Re Susan Hampshire’s article in your series on assisted dying (‘We wouldn’t let animals die in misery. Why should humans?’: Susan Hampshire on why dying must be a choice, 17 June), the problem with assisted dying is not the principle, but the practice. The reality is far more complex than has been presented.
Hampshire says it has been working “perfectly well” in places like Canada and the US. In Canada, people with disabilities have chosen euthanasia not because of their disability, but because their disability allowance is so small that they cannot afford to live. One individual, who could not find affordable housing compatible with their disability, said: “I’ve applied for MAiD [medical assistance in dying] essentially because of abject poverty.”
In Oregon, in 1998, just 13% of people who applied for assisted dying did so because they felt like a burden on their family. Since 2017, over 52% have applied because they felt like a burden, suggesting that once assisted dying is legalised, those who qualify increasingly feel pressure to use it. The neighbouring state of Washington has seen similar trends, with 59% saying they felt like a burden in 2022 compared with just 23% in 2009.
If this is what working “perfectly well” looks like, then we need to urgently reassess. Can assisted dying truly be an autonomous choice while end-of-life care in the UK is a postcode lottery at best?
Conall Preston
Researcher, Living and Dying Well
• There is good reason for Julian Barnes to “hope” that physician-assisted suicide of people with a terminal illness is the “thin end of the wedge” and will later be expanded to people who are not dying (‘The flight to Zurich sounds like the worst mini-break possible’: Julian Barnes on why Britain must legalise assisted dying, 15 June). This shift has already happened in Canada and in Colombia. The slippery slope is real.
However, physician-assisted suicide is difficult to apply to the condition that Barnes most fears, which is late-stage dementia, where you “forget yourself before you die”. The problem is that dementia progressively takes away first the ability to consent to assistance in suicide and then the ability to attempt suicide. Those most affected are least able to make use of it.
Fear of dementia does not stop with assisted suicide, but leads logically to euthanasia on the basis of advance decisions. In a case in the Netherlands five years ago, a woman was given a sedative in her tea and members of her family held her down as she struggled against the lethal injection. It was declared legal as some time in the past she had signed a form. She once stated that she would want to die in these circumstances, even though she did not seem to want it at the time. Euthanasia of people with dementia is increasing in the Netherlands. This is where the slippery slope leads, and it is very far from the “heroic” and “exemplary” ideal of death that Barnes begins with.
Prof David Albert Jones
Professor of Bioethics, St Mary’s University, Twickenham; director, Anscombe Bioethics Centre, Oxford
• Death, for those who know when it is coming, is untidy. My wife was diagnosed with metastatic breast cancer six years ago and died last year. Not once during those five years of palliative treatment, brutal and unremitting as it was, did she feel that her life should be ended, or ask for it to be. Not out of some vain hope of cure, ending of the pain or some religious belief, but simply because every moment of the life she had left remained as important to her as the life she had led. Despite everything, she did die with dignity and as herself. She had no need of assisted dying and remained in full control of her choices. Laws are there to protect us as a society and not to facilitate individual choices, which we all still have.
Name and address supplied
• It is entirely appropriate to have high-profile campaigners putting forward and explaining their reasons for wanting to change the law on assisted dying. Are there plans, though, for a follow-up article putting across the views of those opposed to changing the law? It seems biased not to do so. However heartfelt the convictions of those interviewed and well-argued their case, I’m not convinced that they’ve seen the recent BBC documentary Better Off Dead? by Liz Carr (still on BBC iPlayer) and carefully considered her perspective.
Hannah Pursey
Birmingham
• It’s good to have a group of celebrities justifying their hopes for a change in the law on assisted dying. I would also like to see such a change, but with an additional emphasis. I have had multiple sclerosis for over 30 years and now have considerable mobility problems and other symptoms. For the present, by some miracle, I can still push the pedals on our yellow tandem trike. Most days, with my husband, I enjoy rides on the riverside cycle path, the promenade and through the town in Aberystwyth, so life is positive in important ways.
However, unlike some disabled people, I would definitely like to have the choice of an assisted death if my MS progresses to the extent that my life is one of helplessness and serious bodily suffering. The emphasis in your articles was on having a good and painless death for people with a short time left to live. However, for some chronic diseases such as MS it is possible for suffering to go on for a long time without release through death being likely.
I support the pressure group My Death, My Decision, which argues that continued unbearable suffering should also be a reason for having an assisted death. There are complex and difficult issues involved, but I would wish to see carefully drafted legislation that encompasses unbearable suffering as well as expected death in the short term.
Katherine Cuthbert
Aberystwyth, Ceredigion
