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Angela Tilby: Dying, and potentially harassed

23 October 2020

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I COULD not help but feel sickened by the news last week that the Dutch government has approved plans to extend euthanasia, which is legal in the Netherlands, to terminally ill children below the age of 12.

Already, parents may choose euthanasia for desperately sick babies. Children over 12, with their parents’ consent, may also choose a medically administered death. So, in a sense, this is only tidying up provision that is already in place for those suffering “hopelessly and unbearably” to have their lives ended.

To be clear, this is euthanasia: death by doctor, not assisted suicide. Although the new provision for children makes me deeply sad, my moral queasiness extends to all forms of legally sanctioned euthanasia.

I do not doubt that there are some terminal illnesses that are extremely difficult to manage well. The reassurance that we often receive from those opposed to euthanasia that a “good death” can be achieved without recourse to mercy killing does not always ring true.

I am comfortable with the rule of “double effect” — that it is morally legitimate to increase pain relief even when it hastens death. I would hope, were I terminally ill, to be kept as comfortable as possible, and if that meant upping the dose to the point of advancing my death by hours or days, I would accept that.

But true euthanasia is different. Legalising it for any age group worries me. First, because it could encourage people to decide too early, or out of understandable and relievable anxiety or depression, that their state is hopeless and unbearable. I wonder whether dying seven-year-olds would be told to say these words, or whether others would decide it for them.

Many who work in palliative care testify to the importance of allowing the process of dying to unfold as naturally as possible. Those last weeks and days are often really important for those whose lives are ending as well as those left behind.

Second, I simply cannot see how a euthanasia law can operate without implying to terminally ill patients that staying alive is simply selfish. No one can deny that cutting short a life frees up a bed and saves medication and care.

If there were any doubt about this, it is worth reading the chapter in Kathryn Mannix’s With the End in Mind about a cancer patient in Holland who was — the only word for it — harassed by well-meaning medical staff to agree to being euthanised.

Again and again, they told him how much worse his condition would become and how undignified its consequences, and how mess and pain would be avoided if only . . . The patient fled to England, where he died peacefully in a hospice.

A good death is a good death. Euthanasia is, I fear, a misuse of language.

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