THE BLOG

Tony Nicklinson and the Ethics of Assisted Dying

31/08/2012 09:09 BST | Updated 29/10/2012 09:12 GMT

His own determined advocacy, the effective use of the media to promote his cause, and the ongoing eloquent, ethical and dignified support of his wife and daughters have guaranteed that Tony Nicklinson's death has not been the end of the public debate he reignited.

In the debate, though, there has been a general absence of supporters from public life for his position; those who have not opposed assisted dying entirely have nonetheless restricted themselves to advocating the legalisation of assisted dying only for people who are terminally ill.

The case of Tony Nicklinson, unbearably suffering from an incurable condition that prevented him from taking his own life but not terminally ill, went further and it was further than some campaigners said they were willing to go. Because of that, it is worth rehearsing the strong moral case for us, as a society, to provide exactly what Tony Nicklinson wanted to be provided.

Firstly: a mentally competent adult should be afforded control over his or her own body. Only our thoughts are perhaps more personal and more wholly owned by us than our bodies and the right to bodily integrity and autonomy of each person is the most important guarantee we have of individual dignity.

Secondly: some people - through disability - are unable to give effect to their own desires. This can create great suffering for them.

Thirdly: compassion should motivate us to alleviate suffering and we should be moved to help those who cannot help themselves. If a person is not capable of fulfilling their own legal desires and there are others willing to assist them in fulfilling their wishes, there is no obvious reason why the law should criminalise the helper.

Fourthly: the intentional ending of one's own life is legal and, more than that, is an act that a rational and mentally competent person may well consider - in extreme circumstances - to be preferable to continued life.

Respect for the autonomy of a free individual, however disabled, combined with the principle of compassion, undeniably indicates that society should provide assistance to those in Tony's position.

In 2011 I was called to give evidence to Lord Falconer's Commission on Assisted Dying and I made this case. In the end, the Commission came out only for assisted dying for the terminally ill. This was a great shame because, ultimately, support for assisted dying for terminally ill people but not people like Tony Nicklinson is a vote for more human suffering, not only on a social scale but at the individual level. After all, someone like Tony Nicklinson might have to suffer decades of torment compared with the briefer suffering of a terminally ill person who the Commission would be happy to see assisted to die.

Recognition of the inhumanity of this has recently come in British Columbia, where the Supreme Court has ruled that Canada's laws against assisted suicide are unconstitutional, because they discriminate against physically disabled patients (who, unlike other people, cannot take their own lives). The court has given Canada's federal parliament one year to legislate on the matter while, in the meantime, giving Gloria Taylor (seriously ill with Lou Gehrig's disease) permission to seek doctor-assisted suicide during that period.

It is right for us to act compassionately to alleviate suffering, just as we would hope that our suffering would be alleviated; and it is right that we respect the choices of the person who we wish to help, just as we would wish our own choice (whether to live or die) to be respected. The only really difficult ethical question surrounding assisted suicide is how we can ensure that an individual's desire to end their life is the genuine, settled, free choice of a mentally competent individual. Of course, therefore, there must be safeguards in any future regulation of assisted dying. But as long as stringent safeguards are put in place, it is difficult to see the ethical case against it being provided at all.