Opinion: Ironies abound in the euthanasia debate

Peter Cardy, chief executive of Macmillan Cancer Relief

The dictum, attributed to Voltaire, "I disapprove of what you say, but I will defend to the death your right to say it", has rarely seemed more apt than in the rumpus in Parliament and the press between the palliative care charities and Dignity in Dying, the renamed Voluntary Euthanasia Society.

The palliative care organisations want to prevent the appropriation of a benign-sounding phrase by an organisation they see as anything but benign.

They suggest that the real intention of Dignity in Dying is still to secure a change in the law to permit euthanasia.

Whatever your position on euthanasia, the situation is full of irony.

The development of palliative care in the UK, along with advances in medical technology and a consumerist view of health and disease, have together been responsible for an expansion of choices about dying in the past 25 years. The palliative care movement is leading a campaign on choice at the time of death: most of us say we wish to die at home, but most people usually die in a hospital.

This advance will mean you can choose where you die, whether you accept artificial feeding or ventilation, whether you have pain control and whether you are to be resuscitated if you have a heart attack. For decades since a change in the law, you have been able to choose suicide without fear of jail if you make a mess of it. You can in principle make choices about almost every aspect of your own death. What you can't do is get someone else to help you without them risking prosecution.

Many of society's anxieties converge in this argument. Doctors worry about what it would do to their role if they were accomplices in killing, others point out the 'slippery slope' towards doing away with inconvenient individuals, and others argue for the sanctity of all life. There is a dispute about the evidence from jurisdictions where assisted dying is legal. Yet the fact that the argument can take place at all, and that the British Medical Association and the Royal College of Nursing, among others, have softened their stances, indicates a wider shift in attitudes.

Only the voices of people shortly to die remain inaudible in the uproar.

The voluntary sector in the UK permits, even encourages, divergent and opposing beliefs to be articulated. How strange if an alliance of one set of voluntary bodies were to lead to the suppression of another. What would Voltaire have said?

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