Economist Essay Series on Assisted Dying

The Economist is publishing a series of essays by those involved in the Assisted Dying debate. We are delighted that one of the invited authors is Dr. Michael Irwin, MDMD’s founder and now a patron. Michael’s piece describes the five occasions where he has been present at an assisted suicide in Switzerland.

All the essays are well worth reading. The series keeps a balance between those in favour of a change in the law, and those opposed.

Steven Fletcher gives the perspective from someone who is severely disabled. Steven, a¬†quadriplegic since he was 21, disabled from the neck down after a motor accident, was a member of the Canadian parliament, including five years as a cabinet minister. As a backbench MP he “introduced the private members’ bills into parliament that ultimately resulted in the changes in the law that ended the prohibition on medical assistance in dying in Canada.” He ends by saying “Dying with dignity is the greatest shift in morality in Canada in this generation. As long as the shift is in the context of empathy, compassion, choice, hope and common sense other countries should learn from our example.”

Another particularly informative essay, also from Canada, is from Ellen Wiebe, a doctor who says she has “provided about 150 assisted deaths”. Talking about this role from the doctor’s perspective she says “an important part of being a good doctor is helping our patients have a good death, but the only person who can define a good death is the person dying.” (For a discussion of what is meant by a “good death” see our article here.)

This article is in stark contrast to the essay from Ilora Finlay, a crossbench peer in the House of Lords, professor of palliative care, and leading critic of attempts to legalise assisted dying in the UK. Baroness Finlay argues that a change in the law is not necessary and that we have a lot of choice already, in particular a choice to refuse life prolonging treatment, relying on doctors to provide “analgesia and other measures to relieve distress”. Unfortunately that can fall far short of a “good death”, as defined by the dying person. This is especially so when accompanied by the fear of what may happen, coupled with the inability to do anything about it. The option of a medically assisted death, as part of the palliative care process, would alleviate that fear and help prevent early suicides both in the UK and in Switzerland.

Baroness Finlay also says that, due to improved palliative care, “for most people in Britain today, dying does not mean an agonising death, but a gentle ebbing away of life.” MDMD agrees that palliative care helps ensure a good death for many, and we fully support better palliative care provision. However, our fear is for those who fall outside “most people”, and also for those whose idea of a good death is not “a gentle ebbing away of life” – especially if this is protracted, unpleasant, and undignified as can so often be the case, particularly for those facing advancing dementia and other degenerative conditions.