On 29th November 2024, MPs in England and Wales voted in favour of the Terminally Ill Adults (End of Life) Bill, which is ‘a Bill to allow adults who are terminally ill, subject to safeguards, to be assisted to end their own life; and for connected purposes’. The Bill is far from passed; there are many stages before this becomes law, and the next stage is unlikely to happen before April 2025, but this is a significant step towards the legalisation of assisted dying and has, unsurprisingly, been a contentious topic for the two countries.
The concept of human euthanasia has always fascinated me, so much so that I wrote a novel about it in 2018, These Unnatural Men. In it I imagined an England in which supported suicide was legal, and it was as much a part of the medical world as obstetrics or oncology. That being said, the ‘euthanasists’ in the novel were not always regarded in a positive light, and protestors camped outside of the euthanasia clinics, much like the protestors we see outside of abortion clinics. Even in my fictionalised world where assisted dying laws had been part of legislation for decades, I couldn’t fathom it to ever be non-controversial.
And in my opinion, that is a good thing. While I am in favour of assisted suicide myself, it is not and should never be a black and white subject. In These Unnatural Men, a euthanasist’s job is to determine whether a patient’s medical diagnosis or psychological state is assuredly terminal enough to need euthanasia by weighing it up against a set of medical guidelines. They deliberate over their decision in a removed, calculated way, and then a yes or no decision is confirmed, sometimes by panel.
However, I don’t agree with this approach to euthanasia. No two cases should ever be treated the same – two people suffering with the same disease might experience and view their situation very differently. My aim with These Unnatural Men was to show that there can ultimately be no ‘dignity in dying’, we are unable to control that. What we can control is better palliative care, understanding of individual experience and needs, as well as mercy. Will an assisted dying law be flexible enough to allow for this? Or could it be abused to cause more harm than good?
My personal view on euthanasia has largely been moulded by my pets. I have had many animals in my life, including dogs, cats, fish and a variety of rodents, but the species that has taught me the most about death, and the difference between a ‘good’ and a ‘bad’ death, are rats. Rats are exceptionally intelligent and full of personality, but unfortunately are susceptible to tumours and have a life expectancy of just two years. From the age of eleven to thirty-five I bought from breeders and rescued dozens of rats, but this year decided to take a break from having them as it was simply too heart-breaking. Death and illness are a constant with rats, and while it was often upsetting and at times seemingly relentless, these experiences taught me to be better attuned to an animal’s limits and needs rather than my own. I have put small little rat bodies through operations and months of medical treatments in a bid to provide them with longer and more comfortable lives, and have also watched their mental and physical health deteriorate, but there is always a moment when I know they can’t go on any longer and it would be ‘better’ for them to put them to sleep. Of course, there is no knowing what an animal is truly going through, but I feel I have come close to understanding what quality of life means for each individual rat. Plus, animals put up with a remarkable amount of pain before even showing it, so by the time I’ve noticed they’re unhappy, they’ve probably already suffered a great deal.
Surely this is the same for humans who opt for assisted dying? They have already suffered through so much to get to the point of requesting death, so it’s unlikely to be a rushed decision based on inconvenience or mild discomfort. That is why human euthanasia needs to become legal, for those who know and can verbally express their will to die after much suffering, but what about those suffering with poor mental health? Or severe physical or mental issues that stops them from speaking or expressing themselves? Should we end the suffering of those who cannot ask for it and, if so, how do we determine what is suffering? What person or people can decide with one hundred percent certainty to end a person’s life? Should it be the responsibility of medical professionals? The family? Society’s agreed perception of a worthwhile life?
These are rhetorical questions, since the answers are too subjective to answer with absolute certainty. Determining someone’s right to die, or their loss of right to live, is not something any single human being should be in charge of, perhaps not even the person who wants to die themselves, and yet humans decide who should or shouldn’t receive medical treatment every day, which plants should be cut down or grown, which animals should be bred and loved or killed and eaten. We are a species constantly seeking control.
An assisted dying bill brings up life’s biggest and least answerable questions, and the potentiality of it becoming part of law fills me with both relief and dread. This could be something that some of us will be grateful for, either for ourselves or our loved ones, or it could be the beginning of the darkest period in medical history.
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