Is there a right to assisted suicide?

The debate about assisted suicide will go into another round with the UK's Supreme Court dealing with this issue soon. The European Court of Human Rights in Strasbourg has also recently criticise the German government in this area so this issue presents a serious headache for governments across Europe. It seems to me however that some of the arguments in favour of a right to end your life make little sense. 

Proponents of assisted suicide have changed tack over the last 5 years. As direct legal challenges to the ban of ethanasia have largely failed, campaigners have redirected their efforts. They now argue that the provision of human rights covers assisted suicide. The main thrust of their challenge regards the notion of rights and entitlements which, so the theory goes, includes the right to end your life. 

There is something odd about this position however. Rights do not exist in a vacuum. Rights, understood as a specific entitlement, require obligations of other parties. A right to employment for example is worthless unless it is sustained by somebody else's obligation to provide this employment. In other words, entitlements are reciprocal goods, that can only materialise if other people have a duty to carry out actions that ensure the fulfillment of the right. 

This reciprocal nature of entitlements applies to all rights, even though often the recipient of a reciprocal duty is left unspecified. The universal right to life for example carries no defined duty of others to ensure that the holder of the entitlement continues to live. What it does however is to forbid any actions by any person that would end prematurely anybody's life. 

This is where campaigners of assisted suicide blur the distinctions between universal unspecified rights and specific entitlements. Assisted suicide requires the direct intervention of a medical professional. Formulating a right to assisted suicide hence entails the need to institute an obligation of others to assist. In assisted suicide there is no unspecified non-reciprocal entitlement. What campaigners want is a right that carries with it the duty of medical personnel to assist. 

Looking over the judges' decision now it seems clear that this confusion runs through their verdict as well. Although they emphasise that the final decision about assisted suicide should be left to national parliaments, the line of argument once again blurs the distinction between unspecified, non-reciprocal rights and entitlements that carry a direct obligation of third persons. 

To argue, as the judges do, that people have been denied a right who have not been assisted in suicide, is to argue that there is an entitlement to assistance, which in turn means there must be a duty by some to assist. This assumes that there is an obligation of medical personnel to kill. I struggle to see any justification for such an obligation in any professional code of conduct or, indeed, in any law. 

Perhaps the real problem is that rights are not offering a suitable framework to discuss assisted suicide. There are situations in our lives where we find that we have indeed no entitlements or rights, without necessarily having been deprived of one. We simply do not have rights to all and everything. 

Why Simon Jenkins is wrong

There are issues that defy ideological categorisations and hence present a particular problem for political parties and governments. One such issue is assisted suicide. In Britain the law is vague at best on what constitutes assistant suicide and, more recently, the director of prosecutions has tried to clarify the conditions under which the CPS would or would not pursue cases in court. A recent report has stirred the debate once more in the New Year. A commission funded by supporters of assisted suicide has asked the government to look at introducing legislation to enable doctors and medical staff to help people die in certain circumstances. The report is careful in spelling out the strict conditions under which assisted suicide should be legal, and where support should be provided. 

Clearly this is an emotive issue. It is also a matter which cannot be considered in isolation from other areas such as quality of end of life care, and how we treat and talk about people who are vulnerable and rely on help and support from others. It also seems clear that there is a need for some legislation, given that a two tier system has effectively established itself with those who can afford it traveling to Switzerland, and those who cannot remaining in often inadequate palliative care. 

This however does not mean that the outcome should necessarily be legalisation of assisted suicide. The issue is complicated by the fact that assistance to die would naturally be provided by the NHS, i.e. a tax funded public body. In other words, since suicide itself is legal in the UK, the debate revolves around not suicide, but the nature and provision of assistance and whether or not the state may have a duty in this area. 

Simon Jenkins came down on the side of supporters of assisted suicide in a piece in the Guardian recently. However I take issue with the line of argument he presented. Here is what he said: 

‘The state is already preoccupied with trying to stop individuals doing what they wish - always “in their own interest”. It daily increases control on how they work, play, eat, drink, smoke, drive and learn.... The modern individual is regarded by the law as first and foremost a possession of the state, the purest form of communism.’ (you can read his article HERE) 

He goes on to say that ‘an adult’s freedom of decision over his or her own body should trump any claim from the state.’ 

I find this line of logic confusing to say the least. As mentioned before, suicide is legal in the UK. What is not legalised is to assist somebody to take their life. The object of prosecution is assistance, not suicide. At the heart of the issue is not the help spouses give to their loved ones who want to die (the director of prosecution has refrained from pursuing these particular cases for a long time now) but whether or not NHS doctors should provide the medical assistance and resources to end one’s life. In essence, then, if Simon Jenkins is against the state regulating every aspect of somebody’s life, he should oppose legislation about assisted suicide as well. 

The insidious nature of communism is not demonstrated through abundance of legislation, but in control of people’s lives through universal provision of state services. I think the expression is: from cradle to grave and it is exactly this type of universal provision which assisted suicide would contribute to. 

Jenkins’ suggestion that the government’s failure to legislate in this area is denying people the freedom of decision over their body is misleading at best. They can take their own life at any time without breaking the law. What campaigners for assisted suicide want to achieve is that the state provides the means to kill yourself. 

It is this obfuscation of the real issue that sometimes infuriates opponents of the assisted suicide campaign. As Jenkins calls on the government to draw a line in the sand, he should stop blowing sand into our eyes.