High Court rejects Tony Nicklinson's plea to allow doctors to end his life

When does the right to life become a right to die?

Today the High Court rejected Tony Nicklinson's plea to allow doctors to end his life. Nicklinson is not terminally ill, but for the past seven years he has been "locked in" as a result of a stroke: fully conscious, but immobile, able to communicate only by blinking. With the full support of his family, he had asked the court to extend the defence of necessity to cover doctors who acceded to his request. As the law stands, any doctor who carried out his earnest request might have found themselves facing a charge of murder. He also hoped to establish that his human right to a private life (under Article 8 of the European Convention) included the right to choose the manner of his death.

The result isn't a surprise. Nor will it be the end of the matter: the family had already announced their intention to appeal should the decision go against them. In the end, though, even the highest court in the land might well conclude, as this hearing did, that such a profound change in the law could only be made by act of Parliament. "It is not for the court to decide," said Lord Justice Toulson this afternoon, "whether the law about assisted dying should be changed and, if so, what safeguards should be put in place." Yet there seems little immediate prospect of legislation. Despite decades of debate and the fact that public opinion has long been sympathetic to euthanasia (provided that there are strict safeguards to protect the vulnerable) Parliament has so far proved reluctant to act.

Instead, the law finds itself in a position of moral incoherence. On the one hand, it refuses to draw distinctions that most normal people would regard as obvious. As the Lord Chief Justice made clear in 2010, upholding the murder conviction of a mother who ended the life of her severely brain-damaged son, the law "does not distinguish between murder committed for malevolent reasons and murder motivated by familial love." A law that puts a loving mother in the same legal category as Ian Huntley, sentencing both to life imprisonment (albeit with different tariffs), is clearly deficient. Nor can the Crown Prosecution Service be relied upon to act with common sense and compassion in such cases. 

At the same time, the law draws distinctions that are, in moral terms, pedantic. For example, it makes what is taken to be a significant distinction between actively ending someone's life (for example, by administering a lethal cocktail of drugs) and passively doing so by withdrawing nutrition. The latter has, since the Tony Bland case twenty years ago, become an almost standard procedure in cases where a patient is assessed to be in a persistent vegetative state with no hope of recovery. The difference means almost nothing to the person concerned - who is unable to express a preference either way. Tony Nicklinson himself could choose to refuse nutrition. This would condemn him to a slow and agonising death, and increase the suffering of his wife and daughters who would be forced to look on helplessly. But it would be legally OK. Death by lethal drugs would be quicker, painless and dignified. But it would be murder. 

If Tony Nicklinson were a dog, it would not merely be legal to end his suffering, it would be a criminal offence not to do so. The RSPCA routinely prosecutes pet-owners who cannot bear to see their beloved animals put down. Perhaps the dog, if it could talk, would express a wish for its suffering to end; perhaps it would cling to life. Society assumes, though, that to be merciful and compassionate is to put the animal to sleep. Why should a fully conscious and intelligent adult human being be treated with less humanity and compassion than a dog? 

The usual answer is that the law exists to protect vulnerable people who might otherwise feel under pressure to choose death so as not to be a "burden" on their loved ones. But their must be other, less cruel, ways of protecting the vulnerable. And the current law risks imposing another sort of burden on the families of people in Tony Nicklinson's position: a stark choice of watching someone you love in agony and asking to die, or acceding to their request at the risk of being convicted of assisted suicide or even murder. 

It's also sometimes argued that to allow profoundly disabled people the right to euthanasia would undermine the value of the lives of all people with similar disabilities. This must be nonsense. To respect human life is to respect more than the continuance of bodily functions: it is to afford respect and dignity to individuals, and that means allowing people to make decisions about their own lives. Including the ultimate decision to end it. 

A civilised and compassionate society will allow, even encourage, people to make the most of life whatever physical or mental disabilities they may have. We will shortly see at the Paralympics a triumphant demonstration of the fact that disability is no bar to achievement. It's possible to have even Tony Nicklinson's level of disability and lead a positive and worthwhile, even successful, life: just look at Stephen Hawking. But forcing someone to live against their will, as a demonstration of society's attachment to the sanctity of life, is neither civilised nor compassionate.

There is, in fact, no real conflict between the sanctity of life and the right of someone in Tony Nicklinson's position to end it. If human life has any special meaning over and above any other sort of life, it is because human beings are capable of self-reflection, of mental anguish, of conscious suffering, which includes the knowledge that one's suffering will end only in death. In such a case as Tony Nicklinson's, such human characteristics only add to the predicament in which he finds himself. For him, the right to die has become indistinguishable from the right to life.

What such a situation reflects, perhaps, is a continuing desire on the part of the law (or of its defenders) to want to punish suicide. A nominally secular society continues to see suicide not as a viable option - even an affirmation of life, because it is an affirmation of autonomy - but as a moral and personal failure, an admission of defeat. This was the mentality that for centuries refused suicides burial in consecrated ground. It is an attitude that ultimately limits human dignity, while at the same time pretending to exult it.

 

Tony Nicklinson's wife Jane comforts him as he reacts to the High Court decision. Photograph: Getty Images
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"We repealed, then forgot": the long shadow of Section 28 homophobia

Why are deeply conservative views about the "promotion" of homosexuality still being reiterated to Scottish school pupils? 

Grim stories of LGBTI children being bullied in school are all too common. But one which emerged over the weekend garnered particular attention - because of the echoes of the infamous Section 28, nearly two decades after it was scrapped.

A 16-year-old pupil of a West Lothian school, who does not wish to be named, told Pink News that staff asked him to remove his small rainbow pride badge because, though they had "no problem" with his sexuality, it was not appropriate to "promote it" in school. It's a blast from the past - the rules against "promoting" homosexuality were repealed in 2000 in Scotland, but the long legacy of Section 28 seems hard to shake off. 

The local authority responsible said in a statement that non-school related badges are not permitted on uniforms, and says it is "committed to equal rights for LGBT people". 

The small badge depicted a rainbow-striped heart, which the pupil said he had brought back from the Edinburgh Pride march the previous weekend. He reportedly "no longer feels comfortable going to school", and said homophobia from staff members felt "much more scar[y] than when I encountered the same from other pupils". 

At a time when four Scottish party leaders are gay, and the new Westminster parliament included a record number of LGBTQ MPs, the political world is making progress in promoting equality. But education, it seems, has not kept up. According to research from LGBT rights campaigners Stonewall, 40 per cent of LGBT pupils across the UK reported being taught nothing about LGBT issues at school. Among trans students, 44 per cent said school staff didn’t know what "trans" even means.

The need for teacher training and curriculum reform is at the top of campaigners' agendas. "We're disappointed but not surprised by this example," says Jordan Daly, the co-founder of Time for Inclusive Education [TIE]. His grassroots campaign focuses on making politicians and wider society aware of the reality LGBTI school students in Scotland face. "We're in schools on a monthly basis, so we know this is by no means an isolated incident." 

Studies have repeatedly shown a startling level of self-harm and mental illness reported by LGBTI school students. Trans students are particularly at risk. In 2015, Daly and colleagues began a tour of schools. Shocking stories included one in which a teacher singled out a trans pupils for ridicule in front of the class. More commonly, though, staff told them the same story: we just don't know what we're allowed to say about gay relationships. 

This is the point, according to Daly - retraining, or rather the lack of it. For some of those teachers trained during the 1980s and 1990s, when Section 28 prevented local authorities from "promoting homosexuality", confusion still reigns about what they can and cannot teach - or even mention in front of their pupils. 

The infamous clause was specific in its homophobia: the "acceptability of homosexuality as a pretended family relationship" could not be mentioned in schools. But it's been 17 years since the clause was repealed in Scotland - indeed, it was one of the very first acts of the new Scottish Parliament (the rest of the UK followed suit three years later). Why are we still hearing this archaic language? 

"We repealed, we clapped and cheered, and then we just forgot," Daly says. After the bitter campaign in Scotland, in which an alliance of churches led by millionaire businessman Brian Souter poured money into "Keeping the Clause", the government was pleased with its victory, which seemed to establish Holyrood as a progressive political space early on in the life of the parliament. But without updating the curriculum or retraining teaching staff, Daly argues, it left a "massive vacuum" of uncertainty. 

The Stonewall research suggests a similar confusion is likely across the UK. Daly doesn't believe the situation in Scotland is notably worse than in England, and disputes the oft-cited allegation that the issue is somehow worse in Scotland's denominational schools. Homophobia may be "wrapped up in the language of religious belief" in certain schools, he says, but it's "just as much of a problem elsewhere. The TIE campaign doesn't have different strategies for different schools." 

After initial disappointments - their thousands-strong petition to change the curriculum was thrown out by parliament in 2016 - the campaign has won the support of leaders such as Nicola Sturgeon and Kezia Dugdale, and recently, the backing of a majority of MSPs. The Scottish government has set up a working group, and promised a national strategy. 

But for Daly, who himself struggled at a young age with his sexuality and society's failure to accept it, the matter remains an urgent one.  At just 21, he can reel off countless painful stories of young LGBTI students - some of which end in tragedy. One of the saddest elements of the story from St Kentigern's is that the pupil claimed his school was the safest place he had to express his identity, because he was not out at home. Perhaps for a gay pupil in ten years time, that will be a guarantee. 

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