Dudley Clendinen, a writer and journalist, has amyotrophic lateral sclerosis, a terminal degenerative illness. In The New York Times earlier this year, he wrote of his current enjoyment of his life, and of his plan to end it when, as he put it, “the music stops — when I can’t tie my bow tie, tell a funny story, walk my dog, talk with Whitney, kiss someone special, or tap out lines like this.”
A friend told Clendinen that he needed to buy a gun. In the US, you can put a bullet through your brain without breaking any laws. But if you are a law-abiding person who is already too ill to buy or use a gun, or if shooting yourself doesn’t strike you as a dignified way to end your life, what are you to do? In most countries, if you tell your doctor that you would like his or her assistance in dying, you are asking your doctor to commit a crime.
Months ago, an expert panel of the Royal Society of Canada, chaired by Udo Schüklenk, a professor of bioethics at Queens University, released a report on decision-making at the end of life.
The report provides a strong argument for allowing doctors to help their patients to die, provided that the patients are competent and freely request such assistance. The ethical basis of the panel’s argument is not so much the avoidance of unnecessary suffering in terminally ill patients, but rather the core value of individual autonomy or self-determination. “The manner of our dying,” the panel concludes, “reflects our sense of what is important just as much as do the other central decisions in our lives.”
Several surveys suggest that ending a patient’s life without an explicit request is more common in other countries, where patients cannot lawfully ask a doctor to end their lives. In Belgium, although voluntary euthanasia rose from 1.1% of all deaths in 1998 to 1.9% in 2007, the frequency of ending a patient’s life without an explicit request fell from 3.2% to 1.8%. The panel concluded that there is strong evidence to rebut one of the greatest fears that opponents of voluntary euthanasia or physician-assisted dying often voice — that it is the first step down a slippery slope towards more widespread medical killing.
Surveys show that more than two-thirds of Canadians support legalisation of voluntary euthanasia. What is puzzling is the cool response from the country’s political parties, none of which indicated a willingness to support law reform in this area. Why, when it comes to dying, do democratic institutions so often fail to translate what people want into legislation? I suspect that, above all, politicians fear religious institutions that oppose voluntary euthanasia, even though believers often do not follow their religious leaders’ views. Polls in countries have shown that a majority of Roman Catholics, for example, support legalisation of voluntary euthanasia. Even in strongly Catholic Poland, people now support legalisation than oppose it.
In any case, the religious beliefs of a minority should not deny individuals like Clendinen the right to end their lives in the manner of their own choosing.
Copyright: Project Syndicate, 2011
The writer is a professor of bioethics at Princeton University and Laureate Professor at the University of Melbourne
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