The right to die debate is an emotive and contentious one. The arguments are usually focused on the ethics and legalities of allowing people who are terminally ill to request and receive assisted dying. Often the biggest problems exist around who should decide if euthanasia should be carried out, especially if the persons in question are not in a fit state to make their own decision for reasons of illness or injury.

Euthanasia, or ‘mercy killing’ as it is sometimes called, is legal or partially legal in some countries. These include Switzerland, Belgium and the Netherlands. So what about Malta? Is it not time that we seriously and openly discuss this till now taboo and prohibitive subject?

My own experience

The answer is not easy at all. I, for one, up to a few years back used to be all out against euthanasia. But, after having directly and personally witnessed family members and close acquaintances spending years of needless and hopeless sufferings confined to a bed or other immobilising equipment, I started having second thoughts.

Is it not time that we seriously and openly discuss this till now taboo and prohibitive subject?

In the meantime, I have developed a debilitating, practically terminal, disease that will eventually immobilise me completely and make me a helpless and useless burden on everything and everyone, not to mention the pain and sufferings I will have to go through. A future hard to digest. And let us face it, there is a limit to palliative care. We all know the Church’s ultra-conservative stand and perhaps even the position taken by a number of local NGOs and political organisations. Only the Labour Movement recently boldly took the unprecedented approach of eventually bringing euthanasia up for an open and holistic discussion. This is why I wish to share my opinion on the subject with you here.

The experience of death is going to get more and more painful, contrary to what many people believe. Assisted suicide is where a doctor helps a patient to kill themselves by prescribing a lethal drug for the patient to take. This becomes euthanasia when the doctor administers the drug directly.

I can identify at least three legitimate and justifiable reasons for euthanasia.

1. Possibly we need it.

This is ‘the compassion argument’. Supporters of assisted suicide believe that allowing people to ‘die with dignity’ is kinder than forcing them to continue their lives with suffering.

2.  I have encountered many people who want it.

This is known as ‘the autonomy argument’. Some believe that every patient has a right to choose when to die.

3.  I strongly believe that we can control it.

I would describe this as ‘the public policy argument’, believing that assisted suicide can be safely regulated by government legislation.

Admittedly, euthanasia will put the emphasis on the personal decision in a way that was blissfully alien to the whole problem of dying in former times. It will make death even more subjectively intolerable, for people will feel responsible for their own death and morally obliged to rid their relatives of their unwanted presence. Objectively thinking, opening the doors to voluntary euthanasia and assisted suicide could lead to involuntary euthanasia, by giving doctors the power to decide when a patient’s life is not worth living. Also, even where euthanasia and physician-assisted suicide are legal, there is the real danger that doctors will not always report it. Taking the argument further, if we are to assert that patients should have a right to die, would that impose on doctors a duty to kill, thus restricting the autonomy of the doctor? Yes, dear readers, there is much more to debating this delicate subject than meets the eye.

Surely, however, the debate should not be about the right to die but about the right to help patients terminate their lives when helplessly, terminally ill. Instead of giving freedom to patients, euthanasia and assisted suicide are about giving other people the legal power to end another person’s life. Assisted suicide is not a private act. Nobody chooses assisted suicide in isolation. Euthanasia and assisted suicide are matters of public concern because they involve one person facilitating the death of another. Any change in our law would have profound effects on the social fabric of our society, on our attitudes towards each other’s deaths and illnesses, on our attitudes towards those who are ill and have disabilities.

The debate should not be about the right to die but about the right to help patients terminate their lives when helplessly, terminally ill.

The pro-euthanasia and assisted suicide lobby emphasises the importance of personal choice and autonomy. Should not patients have the right to end their lives? Of course, specific criteria laid down by law would have to be fully satisfied and met for lawful eligibility. If we are referring to a disease where the prognosis is not straightforward, dementia or a chronic but not terminal disease, then there should be no room for euthanasia or assisted suicide.

The more I think and ponder on euthanasia the more I find myself not being able to decide one way or the other. Changing the law to allow euthanasia or assisted suicide will inevitably put pressure on vulnerable people to end their lives for fear of being a financial, emotional or care burden upon others. This would significantly affect people who are disabled, elderly, sick or depressed. Some would face the added risk of coercion by others who might stand to gain from their deaths. Fear and anxiety would be promoted rather than Individual autonomy. There have been tragic cases of people suffering terminal illnesses who want other people to help them end their life. It is important however that we do not lose sight of the large number of people who are terminally ill and have exceptionally found richness and purpose in life despite the pain and hardship.

We have no control over how we arrive in the world but at the end of life, we should have control over how we leave it, without in any way debasing the value of life. I am not afraid of being dead. I only ask for dignity in dying.