Introduction
I will just say out front, that personally I deplore anyone’s suicide – the world needs each and all of our unique lights. However I am writing this about the subject of the private members bill which is being brought by the MP Kim Leadbeater for debate by Parliament, which is to do with ‘Assisted Suicide’ which is currently not legalised in the UK but is in various parts of the world including Switzerland, Belgium and Canada. Particularly I want to focus on the ethical situation for doctors, as this seems to get less attention, and also consider the ramifications for society at large.
I did write about this about 18 months ago, but when it failed to save (after I had mainly composed it on the keyboard) I ditched it. Before and since then the subject has come up in the news and with friends and so I wanted to put down my thoughts.
Medical Ethics
Loss of a boundary
My main concern is that with a change in the law would come the loss of an important boundary in the charge of doctors: that medical practitioners will at all times do their best to save the lives of their patients. I was surprised to learn that the Hippocratic Oath is no longer obligatory in all medical degrees, but nevertheless I think the understanding is still implicit that their role is to ‘First do no Harm’. I do not think that proponents of Assisted Suicide have thought through what it means to lose this boundary when there is no clear alternative. Should they provide a fatal dose only to those patients where the outcome of imminent death is certain? What about for those with long-term conditions for which there is no hope of improvement? Mental health conditions also involve pain, and can feel quite hopeless: should sufferers be deprived of this mercy?
Responsibility
To illustrate the position of doctors who are faced with such a request, I want to bring up the film ‘They Shoot Horses, Don’t They?’ directed by Sydney Pollack, 1969. (If you haven’t seen the film, look away for this next part.) At the end of an exhausting marathon dance, the male protagonist is with the female lead (played respectively by Michael Sarrazin and Jane Fonda) who tries to kill herself with a gun and fails to pull the trigger, so requests that he shoot her, which he does. He is acting from compassion, but still – was it right to ask him to do this, or even for that matter, to make him witness her own suicide? Even if he had not been shortly bundled into a police van, and presumably tried for her murder – he would forever afterward be wondering whether, had she lived, she might ultimately been able to lead a happy, fulfilled life/be of service to her community. He might well have experienced remorse for a decision made in a moment of intense despair.
As for her hesitation in pulling the trigger: could this have been a part of her that wanted to stay alive, despite everything? A voiceless protest from the human organism? Why does that part not matter? The fact is that a person acting in solitude might well step back from the brink of violence against themselves, in encountering their hitherto-ignored desire to live. How much less likely is this, when someone has a pact, as it were, with another person, a doctor who will provide the euthanizing drug? People also have an innate desire not to let other people down.
Societal Consequences

Do I want the UK to be a country in which the option of assisted suicide is opened out? The change this has made in Canada with MAiD leads me to a resounding ‘no!’ The initial parameters of who is able to request the service were subjected to successive challenges, although mental health issues which were due to apply have been paused this year, I believe. People who are struggling to get by due to a combination of poverty and long-term disabilities have opted for death, in despair of ever receiving any other alleviation ( https://globalnews.ca/news/9176485/poverty-canadians-disabilities-medically-assisted-death/ ) The message ‘well, you can always kill yourself’ strikes me as utterly heartless, however it is framed.
I want to be able to trust my doctors, and other workers in the health and social care field. I want us to be a society which, in the words of Arthur Hugh Clough (1819 to 1861) in his poem ‘The Latest Decalogue’, strives ‘officiously to keep alive.’
Is Change Needed?
Let us say that the decision to end my life rests on me, and me alone. But what about cases where someone is bedridden and helpless, (but still in charge of their faculties)? However, such people still have the choice whether or not to take food. No one will force them against their will if they decide not to, and palliative care can still be provided. It won’t be as swift as taking poison, but it will bring an end in a matter of days.
Where does the idea come from that the process of dying should be swift? I am not saying that anyone should be left in pain; but what is wrong with a slow death? My neighbour years ago died after spending three weeks unconscious in hospital. I never had the thought that he would have been better off dying sooner. Perhaps that is what it takes to come to terms with all that has happened in the course of one’s life.
Also I quarrel with the idea that the highest ideal is to eliminate pain, in life or in dying. Lots of things in life are painful – writing this essay for one, and the break-up of relationships. Athletes speak of ‘going through the pain-barrier’ to achieve more of their potential. Pain is a necessary component of growth. Moreover as well as conventional analgesics, there are a plethora of complementary therapies which can re-balance the system and prevent the constant recycling of pain-activation that sometimes goes on.
The Value of Human Life
Does one need religion to see human life as inherently valuable? I don’t think so and it is surely foundational in the normal processes of raising families and serving the community as carried on by those of all religions or none. However in the context of climate-change becoming an increasingly apparent threat I have been concerned by some of the comments that have come my way to the effect that: ‘there are too many people in the world for it to support.’ This enrages me. Why pile the responsibility on something which nobody can do anything about? Why not face up to the fact that we as a civilization need to make fundamental changes to stop the way we make war on each other and war on the natural world ie. deforestation, mining, ruinous agricultural practices etc.
I am saddened to think that this way of thinking that the problem is overpopulation may have seeped into the public consciousness to such an extent that an individual at a low point might consider their own life to be superfluous. No! We are the solution and we need all of us.
Conclusion
I think that the proposal to make changes to the law to allow assisted suicide has been largely driven by people who have been very used to exercising power and control in their own lives and do not take into account that many people are far less confident in themselves and place a lot of faith in the professional class. I wonder how much the issue is about sparing pain (including the mental pain of their witnessing relatives) and how much is about taking technocratic control of the process of death: the final frontier.
Let us continue to ask our doctors to exercise their professional duty in preserving the lives in their care with compassion, alleviate pain as far as is in their power, and not ask them to become our executioners. I believe that is what most doctors want.






