“Assisted Suicide: Aid or Murder?”
Anusha Islam Raha**
The paper is based particularly on the topical issues, assisted suicide and whether an individual can refuse medication that could save their lives at least, for a certain period of time.
It is vital to understand that, assisted suicide is an offence under s.2 (1) (a) of the Suicide Act 1961.[1] In England and Wales, this has been a successful law for the past fifty-five years and counting.[2] Many attempts were made and measures were undertaken to change or challenge this piece of legislation but they somewhat failed or still is a work-in-progress, and few insertions of conditions are yet remaining.[3] The discussion will chiefly put light on these issues; questioning the substance of current law and whether it should be altered.
Assisted suicide is a crime which is both unethical and heinous in nature for which there will be debates and deliberations leaning towards the illegality of assisted suicide, and hence why the legislation should remain unchanged.
As mentioned,[4] currently England and Wales is unsupportive of assisted suicide, nevertheless, present point of assisted suicide is, to some extent, indistinct. Although it is technically an offence in the Suicide Act where punishment for such assistance is up-to 14 years,[5] there have been many cases where issues were not even prosecuted, becoming a clear violation of rule of law and Parliamentary Supremacy, according to John Spencer.[6]
According to the legislation, such cases should always be tried and permission to assist suicide must not be granted.[7]If supporters of assisted suicide argue that this current law is not upholding autonomy,[8] apposite Article 2 of ECHR,[9] it should be understood that the legislation is not intervening with autonomy either.[10] Recognition of prospective autonomy by the law of England and Wales is preserved in the Mental Capacity Act 2005 with the aid of a variety of protective provisions, namely the right to refuse medical treatment given the patient has capacity to make that decision.[11]Additionally, MP Caroline Spelman [12]had stated that there are provisions already made by law that preserves benefits for terminally-ill patients.[13] Thus, creation of a new legislation is somewhat unnecessary.
Article 2 of the ECHR,[14] nevertheless provides the argument that if everyone has a right to life, why they should not have a right to die. Since, autonomy generally means self-governance,[15]with relation to ECHR,[16] preventing a terminally-ill patient from dying even with their own voluntary will,[17]will be, in a way, rejecting the law, thus arguing for a legislation that assists suicide of terminally-ill patients. Perhaps the chief executive of ‘My Death, My Decision’ has correctly pointed out that “the right to choose the manner and timing of your own death is a fundamental human right”.[18]
Nonetheless, assisted suicide itself is an immoral action since assisting one to die will not help safeguard human life; a rudimentary and essential responsibility of the society.[19]“An objective evaluation of the individual’s moral worthiness, not the individual’s decision about the value of continued life, is critical”.[20]Helping the elderly in fighting isolation and upholding their self-esteem has always been the healthier choice for a society. But when these elderly people realize that they are somewhat unwanted amongst their own people, they wish not to be a burden on them and give up life when they become terminally-ill. These external influences manipulate the patient leading them to take assisted suicide into consideration. This theory was also recognized by a populist politician, Geert Wilders.[21]Hence, changing the current law and enacting a legislation that assists suicide is erroneous since these people will be given an easy way to die;indeed a wrongful act.
Furthermore, passing a legislation which allows assisting suicide permits anyone to enthusiastically participate in assisting one to die which will impose a danger to all guiltless lives. Many, who would want to change their minds after wishing to die when they fall terminally-ill, will seldom be capable of making their wants recognized. Their lives will be worth nothing more than what we deem it to be, perhaps unwelcomed or annoying. Passing of a legislation will thus, result into disastrous consequences since people would be given implied permissions to let another die, judging by themselves, what quality of life is worth giving life to. An aftermath of such a legislation is a question that should be asked by every individual, ‘who shall be held responsible for all the deaths, Parliament, who is the supreme law-making body, or the assistant to suicide?’[22]
Certainly, the doctors and nurses (the probable assistant to suicide) cannot be impugned since they might be “pressured” into taking the life of the terminally-ill patient,[23]because the permission to assist suicide may encourage many terminally-ill patients to give up life,making them feel that they have lived their part of life i.e. “completed life” even if they stand a chance to live a little longer.[24]Therefore, the proposed legislation should not be enacted.
Moreover, terminally-ill patients who want to give up life, should not be encouraged to do so by creation of a legislation, rather should be explained in light of the sanctity of life.[25]Without a doubt, someone who is disabled and wants to end life will be more demoralized if they do not get moral support from their loved ones or the people surrounding them. For example MariekeVervoort, the 38-year-old Belgian Paralympian gold medalist had commented that her body was “exhausted” and surely, any further negative comments would not encourage her to live any longer.[26]However, her will to live stays intact since she sees life with a new perspective now. Clearly, these people are “not dead yet”, hence it is feasible if they are not made feel that way by the creation of a legislation,[27]as was proposed through the Assisted Dying Bill.[28]
Additionally, if terminally-ill patients are given assistance to suicide, patients amongst them who are afraid of high medical bills or do not have insurance coverage will wish to die.[29] This leads to too many deaths for very wrong and unreasonable causes.Thus, it is correct to state that legislation should not be created which assists suicide.
If religion is taken into consideration, believers of Christianity claimed that the wished-for legislation will boost murder which in fact will be authorized by the state.[30] The Vaticans had established in 1965 again that, killing any human “poisons the society”.[31] In Islam, human lives are considered sacred and a gift from Allah and shortening it through humanly interference is considered a major sin.[32]This has been mentioned in the Holy Quran and reiterated by Prophet Muhammad (SAW) which was later on highlighted by Dr. MuzammilSiddiqi[33]upholding the current law on assisted suicide.[34]Nevertheless, Dr. Ignacio Castuera debated that God would agree to ease HIS children’s death if there was any way to do so.[35] His statement and compassion evidently supported the making of a legislation that assists suicide to people who are terminally-ill.[36]Nevertheless, this covertly disrespects sanctity of lifeas human lives are not only precious but sacred and allowing assisted suicidewill assist clear violations of the very fabric of most religions.
Supporters of assisted suicide who promote such course of action state for compassionate reasons that it is coldhearted-ness to deny requests of people who have nothing left in life but more grief, dreadful conditions, and corrosion to bear.[37] It is argued by them that, assisted suicide shall avoid situations where the patients’ causes are unreasonable through the provisions of conditions and requirements that must be fulfilled in order to gain permission to assist their suicide. Inserting such clauses is an attempt to move away from committing a crime under s. 2 (1) of the Suicide Act 1961 i.e. intentionally encouraging or assisting suicide, and such clauses have been designed and proposed in the Assisted Dying Bill as following.
The first requirement is that the patient must be terminally-ill meaning that the doctors must certify that the illness is progressive and cannot be reversed with the help of any treatment and the patient does not have more than six months to live.[38]However, it is nearly impossible to predict, how much life is an individual left with.[39]
The judgment given in the case of Pretty by the European Court of Human Rights, however, supports this bill,[40] and stiffens that a legislation as such would have prevented the trouble Mrs. Pretty had to undergo when asking for permission from the House of Lords,[41] who had rejected her claim. The claim that was brought by Mrs. Pretty was that her rights under Article 9 was infringed. The approach taken by her was to establish the fact that she believed in assisted suicide thus, making that belief in accordance with Article 9 namely, the right to be free to show those beliefs, leading one to comprehend that new legislation should be introduced. The current law had in fact given her the right to life i.e. it is an individual’s right to choose whether or not they want to live under Article 2 of the convention, apposite to Protocol 6 Article 1 and 2.[42] By refusing her application, DPP had also rejected her claim under Article 3 of the Convention since not allowing her to die would force her to take painful medication that was not helping her live a better life either.[43]House of Lords had later admitted that Article 8 was also applicable in the case,[44] with reference toSanles.[45]
This led to the encouragement of further cases as seen in Purdy,[46]where the claimant wished that DPP creates an “offence-specific policy”[47] which classifies the particular circumstances as to what is and what is not appropriate under s. 2(1) of the 1961 Act,[48]meaning, people who will and will not be prosecuted for assisted suicide, should be specified. Nevertheless, the House of Lords had allowed her appeal unlike Pretty because here, the requirements to indicate the right to respect private life under Article 8(1) was determined by them.[49] Thus, this analysis indicates that creating a legislation may not result negatively if such specifications are added with it as terms and conditions in order to seek assisted suicide by terminally-ill patients.
Furthermore, the bill also mentions that one should be above eighteen and must be a capable citizen of England and Wales to take the decision of acquiring assistance for his/her suicide.[50]This filters out any possibility of immature and mentally unstable people from seeking permission for assisted suicide. The case of Gilderdale,[51] assists in establishing this section of the bill by indicating that even though the current Suicide Act punishes for 14 years, people who can prove that the victim had decided with a sane state of mind to die, will be able to prove their innocence.[52] The argument that patients may be encouraged to seek assisted suicide because of the fear of becoming alone or a burden on loved ones, however, remains applicable since these patients now will know an easier route to assisted suicide. Thus, creating a legislation leaves lacunas that can be abused by cruel and greedy relatives of the victim.[53]
For example in the case of Frances Inglis,[54] a mother killed her own son against his wishes.[55] If a legislation was created before the verdict for this case was given, Frances might have made her way out of murdering her disabled son without him requesting for assistance to suicide. Nevertheless, the condition given in s.1 (2) (a) of the Assisted Dying Bill would have prevented such an abuse of law.[56]
But it is imperative to understand that those who wish to die with dignity should not become victims for the absence of legislation like this for such apparent reasons. People commenting that they do not wish their children to watch them die a painful death,[57] certainly do not deserve to die a death with no dignity. Hence, creation of a legislation for them is a mandatory. Every individual has a legitimate right to end their own lives, thus, when their illness does not allow them to do it themselves, their decision must be respected and assisted.[58]Nevertheless, people refusing medication and fasting until death following “prayopavesa”, [59]like the Indian activist Vinayak Damodar Savarkar, [60]is not what this legislation should allow or assist with. Thus, there should be an insertion of a condition where such activities i.e. euthanasia is discouraged in that legislation, if ever created in the future, through imposition of fines on the people who assists the victim and accepts their rejection to medication, leading to passive euthanasia.[61] In some cases, imprisonment should also be valid because rejecting medication or fasting until death would essentially mean allowing ‘suicide’ (which is still a crime)as the patient is taking matters into his own hands.
In accordance to the rule of law, the “liberty” given by the United States Constitution through the Due Process Clause does not give any individual the right to assist suicide.[62]But seven states of the US including Colorado and California have now announced assisted suicide to be legal given the conditions are fulfilled.[63] Countries outside the boundaries of The United States such as Belgium, Canada, Colombia, Holland, Luxembourg and Switzerland have also recognized assisted suicide as legal.[64]Hence, following the modern trend, England and Wales can be recommended to pass the Assisted Dying Bill as well. Lord Carey (retired Archbishop of Canterbury)[65] has also corroborated clear reasons as to why this bill should be passed. From his statements, it is clear that compassion and dignity are not the only reasons but also refers to the suffering of excruciating pain, which is more serious, in support of the creation of a legislation.[66] His approval was essentially influenced by his experience witnessing Tony Nicklinson’s ‘needless suffering’[67]that only escalated after his appeal for his right to die was refused by the high court leaving him devastated and with no choice but to fast till death.[68]
However, MP Fiona Bruce,[69] had commented that it was the Parliament’s duty to protect the susceptible and not to allow those patients to kill themselves. “This bill is not merely flawed, it is legally and ethically totally unacceptable.”[70]
Additionally, it can be stated that allowing assisted suicide in fact saves many lives. This is because patients who fail to receive sufficient time and attention may now enjoy treatment, provided they get the proper treatment within due time.
Moreover, numerous government funds i.e. tax-payers money are being utilized in order to finance the treatment of people who do not have more than six months to live. But it is imperative to note that “life” does not boil down to a monetary value and no life can be weighed financially. Everyone should be given the opportunity to live even to the last day of his/her life.
Moreover, if assisted suicide is made legal, scientists and other researcher example in NHS,[71]will lose their motivation to work and find out antidotes for new and incurable diseases such as cancer, schizophrenia and Creutzfeldt-Jakob disease.[72] It is important that they continue their research since many people who do not prefer assisted suicide, even when they are terminally-ill, will suffer from the absence of proper medication.
Hence, taking all the arguments into consideration, it is feasible to mention that assisted suicide should not be made legal. It should remain an offence under the Suicide Act, [73]and terminally-ill patients should not be given such an open door to kill themselves. This shall remain as an offence also because creation of a legislation that allows assisted suicide will open a floodgate for many abusers of law. With references provided, it can be stated that the current law already provides the necessary assistance for elderly and disabled people and there is no need for the creation of a new legislation. Apposite to NHS as well, it can be stated that, corroboration of such an act will pose a great threat to the making of life-extending drugs as many people may find it difficult to afford such expensive drugs.[74] Furthermore, NHS might lose inspiration seeing the increasing number of assisted suicide, given that it is legalized. Thus, it is better to keep the current law that “carefully balances an individual’s rights with the need to protect vulnerable people”[75]and not create a new legislation.
****Anusha Islam Raha is a Masters Student currently studying her second
semester in Eastern University, Dhaka. Prior to this, she has successfully
completed her LLB (Hons.) in the 2018-2019 sessions from BPP University
[1] Suicide Act 1961 s.2(1)(a)
[2]Gerry Holt, ‘When suicide was illegal’ (BBC News, 3 August 2011) <http://www.bbc.com/news/magazine-14374296> accessed 9 December 2016
[3] Assisted Dying (No.2) Bill 2015-2016
[4] Footnote 1 & 2
[5] Suicide Act 1961 s.2(1)(a)
[6] Jonathan Herring, Criminal Law: Texts, Cases and Materials (6th edition, Oxford University Press 2014) 37
[7] Suicide Act 1961
[8] Jo Samanta and Ash Samanta, “Holistic determination for oneself: a new paradigm for self-determination at end of life” [2013] C.L.J.72(3)
[9]European Convention on Human Rights 1950, article 2
[10]R v DPP ex p Purdy [2009] EWCA Civ 92
[11] Mental Capacity Act 2005 s.1-4
[12] Conservative MP Caroline Spelman
[13] James Gallagher and Philippa Roxby, ‘Assisted Dying Bill: MPs reject ‘right to die’ law’ (BBC News, 11 September 2015) <http://www.bbc.com/news/health-34208624>accessed 13 December 2016
[14] European Convention on Human Rights 1950, article 2
[15] Jo Samanta and Ash Samanta, “Holistic determination for oneself: a new paradigm for self-determination at end of life” [2013] C.L.J.72(3)
[16] European Convention on Human Rights 1950, article 2
[17]Assisted Dying (No.2) Bill 2015-2016
[18]Owen Bowcott, ‘Legalise assisted dying for terminally ill, say 90% of people in UK’ The Guardian(London, 3 March 2019)
[19]Claire Andre and Manuel Velasquez, ‘A Right or a Wrong?’ (SCU 16 November 2015) <<https://www.scu.edu/ethics/focus-areas/bioethics/resources/assisted-suicide-a-right-or-a-wrong/> accessed 27 November 2016; Issues in Ethics – V. 1, N.1 Fall 1987
[20] New York State Task Force on Life and the Law, When Death is sought : assisted suicide and euthanasia in the medical context(first published in 1994, New York State Task Force on Life and the Law 1994)
[21]Dan Bilefsky and Christopher F. Schuetze, ‘Dutch Law Would Allow Assisted Suicide for Healthy Older People’ The New York Times (13 October 2016)
[22]Claire Andre and Manuel Velasquez, ‘A Right or a Wrong?’ (SCU 16 November 2015) <https://www.scu.edu/ethics/focus-areas/bioethics/resources/assisted-suicide-a-right-or-a-wrong/> accessed 27 November 2016; Issues in Ethics – V. 1, N.1 Fall 1987
[23]Claire Andre and Manuel Velasquez, ‘A Right or a Wrong?’ (SCU 16 November 2015) <https://www.scu.edu/ethics/focus-areas/bioethics/resources/assisted-suicide-a-right-or-a-wrong/> accessed 27 November 2016; Issues in Ethics – V. 1, N.1 Fall 1987
[24]Dan Bilefsky and Christopher F. Schuetze, ‘Dutch Law Would Allow Assisted Suicide for Healthy Older People’ The New York Times (13 October 2016)
[25] Jo Samanta and Ash Samanta, “Holistic determination for oneself: a new paradigm for self-determination at end of life” [2013] C.L.J.72(3)
[26] Liz Carr, ‘Legalising assisted dying is dangerous for disabled people. Not compassionate’ The Guardian (London, 9 September 2016)
[27] Liz Carr, ‘Legalising assisted dying is dangerous for disabled people. Not compassionate’ The Guardian (London, 9 September 2016)
[28] Assisted Dying (No.2) Bill 2015-2016
[29]The Associated Press, ‘California Judge Rejects Request to Suspend Assisted Suicide Law’ The New York Times (27 August 2016)
[30]Dan Bilefsky and Christopher F. Schuetze, ‘Dutch Law Would Allow Assisted Suicide for Healthy Older People’ The New York Times (13 October 2016)
[31] Kevin Drum, ‘My Right to Die’ Mother Jones (San Francisco, bureaus in Washington DC and New York City, 11 January 2016)
[32]Elizabeth Aguilera, ‘Major Religions oppose assisted suicide’(89.3 KPCC 14 May 2015) <http://www.scpr.org/news/2015/05/14/51609/major-religions-oppose-assisted-suicide/> accessed 27 November 2016
[33] Chairman of the Islamic Law Council of North America
[34] Suicide Act 1961 s.2(1)(a)
[35]Elizabeth Aguilera, ‘Major Religions oppose assisted suicide’
[36] Jo Samanta and Ash Samanta, “Holistic determination for oneself: a new paradigm for self-determination at end of life” [2013] C.L.J.72(3); Steve Field, ‘Why assisted suicide has no place in the UK’ The Guardian (London, 22 June 2009)
[37]Claire Andre and Manuel Velasquez, ‘A Right or a Wrong?’ (SCU 16 November 2015) <https://www.scu.edu/ethics/focus-areas/bioethics/resources/assisted-suicide-a-right-or-a-wrong/> accessed 27 November 2016; Issues in Ethics – V. 1, N.1 Fall 1987
[38] Assisted Dying (No.2) Bill 2015-2016
[39] James Gallagher and Philippa Roxby, ‘Assisted Dying Bill: MPs reject ‘right to die’ law’ (BBC News, 11 September 2015) <http://www.bbc.com/news/health-34208624> accessed 13 December 2016; Conservative MP Caroline Spelman’s argument against the Assisted Dying Bill
[40]Pretty v United Kingdom 2346/02 [2002] ECHR 427
[41]Pretty v DPP and Secretary of State for the Home Department [2001] UKHL 61
[42]Rosalind English “Pretty” 1COR Resources-Human Rights and Public Law update, 2009)<http://www.1cor.com/1315/?form_1155.replyids=299> accessed 19 November 2009; European Convention on Human Rights 1950, article 2
[43] European Convention on Human Rights 1950, article 3
[44] European Convention on Human Rights 1950, article 8
[45]Sanles v Spain Application no : 48335/99
[46]R v DPP ex p Purdy [2009] EWCA Civ 92
[47]R v DPP ex p Purdy [2009] EWCA Civ 92
[48] Suicide Act 1961 s.2(1)(a)
[49]European Convention on Human Rights 1950, article 8 (1)
[50] Assisted Dying (No.2) Bill 2015-2016 s.1 (2)(c)(i)(ii)(iii)
[51]R v Gilderdale [2010] Unreported Central Criminal Court
[52]Afua Hirsch, ‘Kay Gilderdale case : a clear verdict on the law’s confusion on assisted suicide’ The Guardian (London, 25 January 2010)
[53] Editorial by Ruth Gledhill by Christian Today, Statement made by Lord Carey in the debate held regarding whether or not assisted dying bill should be passed
[54]R v Inglis [2010] Crown Court (Lewes)
[55] Helen Pidd, ‘Mother guilty of murdering disabled son’ The Guardian (London, 20 January 2010)
[56] Assisted Dying (No.2) Bill 2015-2016 s.1 (2)(a)
[57]The Associated Press, ‘California Judge Rejects Request to Suspend Assisted Suicide Law’ (The New York Times, 27 August 2016) <http://www.nytimes.com/2016/08/28/us/california-judge-rejects-request-to-suspend-assisted-suicide-law.html?rref=collection%2Ftimestopic%2FAssisted%20Suicide> accessed 27 November 2016
Dan Bilefsky and Christopher F. Schuetze, ‘Dutch Law Would Allow Assisted Suicide for Healthy Older People’ The New York Times (13 October 2016)
[58]Claire Andre and Manuel Velasquez, ‘A Right or a Wrong?’ (SCU 16 November 2015) <https://www.scu.edu/ethics/focus-areas/bioethics/resources/assisted-suicide-a-right-or-a-wrong/> accessed 27 November 2016; Issues in Ethics – V. 1, N.1 Fall 1987
[59] S.K. Verma and R.N. Sahai, Oxford English-Hindi Dictionary (first published on February 2003, Oxford University Press)
[60]ChittaranjanTembhekar, ‘Savarkar’s death was out of devotion to life : Nephew’ Times of India (8 March 2011)
[61]Ethics Guide, ‘Forms of Euthanasia’ (BBC News) <bbc.co.uk> accessed 13 December 2016
[62]Washington v Glucksberg [1997] 117 S. Ct. 2258
[63]Lauren Gambino, ‘Euthanasia and assisted suicide laws around the world’ The Guardian (London, 17 July 2014)
[64]Lauren Gambino, ‘Euthanasia and assisted suicide laws around the world’ The Guardian (London, 17 July 2014)
[65] Lewis M. Cohen, ‘Dignified Debate’ Slate (United States, 11 August 2014)
[66] Nicholas Watt, ‘Former archbishop lends his support to campaign to legalise right to die’ The Guardian (London, 11 July 2014)
[67] Nicholas Watt, ‘Former archbishop lends his support to campaign to legalise right to die’ The Guardian (London, 11 July 2014)
[68]Sarah Boseley, ‘Tony Nicklinson dies six days after losing ‘right to die’ case’ The Guardian (London, 22 August 2012)
[69] The MP for Congleton
[70] James Gallagher and Philippa Roxby, ‘Assisted Dying Bill: MPs reject ‘right to die’ law’ (BBC News, 11 September 2015) <http://www.bbc.com/news/health-34208624> accessed 13 December 2016
[71]National Health Service launched in 1948 in England
[72]Alicia, ‘Top 12 Incurable Diseases You Should Know’ <http://www.enkivillage.com/incurable-diseases.html> accessed 27 December 2016
[73]Suicide Act 1961 s.2(1)(a)
[74]Sarah Boseley, ‘Life-extending cancer drugs to be axed by NHS’ The Guardian (London, 3 September 2015)
[75] Owen Bowcott, ‘Legalise assisted dying for terminally ill, say 90% of people in UK’ The Guardian(London, 3 March 2019)