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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After Richmond Park, Labour MPs are haunted by a familiar ghost

Labour MPs in big cities fear the Liberal Democrats, while in the north, they fear Ukip. 

The Liberal Democrats’ victory in Richmond Park has Conservatives nervous, and rightly so. Not only did Sarah Olney take the votes of soft Conservatives who backed a Remain vote on 23 June, she also benefited from tactical voting from Labour voters.

Although Richmond Park is the fifth most pro-Remain constituency won by a Conservative at the 2015 election, the more significant number – for the Liberal Democrats at least – is 15: that’s the number of Tory-held seats they could win if they reduced the Labour vote by the same amount they managed in Richmond Park.

The Tories have two Brexit headaches, electorally speaking. The first is the direct loss of voters who backed David Cameron in 2015 and a Remain vote in 2016 to the Liberal Democrats. The second is that Brexit appears to have made Liberal Democrat candidates palatable to Labour voters who backed the party as the anti-Conservative option in seats where Labour is generally weak from 1992 to 2010, but stayed at home or voted Labour in 2015.

Although local council by-elections are not as dramatic as parliamentary ones, they offer clues as to how national elections may play out, and it’s worth noting that Richmond Park wasn’t the only place where the Liberal Democrats saw a dramatic surge in the party’s fortunes. They also made a dramatic gain in Chichester, which voted to leave.

(That’s the other factor to remember in the “Leave/Remain” divide. In Liberal-Conservative battlegrounds where the majority of voters opted to leave, the third-placed Labour and Green vote tends to be heavily pro-Remain.)

But it’s not just Conservatives with the Liberal Democrats in second who have cause to be nervous.  Labour MPs outside of England's big cities have long been nervous that Ukip will do to them what the SNP did to their Scottish colleagues in 2015. That Ukip is now in second place in many seats that Labour once considered safe only adds to the sense of unease.

In a lot of seats, the closeness of Ukip is overstated. As one MP, who has the Conservatives in second place observed, “All that’s happened is you used to have five or six no-hopers, and all of that vote has gone to Ukip, so colleagues are nervous”. That’s true, to an extent. But it’s worth noting that the same thing could be said for the Liberal Democrats in Conservative seats in 1992. All they had done was to coagulate most of the “anyone but the Conservative” vote under their banner. In 1997, they took Conservative votes – and with it, picked up 28 formerly Tory seats.

Also nervous are the party’s London MPs, albeit for different reasons. They fear that Remain voters will desert them for the Liberal Democrats. (It’s worth noting that Catherine West, who sits for the most pro-Remain seat in the country, has already told constituents that she will vote against Article 50, as has David Lammy, another North London MP.)

A particular cause for alarm is that most of the party’s high command – Jeremy Corbyn, Emily Thornberry, Diane Abbott, and Keir Starmer – all sit for seats that were heavily pro-Remain. Thornberry, in particular, has the particularly dangerous combination of a seat that voted Remain in June but has flirted with the Liberal Democrats in the past, with the shadow foreign secretary finishing just 484 votes ahead of Bridget Fox, the Liberal Democrat candidate, in 2005.

Are they right to be worried? That the referendum allowed the Liberal Democrats to reconfigure the politics of Richmond Park adds credence to a YouGov poll that showed a pro-Brexit Labour party finishing third behind a pro-second referendum Liberal Democrat party, should Labour go into the next election backing Brexit and the Liberal Democrats opt to oppose it.

The difficulty for Labour is the calculation for the Liberal Democrats is easy. They are an unabashedly pro-European party, from their activists to their MPs, and the 22 per cent of voters who back a referendum re-run are a significantly larger group than the eight per cent of the vote that Nick Clegg’s Liberal Democrats got in 2015.

The calculus is more fraught for Labour. In terms of the straight Conservative battle, their best hope is to put the referendum question to bed and focus on issues which don’t divide their coalition in two, as immigration does. But for separate reasons, neither Ukip nor the Liberal Democrats will be keen to let them.

At every point, the referendum question poses difficulties for Labour. Even when neither Ukip nor the Liberal Democrats take seats from them directly, they can hurt them badly, allowing the Conservatives to come through the middle.

The big problem is that the stance that makes sense in terms of maintaining party unity is to try to run on a ticket of moving past the referendum and focussing on the party’s core issues of social justice, better public services and redistribution.

But the trouble with that approach is that it’s alarmingly similar to the one favoured by Kezia Dugdale and Scottish Labour in 2016, who tried to make the election about public services, not the constitution. They came third, behind a Conservative party that ran on an explicitly pro-Union platform. The possibility of an English sequel should not be ruled out.  

Stephen Bush is special correspondent at the New Statesman. His daily briefing, Morning Call, provides a quick and essential guide to British politics.