A report on assisted suicide in Oregon showed that over 53% of people whose lives were ended by the procedure in 2020 reported the fear of being a burden on family, friends or other caregivers as a reason.
There is something desperately sad in that statistic - one that was consistent with findings in previous years in Oregon and with reports from other states such as Washington. It speaks to a fear that is not connected to physical pain or suffering but to the terrible realisation that there may be a deficit of love in the world. An elderly person, no more than a child, should never be made to feel unwanted nor be made to feel a burden. That would be a measure of a fundamental failure of society, and of the social contract that is supposed to keep us all safe from cradle to grave.
In an increasingly utilitarian world, however, ideals around duty and sacrifice are held to be old-fashioned at best, and are often seen as an intrusion on autonomy. As with many other life-ending proposals, while assisted suicide is heralded as being about choice, in reality it can often feel more like an obligation.
The very valid concerns around the state playing a role in facilitating a person to end another person's life - even with the latter's consent - are often dismissed as being based on religious grounds. Last week, however, the Oireachtas Committee looking at assisted suicide heard from Dr. Kevin Yuill, CEO of Humanists Against Assisted Suicide and Euthanasia, who gave a clear and compelling case against moves to change the law and permit the life-ending procedure.
Dr Yulli sais that in every country where the procedure has been legalised for a reasonable length of time, cases have increased rapidly and the criteria for eligibility have expanded - and that a "number of grotesque examples of unnecessary deaths" have been observed.
"The case for assisted dying is based on fear. The answer to fears about death, however, is better palliative care," he said.
Speaking of Canada, he said that assisted suicide was legalised in 2016 and that "many seek it for problems of homelessness, poverty and inadequate medical resources", whilst "some 17.3% of those who opted for it in 2021 cited loneliness and-or social isolation as a reason."
"This is before mental illness becomes an eligibility criterion in March 2024," he told the Oireachtas Committee, adding that "there have been at least eight cases in the Netherlands where the only illness was autism and the reason cited was intolerable disruptions to daily routines."
"There have been many more for mental illness. In Belgium, euthanasia for those suffering from dementia is increasingly routine. Dr Yuill, who is associate professor of American history at the University of Sunderland, said.
He also argued that "the case for legalised assisted dying is flawed", saying that "true autonomy" would actually mean anyone who wanted to die by suicide should have the right to assisted dying, while using compassion as a premise involved judgment in regard to another person's life.
"The case rests on two basic premises, and has done since it was first brought into being or proposed seriously in the modern form in 1870. Those premises are autonomy and compassion. True autonomy would mean that anyone with suicidal impulses should be allowed to have an assisted death. Compassion implies euthanasia and a judgment that death is in another individual’s best interests. As a historian, I can provide many examples of how that has become problematic and of how acting on compassion is not always a good thing," he said.
We believe that it is wrong for the state to kill citizens, whether as punishment for a crime, as in capital punishment, or simply because peoples’ lives are wretched, either in their judgment or somebody else's. The problem is not the fate of the individual concerned but the fate of a society that agrees to kill them. Even when it involves best possible motives, institutional killing by the state is problematic," Dr Yuill said.
He introduced a welcome element of realism into the debate, if you can call the media's mostly one-sided coverage of the issue a debate. Assisted suicide - coyly described by its proponents as assisted death - demolishes the idea that the state should have no part in killing a human being.
And, his observation is entirely correct: what does it say about a society when it agrees that people who are sick, or lonely, or depressed or fearful can be killed? We can dress our motivations up as compassion all we alike, we can argue for autonomy and better decision-making and choice, but we know in our hearts that assisted suicide is often quietly seen as ridding society of the burden of caring.
"Opposition to assisted dying is usually derided as being religious in nature, which is easier than confronting hard questions or inconvenient truths. It is easier to shut down “religious bigots” than to consider what they say, just as it is easier to use the term “assisted dying” instead of the more accurate but controversial “assisted suicide," Dr Yuill wrote in the Economist recently.
But he warned, as an atheist and a liberal, he could see that "anyone who looks closely and critically at the issue will see past the emotive stories and simplistic assumptions used to justify the push for legalisation."
He also made the point that the argument for autonomy was undermined by the involvement of medical professionals and that "assisted-suicide regimes use physical criteria to divide a population between those whose suicides are regarded as terrible and those whose suicides are regarded as desirable".
"Some lives are worth more than others. No wonder so many disabled people agree with their religious compatriots in resisting the headlong rush to assisted death," he said.
Dr Yulli was joined by Irish expert, Dr Thomas Finegan, at the Oireachtas Committe, and he too referred to the enormity of the change that would be accepted by society is assisted suicide was legalised. It is not simply a matter of changing the law: it is an upending of norms that have long protected us when we are vulnerable.
"The unique, distinguishing feature of euthanasia is the consensual, intentional killing of the patient. Introducing death as a legitimate healthcare intention would not be a mere expansion of healthcare. Rather, it could only be introduced by disavowing a primary healthcare norm, that of no intentional killing," Dr Finegan said.
Gino Kenny, the PBP representative for Dublin Mid West took issue with both men for their use of the word 'killing', but he must know that this is nonsense. No amount of circumlocution nor the use of euphemisms can change the reality of what's happening, and those supporting assisted suicide should at least be honest enough to admit that.
In Canada, where the number of assisted suicides have gone through the roof, a paper, entitled “Cost analysis of medical assistance in dying in Canada” and published in the Canadian Medical Association Journal, noted approvingly that assisting patients to end their own lives “could result in substantial savings”.
It said:
If Canadians adopt medical assistance in dying in a manner and extent similar to those of the Netherlands and Belgium, we can expect a reduction in health care spending in the range of tens of millions of dollars per year”.
We should all - those of all faiths and none - be saddened by a drift to a society where the old, the sick, the most vulnerable are now being offered assistance to kill themselves rather than assistance to live. And we should all oppose it.
This article was first printed in the Irish Catholic and is printed here with permission