Tuesday, November 18, 2008

On Voluntary Euthanasia #2

That's enough frivolity for now, let's get back to matters of life and death!

The Right To Choose and The Obligation to Interfere

It never made sense for suicide to be a crime (although it was before the 1960s); a person's body does not belong to anyone other than its inhabitant so ultimately, one is free to do whatever one likes with it.Meanwhile, a person who is dead cannot answer for their actions, and the main concern with someone who has survived an attempt on their life is to keep them safe and help them feel better – an objective somewhat undermined by criminal prosecution.

But suicide is the only non-criminal activity I know of which we are allowed to use physical force to prevent. If you see someone about to jump off a bridge, you're allowed to tackle them, drag them away, knock them unconscious if necessary without being charged with assault. It's reasonable force, you understand; deadly force would be to defeat the point.

If you fail to prevent a suicide when it would be reasonable for you to do so, e.g. if you fail to phone an ambulance following an overdose or potentially fatal injury, then you risk being charged with manslaughter. Assisting suicide carries up to fourteen years in prison and even verbally encouraging suicide is a serious criminal offense. Meanwhile, if healthcare professionals believe you to be a serious risk to yourself, then they are allowed to detain and forcibly medicate you.

This does kind of make sense. What it means is that ultimately, you do have the freedom to die if you want to, but the rest of us are going to try and stop you. And the potential benefits of our interference greatly outweigh any harm we can do to you. If you are still alive, you still have the opportunity to choose. If you survive and go on to have a wonderful life, then what a glorious gift that is! If you still choose to die and go on to try again, then you haven't lost anything. But if we butt out, all will be lost in any case.

So it could be said that you have a right to die by your own hand and you certainly have a right to refuse medical treatment (or food, hydration etc.). But if you are not in need of life-sustaining treatment and you don't have the physical capacity to kill yourself, you're kind of stuck.

In most countries which have legalised euthanasia, it is exclusively about hastening an inevitable death. The Swiss example is pretty deplorable; assisted suicide is not a crime at all, so long as it is not done out of self-interest (e.g. you can't be paid). So for example, if your friend is unhappily gay, becomes suicidal about their sexuality and you happen to agree that it is better to be dead than gay, well you can help your friend shuffle off their deviant mortal coil. I think that lfe is worth a whole lot more than that.

And yet, I can't quite believe that a person must be condemned to be alive because an impairment stops them opting out. It's not a right, exactly - since we're talking about another person's (remarkable) participation, assisted suicide could never be guaranteed. Hmm, I don't think I'm going to get any further with that one.

But I completely reject the idea that we shouldn't comment on other people's decisions on this matter. I don't believe in harassing people or threatening them with the seventh circle of hell, but I do believe in trying to make the most fundamental decisions a person can make as informed as they possibly can be. We all have a responsibility to give one another the best shot possible.

The Last Resort

Most people who commit suicide have depression, which is a treatable (if not universally curable) condition. Meanwhile, very many people, including myself, have contemplated and/ or attempted suicide, failed and feel that the whole thing was a ridiculous mistake. Most people know someone who has succeeded and rarely it is anything but an unequivocal tragedy, a terrible waste and one of the most devastating kinds of bereavements for those left behind to come to terms with.

I don't believe that many people want death; what people want is change and it can seem that death is the only way to bring about that change. This is not an easil- corrected mistake; I spent about a year of my life thinking in this way, and it wasn't particularly irrational given my circumstances and my understanding of the world then. Because of illness, I could not have the sort of life that I had always wanted and expected, and while I had imagined myself to be quite open minded and flexible, it seemed that the doors had slammed shut on every other option. I had lost my future.

Meanwhile, I couldn't do any of the things I wanted to do. All the things I liked to do with my time had either been taken away from me or were massively disrupted by illness. All my friendships had been changed by my illness and at this point, I didn't really trust anyone any more – since I was so boring and inarticulate, I imagined the friends who stayed did so out of a sense of duty. I was living in a place I didn't want to live with people I didn't want to live with – which in turn I felt very guilty about.

I've often said that [...] saved my life, because if he hadn't come along, well I had a date and it was coming up very fast. Even so, it took much longer to learn that my life didn't need to have been like that - it wasn't just a question of “snapping out” of it or even a gradual recovery from depression – whilst I did get very depressed, none of the above was fantasy.

If I had died, it would have died because of an inflexible and unimaginative attitude towards education, work and the value of my existence, the stigma of chronic physical illness, the stigma of mental illness, my own disablist prejudice, self-disgust, inadequate pain management, unintentional familial pressure, careless drug prescription, inadequate options for housing, homophobia and living in Ipswich (it is a terribly depressing place). Not because of my physical and cognitive limitations.

It wasn't purely a change in my feelings which changed my mind, but different information. Feelings cannot be either legitimate or illegitimate, but you can have the wrong data. If every other option for improving a person's life and happiness has been totally and utterly exhausted before they decided to die, then it would be difficult to argue with that decision. But there is rarely any clue to that in the way these stories are reported.

Unintended Consequences.

Any change in the law is likely to effect only a small number of people directly, but disabled people are affected by the mere discussion. As it is, the lives of disabled people are not seen as on a par with those of non-disabled people. We are both pitied and regarded as a burden by very many people very much of the time. If society is able to forgive some disabled people for wishing to end their lives, will it be able to forgive the rest of us for wishing to live?

Almost all media stories about euthanasia ramp up the tragedy in ways that they could never get away with talking about disability in another other context. Generally it is pain which makes a condition unbearable, but instead these stories tend to focus on things like the level of personal care people need. Yesterday the BBC news website published an open letter from Lizz Carr to a chap called Noel Martin who wants out (and wrote back), concluding it with a video of the man getting his hair washed. As if this offers the other point of view; Carr says that life is worth living, but look, he needs someone to wash his hair for him!

However, I don't think a change in law could make society value us less. I certainly don't believe in any slippery slope where we begin find ourselves under social pressure to die - or that when disabled people are in despair, that those around us will agree that death is the answer. (Tayi points out in the comments to my first post on this subject that things might be different where there isn't socialised medicine, and illness is far more of an individual economic burden.)

I reckon that debates on euthanasia merely bring to the surface the stereotypes that people have always held - and then allow them to be contradicted. We're getting louder and more visible all the time; a fact demonstrated by the BBC publishing a bit of a debate between two disabled people as opposed to two non-disabled 'experts'. Meanwhile, people sneaking off to abroad to die and recently bereaved people risking criminal status is not doing anything for us at all, let alone what it is doing for the individuals who find themselves compromised in this way.

A small but significant proportion of disabled people will ultimately face a very slow and painful death. Some of us would be able to face that with less fear if we knew that we'd continue to have control of our lives, whatever happened to our bodies. I think the time has come for a change.

But I'm still not terribly happy about the subject!


Anonymous said...

I wanted to leave commenting on the subject until you had finished...so no more baked goods.

Several things you have written about yourself ring true in my life. I have never made a 'date' as I believe any sort of planning based around a time marker is damaging. I suppose in my case I have a set of scales...where the upset would be too great. I understand that things can change...and I am so glad that AJ entered your life. I suppose my cynicism (which is very small, really, given the expression I usually favour for my face) says that there are very few people with the ability to see what some disabled people can offer. And as I have my own issues with 'self-disgust' (that really made me snort...I would usually say 'low self esteme in an almost euphamistic sense)...it seems even less likely that someone would want to be with me. And as I feel that a lonely life would cripple me more thoroughly than ME ever could...I see death as a healthier avenue.

But would I say the same to anyone else? Probably not. I would point out the wonderful relationships that can be forged over the internet. I would suggest that someone who is unable to see their own worth would be better addressing that than relying on other people for fulfillment.

As for suicide solely due to a degenerative illness...I am relatively open to people finishing things early. It saves pain both for the person suffering the condition and those having to witness it. I think in those cases it's the certainty of the future that allows, what is a very definite decision, to be appropriate.

Suicide due to depression is a terrible thing and I am thankful to have never been truly, clinically depressed. Hmmm...I say that...but perhaps I was at school for a time. But that was before I was ill. I have known several people with depression and various other mental illnesses. I studied them informally and have been used as a sort of cheap counselor at times. The wonderful thing about depression is that it is treatable and that when the condition is sorted, life can be sweet again.

That phrase (life can be sweet again) reminds me of one of my favourite plays called The Man Outside (its also the title of my blog) which, essentially, is about a man's search for a reason to live. The play starts with his suicide attempt. The man, home again after fighting in Russia in WWII, finds his child dead and his wife with another bloke. He drags himself, his damaged leg, his gasmask glasses and dodgy haircut off to the Elbe River...and throws himself in. The river tells him he's pathetic and to come back later when he has some *real* troubles to worry about. He ends up on a quest of sorts...desperate to relieve himself of the responsibility of things he did during the war. He also tries to find other reasons to live. Along his journey he is accompanied by The Other. A sort of Jiminy Cricket character...but rather than just being his conscience, he's a driving force, saying 'yes' to his 'no', pushing him onwards. It's easy to think of this Other as being indestructable...an innate and permanent part of our self. But I think the play shows that it is a fragile part of ourself...something that must be looked after, treasured and fed. I wonder if the amount of care and attention that is wasted each day were spent helping people grow their 'Other', there would be less need for suicide?

And yet...I'd never want to take away a person's right to act independently. It's a tricky situation...but yes, I think I favour care for a person rather than limitation. If you take away a person's ability to kill themselves, you're not taking away the pain and desire to end it all. Effort needs to be made to improve life rather than extend it.

The Goldfish said...

That was a really beautiful and moving comment Stephen, thank you. :-)

Anonymous said...

Oh give over...it was early morning rambling at its worst. It's a wonder the comment in itself didn't cause mass suicide. "Please make him stop!"

Gone Fishing said...


Phyall, who had been drinking alcohol but not taken any drugs, tied the chainsaw to the leg of a snooker table and plugged it into a timer.

Police were called to his apartment in Bishopstoke, southern England, on July 5 when his parents could not contact him.

Requesting the parents to remain outside the property, officers broke in and found the walls and floor covered in blood, with Phyall's partially decapitated body in the lounge.

The apartment block where he was living was set to be demolished and despite various efforts from the local housing authority, Phyall - who suffered from mental illness and had attempted suicide in the past - had declined several offers for an alternative home.

Eventually, a court decided that his home, the only apartment in the block still occupied by anyone, was to be repossessed.

One may have thought Exorcisssed more appropriate.

Sorry just my innparptoriate weird brain injured sense of humour at such times I guess

Unknown said...

Amazing, once again your posts have relevance to no doubt many.

I am seeing two sides of the story once again.

On one hand having had the system get itself into so much trouble over altering my identity in atempts to avoid paying out so called entitlements that seemingly the only choice of those involved has been to try at times and end my life to cover their deeds, as unbelviable or 1960's Britain as that seems.

On the other hand a child close at hand has developed Cancer which Specialists have no doubt was due to my occupational exposure to chemicals.

This seems to not only have caused a major U turn in diagnosis of my injuries but also is giving me an insight into what happens when a person develops the Cancer and the side effects of a compromised immune system and how one keeps charging ahead because to stop doing so would be a rather miserable existance.

yes they could stop and go onto a sickness benefit but as long as possible they prefer not to and to live life in the fast lane as long as they possibly can.

Thank You I shall try and write a co herant post of all this on my own blog.

Strange how such events it seems should be kept private and almost hidden and yet sharing brings comfort in many ways to hopefully a lot of us.

The Goldfish said...

Thanks very much for your comments. :-)

Ettina said...

"What it means is that ultimately, you do have the freedom to die if you want to, but the rest of us are going to try and stop you."

Just because suicide isn't illegal doesn't mean it's OK. It's more like: 'for your own good, we will do our best to stop you from doing this to yourself'.
Which means that impairment making a suicidal person less able to try to kill themselves is not at all unfair, or something that needs accomodation. It's a bonus, because it makes it easier to prevent suicide.

Anonymous said...

I can't commit suicide. My older sister and brother lost their mother to suicide. And I couldn't imagine doing that to my parents. I'm actually in little danger of committing suicide; I'd never have the courage. OR so far I've never experienced enough desperation. But I feel so alone and if that could end, oh if only. I don't see why that wouldn't scare people. And I'm terrified to talk about it because I have no idea how people would react. I'm afraid I won't get understanding, just pity. And who wants to live like that.

So, I do my best. And hope like hell someone I can trust will come along. And I try to be a better person, a better advocate, a better activist. I try to be better informed, more connected, more a part of something. Trying to talk people into networking with other movements. And hope to god somebody reads something hears something and something I did will eventually make things better. Actually, I'm pretty selfish. A better world for everyone means a better world for me. I have plenty to hang onto.

I've actually had connections before. And lost them more than once. Lost that feeling of connectedness. Felt betrayed, felt ashamed of myself. Felt like "nothing I've experienced has been worse than this" and I only felt like that once so far. Life went on.

I meant to be a lot less self-centered in this post, but I can't post this anywhere with my name or that's connected to my email address.