On Voluntary Euthanasia #1

There are two things on my mind at the moment; euthanasia and party dresses. I got to writing about euthanasia and it got so long it will become two posts, but I'll do the one about party dress in between. If only I could post a cake recipe and some advice on dieting, this could be the blog equivalent of daytime TV!

Truth is that I long ago established that suicide might be one way to go. Much later on, if things get really grim. It is a rather morbid thought for someone who is neither depressed nor in any imminent physical danger, but it means I don't worry too much about future some worst-case scenario in which everything is suffering and pain. Might never happen, but if it does, I shan't be stuck here.

Meanwhile, I believe people should be allowed to do whatever they like with their bodies as long as they don't harm other people. However, the debate on voluntary euthanasia has always troubled me. It is one of those debates where I find myself disagreeing with everyone, so I am going to try and unpick this for myself.

We'll start with something relatively straightforward.


The Sanctity of Life

Human life is very precious, but I have no God to make it sacred. Death may be final, but it is not the worst thing that can happen to a person – which is a relief, since it's going to happen to everyone of us. Yes, maybe even you, should you accidentally eat some garlic or if someone set your alarm clock to go off before dusk. Meanwhile, the value of a life is all about quality, not the number of years, months, weeks or days that it can be sustained. Life-sustaining treatment is not always in an individual's best interests. Nor is it always reasonable; in the UK it is too high to effect many of us, but there is a limit on the resources that can be dedicated to maintaining any given pulse. I don't believe in life at any cost.

What's more, we bring life to a premature close all the time when the dose for effective pain-relief during the end stages of terminal illness becomes deadly. We don't take years away, but maybe a few days of agony here and there. An American friend told me of her childhood preacher who objected to diamorphine on the grounds that dying people could no longer feel the flames of hell licking at their feet and might miss their final opportunity to repent. But that's the only objection I've ever heard of.

If we are happy with this, it seems that there seems no fundamental problem with ending life. There is some argument about a big difference when killing is not the primary intention, but clearly it is regarded as an acceptable side-effect in these very extreme circumstances. It seems to me that in the case of someone who is dying and in great physical suffering but wants to shorten their suffering (and thereby, their life) by months or years, the only difference is one of timescale.

However, not everyone who seeks euthanasia is on their way out.


Manner of death vs. quality of life

There have been two news stories about voluntary euthanasia in the last month. I don't wish to write about individual cases, since these are ordinary people's lives and deaths, but the contrast between them is very important.

One story is about a lady with the sort of MS that can kill you, who says she would like to go on forever but she was seeking reassurances that, should the situation arise, her husband could travel to an euthanasia clinic abroad and not face prosecution on his return. Her case has failed. The other story is about a young man whose parents took him to Switzerland to undergo assisted suicide. This chap was in his early twenties and had been tetraplegic (quadraplegic) for just eighteen months. His parents supported and facilitated his choice in order to relieve their son of what they considered a second class existence. It is unclear as to whether they will be prosecuted.

These two stories demonstrate a big problem for me because one case seems totally reasonable - I instinctively wish that the lady didn't have to travel abroad to do what she wants to do - and the other makes me feel very uncomfortable indeed. One is about the kind of death a person hopes to have, the other is a rejection of a certain sort of life.

The life of someone in the latter stages of a terminal condition is as precious as anyone else's, but having decided that they want to die, it is extremely unlikely that they would change their mind should they survive. There is unlikely to be the time to develop a completely new perspective. The things which might make life pleasurable are only likely to decrease as the things which make life seem intolerable increase.

Someone whose life is not in any danger – especially someone whose condition is stable and might even improve – has a lot more to lose. I don't think there are any statistics on this, but I wouldn't be at all surprised if most people with any kind of acquired impairment, an injury or chronic illness, experience a period of despair. Similarly, people experiencing a nasty divorce, sudden bereavement, a terrible assault, financial ruin, some great personal humiliation or other, are likely to have a spell when they can't see how they could ever be happy again.

But they will be. When people say, “If I went through what you've been through, I would have killed myself,” the chances are that they wouldn't. Most disabled people were once non-disabled and almost all of us survived the change. So why should we condone someone's pessimism just because they have a physical impairment? How is a spinal cord injury different from a broken heart or bankruptcy?

I suppose there are three differences. The first is that we kind of think of non-medical disasters as recoverable from. One's heart is broken, it will heal with time, whereas physical symptoms won't go away. I'm not entirely happy with this. Physical symptoms can often be improved, and most certainly the impact of those symptoms on one's quality of life can be changed completely. Not always, not necessarily, but very very often.

The second difference is that one acquires impairment in a culture which completely accepts the idea that we live a second-class existence. If the whole world believes your life must be rubbish, then your own suicidal feelings on the matter are likely to seem completely reasonable.

But perhaps the most pertinent difference is that something like tetraplegia and certain other conditions, a person who is desperately unhappy about there situation can't escape it without help - or without a terribly painful and degrading death like starvation. We encourage one another to stick it out through the bad times, but there is no law against suicide. Which brings us onto the matter of Human Rights.

Which I shall write about after I've written about party-dresses. I bet you can't wait!