A man is suffering and needs help. The treatment is easily administered and has almost guaranteed success. We watch, and sympathise, and discuss at length the shame and the shock of his situation, how we couldn’t imagine his pain. But we do nothing.
Tony Nicklinson has locked-in syndrome. A stroke seven years ago left him paralysed, unable eat or move or speak without help. Some with the same syndrome do not want to die. But Mr Nicklinson does. Talking through a computer, he describes his existence as “undignified, distressing and intolerable”. His condition means he could only take his own life unaided through starvation, a torturous process that could take weeks. Tony wants help to enable a quick and dignified death.
Mr Nicklinson appealed to the Divisional Court to allow others to assist his suicide. But the judges who reviewed his case felt that allowing his euthanasia would alter the law as to create a defence for murder. The court decided it was for Parliament, not judges, to make such significant legal changes.
Assisted suicide has been discussed in Parliament before, and I suspect another Commons review will alter little. We have yet to find the mechanism that enables people like Tony Nicklinson to end their own life with the help of others, without creating a potential for the elderly, disabled or terminally ill to be coerced into death.
The intellectual argument is sound – benefitting a minority of rare, well-publicised cases is not enough to outweigh the potential harm to a far larger group of vulnerable people. But that doesn’t help Mr Nicklinson. The needless distress of a man powerless to choose his own fate is deplorable. No matter how well we justify our position, what we are doing to him remains wrong.
I want to help Tony. He has been robbed of his self-determination, and now his dignity is further degraded as he becomes the visceral embodiment of an ethical curiosity. He demonstrates the lag between our slowly evolving law and rapidly changing medicine. As the arguments stack up on either side, Tony is left in the middle.
Campaign group Care Not Killing hopes that a line is now drawn “once and for all under legal debate”. I would urge for the opposite. Just because we don’t have a way to treat Tony fairly doesn’t mean we should stop trying to find one.
It is easy to know what’s right and wrong when circumstances are clear cut and precedents have already been established. Rather than ignore the difficult questions, or prevaricate and pass the buck between different branches of government, we have to engage with these problems. People like Tony are not going to go away. They will continue to fight for their cause and become increasingly numerous as our medicine becomes ever more sophisticated. Closing ourselves off to the possibility of a more just and dignified approach to death is surely the wrong attitude.
Tom Riddington is a NHS hosptial doctor with a special interest in medical ethics and healthcare politics. You can find him on twitter @drtomriddington.
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