The ethics of euthanasia, our books, this website, right or wrong?

motor way aheadIn almost every religion and philosophical system, the right to life and the right to live the way we want to as long as it does not interfere with the same rights of others, is something universally respected. I don’t much like the phrase “the right to die” because each of us is going to die anyway. Each of us is going to experience that both in our life one day, and as an ‘observer’ long before that. You could ask every family on this planet today and not one of them could say they have not experienced the loss of someone through death. Death, undoubtedly, is a fact of life. You have no right to die but you have a right to choose when and how. However, for ease of everyday expression we can talk about a right to die.

Rights can be a natural, civil or political privilege. They are a claim to an entitlement of some sort, and it follows that to mean anything your entitlement has to be recognised by others, hence our laws – and the philosophical idea that all rights entail duties (FindLaw UK). In the example I gave above, the duty is to observe the same rights in others.

Liberties and rights are not always the same. You have a liberty to be promoted in your job, but not a right (as it would affect the rights of others). But as a woman, you have a reasonable right not to be discriminated against on account of your gender! This is not something we will always feel instinctively. Your boss may feel privately and even passionately that he can discriminate on account of your gender: but the moral law, now enshrined in the laws of the country, says he may not do so. As he considers the moral position, how you are entitled to the same freedoms as man, as any person, he may come to understand. A person’s freedom, every person’s individual freedom, is the reason we have moral law at all; correspondingly, it is the moral law that provides us with the opportunity to understand our freedoms and the freedoms of others. In a way it is, and has long been, the basis of our society for many years (Kant 1788). For without freedom, what is your life worth?

At a recent conference, I started by listing some of the freedoms we often take for granted. You have for instance the freedom to live the way you want, to speak however you want, to write what you want, to love others the way that you want to. The only moral argument is that you do so without infringing the same rights in others, and unless there is a law set in stone then you also often have to be the judge of the morality of your action. You can’t walk into the National Gallery and write your name on a Picasso just because you have an innate right to write what you want to. You may decide, in certain circumstances that you have a moral right to help someone else, including helping them to die. The law however may disagree (in some circumstances and not others); and sometimes when you exercise what you believe to be your right the consequences might be so severe that your own right to freedom would be infringed, so you would have to weigh up the options carefully (DPP 2010). A person also has the right, let us not forget, to try dissuade someone else whom he feels is misguided in wanting to die.

Having dissected the “right to die” to find what it really consists of, it would feel natural to look at a similar “right” and ask the same questions. What is the “right to life”? Thomas Jefferson wrote in the Declaration of Independence that it was self-evident that all men are endowed with certain inalienable rights, among which are the rights to life, liberty and pursuit of happiness. It was not, however, self-evident to everyone – since a war for independence quickly ensued (Hood).

The “right to life” does not mean quite the same as the “sanctity of life,” but both ideas are deeply embedded in our society and way of thinking, without being absolute (Lord Keith 1993). War is a commonly quoted exception, which could be defined as the defence of one’s right to live the way one justifiably wishes to, without interference from others. Many books have, and still could be written on this subject. A difference between “right to die” and “right to life” organisations might be caricatured as “I have the right to live and die the way I want to, and I wouldn’t want to stay alive as a ‘vegetable’,” vs “I have the right to live and die the way I want to, and I want to stay alive as long as possible, even if I’m in a vegetative state.” The difference between the two sides is either a) a desire to extend one’s personal interpretation of these rights to others, or b) a fear that others will infringe on one’s rights.

What we are talking about is the rights of the living, to make choices, to do. Not so much of existence, but of the right to exercise and enjoy that life, that existence, in the way that one sees fit, without fear or favour. The idea of a debate between “right to die” and “right to life” can throw light on the issues but, alone, not progress them. Most people are somewhere in the middle. It is philosophically disingenuous not to see things from all sides and for this reason it is mostly not in my nature to engage in debate. Yet however all-embracing any one of us might wish to be, as individual, as persons, individual organisations, we still have specific lives to fulfil, specific tasks to achieve, and particular people we are drawn towards helping. Suicide prevention is as important an issue as rational assisted suicide (I’ve studied and worked in both.) I’m trained as an ethicist to examine all sides equally. Who can not feel the pain of someone bereaved at a moment that seemed wrong? Also, who could not feel the pain of someone forced to exist against their wishes, their lives fulfilled, but tortured to a slow death in direst agony? Suicide prevention is still, relatively, a new science. If society intervened with everyone displaying ‘at risk’ signs, ten times as many people would have their lives disrupted than helped (Smith 2008). Only when someone is clearly a danger to themselves can we, as society, intervene; but if there is any doubt then the principle of autonomy, of self-determination, takes precedence (Lord Keith).

The roots of Exit go back to 1935 (when the first voluntary euthanasia society was formed, in London) and to 1980 when it broke away from its parent group to publish a manual detailing ways of painless, dignified death. It was imperfect (and still is, as are all such manuals) but the work continues, and it is to address the rights of those people who want to be able to determine their own time and manner of dying. The purpose of this Blog, our books, our workshops, is to look at the practical options for that group of people. Years ago, such people would have thrown themselves off Beachy Head, put their head in a gas oven, hung themself from a light fitting or driven their car into a tree. If you have lost someone to an untimely suicide that was at least relatively painless, would you really have preferred their bodily remains to be scattered over the rocks below a cliff-top? Doing everything we can to prevent untimely suicide and empowering people with knowledge, even knowledge of the methods of suicide, are not mutually exclusive. Almost 280 pages of our current manual are devoted to examining the moral issues, to dissuade the unprepared and encourage them to explore all other possible solutions rather than death, and, if no other solution is acceptable to them, how to communicate with their loved ones and those dear to them and minimize their pain as well.

Among groups concerned euthanasia and with self-euthanasia, Exit is among the most conservative. Our legal proposals are for exceptions to the rule; our books are quite voluminous to read and absorb the information; there are no “how-to” instructions on our Blog or Homepage and we do not offer one-to-one advice even to members. We work (and encourage others to work or act) completely within the law. We run on a tiny budget (data-led research is costly) and are frequently harassed and blamed: yet it is a fact that anyone with internet access can simply skip our websites and find “instructions” on how to die from underground chatrooms and discussion groups (many of those are so irresponsible that we really can understand attempts to have them shut down for good, but please, leave us in peace!) If you are among the small proportion of people in this thankfully democratic country that opposes euthanasia, this is not the place for you (unless you are genuinely trying to understand a different view). We are sorry for your pain but please don’t send us your haranguing emails or death threats: really, we did not cause the problems in the world. We built the motorway for people who need to get somewhere quickly and safely; we put up a sign saying No Learner Drivers or Persons Unfit to Drive. We can point you to responsible sources for suicide prevention, bereavement, mental illness and so on, but that is not the job that Exit was set up for, the work that people desperately trust us to do to give them that insurance, that key to the door marked Exit if things get so bad they cannot take it any more. (And many have said how simply knowing how they could take matters into their own hands gives them courage to live on, to live longer.)

There is a small book in our office compiled in 1989 by one of the founders of Exit, Sheila Little, a tireless, charismatic, elderly grey-haired lady who devoted her life to our mission. That mission is expressed in the letters printed, with permission, in its pages: heartbreaking tales of people who just needed to know there would be a way out for them. They trust us to do that work.

And Who Should Forbid Them

 

Professional bodies working in law, medicine, psychiatry or other areas specific to our work are invited to contact us at any time. We cannot as a matter of course enter into general correspondence with the general public however, and if you are a member of the public wishing to discuss the issues raised on this website, please follow the appropriate links. (This is not a discussion forum.)

References. These are a small selection. Our book The Exit Path contains a deeper look at the ethics of publishing data on self-deliverance for both professionals and the public. It includes over 1000 references. Exit is committed to empowerment: that means data-led knowledge of methods of rational suicide as well as suicide prevention wherever that is a realistic option.

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