How the right to die improves the quality of life of rational dying people and their loved ones

Today’s Irish court judgment, in which Waterford man Gerald Vollrath was given a suspended sentence for attempting to murder his dying mother in a nursing home, shows the type of tragedy that will inevitably occur when we criminalize something that is morally good, and indeed that some people see as a moral obligation, which is helping a dying loved one to avoid unnecessary suffering.

Gerald Volrath is not a doctor or a lawyer or a criminal. He is an aviation worker, with no knowledge or desire to help somebody die, and no desire to break the law and become a criminal. He was watching his dying mother suffer unbearably from a severe stroke, Alzheimer’s, diabetes, heart and kidney problems. She was already receiving end-of-life care, and he did what his conscience told him was the morally right thing to do.

The case is complicated because it was not clear whether or not Mrs Vollrath was already dead before her son tried to end her life by suffocating her with a pillow. If it had been clear that she was still alive, her son could be facing a life sentence.

If assisted dying was legal for rational dying people, both he and she would have had the option of getting expert medical and psychiatric advice and help. She would have had the safeguard of knowing that her wishes would be legally respected, whatever they were. And if she had chosen to die, she could have had a more peaceful, painless and reliable option than possibly being suffocated.

Instead, we have the typical Irish tragedy of a nod-and-wink approach to the law, where even the High Court has effectively said that, yes, this type of thing is illegal, but in the case of Marie Curran the DPP will look at it compassionately. This ‘Irish solution to an Irish problem’ helps nobody. We need to know how the law will be interpreted.

To understand how the right to die improves the quality of life of rational dying people and their loved ones, we have to distinguish between rational and irrational desires to die, and between murdering a person against their wishes and helping a rational dying person to die peacefully rather than undergo unnecessary suffering.

Why do people choose to die?

Some people are not thinking rationally, and are undergoing problems in their lives that seem unbearable but are reversible. Some of these people will choose to take their own lives while they are not thinking rationally, and they will cut short what could have been a much longer life.

We should encourage these people to discuss their suicidal thoughts with appropriate professionals, and we should hope that they will find a way to deal with their problems rationally without wanting to kill themselves.

Indeed, one of the reasons for making suicide legal in Ireland was to encourage suicidal people to discuss their problems without fear of being criminalized, and to therefore help reduce the number of suicides.

On the other hand, some people are thinking rationally, and are terminally ill, and are undergoing unnecessary suffering before they inevitably die. For these people, it is not a question of whether they die, but of how they die.

Some of these people will want to stay alive until they die naturally, and some will want to die peacefully in order to avoid that suffering. We should respect the wishes of each of these people to choose to die in accordance with their own conscience.

Instead, we actively assist rational dying people who are willing to undergo unnecessary suffering before they die, but we actively hinder rational dying people who want to avoid unnecessary suffering before they die.

This is the opposite of morality, which should be based on applying compassion, empathy, cooperation, reciprocity, fairness and justice to minimize unnecessary suffering and to maximize quality of life.

The right to die improves quality of life

At this stage I am talking only about a specific type of person.

I am not talking about people who are thinking irrationally, and who want to die to avoid reversible life problems. And I am not talking about people who are thinking rationally and are terminally ill, and who want to continue to live as long as they can.

I am only talking about people are thinking rationally and are terminally ill, and are undergoing unnecessary suffering before they inevitably die, and who want to die peacefully, painlessly and reliably based on their own conscience.

For such people, the right to die is not mostly about the act of dying itself. It is about the increased quality of life that they can have, while they are still alive, by knowing that they have the safety valve of being able to end their suffering if they have to.

This was certainly the case with my late wife Anne Holliday, who died of cancer three years ago. Anne did not want to die, but she was not afraid of dying. What she wanted to avoid was unnecessary suffering before she died.

Once she had made preparations to be able to die peacefully, painlessly and reliably, and once she knew that I would help her to do this if she chose to, her quality of life increased massively for the remainder of her life.

Anne ended up dying naturally, as do most rational dying people who make preparations to be able to die in their own way. Also, Anne lived for year longer than was medically predicted, as do many rational dying people who make preparations to be able to die in their own way.

For this specific group of people, the right to die is not about the act of dying. It is about improving their quality of life while they are still alive.

Why do people choose to help a loved one to die?

Again, please remember that I am talking here only about people are thinking rationally and are terminally ill, and are undergoing unnecessary suffering before they inevitably die, and who want to die peacefully, painlessly and reliably based on their own conscience.

Ironically, if such people are capable of committing suicide without any help from anybody else, we in Ireland allow them to kill themselves legally. But if they need help or advice from anybody else, we make it illegal for anybody to help them to die peacefully.

In practice, often because of their illness, many rational dying people will need help to carry out their wishes to die peacefully. Ideally that should be professional help. However, when assisted dying is illegal, often the only help they can get in practice is from their loved ones.

This puts the loved ones of the dying person in a terrible situation. They typically do not have the knowledge or desire to help somebody to die, and they typically are law-abiding citizens who do not casually choose to commit a crime.

It also adds to the stress of the dying person, who typically does not want his or her loved ones to be criminalized for helping them to avoid unnecessary suffering.

How the law can improve quality of life

We have made it legal for a person to commit suicide, whether or not they are thinking rationally, partly because that encourages suicidal people to talk about their concerns without fearing that they will be criminalized, and can therefore result in fewer people actually committing suicide.

We should apply the same reasoning to assisted dying for rational dying people, who want to avoid unnecessary suffering. This is on the most morally clear end of the spectrum of people wanting to choose how to die.

Mr Justice Paul Carney quoted from the judgment of an English case, where a mother had taken the life of her severely disabled son with the intention of ending his suffering.

“The law of murder does not distinguish between murder committed for malevolent reasons and murder motivated by familial love… Mercy killing is murder… Even a life lived at the extremes of disability is not one jot less precious than the life of an able-bodied person… Until Parliament decides otherwise, the law recognises a distinction between the withdrawal of treatment supporting life, which, subject to stringent conditions, may be lawful, and the active termination of life, which is unlawful.”

The key phrase in that quote is “until Parliament decides otherwise”. The Irish Parliament, like the English Parliament, can change the law to make assisted dying legal, along with safeguards to protect vulnerable people from being pressurized into dying earlier than they wish to.

Until then, some rational dying people will undergo unnecessary suffering before they die, and some will take their own lives to avoid that suffering, and some people will help their loved ones to do this and will be criminalized for doing something that is morally good.

Leave a comment

Your email address will not be published. Required fields are marked *