EAS Undermines Public Safety

One example illustrating this failure took place in Oregon, which many proponents of EAS present as an exemplary system for assisting patient suicide. In 2008, a man suffering from Motor Neurone Disease, Thomas Middleton, moved into the house of a friend, Tami Sawyer, before procuring an assisted suicide. Two days later, Sawyer placed his home on the market and transferred $200,000 to her own account. Sawyer and her husband were later indicted for first-degree criminal mistreatment and first-degree aggravated theft.

Given the vulnerability of those most likely to be pushed towards EAS, and given the ‘epidemic of elder abuse across the UK’ revealed by a recent poll which found that almost 10% of older people say that they are being abused, and closer to 20% have been abused previously, the failure of safeguards which proponents of assisted suicide wish to introduce into UK law should be deeply concerning.

Nothing in the typical Oregon two-doctor model of euthanasia or assisted suicide practice which has been presented before legislatures on multiple occasions enables proper diagnosis of mental health problems like depression. The same constraints of doctor training or time with the patient can prevent realistic detection of the more subtle pressures on an individual to end their own life by unscrupulous family and supposed friends, or manipulation into premature death.

Introduction of EAS into Jersey law and medical practice also creates the danger that terminally ill and disabled individuals may opt for being euthanised or assisted to commit suicide because they begin to devalue themselves because they feel a burden on others. Evidence from American jurisdictions shows that these practices, whilst intended to empower patients, actually erode the choices of those who are most of the most vulnerable, and enable undue pressure to be brought to bear on them to end their lives prematurely.

Pressure is subtle and may be exerted by families and clinicians. Patients feel a burden in all sorts of spoken and unspoken ways. This reality is expressed by the increasing and then consistently high proportions, and more recently majorities, of those seeking assisted suicide in Oregon who give as one of their motivating factors for asking for assistance in suicide is that they wish not be a “burden” on their family, friends, and caregivers. The same situation has been seen in Washington State, which was the first U.S. jurisdiction to follow the Oregon system.

In Canada, the first two annual reports on their system of joint assisted suicide / euthanasia (‘MAiD’; short for ‘medical assistance in dying’) recorded the same reason given by 34% of patients in 2019 and 35.9% in 2020.

That such situations have been allowed to develop illustrates how a legal provision for assisted suicide necessarily entails a risk to the right of vulnerable patients not to be manipulated, harassed, or demoralised when their personal autonomy is at its least due to their physical or mental state.

The ‘right to die’ for those who are mentally stronger is translated to those who are more psychologically weakened by such realities into a ‘duty to die’.

Not merely direct abuse by those closest to them can achieve this, but a medical and general culture in which impatience with individual lives which involve investing resources, or experiences of dying that are protracted, has become normalised and expressed through the practice of foreshortening that process through euthanasia or assisted suicide.

Clearly, whether through direct or indirect means, EAS compromises protections and care for very vulnerable people, due to latent problems we see already existing in our society. This leads to genuine personal autonomy being undermined rather than enabled. As Prof. Julian Hughes, Professor of Old Age Psychiatry at Bristol has pointed out:

‘If anyone were in any doubt about the risk of covert or silent coercion of vulnerable adults, they should look at the placement of older people, including those with dementia, in care homes. Many older people give up their homes to live in institutions because they perceive (rightly or wrongly) that others wish them to do so. Some regret the decision; and those with dementia (where the assessment of capacity can be difficult) are often hardly involved in such decisions. Lonely, sick and disabled older people may well succumb (especially where the resources to care are scarce) to the suggestion that they should accept physician-assisted suicide or euthanasia, but this may well not reflect their true choices’.