I’m sure my past correspondents at the VES would vehemently disagree with the following, but I found Dr Kathryn Mannix’s letter in yesterday’s Guardian to be considered, interesting, and well-argued:

I am a consultant in palliative medicine and over my 19 years in this area I have been asked about euthanasia by patients many times, but only three patients have ever asked me to provide assistance with their deaths. Patients usually ask about euthanasia as they consider all the future possibilities of dealing with a progressive and incurable illness. But it is a measure of the ability of human beings to cope with situations previously considered unendurable, so few requests for euthanasia actually arise. However, a small number of people continue to consider that they would prefer to be dead, and for them and their supporters the current law is the cause of much criticism.

The bill to legalise assistance with dying, currently before the House of Lords, arises from the argument that to deny assistance is to deny the autonomy, or right to choose, of an individual. Proponents describe this denial as dehumanising, as though exercise of autonomy alone is the mark of human personhood. The humanising aspect of choice is its potential for nobility: as humans, we can reflect on our being and on the consequences of our choices. The right to choose to die with medical assistance, when placed in this context, must be weighed against the nobility of relinquishing this right if its commission would damage other, possibly more vulnerable, members of our society.

The person who is more vulnerable is the person with a terminal illness who acknowledges that the part of their life that is without suffering is over, but who is now afraid that other, powerful people may assume that they would prefer death to continuing to live in this way.

The current law presumes that life should not deliberately be ended. This protects thousands of dying people from any anxiety or uneasy self-doubt that they may be selfish not to opt for euthanasia and relieve their loved ones of a burden of care. It protects doctors from the accusation that we act to end life as we carefully adjust the doses of sedatives that are sometimes needed to control pain for terminally ill people.

To change the law so that euthanasia is permissible would immediately remove these protections, for the benefit of a small but vocal number of patients who would value their own autonomy above the protection of those even more vulnerable than themselves. This bill is clearly grounded in compassion, but it is compassion without clear vision. For the sake of the human dignity of those most vulnerable in our society, legalisation of assisted dying should not be permitted.

This is certainly one argument I haven’t really considered in detail before, but, on balance, I don’t think it radically alters my personal position on the issue; but that’s not to say that I can’t be swayed.

Another letter states that

Recent correspondence was summarised in the current issue of the British Medical Journal as showing an overwhelming response against physician assisted suicide.

This raises a further important question: If the majority of doctors are against the idea of physician assisted suicide, then presumably a majority will choose not to do so, even if given the power, on ethical grounds, in the same way that many doctors refuse to carry out abortions, or directly refer their patients to abortion clinics. Who, then, is to carry it through? Are we to blindly create a new speciality of killing patients? And if so, are these really the best doctors to judge the situation, or would it not be very difficult for a doctor who has never previously met a patient or assessed them over time to truly judge whether a patient is ready and actively wanting to die?

Clearly, there’s a lot of suffering that could be relieved through the legalisation of euthanasia, and I don’t think anyone can deny that. Therefore, it’s difficult to do anything but support the idea in principle. But then, communism works in principle. Reality is often a very different kettle of fish, and hence I can see no other choice than to oppose the proposed legislation.