Sunday, August 05, 2007

Legalising assisted suicide

I would like to thank the US social worker working with senior citizens and people with disabilities for the comment on my earlier post on this subject (link).

I agree that my proposal (1) to recognise the right of any adult of sound mind to take his/her own life and (2) to make it legal for others to assist in the suicide of someone who satisfies (1), carries with it the risk of abuse. While steps can be taken to minimize that risk, it cannot be eliminated altogether. But if “People with disabilities (and or terminal illness) who want to commit suicide are going to fit the criteria for clinical depression”, then they would not, under the guidelines I envisage, qualify for legal assisted suicide. I doubt, actually, whether someone who is reasonably depressed about his appalling medical prospects would easily be confused with someone suffering from clinical depression, but it clearly behoves us to tread very carefully here.

Yes, it would be some committee consisting of psychiatrists, psychologists, social workers, other health professionals and secular or religious experts on ethics, that would have to reach a view of whether the person wishing to end her life was of sound mind - any potentially conflicted party should be kept well away from the process. That’s a tough decision, but one that comes with the territory. Heroic modern medicine allows us to keep people alive well beyond what their bodies evolved for. We are paying the price for a disjuncture between what we can do medically and what we ought to do morally.

Against the risk of abuse of the right to die and of the legalisation of assisted suicide, we must put the existing certainty of the widespread abuse of those kept alive against their will. I have witnessed friends and relatives who begged to be allowed to die but were denied that right. People trussed up like Christmas turkeys with tubes, needles, sensors, monitors and other medical contraptions, with every vital organ supported by some engineering miracle, and with no realistic hope of a change for the better in their condition. I have seen too much torture in the houses of the dying to be willing to sit back and whisper supportive nothings about sharing your pain.

If we could really share in the suffering, that is, take for ourselves some of the pain and agony of those living a slow death, and in so doing diminish the pain and agony of those who are suffering, that would be a true alternative to what I propose. Unfortunately, that is not possible. According to my faith, Christ took away the sins of the world, but even He did not, through His suffering, take away the world’s, that is, our pain and suffering. We all have to bear our own pain and cannot volunteer to bear even the smallest part of another’s.

Sympathy, empathy and love are great blessings, but they don’t alleviate pain. It is therefore an abuse of language to speak of sharing someone else’s suffering or pain, because this choice of words implies that suffering or pain are what economists call ‘rival goods’ (or bads), that is, something of which there is less for you when I take more of it. ‘Sharing pain and suffering’ instead really means that the person in pain continues to suffer as he would have without the sharing, and that, in addition, the person sharing the pain now is miserable and depressed as well. Any psychological benefits of the sharing for the original person in pain are likely to be minor, if the original sufferer has empathy for those who wish to share his pain.

I believe that the caring professions, including psychologists, social workers, physicians, other medically qualified people like nurses, have a duty of care towards their clients/patients, but that this duty of care does not amount to keeping them alive at all cost, even against their will. The medical profession should work to reduce human suffering, not to prolong life regardless of the pain and suffering this inflicts on those whose lifespan is being stretched beyond endurance. For a Christian, the second commandment is to love your neighbour, not to torture your neighbour by keeping him alive well beyond his appointed time.

I hope to be in a position, when my time comes, to use my God-given intellect to find a way to avoid living past my sell-by date. I also believe that my sell-by date should be determined either by blind fate or by myself, not by a committee of utilitarian economists or by some other group of servants of the state.

1 comment:

Assistive technology said...

My goodness, what a good point. It's hard to say that someone's in their right mind if they're depressed to the point of suicide. There are so many alternatives out there to help people with disabilities. Perhaps we could reduce the desire for euthanasia laws by increasing people's access to assistive technology.