Suicide bill exposes the myth of choice

Of all the misleading concepts, the right to “choice” must take the biscuit. As a child, did I choose my family, where I lived or how I spent my days? No. Did my parents choose to be poor, to struggle to earn a living?

All our choices are hugely constrained by our age, our resources, our knowledge and skills, the needs of others around us, the rules we must adhere to and our status in the world. Most institutions choose us – or reject us – rather than the other way round. The choices we can actually make are just little details – peas or cabbage, the red shirt or the blue, Bob Dylan or Bob Marley. We are like prisoners choosing our cell. It is not easy for us to acknowledge this in a country that champions the values of democracy and freedom for all. We attempt to cover up this reality by pretending these little choices are evidence of our autonomy and rights when they are just a smokescreen for our growing inequality.

Take Lord Joffe’s proposed bill on assisted suicide. Many people are proclaiming that the terminally ill should have the right to choose suicide even when it involves the help of a doctor. They say safeguards will be included against any mistakes in prognosis or any sense of being burdensome to others. They also say there will be equality in the provision of effective palliative care, and measures taken against pressure from tired and stressed relatives to get it over with and prejudice against disabled people. So why don’t I believe them?

First, I have to ask who will benefit from this bill. If there is to be a choice between two types of death, which will cost more? Prescribing a lethal drug dose? Or doing something to change the fact that most of us will die alone and afraid in hospital, benefiting or suffering from the postcode lottery on palliative care and wishing to be at home?

Look what happens to disabled people when they are critically ill. Two of my best friends have been in hospital recently with severe chest infections. Both were asked whether they wanted to be resuscitated if they should stop breathing. You may say, “Good, they were given a choice”, but non-disabled people are not asked these questions. Different assumptions are made about the quality of their lives. Both were adamant that they still had a lot to do and needed all the time possible to do it. Both lived and are still active in their own fields. Many disabled people do not have such a strong sense of their worth or may not have been able to communicate their wishes about the choice but the assumptions would still be made.

Second, in this proposed bill, one person’s right to choice will require the active co-operation of another who will be asked to collude in the ending of a life. Until now this has always been considered illegal. To cross over this line by requiring a doctor to administer a lethal drug at the request of the patient seems dangerous to me. Many of us believe that human beings are not programmed to consciously harm each other. That we do so is an indication of how we can be persuaded that all our actions are in fact “good”. The use of the term mercy-killing is one example.

Third, I would want to look at other areas of government policy where people have been offered choice as a right – education, for example. The replacing of comprehensives with the dazzling array of city academies, specialist schools and so on has led to less choice for the poor and more for the middle classes.

Equality means we all get the same chance. We can decide to fight for a better quality of service for everyone, or to fight for choice for a select minority. If we opt for the choice route, we must accept that many more people will be left behind, struggling in under-resourced provision and unprotected in law.

We cannot have both equality and choice.