessed 18/12/2014.
8
Liberty 80. (2014). Article 8 Right to a Private and Family Life. Available: https://www.liberty-human-rights.org.uk/humanrights/what-are-human-rights/human-rights-act/article-8-right-private-and-family-life. Last accessed 18/12/2014.
9
NHS Choices. (2014). Euthanasia and Assisted Suicide- Arguments. Available:
http://www.nhs.uk/Conditions/Euthanasiaandassistedsuicide/Pages/Arguments.aspx. Last accessed 15/12/2014.
Helen Griffiths
22/01/2015
and death should be determined by God, as he alone is said to have dominion over our lives. Christians, for
instance, believe that “God gives and God takes away”10 (The Bible, Job, 1:21), implying that the deliberate
cessation of life, by means of suicide or euthanasia, could be seen as going against God’s will. Yet the
position of religion in society has declined notably in recent years, with the proportion of the British
population describing themselves as having “no religion” in the national census rising from 15% in 2001 to
25% in 201111; thus the significance of religious principles is becoming less valid and should not dictate
national law. According to Paterson, the judgement of whether a life of pain and suffering is worth living
“should be determined by the conscience of the individual patient and not of blanket prohibitions inspired
by religion”12. In keeping with the concept of a multicultural British society, the right to freedom of belief
should allow citizens to determine their own position on the issue. The law should therefore recognise a
right to die in order to permit those without religious inclinations to terminate their life if they require
assistance; those holding unyielding spiritual views are still able to live out a natural death.
Regulating assisted suicide could prove problematic if it were legalised, potentially leading to involuntary
euthanasia. This may occur as impatient relatives may no longer wish to tend to a dying family member, or
perhaps arise from the pressure that the beleaguered elderly might feel to consent to doing away with
themselves as the practice becomes normalised. In the Netherlands in 1990, 1,040 patients were killed
without request due to the legalisation of euthanasia13, thus demonstrating the associated risks. It could
also be debated that by legalising euthanasia, life may become seemingly disposable as it is difficult for
procedures not to become established in ethical and administrative habit; hence it must be considered
that legalising euthanasia may result in callousness within the medical profession. However, the
implementation of laws to protect the vulnerable from being wrongfully killed would suppress exploitation
within the system: the Assisted Dying Bill debated in parliament in 2014 created 3 offences, including
“knowingly or recklessly providing a medical or other professional opinion which is false or misleading in a
material particular.”14 Providing that firm measures protecting the vulnerable from involuntary euthanasia
were formulated, the law should recognise a right to die, as the difficulties of drafting exact legislative
provisions should not be allowed to block the attempt to alleviate suffering.
It could also be questioned whether the terminally ill, or others enduring extreme pain, are in a position to
be considered “rational choosers” of the future direction of their lives, due to the severe psychological
distress that their condition may impose; therefore legislation freely granting the right to be assisted in
dying must be approached with caution. In regards to euthanasia, Fieser asserts that: “Often people do not
have the mental competence to make these decisions, such as when they are unconscious, delirious, or
demented.”15 Yet, trusting that there are well-established medical criteria to determine patient state of
mind, it is feasible to conclude that the authorization of euthanasia would only occur if it were undoubted
that the sufferer was in his rational state of mind, so as not to result in involuntary death. Equally worthy
10
Job (2000). The Bible: Contemporary English Version. London: Harper Collins. 1:21.
BBC News. (2012). Census Shows Rise In Foreign Born. Available: http://www.bbc.co.uk/news/uk-20675307. Last accessed
18/12/2014.
12
Paterson, C. (2008). Justifications for Suicide, Assisted Suicide and Euthanasia. In: Assisted Suicide and Euthanasia. Hampshire:
Ashgate. 16.
13
Patients' Rights Council. (2014). Background About Euthanasia in the Netherlands. Available:
http://www.patientsrightscouncil.org/site/holland-background/. Last accessed 18/12/2014.
14
Qureshi, K. (2014). Assisted Dying Bill: Time to Reflect?. The New Law Journal. 164 (11).
15
Fieser, J . (2008). Euthanasia. Available: http://www.utm.edu/staff/jfieser/class/160/6-euthanasia.htm. Last accessed
15/01/2015.
11
Helen Griffiths
22/01/2015
of consideration is the idea that individual response to circumstance may be widely divergent; for example,
a stoical personality may tolerate the same high level of physical pain that renders life futile for another,
and so he may not wish to end his life, but his wishes near life’s end may be difficult to determine;
therefore effective safeguarding protecting vulnerable individuals must be imposed. A State determined
fitness-to-decide must be met with forethought, and strict regulatory laws should be regarded as essential;
yet ultimately, the freedom to determine one’s own life and death should not be refused.
A further secular objection to legalising euthanasia is the consideration of emotional impacts on
participants that result from assisting in another’s death. The decision to die by euthanasia may impact the
wellbeing of others, causing family, friends and healthcare professionals varying psychological grievances.
The General Medical Council stated its position on the Assisted Suicide Bill in 2005: “A change in the law to
allow physician-assisted suicide would have profound implications for the role and responsibilities of
doctors and their relationships with patients.”16 This demonstrates the view that the role of medical
professionals would be heavily impacted, many of whom may feel uncomfortable with deliberately
terminating somebody’s life. However, it is paramount to emphasise that no duty would be enforced on
medical professionals to participate in anything to which they have a conscientious objection.
Furthermore, while it may be upsetting to oversee a voluntary death, this is clearly outweighed by the
forceful argument of the right to self-determination; therefore conclusively undermining the case against
legalising euthanasia.
The right to die should be recognised to a fuller extent than is already lawful, as it is discriminatory to
prevent those who are physically incapable of taking their own life from dying if they desire to curtail their
suffering in this way. The Assisted Dying Bill proposed in 2014 is, in many respects, “as currently drafted…
highly unsatisfactory”17; therefore several imperative amendments are required to alleviate any technical
objections to the Bill. In order to protect the vulnerable from violation of the law, the eligibility criteria
need to be strengthened and appropriate monitoring systems must be in place before a further Assisted
Dying Bill can be accepted in parliament. Furthermore, while the proposed legislation would only allow
doctors to assist those with less than 6 months to live, those living with a disability over a longer period of
time may in fact find their condition progressively more intolerable, and they too should be granted the
right to die. Purdy, who lived with MS for 19 years, stated: “I think Lord Falconer, in saying that if you’re in
the last six months of your life, misses the point that Tony Nicklinson, myself, Paul Lamb – the people
whose cases have all been public- all have to face decades of a life that we don’t consider acceptable… that
is the thing I find hardest”18, thus demonstrating the need for the law to be universally inclusive. The
present restriction in current legislation is considered to be “a devastating, odious form of tyranny” 19 in the
words of Dworkin, as everyone should be awarded equal rights to self-determination: therefore it can be
concluded that, once amendments are made, an Act should be passed legalising the right to die by means
of assisted suicide.
Word Count: 2,491
16
Pitcher, G. (2010). A Time to Live. Oxford: Monarch Books. 106.
Qureshi, K. (2014). Assisted Dying Bill: Time to Reflect? The New Law Journal. 164 (11).
18
Moss, A. (2014). Debbie Purdy: Pain "too much" for right-to-die campaigner. Available: http://www.bbc.co.uk/news/ukengland-leeds-25724608. Last accessed 03/01/2015.
19
Dworkin. (1993). Life’s Dominion.
17
Helen Griffiths
22/01/2015
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