Tuesday, June 20, 2006

Suffering Succotash

Bit heavy today. Am in dark and heavy mood.

I have long felt that the thing which makes us truly moral beings isn’t the fact that we can devise rules about what is right and wrong and live by them. The thing which makes us truly moral beings is our capacity to navigate the grey areas, our capacity to recognise that in some situations, one cannot make a choice that is completely and utterly comfortable. That’s what makes us amazing, really; that we are not completely paralysed when forced to determine the lesser of two evils.

Unfortunately, none of us are up to the task all the time. When I look at discussions about abortion and euthanasia, whether it's proposed legislation here or abroad or new technologies in development, all I see are the same black and white arguments being made over and over. And given that we are talking about life and death, some of the most serious moral questions for society, you would think that we would acknowledge that these decisions are all grey – no decisions can be made around abortion or euthanasia, the outcome of which is wholly good. The situations where these questions arise always involve some tradegy.

Now some people have religious beliefs that I don’t subscribe to, but even religion acknowledges that sometimes our greatest deeds involve the compromise of a profound moral principle. For example, despite the fact that life is sacred and suicide a mortal sin, one of the greatest things a person can ever do is to give up their life in order to save another person or in the name of their God.

Similarly, whilst our culture and in particular our medical profession is geared up towards the preservation of life (including pregnancy) as the primary objective, perhaps there may be extreme circumstances where there is virtue in breaching this principle. I do believe that.

However, all around I still see folks attempting to simplify this as all life is sacred and must be preserved or all suffering is intolerable and must be avoided. And whilst I am no kind of moral relativist, neither of these are useful starting points.

Take suffering…

Fact is that honestly, truly, absolutely, I believe that I have an excellent quality of life, despite my morbid compulsion to italicise in almost every sentence.

However, this quality of life is extremely fragile and dependent on a number of unstable factors which make life enjoyable as opposed to barely tolerable. I suffer; I have pain and various symptoms which are challenging to live with. Sometimes life is very hard. Sometimes life seems hopeless. But when things are bad, the thing that gets me is fear of things getting worse, or the worst days becoming normal.

This is so scary, so very scary, that I actually comfort myself with the idea that if it ever gets that bad or goes on that long, then I can always opt out.

Now that might just be a game I play to cope; I haven’t contemplated suicide in a long, long time. And the funny thing is that sometimes it does get worse and the bad days do go on and on, but when this happens, it isn’t nearly as bad as I anticipated.

It has been noted among disabled people that many of us consider ourselves more fortunate than those with a completely different impairment – who in turn consider themselves more fortunate than us. And some non-disabled people tend to feel sorry for all of us, often baffled at how any of us cope.

This is a very simple but fundamental limit of the imagination; we don’t know what it’s like for the other guy. And in general when it comes to medical matters, we tend to imagine it to be really very bad indeed. (The bizarre exception being mental health impairments, where we refer to our own everyday experiences of frustration and melancholy and imagine it’s a bit like that.)

Now I’m not for a moment taking the view that all our lives are as good as they possibly could be and being ill or impaired is no disadvantage. It is a disadvantage, it comes with all kinds of weird and wonderful problems that you’d never have dreamed of. But I always think about these little machines exploring miles and miles under the ocean. Just when you’re sure that you’rer so far down that no organic life could ever survive those pressures, there is the campest-looking crustacean you have ever beheld. It prospers in the deepest darkest places of on the planet. If it gets down-hearted about its place in the universe, it just looks in a mirror.

Similarly with pain, indignity, suffering and so on; it is amazing what people can endure, the lives which remain worth living. The places that we find humour

And it is amazing what some people consider unendurable, and on what grounds. Ballastexistenz writes about folks wanting to eliminate people like herself from the gene pool, simply because of the alleged blank stare on her face. Because she doesn't look like she's having too much fun? Are we all going to have to Botox our faces into an eternal grimace?

And this kind of thing is one of the two major problems. The other is that, with all due respect to the medical profession and the very many conscientious and caring professionals out there, there remains a culture of paternalism; some professionals claim moral authority as well as medical expertise. Patients are inexpert, therefore irrational; they can't be trusted to know their own wishes.

This is complicated by the fact that despite its merits (and believe me, there are a great many) people within the health system can be seen, at times, as economic units.

And thus, this country has only begun to debate the subject of euthanasia and already some "expert" suggests that consent should not be necessary


Anonymous said...

Dark and heavy indeed. Not sure I'm feeling sufficiently coherent to add to the discussion but I wanted to write and register my agreement and appreciation of your thoughts on the theme.
Great simile BTW. I quite like the idea of being the campest crustacean in the village!


spotted elephant said...

There's so much in this post, and I was going to respond to so much, but that last link-euthanasia WITHOUT consent just blew everything else out of my mind.


Paternalism in medicine, indeed!