Assisted dying: who's to decide when a life is not worth living?

Changing interpretations of the Abortion Act show how little legal safeguards are worth when the sentiment behind them is lost

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'Tony Nicklinson made such a powerful figure as his mind was unaffected but his body was ruined.' Photograph: Matt Cardy/Getty Images An extraordinary poll published by the British Humanist Association (BHA) highlights the public ambivalence about assisted suicide and euthanasia. In conjunction with other recent surveys, it shows that more people are in favour of the law allowing the killing of relatively healthy patients like Tony Nicklinson than of those who are terminally ill. The "respectable" wing of the assisted dying movement, Dignity in Dying, wants a very limited right to medically assisted suicide: only people who are terminally ill and in full possession of their faculties would qualify. Even this limited position is hugely controversial. But the BHA believes that doctors should be allowed to help kill anyone who really wants to die and who cannot manage for themselves. This applies explicitly to perfectly healthy people as well as the terminally ill. And it is more popular than the limited position. No more than 15% of the population are opposed, or strongly opposed to it. In fact, these attitudes are perfectly coherent and show that people understand there are clear limits to individualism. What the public wants is for everyone to have the right to determine as much as possible about their own lives. This includes the manner and moment of death.

Suicide then becomes the grandest and clearest declaration that our lives are our own to do what we want with. You may think that this kind of autonomy is unrealistic and that it can lead to a distorting egoism. I certainly do. But that doesn't make it any less attractive. It speaks to a rather gnostic idea of our being free spirits trapped in gross bodies, which is why someone like Nicklinson made such a powerful figure: his mind was unaffected but his body was ruined. Yet in practice we do know that no one is like that, and certainly no one is like that all the time. Nicklinson's reasoning powers may have been entirely unimpaired by his illness, and may even have been sharpened by it. But a mind is much more than the sum of its reasoning powers. The condition of his body furnished the contents of his mind, and the material he had to reason on. Just as important was the attitude of his family and those around him. I don't want to suggest for a moment that they were actuated by anything but love and the desire to help him realise the end he wanted for his life. The point, however, is that their decision and their support were very important. Had they opposed his wishes he would hardly have got anywhere. And, of course, families often do disagree about what's best for a family member. In almost all normal circumstances, the ideal of autonomy comes up very sharply against the reality of interdependence, and sometimes straightforward dependence. That is why people are quite rightly suspicious of the apparently more limited programme of allowing doctors to kill off the terminally ill who are clear that they want to die because their life offers nothing more than suffering. Those who stand to benefit from someone's death are very likely, sincerely, to see the life they want to end as hardly worth living. This is a nasty fact about human nature, but any kind of humanism that isn't grounded in human nature is no more than ludicrous and sinister selfdeception. Our propensity to self-serving self-deception is one reason why Christians must insist that God loves every one of his creatures; no one except God does or could. No wonder that the most recent piece of anti-euthanasia propaganda that I was sent highlighted a figure of 300,000 incidents of elder abuse every year. Supporters of assisted dying see this point. But it just makes them believe more firmly that the right kind of legislation, with the clearest possible safeguards, will stop unwanted grannies being liquidated for their asset value. I can't share that confidence. Really demented and unpleasant old people can appear rather less human than foetuses do and the changing interpretations of the Abortion Act show how little legal safeguards are worth when the sentiment behind them evaporates. Whether or not you think that British women ought to have access to abortion on demand, that's not what the law says, nor what parliament intended in 1967. If a mother has the right to dispose of an unwanted foetus, why doesn't a daughter have the right to dispose of an unwanted, incoherent and incontinent old person whose miserable life will only ever get worse? What could be easier than to propose to such a creature that its life is not in fact worth living? The Tony Nicklinsons are the easy cases to legislate for, not just because they are rare.