We need the right to a dignified death. But we need to acknowledge the risks involved, as well

Tony Nicklinson
Tony Nicklinson, who has died aged 58

The trouble with us as a species is that we’re not very good at complexity and nuance. If we think something’s bad, we think it’s all bad; if we think something’s good, we think it’s all good. It’s been demonstrated that if we think something has plenty of benefits, we tend to subconsciously downplay its risks; likewise, if we think it’s risky, we’ll tend to assume it’s got no benefits.

The psychologist Paul Slovic has shown that, with controversial issues like nuclear power or vaccination, people who are against them think they have little or no benefit and lots and lots of risk. Those who are in favour think it’s got lots of benefits and no risks. What’s more, if someone spends some time convincing you of the benefits, you’ll automatically find yourself believing that it has fewer risks – even though you have no new evidence whatsoever regarding those risks – and vice versa.

This morning, Tony Nicklinson, the right-to-die campaigner and sufferer of locked-in syndrome, died. His lawyers announced that he passed away at 10am this morning. Last Thursday, he lost his High Court case which would have allowed him to choose the time of his own death, by protecting his doctor from prosecution if he were to prescribe Mr Nicklinson a lethal dose of painkillers.

On his Twitter account, his daughters Jane, Lauren and Beth announced that he died peacefully, aged 58, of natural causes. I’m glad to hear that.

I’m a supporter of the right to die. And the reason I mention our inability to process the idea that something has benefits and risks is because, as a supporter, I can’t bring myself to entertain the fears that opponents have: that a widened right to die would lead to more elderly patients being pressured into an early grave by inheritance-greedy or duty-worn offspring, or of doctors to kill off patients who are too much trouble to save. All I can imagine are the benefits: the agony prevented, the dignity maintained. Opponents, meanwhile, see only the risks, and overstate the efficacy of palliative care, thinking that all the horrors of terminal illnesses can be avoided with suitable pain management. Palliative care is vital, but it can only do so much.

There are risks, and there are benefits, and people on both sides have to acknowledge both. Almost nothing good in the world comes without a cost, and it is possible that there would be a rise in horrifying incidents of grandparents forced into suicide. I don’t know of any evidence that it has happened in those places, like Switzerland and Oregon, where assisted dying is already legal, but confirmation bias being what it is, I probably haven’t looked for it.

There’s a serious and difficult question here. What’s the balance? How many forced suicides – murders, let’s call them – are we willing to accept for how much end-of-life agony prevented? Is it literally zero? That seems unlikely: we’re never completely risk-averse. We usually accept a small number of human tragedies in exchange for wider liberties, like traffic deaths for the freedom and convenience of driving, heart failures for the freedom to eat junk food, lung cancer for the freedom to smoke. There’s always a balance.

But to find that balance, we need to find out as best we can, through careful examination of statistics from Oregon and elsewhere, what if any the increased risk to patients is from loosening of right-to-die laws; and we need to work out what steps we can take to reduce them. The freedom to end your life at a time of your choosing should be yours; but those of us who believe that need to start by acknowledging the risks.


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