There’s nothing new about the concept of end of life choice

This post was written by David Barber, media adviser and newsletter editor for the End of Life Choice Society

There is nothing new about the concept of a doctor helping to hasten the end of somebody who is already dying to spare further pain and suffering.

It is not some fanciful New Age idea, as some seem to think in the lead-up to this month’s referendum on the End of Life Choice Act.

Euthanasia (the word translates as “good death” in Greek) was practised in Ancient Greece and Rome, where writers and philosophers reported that good emperors prayed for a dignified and pain-free farewell.

After becoming the first country to allow women to vote, in 1893, New Zealand developed a trailblazing reputation for social reform, but has fallen behind in legalising medical assistance to die, which is seen by advocates as the last human right denied citizens – the right to die when and how one chooses.

Switzerland has allowed assisted dying (barring any selfish motive) since 1942.  In 1997, the US state of Oregon introduced laws that have been copied elsewhere, the Netherlands followed suit in 2001 and Belgium followed a year later.

More than 200 million people in the Americas, Europe and Australia now live in jurisdictions that allow the terminally ill to get a doctor’s help to end their lives peacefully and painlessly, with strong safeguards to protect the vulnerable.

Doctors are understandably divided on the issue and it is known that many in New Zealand support assistance to die but will not say so publicly while it remains a crime subject to 14 years’ imprisonment. Despite this, two studies have shown that more than 4% of doctors deliberately hasten death for some terminal situations.

Medical associations around the world are fundamentally conservative and remain formally opposed, even though, like in New Zealand, they have never surveyed their members – who are a minority of practising doctors, anyway.

Although the Hippocratic oath is rarely cited today as students graduate from medical schools, opponents of assisted dying insist it prevents a medic’s involvement. A Dutch historian who has studied the practice in Ancient Greece and Rome, Anton J L Van Hoof, refutes this.

He said in a paper published in Social Science and Medicine magazine in 2004 that in those days a doctor “shunned death as a failure of his art”.

He wrote:

“Sometimes a doctor was called in to assist in voluntary death, a role that was not forbidden by the Hippocratic Oath. An appeal to this oath by opponents of euthanasia in the modern sense of the word therefore is mistaken.

“Even if the Hippocratic Oath had some meaning as a professional ethical code, it should not be understood as dealing with assisted suicide, but with surreptitious murder by a doctor.”

Van Hoof insists:

“There is ample positive proof that ancient doctors were ready to assist in suicide…the ancient physician had a position that radically differed from that of his modern colleague. In our medicalised world, the doctor is increasingly placed in the moral position that priests used to have.

“The ancient paradigm invites us to redefine the doctor’s role. Why should he be the arbiter of life and death, instead of limiting his role to that of an instrument of euthanasia like his ancient colleague?”

Van Hoof gives the example of the peaceful death of the Emperor Augustus, as reported by the Roman Empire historian Suetonius:

“For almost always on hearing that anyone had died swiftly and painlessly, he prayed that he and his might have a like euthanasia, for that was the term he was wont to use.”

The Dutch historian comments:

“Augustus preserves his bodily decorum. He is not left alone in his final moments, but friends and family surround him. He does not lose the grasp of his mind, apart from a minor slip. Augustus’ end is without much suffering, the euthanasia he had longed for.”

The result campaigners are fighting for in the October 17 referendum.



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