[Annotated] Guernsey was right to reject assisted dying

In a flawed^[각주:1] and complex world, we must err on the side of life^[각주:2], writes Emilie Yerby

There is so much we get wrong^[각주:3] in the provision of^[각주:4] health and care services. Everyone has a story: of misdiagnosis^[각주:5], of receiving the wrong treatment^[각주:6], of hopeless gaps in communication or care. Sometimes such things happen through deliberate cruelty^[각주:7] or neglect, but more often through ordinary human fallibility^[각주:8], and the clumsiness^[각주:9] and imperfection of the systems^[각주:10] we create to try to look after each other^[각주:11]. 

Many who support assisted dying do so out of compassion for^[각주:12] those who are failed by end-of-life care^[각주:13]: people whose pain remains unbearable^[각주:14] despite every attempt to relieve it^[각주:15]; whose sense of self^[각주:16] or dignity is profoundly^[각주:17] undermined by the physical changes they endure; whose illness is so cruel that no amount of palliation can let them experience a peaceful end. 

This is an important argument. It's a sincere and courageous endeavour^[각주:18] to do right by people who are dying. When Guernsey's tiny parliament debated^[각주:19], and ultimately rejected, the introduction of assisted dying earlier this year, I believe we did the right thing. But my respect for those who felt otherwise is undiminished^[각주:20], and I don't wish to make light of the opposite view^[각주:21]. 

I cannot imagine ever supporting assisted dying. I want to avoid the false hope of^[각주:22] "I would support it if... " because my "if" is hardwired into the way our world works^[각주:23]. I would support assisted dying if I could be confident that we got it right every time. And that is impossible. 

I'm not talking about abuse or coercion^[각주:24]. I remain convinced that^[각주:25] we shouldn't approach this debate by looking for the evil in each other. We know it will happen, and occasionally we'll fail to prevent it, and that's a risk we'd have to live with^[각주:26]. But the issues I want to focus on are structural^[각주:27]: more insidious^[각주:28] in effect^[각주:29], and much harder to prevent. 

The impact of assisted dying on disabled people is an especial concern^[각주:30]. As someone not currently disabled, I've been greatly influenced by campaigners who are, and who fear that assisted dying could set back the long fight for^[각주:31] disabled people's lives to be treated with the same respect and dignity as those of non-disabled people^[각주:32]; for governments to invest in services that offer them independence and quality of life on an equal footing with other citizens^[각주:33]. 

What are we saying about the way we view disability^[각주:34], or the way we value disabled people's lives, when any possible definition of eligibility for^[각주:35] assisted dying will encompass^[각주:36] a substantial number of^[각주:37] disabled people? 

This concern is aggravated in^[각주:38] Guernsey, where we still lack the basic legal frameworks to protect people from an unfair disadvantage^[각주:39]. Our equality and non-discrimination law remains a work in progress^[각주:40], and an equivalent to^[각주:41] Britain's Mental Capacity Act is only now being drafted^[각주:42]. It's fair to say that both supporters and opponents of assisted dying shared concerns about these shortfalls^[각주:43] and were committed to^[각주:44] addressing them^[각주:45]. 

But the other serious structural risk is financial^[각주:46]: many of the health and care services which people need to live well with terminal illness are^[각주:47] not free at the point of use here^[각주:48]. Additionally, over the next 20 years, Guernsey will have its largest ever population of older adults, just as a decade of government belt-tightening^[각주:49] means that resources are more stretched than ever^[각주:50]. These factors combine to mean that the economically weakest people in our community are^[각주:51] disproportionately likely to^[각주:52] have a poor quality of life when they become ill, without the resources to continue doing the things that make life worth living for them. Even if money worries were^[각주:53] not a direct cause of death, the risk of a socio-economic^[각주:54] gradient in^[각주:55] assisted dying would be as real as any other health inequality. 

But whether or not social disadvantage, born of prejudice^[각주:56] or poverty, replicates itself in^[각주:57] assisted-dying rates, one thing is inevitable^[각주:58]. Things will sometimes go wrong. We know this for a simple reason: things go wrong all the time in health care, in our best attempts to protect and preserve life. If we are fallible in every other attempts to^[각주:59] care for people through illness and the end of life, we will be fallible in our provision of assisted dying. We have no rational grounds to expect otherwise. And the consequences of our fallibility, however rare, can only be wrongful deaths^[각주:60]. 

No one, whatever their position on assisted dying, would view a wrongful death with less than the utmost concern^[각주:61]. But we differ in^[각주:62] the trade-offs^[각주:63] we are prepared to make. I know my side of the argument requires prolonging some people's suffering in order to avoid the early death of others. Nobody walks away from the realities of illness^[각주:64] and dying with their ethical^[각주:65] compass intact^[각주:66]. But in this flawed and complex world, I think we must still err on the side of life^[각주:67].

1. flawed ; [ADJ] Something that is flawed has a mark, fault, or mistake in it. [본문으로]
2. err on the side of sth ; (안전 등을 기하기 위해) 지나치다 싶을 정도로 ~하다 ;; show slightly too much rather than too little of a quality, especially a good one [본문으로]
3. get (sth) wrong ; 2. ~에 대해 실수를 하다 [본문으로]
4. provision ; 1. [U, C, 주로 단수로] 공급, 제공 [본문으로]
5. misdiagnosis ; (pl. -ses) 오진(誤診), 틀린 진단(분석). [본문으로]
6. treatment ; 1. [U, C] ~ (for sth) 치료, 처치 [본문으로]
7. deliberate cruelty ; 고의적인 학대, 의도적인 잔인함 [본문으로]
8. fallibility ; 오류에 빠지기 쉬움, 그릇되기 쉬움(cf. infallibility) ; 속기 쉬움. ;; 미국식 [fæ̀ləbíləti] [본문으로]
9. clumsiness ; [명사] 어색함 , 서투름 ; 눈치 없음. [본문으로]
10. imperfection ; [C, U] 미비점, 결함 ;; [NOUN] An imperfection in someone or something is a fault, weakness, or undesirable feature that they have. [본문으로]
11. look after ; 1. ~을 맡다[돌보다/건사하다] ;; 참조 care [본문으로]
12. out of compassion ; 측은히 여겨, 동정하여, 동정심에서. [본문으로]
13. end-of-life care ; 시한부 환자 간호 [본문으로]
14. unbearable ; 견딜 수 없는, 참기 어려운(intolerable). ;; [ADJ] If you describe something as unbearable, you mean that it is so unpleasant, painful, or upsetting that you feel unable to accept it or deal with it. [본문으로]
15. relieve ; 1. [타동사] (불쾌감·고통 등을) 없애[덜어] 주다, 안도하게[후련하게] 하다 ;; 2. [타동사] (문제의 심각성을) 완화하다[줄이다] ; 유의어 alleviate [본문으로]
16. sense of self ; 자아감 ; ideas about the type of person one really is [본문으로]
17. profoundly ; [부사] 1. (영향 등을) 깊이 ;; 2. (의학) 극심하게; 완전히 [본문으로]
18. endeavour ((英)) (美 endeavor) ; [U, C] (격식) (특히 새롭거나 힘든 일을 하려는) 노력[시도] ;; [NOUN] An endeavour is an attempt to do something, especially something new or original. ;; 미국∙영국 [ɪnˈdevə(r)] [본문으로]
19. debate ; [자동사] 1. 논쟁[토론]하다, 토론에 참가하다 ((on, about)) ; 유의어 discuss ;; 2. 숙고하다 ((of, about)) [본문으로]
20. undiminished ; [형용사] 줄어들지[약화되지] 않은 ;; [ADJ] not reduced or lessened [본문으로]
21. make light of ; ~을 가볍게 여기다, 가볍게 다루다; …을 가볍게 농담처럼 다루다 ;; …을 경시하다(=attach little importance to), 우습게 보다 [본문으로]
22. a false[idle, illusory, vain] hope ;; 헛된[덧없는] 희망, 기대 [본문으로]
23. hardwire ; [타동사] (보고 듣고 하는 것에서) <행동 양식을> 고정화시키다, 굳어버리게 하다 ;; 2. [美속어] …을 보거나 들어 머리 속에 박힘으로써 해로운 영향을 받다. ;; 3. to cause certain mental processes to become automatic [본문으로]
24. coercion ; [U] (격식) (무력·협박에 의한) 강제[강압] ;; [NOUN] Coercion is the act or process of persuading someone forcefully to do something that they do not want to do. ;; 미국식 [koʊˈɜːrʒn] 영국식 [kəʊˈɜːʃn] [본문으로]
25. convinced ; [형용사] 1. [명사 앞에는 안 씀] ~ (of sth/that…) (전적으로) 확신하는 [본문으로]
26. live with ; ~을 감수하다 ;; [동사] …와 동거하다; 수용하다, 화합하다, 용납하다. ; 유의어 share home with; accept, receive, acknowledge, tolerate. [본문으로]
27. structural ; 1. 구조(상)의, 조직(상)의. ;; 5. 정치[경제] 조직의[에 의한]. [본문으로]
28. insidious ; [형용사] (격식, 못마땅함) 서서히[은밀히] 퍼지는 ;; [ADJ] Something that is insidious is unpleasant or dangerous and develops gradually without being noticed. [본문으로]
29. in effect ; 1. 사실상[실제로는] ;; 2. 법이나 규정이 시행[발효] 중인 ;; in actual practice; in fact [본문으로]
30. especial ; [형용사] (명사 앞에만 씀) (英, 격식) 특별한 ; 참조 special (5) [명사 앞에만 씀] 특별한(보통보다 더 많거나 나은) [본문으로]
31. set back ; [동사] 저지[방해]하다, 지연시키다; 역행하다; (비용이) 들다. [본문으로]
32. nondisabled ; (of people) Not disabled. [본문으로]
33. equal footing ; 대등의 지위, 대등한 관계, 동등한 지위[자격]. [본문으로]
34. disability ; 2. [U] (신체적·정신적) 장애(가 있는 상태) [본문으로]
35. eligibility ; [U] 적임, 적격 [본문으로]
36. encompass ; (격식) 1. [타동사] (많은 것을) 포함[망라]하다, 아우르다 ;; [VERB] If something encompasses particular things, it includes them. [본문으로]
37. substantial ; . (양·가치·중요성이) 상당한 ; 유의어 considerable ;; [ADJ] Substantial means large in amount or degree. [본문으로]
38. aggravate ; 1. (고민·병 따위를) 악화시키다(make worse), (부담·죄를) 가중하다, 한층 무겁게 하다. ;; 2. (구어) 화나게 하다, 노하게 하다(exasperate, annoy, irritate). [본문으로]
39. disadvantage ; 1. (…의 점에서/…에게) 불리, 불이익, 불편; 불리한 상황[입장][in/to]. [본문으로]
40. in progress ; (격식) (현재) 진행 중인 [본문으로]
41. equivalent ; [명사] ~ (of/to sth) (…에) 상당[대응]하는 것, 등가물 ;; [NOUN] [oft N of n] If one amount or value is the equivalent of another, they are the same. [본문으로]
42. draft ; [타동사] 1. …의 윤곽[밑그림]을 그리다, …을 스케치하다 ; …을 기초하다, …의 초고를 쓰다. ;; [VERB] When you draft a letter, book, or speech, you write the first version of it. [본문으로]
43. shortfall ; [명사] ~ (in sth) 부족분, 부족량 ; 유의어 deficit ;; [NOUN] If there is a shortfall in something, there is less of it than you need. [본문으로]
44. be committed to doing ; ~에 헌신, 전념하다 [본문으로]
45. address ; [타동사] 5. ~ (yourself to) sth (격식) (문제상황 등에 대해) 고심하다[다루다] [본문으로]
46. financial ; 재정(상)의, 재무의; 재계의; 금융(상)의; 금융 관계자의 [본문으로]
47. (a) terminal illness ; [명사] (암 따위의) 불치병. ; 유의어 terminal disease. [본문으로]
48. at the point of ; …하려는 순간에, …하려는 참에 [본문으로]
49. belt tightening ; 내핍 (생활), 절약, 긴축 (정책) ;; [NOUN] If you need to do some belt-tightening, you must spend less money and manage without things because you have less money than you used to have. [본문으로]
50. stretch ; 9. [타동사][VN] (돈시간보급품 등을 많이 써서) 부담을 주다 ;; 5. 무리한[제멋대로의] 해석을 하다, 곡해하다, 견강부회하다(strain) ; 한껏 이용하다(make the most of) ; 남용[악용] 하다(abuse). ;; [본문으로]
51. combine to mean that ~ ; 흐름상 "위에 설명한 요소들로 인해, 종합적으로 ~을 의미한다" 정도의 의미 [본문으로]
52. disproportionately ; [부사] 불균형적으로 [본문으로]
53. money worries ; [명사] 돈 걱정 [본문으로]
54. socio-economic ; [ADJ] Socio-economic circumstances or developments involve a combination of social and economic factors. [본문으로]
55. gradient ; 1. (grade 특히 美) (특히 도로·철도의) 경사도 ;; 2. (전문 용어) (두 지역간 온도·기압 등의) 변화도[증감률] ;; [NOUN] A gradient is a slope, or the degree to which the ground slopes. in AM, usually use grade [본문으로]
56. born of ; …에 유래[기인]하는 [본문으로]
57. replicate ; 1. [타동사][VN] (격식) (정확히) 모사[복제]하다 ;; 유의어 duplicate ; [VERB] If you replicate someone's experiment, work, or research, you do it yourself in exactly the same way. [본문으로]
58. inevitable ; [ADJ] If something is inevitable, it is certain to happen and cannot be prevented or avoided. [본문으로]
59. fallible ; [형용사] 실수를 할[틀릴] 수 있는 ;; [ADJ] If you say that someone or something is fallible, you mean that they are not perfect and are likely to make mistakes or to fail in what they are doing. [본문으로]
60. wrongful death ; (법률) 불법 사망(타인의 불법행위로 야기된 사망으로 손해 배상 청구의 원인이 된다). [본문으로]
61. utmost ; 1. 극도의(extreme), 최고의, 최대의(greatest). ;; 2. 가장 먼, 제일 끝의(farthest). [본문으로]
62. differ in ; …에 대해 다르다. [본문으로]
63. trade-off ; [명사] ~ (between sth and sth) (서로 대립되는 요소 사이의) 균형 ;; [NOUN] A trade-off is a situation where you make a compromise between two things, or where you exchange all or part of one thing for another. [본문으로]
64. walk away from ; 3. [사고]를 (가까스로) 상처없이 피하다[벗어나다] ;; 4. …에 말려드는 것을 피하다 [본문으로]
65. ethical ; 1. 윤리적인, 도덕에 관계된 ;; 2. 도덕적으로 옳은, 도덕적인 [본문으로]
66. intact ; [형용사] (대개 명사 앞에는 안 씀) (하나도 손상되지 않고) 온전한, 전혀 다치지 않은 ;; 유의어 undamaged ;; [ADJ] Something that is intact is complete and has not been damaged or changed. [본문으로]
67. err on the side of ; (안전 등을 기하기 위해) 지나치다 싶을 정도로 ~하다 [본문으로]