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Capturing the language of (assisted) death

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Those promoting the agenda that, in plain speaking, wants the UK to legalise doctors to be able to provide a prescription for a lethal draught with which patients can kill themselves, have a long history of shape-shifting their language. Morphing from the Voluntary Euthanasia Society to Dignity in Dying in 2006 was a smart – if not uncontested – move.

Gradually shifting the terms of the debate and hence the questions asked about it in public surveys, from ‘assisted suicide’ to the muddier waters of ‘assisted dying’ was another masterstroke. Resolutely  opposed as I am to legalising doctors assisting patients to kill themselves or to intentionally kill them at the patient’s request, when faced with a YES/NO tick box after the question ‘Do you support assisted dying?‘ even I have ticked YES in the past. At that time I used this term to refer to symptom control by palliative care teams during the dying process. If you ask that question you will get a very different set of responses from asking ‘Do you think doctors should legally be able to help patients kill themselves?‘ This is far less ambivalent but campaigners for assisted suicide know it will get far fewer positive responses, so they will never ask it.

Massaging the numbers of supporters is another well-known ploy in campaigning. Nobody likes to be in a minority do they? There are some 195 countries in the world and only 24 jurisdictions in 12 countries* have made assisted suicide (which for obvious reasons I will continue to call it here) legal (or at least decriminalised). Only seven of these (the Netherlands, Belgium, Luxembourg, Spain, Canada, Colombia and Western Australia) have legal euthanasia as well as assisted suicide.

So only around 10% of the world’s countries have legalised assisted suicide, though the number of people with access to assisted suicide in such countries was recently estimated at 200 million, which is around 2.5% of the world’s population.

You would never know this, however from the recent posting by Humanists UK who have taken manipulation of language to new depths in their Mapping Assisted Dying Laws around the World. According to this map, either assisted dying or a form of euthanasia is lawful in 67 countries thus making it appear that over a third of countries allow assisted dying or a form of euthanasia.

How has this trebling of nations allowing legalised assisted dying or euthanasia been achieved?  By including nations which permit what they term ‘voluntary passive euthanasia’. Having spent the last decade educating a generation of students why this misleading term is best avoided, the use of it here perfectly illustrates why it should be dropped. The Humanists’ website does correctly explain in a footnote that ‘“Voluntary passive euthanasia” refers to the cessation or refusal of life-sustaining medical treatment, which will eventually result in death’ but how many readers will understand that this means it is not euthanasia at all?

Stopping or refusing life sustaining medical treatment can often involve difficult ethical issues but it is not a form of euthanasia by definition, in which doctors take action to end patients’ lives by administering lethal drugs. If refusal or cessation of life-sustaining treatment is included in the map, it is no longer representative of a true picture of the extent of global legalised assisted suicide and euthanasia but rather leads to confusion and obfuscation of the true picture. The compilers themselves seem to demonstrate this very confusion by including some countries such as Trinidad and Tobago and UAE, both in the list of countries in which ‘assisted dying is unlawful’ and also in the list of countries which allow ‘a form of voluntary passive euthanasia’.  No further evidence than this is needed as to why the latter term is confusing.

Truth matters, especially when an organisation seeks to ‘make sense of the world through logic, reason, and evidence’. It should be of the utmost importance for Christians, too, who should also attend to such important ways of understanding. The misuse of language in order to obscure the truth is upbraided many times in scripture. ‘Woe to those who call evil good and good evil,’ Isaiah 5:20 warns. But perhaps the most chilling reminder comes from Jesus himself in the Sermon on the Mount: ‘But let your “Yes” be “Yes,” and your “No,” “No.” For whatever is more than these is from the evil one.’ (Matthew 5:17).

 

Trevor Stammers is a freelance author and editor and retired GP and Associate Professor of Bioethics.

I am grateful to Dr Mark Komrad for drawing my attention to this map.

*There doesn’t seem to be an up-to-date list anywhere of jurisdictions which have passed assisted suicide or euthanasia laws. This figure is drawn from the list in this paper and other internet sources.

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