McPherson and the End of Life “Debate”

The Inconsistency of Our Views

If we genuinely care about alleviating suffering, making people’s lives better, decreasing suffering or perhaps maintaining moral duties, it is inconsistent for us to deny the voluntary right to die. Many people and, more importantly, States oppose voluntary suicide (VS) because of some hang up or slither of of sanctity, even if it’s never explicitly laid out as such. “Sanctity”, or sanctity of life, says there is something almost supernaturally “special” about human life, that it must not be destroyed or diminished to any significant degree. Indeed, it states, human life or living should be promoted, whether on an individual or species-wide capacity.

I find this idea inconsistent with our views in other areas. If it was true that States care about promoting the length of citizen’s lives then all matter of restrictions should be in place: we should not be driving, smoking, drinking alcohol, etc. Why do we allow for these things, which are proven to cause suffering and hasten death, whereas we deny people the means to avoid suffering but bring on a quick death? It is inconsistent and arbitrary. There is no good reason to oppose someone wanting to take his life.

There are obviously reasons to be careful. One important question asks whether people are even in the right frame of mind to decide on issues like this? That is, are they suffering from inebriation, a recent horrible incident (such as the loss of a relationship) which could, at some point, be righted, etc.? There are no clear-cut answers to these questions, since, in many, we cannot know the answer. For example, there are cases of people drawing up wills, arranging their assets, and so on, all in preparation for their death. For many, this is a clear example of someone acting with full use of his rational faculties. We could argue endlessly about what constitutes “full use” but I don’t think there is a definite line as opposed to maybe a continuum. At some point, we have to admit that there exist people who do wish to end their lives with full use of their rational faculties.

A major problem I have, as well as other bloggers, is the idea of equating suicide with insanity. Of course, there are good data supporting this claim but it is mistake to assume all suicides are insane. This comes back to the previous paragraph and the identifiers of rational faculty use. (Yet another dilemma: Is a psychopath ever in a State of mind to decide on suicide?)

A Long-Needed Hero

Recently, for example, Dr Ann McPherson has come under fire for advocating euthanasia. Being a cancer-sufferer herself, and dying fairly rapidly, she has begun campaigning for a change in euthanasia attitude in Britain. A surprising poll tells us that 82% of the British public were in favour of changing the law on assisted death in 2010, while back in 2009, only 39% of GPs and consultants supported such a change. Now, she has begun a fast-moving machine of attention, rolling across all manner of silly traditional arguments against euthanasia. She has already recruited to her group, Healthcare Professionals for Assisted Dying, such giants as Raymond Tallis in support.

“Death is seen as a technological defeat,” McPherson says. “Palliative care specialists see it as a failure if patients want an assisted death. I think that’s ridiculous – it should be part of good palliative care. We have got into a terrible mess about keeping people alive when they shouldn’t be.” (Emphasis added.)

Absolutely. And though it sounds like an appeal to authority, hearing this from the mouth of a doctor certainly adds weight to an already heavy argument grounded in inconsistent, anti-liberal assertions. After all, if we truly care about people’s suffering or want to maintain moral rules – or whatever your focus is to do good in the world – why does such treatment of people retract when they have outlined what will aid them? How can we presume to know that suicide is not an option?

Who are we to force people to continue living, despite their protestations not to? Living is not automatically great and wonderful, rainbows and sunshine. It could be quite horrible and sometimes it’s better to be dead. Living is meaningless without quality, otherwise we are merely husks of biology rather than something that has the capacity for self-reflection and meaning. Human life is not special or sacred; and policies certainly should not align themselves to such dodgy views which cater more for the sleeping patterns of certain loud citizens than the actual sufferers like Dr McPherson.

It is the idea of personhood and, furthermore, whether this person wishes to continue living that should be central to policies. As philosopher John Harris highlights, the capacity does not mean one should utilise the property of consciousness, self-reflection and so on, but that one has the capacity to do so. One may deny these things and certainly that’s the point here.

The issues of, for example, infants, young children, the unconscious, etc., are an altogether more difficult and actually problematic area; whereas voluntary active euthanasia, as given by a fully-rational conscious being, is an argument long over and merely in need of restatement and defence.

“Part of the problem is that those deciding on the legal and political issues concerning assisted dying are not those facing immediate death themselves,” she wrote. “Why can’t people have a rational discussion about assisted dying? Why can’t it be available for those who want it as a choice?”

Notice it is the living who prevent the dying from fulfilling their namesake. It is the dying doctor, not the sober policy-makers, wanting a rational discussion on a subject that actually affects her. Of course, there is a high chance that these decisions will affect more than the current dying. In the future, some cases will definitely arise that could benefit from legalised euthanasia – in Britain but also in countries in which such policies are applicable.

South Africa, of course, is my target. In South Africa, we are still busy with just this problem. It was ignored by our previous Minister of Health stating it was merely a proposal of “health policy for wealthy.” A derogatory statement that implies only those driving Mercs suffer from being denied methods of compassionate killing.

McPherson is a hero. Her bravery and strength are remarkable. Let’s hope this opens up some people’s minds to these issues, by seeing someone in full authority – both as a medical practitioner and a terminally-ill patient – trudge through the long grass of knee-jerk moral thinking. Following this though, I also don’t think support for active suicide should be limited to only the terminally ill or suffering. But what that entails is something slightly different.

Another reason people oppose suicide or euthanasia rests of course with religion. People say that we “play god” by deciding on whether someone can live or die. Some will recall the name the “God Committee”, for example, which essentially decided who lived and died; the committee was formed in Seattle, following Dr. Beldning Scribner’s shunt which paved the way for better and long-term use of dialysis.

The faithful argue that by hastening death we are interfering with god’s plans for our lives, in which there is supposedly a prescribed time and date of our death. I’m not sure why we can’t argue that the euthanasia — that is death through safe, secure, dignified and consented measures — is one of the ways that god “wants” us to die. After all, people die in horrible ways all the time due to cancer and car crashes: But adding any intensional view other than god’s seemed to usurp him of that power.

Oh boy, what a weak little deity he must be. I won’t dissect these very silly and actually ridiculous arguments (the central claims lead down bizarre pathways). Instead, I’ll leave you with this eloquent paragraph by the wonderful Eric MacDonald, from his blog Choice in Dying.

We take death to be somehow something over which God alone rules. That’s why people make such a song-and-dance about helping someone die, because only God gets to do that. God is the killer. We have to stand by and watch him do it. At the point of death our ability to think of better alternatives simply comes to an end. Until then, there is no end of things that we can do. Well, you know what? We can do better than God, anyday. If gods are anything to go by, they rule over a charnel house, where misery is multiplied, and God appoints his sentinels to guard this place of suffering, lest one person help to shorten the stay of another in the inferno.

Read the whole articles on McPherson and from MacDonald. Both excellent people and personally affected, though in slightly different ways, by backward, unthinking policies on assisted-death.

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4 thoughts on “McPherson and the End of Life “Debate”

  1. Pingback: Pancreatic Cancer Survival-Dr Ann McPherson: The GP who believes she should be allowed help to end her life | Symptom Of Pancreatic Cancer

  2. An article you might appreciate if you didn’t see it when it was published:

    http://www.newyorker.com/reporting/2010/08/02/100802fa_fact_gawande?currentPage=all

    Letting Go
    What should medicine do when it can’t save your life?
    by Atul Gawande

    A powerful closing quote:

    “The simple view is that medicine exists to fight death and disease, and that is, of course, its most basic task. Death is the enemy. But the enemy has superior forces. Eventually, it wins. And, in a war that you cannot win, you don’t want a general who fights to the point of total annihilation. You don’t want Custer. You want Robert E. Lee, someone who knew how to fight for territory when he could and how to surrender when he couldn’t, someone who understood that the damage is greatest if all you do is fight to the bitter end.”

    I’m not against euthanasia but I have reservations about some of your language, mostly because of experience with depression, anxiety, and drugs (and because of contact with people that dealt with/deal with the same). You mentioned a “continuum” of how fully one is using their capacity for rationality; that was a very apt indicator of just how problematic the issue of euthanasia is (i.e. there is no objective standard of “rationality-access” to apply here). But then you proceed to sort of write the problem off… It’s a consequential issue! Surely we shouldn’t administer euthanasia to anyone under any circumstances, yes?

    Let’s posit a patient who can’t be anesthetized, is in excruciating pain and wants to die because of said pain. Doctors suggest that with surgery and a short span of more pain-endurance the patient has a high (let’s say 90%) chance of quick recovery… should the patient be allowed euthanasia in this circumstance? Is the pain affecting their capacity for rationality? How do you tell? And, if you could tell, can the pain’s influence be great enough to consider the patient unfit to choose death if they pass a certain “pain influence threshold”? Is denying them death in this situation automatically torture? Is euthanizing them automatically murder? If you went ahead and did the surgery, would they resent you for taking away control or would they praise you for having saved them?

    This is just ottomh – one could envision a million tricky scenarios given enough time, but the word scenario is key here. It seems to me that blanket statements about euthanasia are very problematic, as blanket statements usually are, and that euthanasia should be an option on a case-by-case basis as with many other forms of treatment. And ultimately, in every case, it should be a personal and/or family issue to be decided upon with the help of the relevant professionals. It really gets my dander up when peopletry to make the treatment options of total strangers their business.

    I don’t think we’d actually disagree too much about this, I just thought I’d clarify a bit.

  3. Pingback: baalbek.org » Supporting your right to die

  4. I find the logic of this argument to be woefully half-baked:
    “…Human life is not special or sacred; and policies certainly should align themselves to such dodgy views…”

    Famous persons who aligned themselves with this worldview: Hitler, Stalin, Mao.
    Famous persons who aligned to the contrary: Ghandi, Mother Theresa

    Who would you rather see more of in this world?
    It is reasonable to ask how this proposed change will affect the 4th generation to follow….the logical conclusion is that it will make the world a more violent, less caring place. Think about it. (in light of the advocates listed above)

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