Euthanasia: A Slippery Slope?

By Eimear Crawford

If you watched ITV news in the last week, you may have become familiar with Alastair Hamilton, a British man who chose to travel to Switzerland to end his life at the Pegasos euthanasia clinic. As the law currently stands, Alastair does not have the option of undergoing assisted dying at home in the UK. But this is positioned to change, debates around legalising assisted dying have become widespread within various jurisdictions in the UK. Some of these debates have manifested into bills, forging the first steps on the journey to legality. In Scotland, the Assisted Dying for Terminally Ill Adults Bill has passed the first stage of approval, allowing it to be introduced in Holyrood. The MSP behind it, Liam McArthur, hopes to see his bill passed in 2025. Likewise, in the Isle of Man, it has been postulated that a proposed bill legalising assisted dying could be passed by 2027. There are no current debates around assisted dying in Westminster, but with Keir Starmer, Labour leader and possible future Prime Minister in support of assisted dying, that could be set to change. The question is: should it?

Both the Scottish and the Manx bills are united through the necessitation that assisted dying would only be extended to adults suffering from terminal illness which is ‘advanced and progressive,’ and who have been ruled to be mentally fit by two doctors. On the surface, it seems like there’s enough safeguards here. No one’s saying euthanasia should be extended to anyone suffering from illness, even the legislators creating these bills want to keep them limited to the terminally ill. The point isn’t to lead people to death, it is to give the ones who are already dying a kinder one. But just because a law starts out as restrictive does not mean it will stay that way. In the Netherlands, for example, people suffering from psychiatric illnesses can be eligible for euthanasia. In 2023, 138 people chose assisted dying due to mental health problems. One of them is Zoraya ter Beck, who felt her struggles with anxiety and depression had reached the point of hopelessness.

Of course, there are extreme and compelling cases where people have chosen euthanasia despite not being terminally ill. Mark van Dongen was the victim of an acid attack which left him paralysed and bed bound. He chose to end his life when he was told his next medical procedure would rob him of the ability to speak to his father. But such harrowing cases are not the norm, and the idea that a person suffering from psychiatric illness could have their doctor recommend assisted dying is at worst downright dangerous. In the case of Zoraya ter Beck, for example, she acknowledged she had long suffered from suicidal tendencies. Allowing the suffers of psychiatric illnesses to be eligible for assisted dying surely sends a message to the darkest parts of their illness: that they really can’t live with it, and that their only option might just be to give up.

I watched Alastair Hamilton’s story on social media, told by his mother and his brother. He was 47. He suffered from depression and an undiagnosed stomach problem which he described as causing him pain and fatigue in the 300 words Pegasos gave him to explain why he wanted to die. He didn’t tell his family where he was going. They found out when his mother reported him missing and police traced his whereabouts to the clinic where he ended his life. Watching the report, I was struck by the way it seemed Alastair’s suffering hadn’t gone anywhere, only moved to his loved ones. But I was also struck by the comments underneath the video. People were sympathetic to Alastair’s plight, they understood why he’d done it, they often wanted to do it themselves. And under every one of these comments came a reply that it gets better, that they had once been in the same position themselves and in time had come to find life worth living. It was a massive outpouring of hope under the story of a man who had lost his.

In Northern Ireland, there is a mental health crisis, exacerbated by the challenges faced by the health service as a whole. Alastair’s story emphasises the need for access to effective, timely treatment and support for psychiatric illnesses. People who suffer from mental illness deserve compassion and medical practitioners who believe in their worth and capability to recover. They shouldn’t have their worst thoughts affirmed by their doctors, that their illness cannot be beaten and the only thing they can do is die. Legislators and euthanasia campaigners undeniably have good intentions when drafting these bills; after all, easing the suffering of those dying can surely only be a good thing. But if and when assisted dying is legalised in the UK, they must make sure these restrictive laws remain restrictive, and do not grow to endanger vulnerable groups such as disabled people or those with mental illnesses by pushing them towards extreme ends rather than making their recoveries and accommodation in every day life a priority.

Edited by Fleur Howe