The earlier responses to Marjorie Ngwenyas April article on the need to explore the implications of increased longevity (Antony Ratcliff, June, and Roy Colbran, July) both support the legalisation of assisted suicide (AS) as a partial solution.
The earlier responses to Marjorie Ngwenya's April article on the need to explore the implications of increased longevity (Antony Ratcliff, June, and Roy Colbran, July) both support the legalisation of assisted suicide (AS) as a partial solution. Antony Ratcliff goes further by suggesting the profession has a duty to consider AS 'in the public interest'. I profoundly disagree. Despite the constant campaign to change this, AS remains a criminal offence. It is not the role of the profession to measure the economic advantages of procedures which remain criminal.
The 'Dignity in Dying' campaign invites the view that dignity and worth are contingent upon mental and physical faculties. Some campaigners also suggest that continued existence in a dependent state is intrinsically selfish and that opting for AS is an essentially noble act.
The prohibition on AS, by contrast, is founded on acknowledgement of the intrinsic worth of all and the shared duty of a civilised society to care for all, regardless of stage or condition. This is coupled with a concern that any change in the law designed to facilitate the determined few would adversely affect the vulnerable many, particularly in light of the arguments mentioned and the cultural shift which would inevitably follow. This was the clear conclusion of the Select Committee on Medical Ethics, and was also reflected in the 2015 parliamentary debates. Evidence from experience elsewhere supports this concern and claims by the AS lobby that Oregon offers a safe model to follow are easily refuted.
Baroness Ilora Finlay, past president of the Royal Society of Medicine and a professor of palliative medicine, observes that "Persisting requests [for death] with good sensitive care are almost vanishingly rare". But such care is not always available. Her Access to Palliative Care Bill aims to put that right. Those who are concerned about the future wellbeing of our ageing population (as opposed to their cost) could usefully lobby in its support.
An exploration by the profession of responses to the challenges of increased longevity should be welcomed. In addition to the factors Marjorie Ngwenya mentions, perhaps the reduction in fertility rates to well below replacement level, now causing concern in many countries, should be included. This may well trigger a population reduction over time and as the impact of increased longevity eases - but it will also add to the challenges of caring for an ageing population.
Pauline Gately
19 July 2018