How Tony Nicklinson Already Has the Right to Die
According to a BBC report, Tony Nicklinson, 58, from Melksham, Wiltshire, has “locked-in syndrome” after a stroke in 2005 and “is unable to carry out his own suicide.” “He is seeking legal protection for any doctor who helps him end his life.”
In fact, it is not quite correct that Tony Nicklinson “is unable to carry out his own suicide.” He could at present refuse to eat food or drink fluids. Hunger strikers do this for political reasons. He could do it for personal reasons. People should not be force fed against their own autonomous wishes.
Now suppose that Tony did refuse to eat or drink, because he wanted to die because he found a life locked-in to be intolerable. He would die in weeks, perhaps less. Given that he will die, he should be given medical treatment to make his last weeks as comfortable as possible. He should be given sedation and analgesia. He could even be given such doses that render him unconscious.
Such a process already happens, int he UK, in a slightly different way. In the famous case of Tony Bland, law lords authorized the removal of a feeding tube that was keeping Tony Bland, who was permanently unconscious. They, his family and doctors all judged that continued life was not in his interests.
The process of withholding or removing artificial feeding from patients as young as newborns to elderly people has been common place in medicine in many parts of the world. The Bland judgement made it possible for doctors to cause the death of a patient by removing feeding without being liable for murder. (Interestingly, the legal reasoning was that the act of removing the feeding tube was not an act, it was an omission, and so the removal was not murder. However, if a third party had removed Tony Bland’s feeding tube, for reasons of some personal gain, that person would seem to have been guilty of murder.)
Now if doctors, courts and family members can make a decision that a person’s life is no longer worth living and feeding should be stopped, why can’t the person, like Tony Nicklinson, make that decision, and it be acted upon? Surely the person who has the most right to decide whether life is tolerable is the person who must live that life.
So it seems to me that ethically Tony Nicklinson should now have the right to die by starvation. And if other patients received palliative care in the form of analgesia and sedation for decision made by courts, doctors and their families, like Tony Bland, then Tony Nicklinson has an equal right to such palliative care as he dies.
So we have established that Tony Nicklinson has the right to die, with medical support, over a period of weeks by starvation. He should also be allowed to stipulate that conditions under which, in the future, he should not be fed. This is called an advance directive. He could stipulate, for example, that if he ever became unable to express himself, he should no longer be fed. He would then die, over a period of weeks, with palliative sedation and hydration.
So Tony Nicklinson does have the capacity, now and in the future, to suicide. And he should not be force fed. That is a violation of a basic human right.
But what, you might ask, is the difference between Tony Nicklinson dying by starvation, perhaps unconscious, over a period of weeks and him being given a lethal injection that would kill him in seconds, painlessly? In both cases, he will certainly die. Surely it is more humane, in these circumstances, to give him a lethal injection than to allow him to starve himself to death?
This is the argument of course from suicide, to assisted suicide, to euthanasia. But if one has a right not to eat, then one has a right to euthanasia, at least in moral terms.
The law of course would classify such killing as murder. For that reason, it is not performed in the UK. But ethically, if a man such Tony Nicklinson has the right to refuse to eat any longer because finds his life intolerable, he has the right to be relieved of the suffering of starvation, quickly and painlessly. He has the right to die.