We should not fear assisted dying

Abstract

The argument for allowing assisted dying (ad) is based on two principles: (i) respect for autonomy and (ii) adequate safeguards to avoid coercion or abuse. We should ensure that ad is accessible, equitable and regulated. It is wrong, without very good reason, to impose a set of beliefs on other people who do not hold those views. We should therefore not impose an obligation to go on living if an individual considers that it is associated with unwanted suffering, distress, dependency, indignity or cost. We should accept, and provide for, diversity and variation in people’s views on ad. The right to refuse life-prolonging therapies, or to have drugs to control distressing symptoms that incidentally shorten life, is well-established. The ethical distinction between these and ad is arguable. Worldwide, most people who choose to end their lives, are already close to death. Some people need protection from the possibility of their lives being ended when they did not intend or want it. However, older people are capable of making informed decisions on serious matters, with or without the support of others. To suggest otherwise is paternalistic and ageist. Multiple jurisdictions worldwide have developed and use effective safeguards. In these countries, ad is mostly welcomed and has not led to undue legal, social or human rights problems. Legal provision for ad is both desirable and necessary.