WHAT IS VOLUNTARY EUTHANASIA?
WHY THE NEED FOR SOCIETIES?
IS THERE GROWING SUPPORT FOR THE MOVEMENT?
DOES THE SOCIETY ENCOURAGE EUTHANASIA FOR THE OLD AND INFIRM?
I WANT TO DIE. PLEASE CAN THE SOCIETY HELP ME?
WHAT DOES EXIT FEEL ABOUT MALFORMED BABIES, THE MENTALLY HANDICAPPED OR THE INCURABLY INSANE?
WHY DO YOU NEED VOLUNTARY EUTHANASIA WHEN THERE IS THE HOSPICE MOVEMENT?
WHY ISN'T THE LAW CHANGED?
BUT SURELY SUICIDE ISN'T ILLEGAL?
HOW CAN I HELP PROTECT MY RIGHTS?
I AM INTERESTED IN THE PRINCIPLES YOU'VE TALKED ABOUT - WHAT SHOULD I DO NOW?
1. WHAT IS VOLUNTARY EUTHANASIA?
In the Netherlands, the only country where euthanasia is openly practised, euthanasia is defined as "the intentional termination of life by another at the explicit request of the person who dies" (Netherlands State Commission on Euthanasia). The argument then often centres on the voluntariness of the request. How can one be sure that it is voluntary? Supporters of the voluntary euthanasia movement generally believe that it would be possible to devise sufficient safeguards to ensure that the request was voluntary and that people could never feel pressured.
The Dutch are critical of their own system and are continually refining and testing it - though generally they feel that it respects human rights and is part of good medicine. They get rid of the word voluntary since the explicit request is part of their definition of euthanasia. An explicit request is objectively observable, whereas voluntariness depends somewhat on interpretation. (Some opponents of euthanasia suggest that the true will is impaired if one is asking to die and that therefore there is no voluntariness. Most people would agree if the person was emotionally distraught over, say, being jilted by a lover, or if the person was psychiatrically of unsound mind, but most of us view more considered statements as voluntary, especially if we are unable to find any evidence to the contrary.
Obviously the Dutch definition needs careful implementation to ensure voluntariness, and the Dutch attempt to do this by a series of safeguards within a close doctor-patient relationship, a high standard and availability of palliative care, and general public support. There is much debate over whether we could have a similar system in, say, Britain, but we feel that the present system is unsatisfactory and so we press for reform.
One of the few certainties of life is death, but in the twentieth century it is still a taboo subject. The "forbidden" nature of death adds to the unnamed fears and worries that most people feel when asked to confront the idea of their own death. Yet once people can overcome their reluctance to discuss the subject, most often what is revealed is not the fear of death itself, but the manner of dying. The difficulty of thinking about "death with dignity" is that it implies that one day you, or someone you love, may be in a position to want that choice.
No one can prevent death finally, but we can and should ensure that the dying process is a gentle and peaceful one. When life consists of a few agonising, drugged weeks, many patients beg their doctors to help them die, and many doctors, mindful of the ethics of their profession, feel forced to refuse. Those who, out of compassion, accede to such a request, know they are breaking the law and putting their careers at risk.
This is the dilemma which faces all of us now. Should
we, as potential patients, have the legal right to ask our doctors to help
us die when the end of life is in sight and our suffering severe?
2. WHY THE NEED FOR SOCIETIES?
In 1980 Scottish Exit (later the Voluntary Euthanasia Society of Scotland or VESS, and, later still, "Exit") became an independent group, and published "How to Die With Dignity". This booklet, by Dr George Mair, was the first guide to self deliverance in the world. An updated version, together with the well-researched modern supplement "Departing Drugs," is still available to members of at least three months' standing, as long as they specifically request it. Members can receive the booklet in Scotland, England or anywhere in the world. EXIT also acts as a centre and focus for research concerning medical decisions at the end of life, and particularly living wills. The EXIT Newsletter is considered a leading source of information. EXIT can provide information and support to members of the public, doctors, lawyers, educational institutions and students, politicians and the media. Individuals should note, however, that while seeking a change of the law, we will only act within the law as it stands.
The history of reform shows that humane and well-argued
proposals only tend to pass into law when there is a strong public voice behind
them. The people who struggle against inhumanity make their mark by creating
a better world. We can't help those who have died in abject suffering, but
we can work for the good of those whose death is yet to come - not only by
striving for better, caring services, but by restoring control to the individual
who has entered the last phase of life.
3. IS THERE GROWING SUPPORT FOR THE MOVEMENT?
Opposing voices tend to reveal an ignorance of the true nature of VOLUNTARY euthanasia. Misunderstandings abound, and we hope in this leaflet to lift and remove any fears and misapprehensions. If you wish to write or phone, we are also glad to answer any queries.
International support is growing rapidly. A number
of countries are actively considering legislative reform. Right-to-Die Societies
around the world have increasing support from the swiftly growing numbers
of individuals demanding their rights to self-determination.
4. DOES THE SOCIETY ENCOURAGE EUTHANASIA FOR THE OLD AND INFIRM?
While it is often the old and infirm who choose
self-deliverance, the choice has been made in the light of each individual's
quality of life. Love of life is a primitive instinct: no one should be persuaded
to die through propaganda. But a conviction, deeply held for whatever reason,
that the time has come, should be respected, and everyone should have the
right to choose release.
5. I WANT TO DIE. PLEASE CAN THE SOCIETY HELP ME?
6. WHAT DOES EXIT FEEL ABOUT MALFORMED BABIES, THE MENTALLY HANDICAPPED OR THE INCURABLY INSANE?
7. WHY DO YOU NEED VOLUNTARY EUTHANASIA WHEN THERE IS THE HOSPICE MOVEMENT?
Unfortunately, even with medical advances and excellent hospice research in palliative care, severe indignity, pain and distress cannot always be controlled. The hospices' most optimistic estimate for pain control is 95%. In practice, in ordinary hospitals, it may be as low as 30%.
There are conditions such as cancer, strokes, acute arthritis, and more recently AIDS, to name just a few, where all the medical skills in the world aren't enough for a particular individual case. If that person, after undergoing all possible treatment, still feels enough is enough, they should have the right to be helped to die.
The phrase "terminal illness" suggests a way of
looking at death, not at the moment of brain death, but as a process lasting
some period of time; once this more realistic view is embraced, and the fact
of dying accepted by the individual, the doctors and the relatives, what
can be gained by ensuring that the process of dying is prolonged as much
as possible? Now, a dying person's wishes often count as nothing: hence we
want a change in the law.
8. WHY ISN'T THE LAW CHANGED?
By mobilising public concern this could be changed.
You can help by supporting us; you could write to your MP, or open a debate
in your newspaper.
9. BUT SURELY SUICIDE ISN'T ILLEGAL?
There is the added difficulty that by the time many
people are driven to contemplate suicide because of their suffering, they
are not physically able to accomplish the act. The law is inconsistent inasmuch
as it tolerates suicide, but outlaws the means. To deny a person control over
his or her own life is immoral. It is an abuse of human rights, and should
10. HOW CAN I HELP PROTECT MY RIGHTS?
EXIT also supplies a Living Will Alert Card, to
be filled in and carried in your purse or wallet, indicating you have signed
a living will. We suggest the use of a values history to help guide doctors
should difficult situations arise not adequately covered by your living will.The
values history helps you and your doctor to identify those things that, for
you, make life worth living. It can also further understanding with those
close to you, so they will know what is important to you should you need
their support. We publish regular updates in a Newsletter, providing members
not only with current academic arguments but with valuable practical advice
on their rights within the law.
11. I AM INTERESTED IN THE PRINCIPLES YOU'VE TALKED ABOUT - WHAT SHOULD I DO NOW?
What is required even more urgently is active support. We need more members and more money to increase the momentum needed to change the law. We also need more funds to operate a Support Network and Information Service for members - assessing individual needs and providing information about available options.
All correspondence to members is sent under plain cover and membership is confidential. (Please note: legal considerations require that people wishing to buy the booklet "How to Die With Dignity" must be members of at least three months' standing. This is to discourage irresponsible or unconsidered use of the contents. The price of the booklet is not included in the subscription, and is issued at the discretion of the Society).
The cost of membership is small, but it is an opportunity to stand up for what you know to be right. Take a stand against suffering; protect your own right to choose - and your right to be treated with dignity and compassion in the event of severe, incurable illness. Finally, consider making a donation, large or small, or making a bequest in your will; help us function more effectively and use the coming challenge to ensure proper measures and proper safeguards are enacted. Your money will be well spent.
Neither will you be alone in the battle. Prominent
voices have included the late philosopher Sir Alfred Ayer, father of biomedical
ethics Joseph Fletcher, journalist and broadcaster Ludovic Kennedy, columnist
Claire Rayner, playwright Brian Clark, actor and writer Sir Dirk Bogarde,
actress Katherine Hepburn, mountaineer Sir Edmund Hilary, the late scientist
and writer Isaac Asimov, and such well-known members of the medical profession
as Jonathan Miller, Wendy Savage and Christiaan Barnard.
© 1995-2002 Chris Docker