The following is a letter submitted for publication in Media Isle of Man’s newspapers. To submit your own, write to [email protected]

Assisted Dying: Are We Confusing the Autonomy of the Individual with the Obligation of the State?

We hear that the House of Keys has deliberated the clauses of the Assisted ‘Dying’ Bill. Many MHKs are pleased with the progress and are ‘ready’ to vote on the third reading on 23 July.

My Choice:

Let me make this clear: If I were to have a horrendous diagnosis and await a horrible death, I would most certainly want to die at my own wish. I believe an individual has the autonomy to choose so. Here is the fundamental question, though. Can my autonomous wish be delivered safely without affecting other people? The simplest answer seems to be a resounding yes. If you do not want to use the law of assisted dying, please don’t use it. If you do not want to offer assisted dying, please don’t offer it. Sorted!

Is It a Simple Question?

However, life is not that simple, is it? How many of us struggle to choose between options? Which bank to use, where to shop, which holiday to book, what job to apply for, which course to enrol on, whom to marry; it goes on forever. Even with full mental capacity, we struggle to make decisions on key questions. We know that mental capacity can change based on various life events, such as the death of a close family member.

Hearing a ‘terminal’ diagnosis is one such event where our ability to make sound decisions will be compromised. I am not going to discuss the details of the Assisted Dying Bill, which can be done in a series of meetings or writings stimulating a healthy discussion. As it stands, it is fair to say that the island and its people have not seen enough evidence on both sides to be scrutinized by the public. Even the discussion in the Keys seems to have been rushed with no accurate or satisfactory answers to many questions. However, I am only asking the most fundamental question here!

Simple Choice? Safe Law?

Can any parliament make a safe law delivering my individual autonomy of ‘my life, my death’? Which jurisdiction has done this safely in the past several decades? What have we learned from them? Are we skirting around this question, assuring ourselves of the simplicity of ‘it is there if you want it, don’t use it if you don’t want it’? What happens if the law is misused, abused, or wrongly applied? Someone will die an incorrect and premature death. Won’t they?

So Many Choices:

Let us think about how many other choices, autonomous and otherwise, we wish to make in our lives. Some of these are much more relevant and urgent than this ‘hypothetical’ question of my death on a ‘presumed’ diagnosis of ‘terminal’ illness!

Extra Sessions:

How many ‘extra’ sessions have they endeavored to discuss these choices, which affect a much broader section of the people in this parliament? They have already had 3 extra sessions for discussing assisted dying! Is it a total misplace of priority? This parliament agreed on an island plan for 5 years and assisted dying was not on that plan. It is a private member’s bill from a powerful MHK, who occupies the number 2 position in the cabinet, which has possibly hijacked many of the government’s plans addressing the broader issues affecting all sections of the people. Could this bill have progressed with this speed if the proposer were not holding a powerful ministerial position? I wonder if he should have resigned his position to avoid influencing the outcome.

Where Is the Choice on My Choice?

I, and I am sure many of you, want to be able to decide if I want my autonomous choice enshrined in the law! Why have the MHKs decided that we are not to be given the choice (of a referendum) when talking and deciding about the choice and autonomy (of assisted dying)? If they are so sure that they are only following people’s choice and autonomy, why have they refused to allow a referendum on the matter of assisted dying? Is it because they are scared that non-island people will then not be able to influence the fate of our island?

Too Complicated for the People?

It is on the record that one of the MHKs from the South said that ‘assisted dying is not suitable for a referendum because the question of assisted dying is too complicated for people to understand’. Yet, she and the proposer of the bill claim that they are following the will of the people, despite the proposer’s consultation not showing a majority for his position.

Several Groups of MHKs:

I have been following the debate and I have discussed with many of the MHKs and almost all of them are sincere and passionate about assisted dying. I respect them all. However, I can see that there is a gap in the understanding of the MHKs when it comes to practicality and safeguarding. There are several groups of MHKs on this matter of assisted dying. One group is dying to bring the Assisted Dying Bill in this session (if not in this parliament). Another group raised valid concerns and is desperately trying to prove that their concerns on various safeguards are not clearly addressed by the proponents of the bill. Yet another group comprises possibly two subgroups: one genuinely concerned and wants to vote no, and the other says they are concerned but still want to vote yes. They seem to be convincing themselves that despite all the loopholes, impracticalities, ambiguities, and lack of evidence, it is OK to vote yes to the bill. I would have expected that lawmakers need to be absolutely certain about all aspects of the bill before they vote yes! If you look and consider the names of the eight MHKs who want to push through with this bill despite much ambiguity, you can tell why there is such a sway in their argument.

End of Life Care:

It seems to have been forgotten that ‘end of life care’ has improved tremendously over the past 20 years and our palliative care is one of the best in the British Isles. This potentially means that the fear of horrible death and ‘terminal’ diagnosis has been misplaced and misunderstood.

Questions to the MHKs and All Those Who Support Assisted Dying:

I raise these questions with utmost respect and sincerity to all of the MHKs and indeed all those who want assisted dying (assisted suicide, really) permitted by law on our island:

Referendum:

We had a consultation by the proposer, showing no majority for the bill; we had a survey by the Isle of Man Medical Society showing overwhelming opposition to the bill; we have some ‘local’ Facebook polling with dubious value. However, none of these are binding. A referendum is the only binding way of deciding if we truly want assisted dying on the island.

Constituents are fully capable of making their own choice on this question. After all, you are repeatedly saying that assisted dying is the people’s choice. Let them make that choice! Bring a referendum on assisted dying! It is not too complicated for the people to understand. If you as our MHKs are able to understand, we as people are capable of understanding and making the right choice. Even if you believe they won’t understand, explain it well then!

Dear MHKs, be courageous to accept that there are so many unknowns in the bill as it is written and vote no on the third reading! The state has many obligations towards its people and their broader issues affecting them every day—health, education, infrastructure, etc. Please focus on them, and please stick to the Island Plan—good or bad!

On the issue of assisted dying, go back to the people, ask the question, and provide evidence for both sides! Do not reduce it to a simple headline question but provide solid evidence!

Let the people decide if they want their personal autonomy on the choice of death to be written in the law. Do not hide behind any other excuses!

I finish with this quote from a famous American politician: as a politician, you listen to both sides of the arguments, and decide in favour of the weak, voiceless, and vulnerable and protect society as a whole, not just for a few and not just for now, but for generations to come!

Name and address supplied