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Catholic Medical Quarterly Volume 61(3) August 2011 42-4

Book review
A Time To Live. The Case Against Euthanasia And Assisted Suicide

By George Pitcher
Monarch Books
ISBN 978 1 85424 987 6

Reviewed by Dr Pravin Thevathasan 

Pitcher's fine introduction to these topics gives us some startling truths to ponder. It is often argued by proponents of Assisted Suicide (AS) that the law on AS in Oregon is a paragon of good practice. In fact, Pitcher notes that "if Oregon's experience is proportionally calculated for the UK, we would have had a rise over the period from 1998 (when AS in Oregon was made legal) to 2008 of 389 to 1426 lethal prescriptions issued, while AS would have risen from 259 to 972."

Among the safeguards in Oregon is the requirement that doctors ensure there is no underlying mental disorder suffered by those requesting AS. The number of those referred for psychiatric evaluation has fallen from 37% in 1998 to 0% in 2007. It is of note that those who seek AS in Oregon shop around for ‘sympathetic’ doctors, making nonsense of Lord Falconer's plans to have two registered medical practitioners, independent of each other, certify that they are of the opinion that the person seeking AS is terminally ill and has capacity. The majority of those seeking AS in Oregon say that they find being cared for by others to be intolerable. This is very different to the ‘intolerable pain’ of terminal illness. Few physicians are present when the persons kill themselves. So there is no way of knowing whether the drugs are self-administered or administered by others.

In Holland, the 2002 law legalizing AS and euthanasia is not limited to adults. Nor does an applicant for euthanasia have to be terminally ill. The main criterion is ‘hopeless and unbearable suffering.’ NVVE, Holland's opposite number to UK's Dignity in Dying, has suggested that applicants are invited to opt for euthanasia "when it is virtually impossible for me to perform what for me are worthwhile activities such as reading, writing, watching television, listening to music and doing manual works or handicrafts."

Zurich has become the European capital for ‘death tourism.’ The Attorney General of the Canton of Zurich told the 2005 UK Parliamentary Select Committee that he was concerned about the circumstances where "a person comes today and dies the same day." This is common practice in the notorious Dignitas ‘clinic’. Dignitas helps people kill themselves in hotels and even in cars parked on the outskirts of Zurich. Ludwig Minnelli, the millionaire founder of Dignitas, has said that he would like to help people with mental illness kill themselves: "I say suicide is a marvellous possibility given to a human being. Suicide is a very good possibility to escape a situation which you can't alter. It is not a condition to have terminal illness. Terminal illness is a British obsession." Daniel James, a twenty three year old who was paralysed from the neck down, was taken by his parents to die at Dignitas. Sir Edward Downes and his wife also died there. She had a terminal illness. He did not.

Switzerland, Holland and Oregon are highly developed parts of the world. If AS is unmanageable in these places, would it be better managed in the UK?

Not all the theological arguments put forward by Pitcher are convincing. But his ethical arguments most certainly are.