In 1973 I worked as editor on Into That Darkness, the book Gitta Sereny based on her long interviews with Franz Stangl, commander of the German extermination camp Treblinka. There were four of these camps designed for the sole purpose of slaughtering many thousands of human beings with maximum preliminary humiliation - the most appalling institutions ever to have existed. And when I learned from Gitta's book that all the men chosen to set them up had been employed in the euthanasia programme Hitler launched in 1939 I decided: "Now that is conclusive: one must never accept the legalisation of euthanasia."
So why, 30 years later, have I changed my mind?
It is, I think, because in a comparatively healthy old age (I am 84) I have become more intensely aware of the value of life than ever before: only a little of it is left to me, and anything that spoils that little I most passionately resent. Suppose that, as might so easily happen, I were suddenly condemned to utter helplessness and dependence on other people, and/or to excruciating and irremediable pain so that not only was the present made hideous, but all the richness of the past was lost for ever in the fog of misery ... Suppose, in other words, I were forced to go on existing after anything resembling an acceptable life had stopped: the horror would be unbearable.
With the possibility of that horror just round the corner, so to speak, every time I read of someone plunged into such a situation and pleading for the right to be helped out of it by a death which they themselves are physically incapable of achieving, I am filled with disgusted incredulity at the cruelty which makes their release illegal. Why should we endorse that cruelty when the Dutch, the Belgians and the Swiss have all established systems whereby people can be helped to a painless and dignified death, after careful precautions ensuring that while still in their right minds they genuinely want to die and are in a condition without hope of alleviation?
In 1996 a Dutch doctor, Bert Keizer, who was working in a nursing home for the terminally ill, published a book called Dancing With Mister D - a title which I dislike, but a book that was rightly described by Mary Warnock as "wonderful". It is the best meditation on death I have ever encountered, and includes descriptions of the author's own experiences of administrating euthanasia, which he sometimes had to do. These descriptions leave one convinced that from the point of view of the patients, "merciful" is exactly the right word for it, but they also make it apparent that from the point of view of the doctor it was a dreadful strain. Probably the most powerful argument against euthanasia is that in granting the right to die, it imposes the duty to kill.
As things stand at present in this country, when it is done, it is done as a unique and awful event forced upon a partner, a relation or a doctor by love and/or compassion. In the course of a long life I have met two women who have done it, both in response to pleading by beloved people. Both knew it to be the heaviest - the most momentous - of all the things they had ever done, and both were thankful that they found the strength for it. And that, I feel, is how it should happen: not as an act by a stranger handing out death as part of a job. But what, then, of desperately afflicted people who are not lucky enough to be attended at the end by someone who loves them and has strong nerves? Even if they can't be rescued by love, they ought to be able to hope for rescue by mercy.
It was clearly believed that killing people for Hitler's euthanasia programme would conveniently coarsen the responses of the men chosen to staff his extermination camps, and it probably did. But it should be remembered that at no point were they engaged in what could be called mercy killing: the object was never to help hopelessly ill people, but to "purify the race". The nature of the operation was betrayed from the start by the secrecy surrounding it. It was by "secret decree" that Hitler got it started, and the people recruited for it were confined within a number of institutions, forbidden to tell anyone what went on there. The participants were trapped into madness because madness was becoming their nation's norm, and I don't think it necessarily follows that people coming into euthanasia by some other route would suffer the same corruption.
It would, however, hardly be possible for anyone helping people to die as part of his or her job to remain wholly unaffected, whether they tended towards increasing callousness or towards breaking down. Keizer was obviously a psychologically sturdy young man, but the nightmares and migraines he reports are disturbing, though not surprising. If we ever legalise some form of euthanasia (as I hope we will), this will be the biggest problem: how to care for the carers. The burden of deciding whether a patient's demand for death should be met would always have to be shared, and the doctors enabling the death would always have to be watched, should never be allowed to become "specialists", and should be absolutely forbidden from ever running any kind of institute devoted to the practice of mercy killing. Perhaps there should be limitations on the number of assisted deaths any doctor could attend, as much for the doctor's sake as for the patient's.
Though I no longer believe that we should allow what happened in Hitler's Germany to banish the idea of helping those who ask for the right to die at a time of their choice, I do think we should keep it in mind as a warning. We would be embarking on a course demanding the strictest moral integrity, and therefore the utmost vigilance. But since other countries have risen to it, surely we should be ashamed of considering it beyond our own country to produce such qualities?
