The Right to Die

The number of people committing suicide has been declining since the 1990s, but increased from 2020 to 2021 – the last year for which we have statistics. In 2020, the government and the then minister of Health Bent Høie launched a plan of action for preventing suicide that also included a vision of a future with zero deaths by suicide. The plan has not yet yielded clear results, and the Institute of Public Health’s graph actually shows that we’ve never had a year with zero suicides since we started keeping track of the statistics in 1971. What if we did like the Netherlands and Belgium and made sure that those who want to die anyway have the opportunity to die in a humane way? Would that cause the statistics to go up or would it stay in the same place? And what would that do to us as a society?

The dream of controlling one’s own death

I’ve personally had periods in my life where I’ve dreamed of being able to go to the Netherlands to investigate the possibility of euthanasia. Does that mean I’d receive it? Not necessarily. Would I take the opportunity if I had it? It’s a question that, in hindsight, I’m not sure I want an answer to. Nevertheless, the humanist in me is unable to stop wondering whether we as a society wouldn’t be more humane if we’d given those who die of suicide every year a dignified and humane death. In any case, at least until we manage to get the number of yearly suicides down to zero.

A difficult debate

Ethicist and professor of philosophy at UiB, Espen Gamlund, believes that the debate of whether to open up the use of euthanasia in society is very heated.

– This is one of the major ethical disputes we have, and it is hotly contested. This is because it’s about life and death, and whether society should help people who have a wish to die.

There are several ethical considerations that make up the question of euthanasia, points out Gamlund.

– Some of the most central questions we have to ask ourselves are: Can death sometimes be positive? Can we sometimes benefit from dying? Is it ethically acceptable to take a life? What is the ethically relevant difference between active and passive euthanasia or ending treatment? Is it a part of the doctor’s role to help patients die? What’ll happen if we legalize various forms of euthanasia? Is there a risk of an unfortunate effect where more and more people will ask for euthanasia?

Despite the fact that Norway hasn’t introduced euthanasia, Gamlund believes that our ethical norms are no different to those of Belgium and the Netherlands.

“- MY VIEW IS THAT THE ADVANTAGES EXCEED THE DISADVANTAGES AND THAT WE SHOULD LEGALIZE DIFFERENT FORMS OF ASSISTED DEATH IN NORWAY.“

– I don’t necessarily think so. In a lot of ways, it’s natural to compare Norway to Belgium and the Netherlands, and I think we must expect some of the same development here as in these countries if we legalize euthanasia here.

An important question relates to whether there will be a gradual development in terms of who ‘d be covered by such an offering here in Norway. In other words, whether we’d see a gradual increase in patients similar to what we’ve seen in other countries, he emphasizes.

– This is difficult to predict, and it’d depend, among other things, on how the law itself is designed and which criteria must be met in order to be offered euthanasia.

There are good arguments both for and against, Gamlund believes.

– Against, one can cite a concern about the aforementioned effect, a concern that some people would perceive themselves as a burden on society and therefore accept an offer of help to die when they shouldn’t have done so. Legalization of euthanasia may also eventually change our perception of the value of a life in ways that we cannot foresee, and which may be unfortunate. For euthanasia, it can be argued that those who really want to die because they suffer from an incurable disease would be helped to die in a dignified way. It applies to a not insignificant number of people.

If you’re going to calculate the overall ethical impact of the advantages and disadvantages of various forms of euthanasia on society, Gamlund believes that you must take into account all the relevant ethical questions he’s previously mentioned, and weigh them against each other.

– My view is that the advantages outweigh the disadvantages and that we should legalize various forms of euthanasia in Norway, primarily assisted terminal treatment where terminally ill patients can receive help to end their own life in a dignified way.

Wants to investigate euthanasia

The parliamentary representative for the Progress Party (FrP) and member of the Health Committee, Morten Wold, explains that the FrP wants to investigate euthanasia with strict legislation.

– It’s about being the boss of your own life, even in the very last days of your life. I believe there are too many uninformed views and claims in the euthanasia debate. Therefore, we want an investigation to get to the facts and make proposals for how such a law could be designed. The investigation should look at the experiences of countries that have introduced euthanasia, such as Switzerland, says Wold.

FrP is one of the few parties that has in its party program that it wants to allow euthanasia. The Labor Party is opposed, the youth division of the Conservative Party is in favor, the Liberal Party believes that the dying should have the right to end medical treatment, and the Christian People’s Party is opposed.

– More parties should be in support of this. There’s a large majority of the population that wants to allow euthanasia, and the debate would’ve been raised to a higher level by gaining more knowledge from the countries that have introduced this, believes Wold.

“– IT’S ABOUT BEING THE BOSS IN YOUR OWN LIFE, ALSO IN THE LAST DAYS OF YOUR LIFE.“

Wold is unsure whether the topic of euthanasia is popular among voters, but points out:

– We know from previous surveys that there’s a large majority in the population which supports introducing euthanasia. An opinion poll conducted by Ipsos MMi for Dagbladet in 2019 showed that 77 percent agreed to allow euthanasia in Norway.

Still opposed

Mathilde Tybring-Gjedde is a parliamentary representative for the Conservative Party. She was previously a high-profile member of the youth division of the same party (Unge Høyre, UH), and she’s been opposed to euthanasia since UH decided by a narrow majority that they were in favor.

– The decision was made after a good debate with many good arguments from each side.

The debate concerning euthanasia is difficult, believes Tybring-Gjedde.

– The advocates of euthanasia often highlight the individual’s freedom to decide when and how they want to die. We who are opposed are worried that individuals meeting the criteria for euthanasia will feel pressured to choose the treatment.

Research from Oregon in the US, which has introduced active euthanasia, shows that hopelessness, depression and loneliness are the most important markers for those who request euthanasia – not pain, she explains.

– Many are afraid of being a burden on the health system or the family, and in the long term, perhaps a person who’s dependent on help may feel that the “sensible” choice is euthanasia. No human being makes a choice in a vacuum. We’re influenced by the society we’re part of.

Another objection, points out Tybring-Gjedde, is: Where should the proverbial line in the sand be drawn?

– Should children be able to choose active euthanasia? Is it only physical illness, or mental illness, that should qualify for euthanasia? An incurable disease, or a disease that greatly impairs one’s quality of life? And who decides whether a person has a poor enough quality of life to choose euthanasia? In countries that have introduced it, you see that the boundaries are constantly being extended to apply to new groups, claims Tybring-Gjedde.

There is no doubt that the debate surrounding euthanasia is difficult, and therefore there are several relevant arguments both for and against. But as long as Bent Høie’s vision of zero yearly suicides remains just that – a vision – we as a society must find out what we’re going to do to help those who choose to leave us anyway.