Monday, August 03, 2009

Death

Following the Purdy case, the Yard writes about assisted suicide. The legal position of relatives who assisted with Swiss death trips was previously in a typically fudgy British grey area: illegal but unprosecuted. The Blind Eye was turned. Now we are apparently being forced to shine some legal light on this dark business.

It seems to me that the problem with the assisted suicide debate is that an unstoppable force of a principle meets an immovable object of an argument:

1) each individual should have the final say over how and when he dies – it is no business of the State.
2) a life must have an objective value beyond the worth accorded to it by the individual at any given time - because otherwise we have no obligation to discourage someone who is merely depressed from committing suicide.

This is another interesting instance of the left-right political distinction breaking down, or becoming counter-intuitive. Those on the Left are generally pro-death because of 1, but pro-universal state healthcare because of 2. Position 1 is libertarian but conservatives tend to be anti-death because of 2.

Terry Pratchett was on BBC Breakfast this morning arguing for assisted suicide, but he was soon struggling as the interviewer ran through the slippery slope arguments. Pratchett talked about how in Victorian times doctors would routinely ‘make people comfortable’, ie. kill them softly. The name ‘Shipman’ wasn't spoken but must surely have leapt to everyone’s lips.

There just isn’t a single argument or great, overriding trump card that can win this one and so it defies clean legislation, every attempt at which appears to make things worse. We had the least bad solution already: the British Fudge, the Blind Eye. This is conservatism, I suppose.

11 comments:

worm said...

you know, I also always prescribed the 'fudge' as a conservative trait, and it is certainly evident in the balanced comment sections of The Times and Telegraph. However, other conservative rags like the Mail simply can't abide by fudging

I imagine that a country like Italy or France would simply collapse altogether if fudging were not allowed

Anonymous said...

As much as I tend to the opinion that a person's life is their own, I distrust advocates of assisted suicide. Not that they don't mean well but in a day-to-day practical sense. I wonder how many people would die if doctors are quietly mandated to have the blind eye approach to medical care.

I faced pretty much this situation last year. I saw that the NHS staff (not private care but poorly staffed wards, indifferent to the point of cruelty) approach their jobs with an casual belief that they were 'easing suffering'. I saw a man with a history of chronic chest inflections repeatedly lay on his back despite the constant pleas of his family who told staff that he'd spent the previous 20 years sleeping upright on the adivce of consultants who explained there was a danger of pneumonia. He was moved from a specialist hospital who'd said he'd make a full recovery from his original problem into a cesspit of a local hospital, and, within a few weeks, he developed pneumonia and died. Some might say they eased his suffering and I live every day trying to come to terms with that thought. Yet, deep down, I feel like some people just shrugged their shoulders and made the not-so-inevitable inevitable. For every case where assisted suicide might be thought of as compassionate, I would worry that there are two more where it's considered a convenience.

Hey Skipper said...

Doesn't the fudge essentially concede the libertarian argument?

Also, it is worth noting that, at least in the US, if an adult declines life saving medical intervention on religious grounds, then that adult gets to commit, in effect, suicide.

With medical staff in connivance by omission.

Acknowledging Anon abovie: it is tough to draw the line between convenient and essential.

David said...

Plus, we know that most people with failed suicide attempts are glad to have survived and go on to live their lives. A surprising number (particularly teenagers) didn't actually think they would die in the first place.

As Anonymous suggests, it is particularly problematic when the people in the best position to intervene gently (relatives and caregivers) have ambiguous incentives.

martpol said...

David:

The current problem, though, is that we don't have a legal answer to the question for terminally ill people who want to take control of (what remains of) their own lives. The issue over "anyone who wishes to commit suicide" - including those who might later regret it - doesn't enter into this specific debate, because the circumstances under which assisted suicide could/would be permitted are very limited.

The "ambiguous incentives" argument seems to me more persuasive, although I'd imagine that any new law would have to include pretty strict criteria for doctors to assess a patient's competency to take the ultimate decision.

Peter Burnet said...

What strikes me about this debate is not so much the suicide angle, but the focus on "assisted" with its attendant euphemisms about dignity and being surrounded by loved ones, etc. Sorry to be macabre, but if one wants to take matters into their own hands (and it's not hard to see why some would), isn't it fairly straightforward in many cases to...well... take matters into one's own hands? They seem to be searching for some kind of ceremony and sanctifying of the decision.

There was a terrific movie from Quebec a few years back called The Barabarian Invasions, which was a sequel to The Decline of the American Empire and featured the same gang of witty and lovable friends who had lived out the hedonistic promise of the sixties together, thus cementing an unbreakable lifelong bond amongst themselves and wrecking complete havoc on their families. One of them is hospitalized with a serious illness, which is the occasion for a reunion and much clever comment on many social and personal issues. But it turns dark in the end when it becomes clear he is terminal. He doesn't want to die in hospital, so they move him to a remote cottage by a stunning lake where they had all had many good and wild times. They set a beautiful table by the lake for a final gourmet meal (remember, they are French) with him looking on from a hospital bed. There is a pathetic scene where he is linked by video to a daughter sailing somewhere in the south Pacific who tries to give an approprite faewell to her father, but who ends up mouthing platitudes because she hardly knows him. But he does have his friends and they do love him dearly. The meal over, they send him lethewards with the help of an overdose of heroin supplied by the estranged addict daughters of one of the protaganists, who had been pressed into service for the occasion. He slips away quietly while the others look on with sad, stoic looks of postmodern confusion.

I can't say there wasn't a certain poignant beauty to it all when compared to some alternatives. But there was no wake and you knew none of them would ever come back.

Brit said...

But aren't the problems, Martpol, caused rather than solved by trying to fine-tune with legislation?

It's like the torture debate. You can avoid all sorts of problems by simply banning it as a rule, and then mitigating in individual cases.

worm said...

we should ask the cornish what they think about fudging. They know what they're talking about in these matters

Hey Skipper said...

...isn't it fairly straightforward in many cases to...well... take matters into one's own hands?

In the troublesome cases, such as the one ongoing in the UK, it isn't.

UK law prohibits the woman from having her suicide assisted; however, her physical condition prohibits doing it herself.

Instead, she wants to go to Sweden, where it is legal. However, she requires assistance to get to Sweden, which puts anyone who helps her get there liable to prosecution on returning to England.

IMHO, relying upon individuals for these sorts of decisions will lead to fewer bad outcomes than relying upon the state.

martpol said...

But Brit:

The torture debate is about individual rights vs. military/political expediency. This is about individual rights vs. the state's moral authority over individual lives.

Legalising assisted suicide, for the terminally ill and with all of the relevant safeguards, seems to me not a matter of 'fine tuning'. Instead, it's about the avoidance of unnecessary additional suffering for people who otherwise are entirely at the mercy of a painful and undignified end.

Brit said...

But the meta-debate is about fudge vs legislating.