Choosing to die

Abstract

Having seen Terry Pratchett's film Choosing to Die on Newsnight , (13 June 2011), I was deeply moved by its sensitivity, Pratchett's own personal response, and the bravery of Peter Smedly and his wife. I was disappointed by the ensuing debate where rather entrenched positions entangled people's contributions so that real listening or movement of ideas became impossible. My own views on euthanasia or assisted suicide have shifted over time. Initially I was against, on the grounds that given good palliative care it should not be necessary, and that life is a gift to be received, almost like prayer book matrimony: ‘for better or worse’, and not a consumerist contract to be ended when it suits. While I still think those arguments are valid, I now feel that in individual circumstances an individual can rightly choose to end their life as a positive act of affirmation rather than one of despair. There is something to be said for leaving an ongoing party, rather than waiting for the bitter end. I can think of a few of my patients who over the years have made that decision, and many more who have expressed concern that they might be unable to do so because of incapacity and the medicolegal process. The Newsnight debate oscillated between two poles. Firstly, one of individual self-determinism: an individual has the right to choose the time and manner of his death, especially if, in doing so, he is seeking to escape suffering. In a caring society that respects individual autonomy we should support …