Roy Colbran in The Actuary, July responds to Tony Ratcliffs challenge for the profession to think about assisted suicide, making the case in favour on the basis of personal autonomy and also as a cost-saving measure.
Roy Colbran in The Actuary, July responds to Tony Ratcliff's challenge for the profession to think about assisted suicide, making the case in favour on the basis of personal autonomy and also as a cost-saving measure. Allow me to put the counter-arguments - although, like Roy Colbran, I question whether the profession is qualified to opine on this matter.
Colbran dismisses the argument that no system of assisted suicide could be set up that would be guaranteed to prevent abuse. But surely, in a civilised society, those of us who are concerned about the treatment of the weakest and most vulnerable, the old and the disabled, would want to do what we can to protect them from being simply thrown on the rubbish heap because they are of no use or cost too much?
If the price that I have to pay to defend the weak is that, at some point in my life, I will need to be totally dependent on others, then I am happy to pay. After all, we are already pretty much fully dependent on others to supply our needs in one way or another.
The experience in places such as the Netherlands and Belgium is that, following the introduction of assisted suicide, ostensibly on quite restrictive grounds, the slope quickly gets very slippery and, from terminal illness cases, the scope there has extended to the mentally ill and those who are simply tired of life, including prisoners, and children. There are cases where assisted suicide was actually involuntary euthanasia.
There is clearly a challenge society faces in how to look after, in a dignified and loving way, those who are approaching the end of their lives. It is already the case that pain can be controlled in almost every situation, and relatively few requests for assisted suicide are due to pain and suffering.
It is also morally acceptable to withdraw treatments when they are overly burdensome as long as the intention is not to kill but rather simply to accept the inevitable.
In any case, it is not technology, medical or otherwise, that is the solution, but rather compassion and empathy. This approach is reflected in palliative care, which is proving really important in our culture, as it opposes what makes death most terrifying and unwelcome - pain and loneliness.
Introducing assisted suicide would reduce incentives to develop further the palliative case model.
Dermot Grenham FIA
21 July 2018