This issue is a sensitive, deeply personal matter. Both sides are right. Individuals should have the freedom to end their own suffering, and each person should be able to choose when to fight for life, and when to go peacefully into the night.
There are, however, two main difficulties with enshrining the ‘right to die’ into legislation. Both center on unintended consequence, one more obvious and with good prior evidence, and the other more insidious, but real nonetheless.
First the case of the normative effects of codifying the right to die into law. Many years on, long after the debates are over and when the techniques and technologies have become accepted, will an individual right become a social expectation? We see the power of normalizing certain behaviours – witness the prescriptive success of drinking driving admonishments – in shaping personal behaviour. We are now shamed and shunned should we even contemplate driving in any state of inebriation. Will the 72 year old patient of ten years hence feel some shame at burdening her loved ones, and society with her increasingly complicated medical treatment? Not all will, but I suspect an increasing number will come to feel that way as time passes, and as the forms and permissions are ever more present and as ever more of one’s contemporaries have chosen that path.
And that brings us to the second issue: when does right to die become the right to be euthanized? This issue is real, as countries that have adopted such measure have found. Studies abound about the experience in the Netherlands where euthanasia is both legal and common and distressingly often applied by the medical teams and doctors based on their collective agreement. In a system that requires two doctors to agree a procedure is necessary, how often to doctors disagree?
I’ll add two personal anecdotes. My mother passed away in hospital many years ago. She received excellent and compassionate care from the doctors and nurses. There was, however, an underlying current of discussion from the staff of “it’s her time to go” and so on, culminating in a discussion with a member of the staff that left no doubt that the dosages of pain medications could easily be adjusted to achieve the “end” sooner rather than later. She died the next day, while I was away.
My aunt in Holland, sound of most of her mind, but institutionalized due to a broken hip, was not happy. She wanted to be home. She grew quickly depressed, and her health faltered. Discussion with family determined that she would likely face a deteriorating quality of life over the next year or so and there were options. Two weeks later she had passed away, while her only son was on a family holiday. I wasn’t there and I don’t know the exact details, but the event has left me uneasy ever since.
We should not euthanize people because they are no longer useful or are a burden, that’s an obvious statement. At least I hope so. Neither though, should we create an environment where patients make that choice out of guilt or obligation. Everyone deserves, in our wealthy and accomplished society, to die at a time and manner as much of their choosing as possible. And that choice should not be coerced.