Why assisted suicide is never the right answer to a painful
death
23
Jan 2005
JOHN HALDANE says our quest for perfection has made our society
intolerant of disease and dying, but that will mean a sad end
for all of us.
IN
the past, full life expectancy fell below what we now regard
as early middle years. Thanks to medical science and health care,
in developed countries it is now reaching beyond the 80s and
many of those born today may expect to live to 100.
Possibility, however, is the mother of discontent. The longer we live the longer we want to live, and the greater our resentment of death and of dying. An ideal has taken shape: a long and happy life, without serious travails, without pain - and without the process of dying. Death may remain beyond cure, but degenerative dying is certainly eliminable, and painlessly so by medical means. This is the background to the current moves in Westminster and Holyrood to legalise assisted suicide.
Affluence, technology and a market economy have given rise to expectations of flawless goods and comforts, expectations which feed into the idea that anyone would surely want their lives to end when it is clear that things will get steadily worse. Who would be willing to be bed-bound, incontinent or rambling, an embarrassment and a burden? The young and the would-be young have their healthy lives to live and are not likely to welcome the company of the decrepit and the diseased.
In an era of physical perfection the distasteful business of ageing and dying is likely to prove a lonely fate. The "unlovely" easily become unloved; and it is hard to take being uncared for, along with being incurably aged and conspicuously dying. Add the pain and indignity that often accompany the final stages of life and the case for suicide and voluntary euthanasia is almost complete.
It need not be like this. We can accept death and dying without yielding to self-destruction. We can diminish the prospect .of being abandoned by the young by not abandoning the old. Dying is no less inevitable than death, and our longevity means that it is ever more likely that we will suffer cancer, chronic heart failure;' motor-neurone disease and,brain degeneration.
We live in a world not of our making, under conditions that we have little power to control.
In ancient times these facts called forth philosophies of life. Each arrived at the answer that we need to cultivate the related virtues of courage, fortitude, and patience, as well as that of justice - to which Christianity later tided the virtue of charity.
Adapting this to the present; a reply emerges to the demand for the legalisation of assisted suicide and voluntary euthanasia. Dying can be painful and otherwise miserable. But the science and art of palliative care have kept pace with medical technology and most pain is now manageable. Likewise the hospice movement is dedicated to maintaining respect for the intrinsic dignity of human beings, however advanced their decline.
Further, those opposed to killing the weak and dying are not committed to pointless resuscitation or to preservation by all means. It is said that people who favour passive euthanasia - intentionally causing death by omission - can hardly object to its active form. I agree with this, but not with the presumption that letting die is passive euthanasia. The issue lies in the aim. If an action or omission' were not to result in the patient's death, would that amount to a failure of purpose? If so, the intent was to kill. By contrast, those who would let die are not aiming at death, but not resisting it.
The end of life should neither be delayed nor hastened. We did not choose our lives or their circumstances, nor should we aim to escape them. What we can reasonably seek, however, is the support of others in allowing us to die and not to be killed. Assisted suicide is an evasion and the thin end of a short wedge. The queue may begin with volunteers but it will soon include conscripts.
If that is to be avoided the process has to be resisted at the first stage. Advocates of assisted suicide are often well-intentioned but they tend not to look below or beyond the hard cases they quote, such as those that have been highlighted in recent times. Public policy, however, has to go further and deeper, and in doing so it must recognise the universality and inescapability of death and dying. What we need at the end of life is not killing but care.
John Haldane is Professor of Philosophy in the University of St Andrews and editor of the book series St Andrews Studies In Philosophy And Public Affairs