There is a fundamental shift in the argument used to promote euthanasia. This shift is from dying with dignity arguments based on the alleviation of terminal suffering to rights based arguments on the exercise of personal choice: ‘It’s my life. It’s my right to choose when to end it.’

The ‘rights’ case was argued today by Greg Barns, ‘Dignified death is a right’

‘In other words, the state has no right to interfere with a person’s right to privacy, that is to choose the timing and method of his death, or the right to dignity, when a person is suffering to the point that they are humiliated or they feel somehow less than human.’

This shift of argument forms part of an insightful article, ‘Dying and choosing’ by Ilora Finlay a in the prestigious British medical journal, The Lancet, Volume 373, Issue 9678, 30 May 2009.

‘This shift of emphasis in the pro-euthanasia campaign has potentially serious implications. As long as the case for euthanasia was linked with the symptomatic suffering of the dying process, the issue was more or less anchored to terminal illness. With the recent emphasis on personal choice and control, however, it is coming to encompass people whose illnesses are characterised not so much by distressing symptoms as by conditions, such as immobility and dependence on others, that are essentially person-centred.’

What are the implications of this shift of argument?

‘To put it another way, the choice and control agenda contains within itself the seeds of a natural progression from terminal illnesses, such as cancer or end-stage organ failure where those diagnosed usually have life expectancies of weeks or months, to chronic or degenerative illnesses whose sufferers may have years, even decades, of life ahead of them. If the keystone of the case for legalising euthanasia is to be the right of a patient to decide when he or she has had enough of coping with illness and to demand medical help to die, it is but a short step from there to arguing that such a facility ought to be available to people who face the prospect of many years of living with their conditions as well as to those who are in the closing stages of their lives.’

Also of interest is the compelling life story with which the article commences,

“I have never seen such a clear cut case for euthanasia” were the general practitioner’s words when he referred to me a young man with a fungating malignant spinal tumour. The patient’s distress was palpable and compounded by neuropathic pain. But, most of all, he hated losing control through creeping paraplegia and through his increasing dependence on his young wife, who was struggling to cope with their two children and 7-week-old baby. He asked me to end it for him, and his request persisted …’

‘Dying and choosing’ – valuable food for thought.