I’ll open this article with a quote from a debate in the German Parliament last year. Katrin Göring-Eckhardt of the Green Party said she was worried about becoming the type of society that expects “the suffering elderly and those in need to bring an end to their own lives”. A Social Democrat MP went further and compared assisted suicide to Nazi era euthanasia programmes.

Incidentally, the German Parliament went on to outlaw commercial companies offering assisted suicide for a fee. The capitalist fetish to try to commercialise and commodify everything and anything is frankly downright disgusting.

The second statement might be over the top, but Göring-Eckhardt is right. Of course, the subject is a minefield and very complex. Even the term euthanasia itself is interpreted in different ways. There are bound to be differences which cut across parties, organisations and people who would otherwise agree on most other issues.

I’m against giving in to the neoliberal mindset that vulnerable people are a burden and finding excuses not to spend money on expensive but necessary health services

There are those who trivialise such issues. It is useless discussing with those kinds of people. Then, on the other extreme, there are those, the ‘churchy’ types, who just cannot accept that it does not make any sense to artificially extend life and stop nature from taking its course.

Getting to the point straight away, I am against the direct killing of people – assisted suicide. I feel that there are many other ways that society can ensure dignified end-of-life care and, yes, death.

Some people seem to think that people are kept alive at all costs artificially, when this is simply not true. There are grey areas, but it precisely these which must be tackled and made clear for patients, their families and also for medical staff.

Is the standard of palliative care high across the board in both public and private hospitals and care homes? What services does society offer to the dying, to die in dignity, at home, surrounded by their loved ones? As an aside, on the topic of dignity, I have heard anecdotes of elderly patients at care homes who are neglected, have their food left in front of them for a certain time and not helped to eat, with the food taken away whether they have eaten anything or not, or left soiled for hours.

Surprise, surprise they wither away very quickly. Maybe someone can investigate if these are all made up stories or not.

Some seem to think that treatment cannot or is not withdrawn and that ‘pulling the plug’ is not permitted. Again, grey areas should be tackled. Maybe the confusion is because of the complexity of the issue. To make matters even more complex some call withdrawal of treatment, the administration of potent painkillers and sedatives, and stopping artificial hydration, ‘passive euthanasia’. It is undignified to prolong life artificially and at all costs. Interrupting the artificial extension of life is not ‘assisted suicide’. It is important not to confuse issues – the implications are totally different.

As I mentioned repeatedly there are grey areas which need to be tackled, that’s why I believe that our proposal for a ‘living will’ – testment bioloġiku – is the sensible way forward.

It puts people’s minds at rest that they will not be kept on life support unnecessarily, that treatment will be withdrawn even when they are not in a position to take decisions and would not like to put their relatives in an extremely uncomfortable position to take decisions on their behalf.

Some journalists gave the impression that AD wants to keep people ‘alive’ at all costs and stop nature from taking its course. It’s a lie. They feign ‘surprise’ that there are differences in opinion and simplistically describe the issue in monochrome.

What I’m against is giving in to the neoliberal mindset that vulnerable people are a burden and finding excuses not to spend on expensive but necessary health services. A dangerous assumption is that all people are totally free to choose – freely and independently of everything else.

Again, this is a neoliberal notion which is used to blame people for their predicament. A notion which ignores the ingrained power structures which push people to take one decision rather than another and justifies reducing public services (including in health), which are seen as a waste of money for the ‘undeserving’.

I’m against direct and active euthanasia. What I’m in favour of is providing top palliative care and not prolonging life artificially and unnecessarily. Providing the necessary drugs and the necessary doses, even though these may shorten the life of an already dying patient.

What I’m in favour of is introducing the concept of the ‘living will’. Probably the ultras on both sides of the debate – from the kollox jgħaddi individualists to those who refuse to come to terms with the reality of death and the difficult ethical issues which must be tackled - will find fault with my reasoning and opinion.

Let’s not resort to insults, misrepresentations and sloganeering.

Ralph Cassar is secretary general of Alternattiva Demokratika.