Dying with dignity is open to all, whatever the cause of death

The case highlights the dangers of tampering with laws prohibiting the deliberate taking of human life. Vulnerable people can be manipulated by others — ­including close family members — who may want to shed the ­burden of caring or want to enrich themselves.

Western Australia could be the next state to legalise euthanasia following recent recommendations from a parliamentary committee. Intended to apply to people suffering from a terminal illness, a new law aims to limit what the report called “unnecessary suffering at end of life”.

Cross-party support for the recommendations could lead to a bill being presented in the WA parliament early next year, with MPs promised a conscience vote. If such a bill is passed, WA would become the second state in Australia to permit euthanasia.

Until recently, it was an ­offence everywhere in Australia, punishable by up to five years in prison, to incite, counsel or assist another to commit suicide.

But late last year Victoria passed a Voluntary Assisted Dying Act, making euthanasia and assisted suicide legal from the middle of next year. The Victorian law will allow a person over the age of 18 and suffering from a terminal illness to obtain a lethal drug after having completed a three-stage process involving two independent medical assessments.

Shortly before the Victorian legislation was passed, an attempt was made in the NSW parliament to enact a similar bill, but it failed to pass in the upper house by one vote. Attempts to pass ­euthanasia legislation also have failed in Tasmania and South Australia.

But the movement to decriminalise euthanasia continues to gain momentum. Most recently senator David Leyonhjelm proposed a private member’s bill to restore territory rights to legislate on euthanasia, which were set aside in 1997 by the Howard ­government.

Leyonhjelm’s bill subsequently was voted down but in his second reading speech, delivered in 2016, the senator stated that his principal concern was to assert the “fundamental and legal right to choose whether we wish to continue living” — and to be able to seek help if we choose to die.

His argument was about relief from a supposed experience of unendurable suffering. But once permission for assistance is ­granted to someone who is in physical pain — such as Morant — that permission must be extended to anyone wanting to commit suicide who is in any kind of pain whatsoever.

The terminally ill usually are listed as the first and most obvious candidates for assisted suicide but the categories of eligibility are elastic. They can be extended easily enough to just about anyone of any age who is tired of life — such as 104-year-old David Goodall, who ended his life in a Swiss clinic.

While most opponents of ­assisted suicide, at some time or another, are bound to be cast as ­religious bigots by their critics, not all calls for legal reform come from secular advocates. Many Christians favour ­assisted suicide in the name of human dignity.

Similarly, opposition to legalising euthanasia in Australia comes from a broad cross-section of the community. Some are religious and some are not; but with assisted suicide now legal in Victoria, ­opponents want to stop com­parable changes in the law in the rest of the country.

Language is used in elliptical ways in the debate about ­euthanasia. One prominent phrase that falls easily enough from the lips of many people in liberal democracies, such as Australia, is “dying with dignity”.

It’s a coded phrase, of course, referring to the idea that we should be entitled to decide how and when we die — as if an ­unexpected death or one that comes as a result of illness rather than our own volition is lacking in dignity. “Dying with dignity” appears to be a lifestyle choice.

The Oxford English Dictionary defines dignity as “the quality of being worthy or honour­able”. Worthiness and honour are the central notions of dignity. They are not necessarily to be found or expected in every human being.

Dignity cannot be synonymous with life because a person can live without dignity, but human life is obviously a neces­sary condition of there being human dignity, for without life there can be no possibility of dignity at all.

In their appeals to dignity, those on either side of the debate claim their position is the ethically correct one. As bioethicist Margaret Somerville says, these seem paradoxical until we understand that each side uses the term dignity differently.

Opponents of euthanasia ­insist dignity is anintrinsic characteristic. Humans have it simply by virtue of being human. Dignity is an inherent quality of human beings and cannot be diminished by disease or infirmity or lack of capacity.

Meanwhile, proponents of ­euthanasia insist dignity is an ­extrinsic characteristic that can disappear when an individual loses autonomy and control. Providing assistance in suicide ­restores control and safeguards the dignity of the individual.

Clearly, dignity is used in very different ways in the euthanasia debate.

Some argue that a subjective approach to dignity ­always needs to be adopted when discussing ways of dying: if a person thinks dying in a certain way lacks dignity then it would be ­undignified for that person to die in that way.

But if “dying with dignity” were entirely subjective, its meaning would elude us. Dying without dignity simply would be a felt ­experience. Merely for a dying person to think they were dying without dignity would mean they actually were dying without it.

Fears about a loss of extrinsic — or social — dignity have been fuelled, in part, by advances in medical technology that can allow people to live for far longer than in earlier times. In the name of compassion, some say, we must spare people from the ravages of technology.

Compassion features prominently in arguments for the legalisation of euthanasia. Its advocates say people should not be kept alive against their wishes and should be allowed to die when they choose.

But any person already has the right to refuse treatment, even if it means an increased risk of death. And the right to refuse treatment — or to request treatment to be withdrawn — is very different from asserting the right to die or the right to be killed.

Allowing the patient to die at some point is a practical condition of the successful operation of modern medicine. Killing a ­patient is not.

Sparing vulnerable patients experiencing “unbearable pain” is also invoked as a compassionate ground for legalising euthanasia. Yet available data suggests the ­experience of unbearable pain does not appear to be a principal reason people seek assisted suicide.

The Oregon Death with Dignity Act data summaries record details of those who have taken advantage of the US state law permitting suicide by a self-administered lethal dose of medications.

As of January this year, 143 Oregonians were reported to have died from ingesting the medication. Of those, 87 per cent gave loss of the ability to ­engage in ­activities that make life enjoyable as their reason for seeking assisted suicide. Only 27 per cent gave ­unbearable pain as the reason.

If the Oregon figures are representative of other places where euthanasia is available, the reason for seeking assistance in dying is relief from intolerable pain in only a minority of cases.

Anxiety about loss of autonomy is by far the more prevalent reason. Compassion about pain is misplaced.

The argument for compassion is weak, in part, because of its ­association with those problematic concepts of dignity and “dying with dignity” to which proponents of assisted suicide appeal. Yet it is not external circumstances that determine the dignity with which death is met.

While it is true one can die in undignified circumstances — by execution or torture, for example — such a death can, at the same time, be dignified if the person confronting death does so with a spirit of worthiness, nobleness and honour.

“Dignity in the face of death cannot be conferred from the outside but requires a dignity of soul in the human being who faces it,” philosopher and physician Leon Kass argues.

Dying with dignity is a possibility for all but depends on the character and bearing of the individual who is dying.

In the 20th century, we witnessed the consequences of the profound contempt shown, at times, for the weak and the infirm. Now it is important to affirm that those human conditions do not rob — and must never be allowed to rob — any person of the dignity they possess.

Peter Kurti is a senior research fellow at the Centre for Independent Studies. This is an edited extract from his latest book, Euthanasia: Putting the Culture to Death?