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Global 21 fourth quarter 2015

Arena Health The Netherlands In April 2002 the Netherlands became the first country to legalise assisted dying and euthanasia under the strict conditions that the patient is in unbearable pain and that their demand for death is made in “full consciousness”, and children between the ages of 12 and 16 must require the consent of their parents. In 2010 a lethal cocktail was administered to 3,136 people under medical supervision. Since 2005 there have been an average 15,000 cases of palliative sedation a year, wherein patients who have less than two weeks left to live are put into a medically induced coma with all nutrition and hydration withdrawn, according to the Royal Dutch Medical Association. France In March of this year France passed legislation that gives doctors the power to put terminally ill patients into a “deep sleep” until they die – a move supported by 96 per cent of French people, according to polls. Again, the law applies to patients who are in “unbearable” pain, as well as those for whom treatment has proved ineffective or who have stopped taking medication. The move – one of President François Hollande’s campaign promises – comes ten years after France legalised “passive euthanasia”, in which the treatment needed to maintain life is withheld or withdrawn; under the new law, doctors are able to combine this with deep and continuous sedation. The change in legislation was, in part, triggered by the 2014 suicides of two couples who were in their 80s; one couple took to Le Lutetia, a luxury hotel where they dined in their room and were later found lying hand in hand, plastic bags over their heads and nearby, with a note that claimed “the right to die with dignity”. While Switzerland has allowed assisted suicide since 1942, it was the Netherlands in 2002 that opened the doorway to legalised euthanasia, and other countries soon followed. Belgium made the shift to decriminalise euthanasia in the same year, followed by Luxembourg in 2009 and later by Canada and Colombia. Certain states in the USA – Oregon blazing the trail in 1997 with its Death with Dignity Act, followed by Washington in 2008, Montana the year after, Vermont in 2013, New Mexico 2014 and California in October this year – have joined the ranks since the 1997 United States Supreme Court ruling that each state should be responsible for resolving its own stance on assisted dying. Now the debate on the right to die is again gaining momentum as the population of the developed world grows greyer and greyer: according to figures from the World Bank, low-income countries have an over-65 population averaging 3.4 per cent, while in middle-income countries this figure is at 8.1 and in high-income countries it’s 16 per cent, and growing rapidly. In the UK over- Jeffrey Spector had to travel abroad in search of an assisted death because of the prohibitive laws currently in place in the UK, which ban assisted dying. The case provoked renewed discussion on the issue in the UK 65s represent almost a fifth of the population and in the USA this figure is 14 per cent. Perhaps surprisingly, Switzerland, Belgium and the Netherlands are all on a par with the UK in this regard, having some of the highest numbers of elderly people in the world, with the Netherlands having increased by three per cent in just four years. Japan tops the chart at 25.8 per cent while simultaneously boasting the steepest ageing trajectory in the world. No wonder we’re all anxious about what the future holds. But it isn’t the ageing population that’s championing the right to die; it’s largely the on-looking worried well that are terrified of losing their autonomy. Similarly, it’s largely the onlookers who are admonishing it. In his open letter to The Guardian earlier this year, the UK’s Archbishop of Canterbury equated assisted dying with suicide and otherwise took the view, naturally, of an observer. He talks about how hard it has been for him to sit at someone’s bedside when they have been unwell; he talks about how important it is that “we can show that we love even when people have given up on caring for themselves”. Critics have pointed out that the archbishop’s concerns seem to be less for the suffering of those on the brink of death and more for those who will be left behind and want a clear conscience. “Archbishop Justin Welby’s cri de coeur about the evils of the assisted dying bill is cloaked in social concern, but at its core is standard religious authoritarianism,” writes Dr Christopher Burke in a letter printed in The Observer. “Enacting the bill would not have restrained the archbishop from following his deeply held moral beliefs about his own life. It would have just granted me the right to do the same.” Whichever side you look at, the majority voice is that of the © Lopolo / Shutterstock.com www.global global four th quar ter 2015 -br ief ing.org l 47


Global 21 fourth quarter 2015
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