Assisted suicide: The road to Zurich could easily become the road to hell

Once in Zurich, their daughter Boudicca and her brother Caractacus gripped their parents’ hands as each swallowed a single lethal dose.

Within minutes Sir Edward and his wife were dead. Their ashes are strewn over a Swiss park. There was no funeral.

Anyone reading the interview with Boudicca in The Observer two Sundays ago could not help but be moved. She explained why she had supported not just the last wish of her mother, who only had a few painful months to live, but also that of her father who, at 85, was increasingly frail but was not terminally ill. Indeed, as Boudicca admits, he may have lived for another decade or more.

“He was in terrible, terrible pain and had been for a long time,” she explained. Though he wore a hearing aid, it distorted the sounds around him. “For someone with my father’s ear, that was hard to bear,” she said of the man who conducted the first night at the Sydney Opera House and led the BBC Philharmonic.

“Having lived such an incredible life, he couldn’t read and he couldn’t listen. He didn’t have a terminal illness, but without my mother his life would have been unbearable – he would have been utterly miserable. Ten years of misery – was that really worth fighting for after such a full life?”

But is sorrow and indeed pain grounds for a doctor to assist in a suicide? Is despair? For some euthanasia activists, including the founder of Dignitas, Ludwig Minelli, the answer is yes. They believe in death on demand. “If you accept the idea of personal autonomy,” Minelli argues, “you can’t make conditions that only terminally ill people should have this right.”

He is now seeking legal permission to help an elderly but otherwise healthy Canadian woman, Betty Coumbias, who has indicated she wants to die alongside her husband George who suffers from severe and potentially deadly heart disease.

Others who have travelled to Switzerland had non-terminal illnesses such as Crohn’s disease, inflammatory bowel disease and rheumatoid arthritis. Last year, Daniel James, 23, went to Switzerland and didn’t come back having been left paralysed from the chest down after a rugby accident and in constant pain.

Such cases raise questions about the terminology used in this debate, where advocates far prefer the polite-sounding phrase “assisted dying” over the ugly word “suicide”.

Yet when someone with a painful but non-terminal condition, or indeed no illness at all, opts to die, is that not simply and plainly suicide? In any case, if we privilege personal autonomy and choice above all else, then we must honour all requests for suicide whether they are made by lovelorn 24-year-olds or 80-year-olds with terminal illnesses.

The alternative, surely, is patronisingly to decide which adults’ suffering is legitimate and which is not.

At the same time, who knows how any of us would react to a diagnosis of any extremely painful and incurable – if not strictly terminal – disease? As many as a third of Irish doctors say they have been asked by patients to help end their lives. For others among us, the concern would be not so much to avoid pain as not to become a burden on others. It is seemingly a reasonable and humane desire.

Except being a burden is what life is all about. As babies and children, we are burdens on our parents. As adults, we enter interdependent relationships with friends, lovers, partners, spouses. And as old people, we become burdens on our children or the state, or carers.

Bearing each other’s burdens is what socialises us, what makes us human.

The sincerity of many of those who favour “mercy killing” is obvious enough – but sincerity has never been a guarantee of right thinking. Hard cases make bad law.

Ours is an age which believes that all human suffering is avoidable, if only the right legal, economic and institutional arrangements are made.

But all courses of action are choices between evils, and the practice of euthanasia has the potential to become a very considerable evil.

For if this European trend is unchecked, doctors will not merely be permitted to kill their patients – they will be legally bound to do so.

Old people will become afraid of going to hospital – and with very good reason. How long will it be before people start to argue, in these times of fiscal restraint, that the elderly merely clutter up hospital beds that could be used to greater benefit?

If we were to contemplate the kind of reform which euthanasia proponents suggest, would we not make “he asked me to” a defence to murder, leaving judges and juries to determine case by case whether the accused really had satisfied himself that his victim was of sound mind and had formed the settled desire to have himself killed?

Can we go around killing anyone who asks us to, however emphatically? It doesn’t bear thinking about.

The horrifying story of a stroke victim from Florida should be enough to convince that legal reform in this area is not wise. She found herself disabled and had to be fed through a tube but was not terminally ill. Her brother, however, insisted that it would have been her wish for food and fluids to be withdrawn.

AS SHE was slowly being dehydrated to death, however, she began to show signs of extraordinary stress. Her distraught nurses believed she was signalling she did want food and water after all and fed her small amounts.

A court eventually decided, however, that she was not competent to rescind the instruction given to her brother and the dehydration process continued until she died.

And there is the danger. Just as someone might want to die but be unable to commit suicide, so a patient might have changed his or her mind about wanting to die but may not be able to communicate this.

We would all like to slip away peacefully during our sleep without suffering any pain but some of us will die in grave distress. Nuala O’Loan, the former police ombudsman in the North, is right: we do need a civilised debate about provision for the terminally ill.

But to those contemplating suicide, we should always provide reasons for carrying on rather than counselling despair. Many of us would consider breaking the law and killing a friend or family member if we felt we ever had to.

But the test of our good faith must be that we are also prepared to face the consequences of our actions. That includes the possibility of facing arrest. The case of Sir Edward and Lady Downes could not fail to touch even the hardest heart. The flight to Zurich is paved with good intentions. So is the road to hell.