The following is a story in The Telegraph (20th August 2011):
The law shouldn’t put this poor man out of his misery
A stroke victim who wants to die is fighting a landmark legal case. But changing the law so that medical professionals can end someone’s life is a big step on a slippery slope.
By Alasdair Palmer
No one can read about “Martin” – his name has been withheld in order to protect his privacy – without feeling desperately sorry for him. Three years ago, at the age of 43, he suffered a catastrophic stroke which left him almost totally paralysed: he can move his eyes, but that’s about it.
Before his stroke, he was a fit and active man. Now he spends every hour lying in bed, able to feel the pain from his body but not to move it, managing to communicate only by staring at letters on a special computer which responds to his eye movements and allows him to spell out words.
Read more ….
I will quote the relevant points as I go along, but reading the story is perhaps the best way to get the “full picture.” I speak about “a case in point” because this is just what the standard Christian position holds, though not for the reasons that Alasdair Palmer gives. Well, almost not for those reasons, though these reasons very often — though I do not say this in the case of Mr. Palmer, because I don’t know — stand in for the “real” reasons, which are derived, in one way or another, from the Bible, Christian doctrine, natural law theory of morality (which is supposed to be able to stand completely on its own, independently of Christian doctrine), or other religious sources, which imply an absolute condemnation of so-called “mercy killing,” or what I call assisted dying.
Notice the importance of the term “assisted dying”. The point of it is not to disguise intention, as is so often supposed, or to get rid of ugly words like ‘killing’, ‘murder’, ‘suicide’ and the rest. It is to place the emphasis where it belongs, on the person who is dying, or is living in such conditions that dying seems to them the preferable option to remaining alive.
“Martin’s” case is a case in point. Due to a stroke he cannot move. Though he can feel pain, he cannot move his body (as we all do, unconsciously, all the time) in order to relieve the source of it. He cannot speak, though he can communicate by means of using his eyelids. He is in a situation similar to those who experience “locked in” syndrome, though this term is not used in the article to describe “Martin’s” condition. (He is, however, in another article, so described.) We are also directed to another article which claims that “People with locked-in syndrome are happy, study says.” But Martin has locked-in syndrome and is not happy, and he wants help to die, and has appealed to the High Court for the right to have an assisted death. He’s been like this for three years, and he’s had enough.
But Alasdair Palmer thinks he shouldn’t get his wish. And the reason? Not any apparently “noble” concern for the prescriptions of natural law, but because, in his view, it’s the top of a slippery slope. But let’s look at what he says:
Should we want Martin’s case to succeed? Certainly, it would be horribly cruel if he were forced to continue living a life that is agony for him. At the same time, there are some very good reasons for not extending still further the numbers who can help another person to commit suicide.
So, Palmer notices that it would be horribly cruel not to accede to Martin’s wishes. That says something for his ability to empathise, at any rate. But then he says, no, we mustn’t do it, because we must not make it possible for more people to be entitled to help a person die by suicide. (One of the reasons those who support assisted dying want to get away from the word ‘suicide’ is that in English it is still spoken of as though it were a crime, and the word ‘commit’ is always linked with it, which makes it sound as more or less a criminal business. And, of course, it used to be a crime — in Canada up to the 70s. German, happily, in place of Selbstmord (self-murder) has the much more helpful Freitod (free or voluntary death).)
What are Palmer’s reasons? Well, he says that it will in one stroke devalue the lives of everyone who is a situation like Martin’s, and will make it much easier to think that we are doing them a favour by killing them. Palmer deliberately uses the term “do away with” rather than “kill” or “murder”. He also, I think, deliberately uses ”put out of his misery” in his title, a term which suggests that Martin would not be an active and willing participant in what is being done to him (rather than for him). At least I suspect these terms were chosen deliberately. And I suspect that it was deliberate for the simple reason that if he used “kill” or “murder” it would be obvious that very few people would actually be disposed to kill or murder their patients, and his claim would have had far less force. But “doing away with” is mild enough that we might perhaps think that someone might suppose, if it is to Martin’s benefit, then why wouldn’t it be to Susie’s, say, if she were in the same condition? And “put out of his misery” sounds enough like something being done to a person rather than for a person, that it raises all the fears of others being “put out of their misery” too.
However, the point that is being missed is that we can ask Susie, and Susie can tell us. We can ask her whether her life is simply one long misery, or if there are things that she values about her life. And she can tell us if her life is just a protracted misery. And we would be required to ask Susie if the question of being “put out of her misery” should arise. And it shouldn’t arise unless Susie brings it up. No one could come along and “ease” Susie out of life, and then later say they only did if for Susie’s good. Because law doesn’t work that way. We need to give reasons and provide evidence.
And in what way would Martin’s decision devalue Susie’s life? If Susie’s life is full of happiness, as the study alleges, then there is no reason to suppose that Martin’s finding his situation hopeless and pointless would make Susie’s life hopeless and pointless too. Why should we think so? Martin and Susie are two entirely different people, with different life histories, different abilities, different enjoyments, different hopes and fears, different conceptions of what makes for a good life. Why should what Martin do have any bearing on what anyone else in (roughly) Martin’s situation would do? How would Martin’s choice devalue that other person’s life? If people with locked-in syndrome truly are happy (though, notice, Martin is not), why should Martin’s not being at all happy make a difference? And if it did make a difference, are those so placed really happy, after all? After all, even Palmer thinks it would be cruel to force Martin to go on living.
But more important, why should the effect of what Martin has chosen to do (or to have done for him) have any bearing on whether or not Martin should be permitted to have the relief that he seeks? Palmer says, in a bit of hyperbole:
This is one of those slopes that actually are slippery. The law starts by allowing family members to help others die. The next step is to rule that you don’t have to be a family member – anyone can get involved.
But how does he know that this is a slope that is actually slippery? He goes on to speak darkly about Jack Kevorkian, but there is no proposal here that just anyone should be permitted to help another person like Martin to die. Indeed, there seems to be some idea running in the background that the law should provide some kind of regulated way for people like Martin to receive help in dying, and Palmer is simply ignoring this and speculating that it is all going to become a free-for-all.
However, in order to show that there is a slippery slope here, Palmer really does need to show it. And talking about Jack Kevorkian scarcely settles the matter, since, whatever we think of Kevorkian, he was trying to make a point about the need for options at the end of life, or even, perhaps, in the midst of life, and it is altogether unfair to think that he was some kind of dark criminal. Taking a parallel case, Dr. Morgentaler in Canada did much the same kind of thing in regard to abortion, and was jailed several times, but in the end he was vindicated, and has now received the Order of Canada. But Kevorkian is not germane to the British situation, in any event, where, in fact, prosecutorial guidelines are now in place which enable relatives (for example) to help loved ones to die, if that is their earnest wish (and they are in situations judged to be such as to lead a reasonable person to think that dying might be in their best interests), without the threat of prosecution. Palmer seems to think that extending this right to physicians will so broaden the scope of the prosecutorial exemptions that people’s lives will be placed in danger.
That is nice for him, but just saying it doesn’t make it so. Switzerland has had such a law since 1941, and aside from the fact that conservative Christians oppose the law, most Swiss seem to be very comfortable with it. Nor has it shown a propensity to put people’s lives in danger. One person, like Martin, making such a decision in Switzerland, would touch practically no one else. It wouldn’t even cause a small ripple in the media. And there is no reason to think that it should do so elsewhere, if it weren’t for people like Palmer, and others, worse, in my estimation, than he, who want to lay down the law for the law because of their religious beliefs, and shout abroad about “legalised murder” and “life unworthy of life”, and all the other slogans of the so-called “pro-life” movement. (Though surely we have reason to wonder whether those who are prepared to be horribly cruel to people like Martin are really, in any ordinary sense pro-life.) In such an atmosphere, of course, every case like Martin’s will receive enormous media attention, and people will run around hysterically saying that the sky is falling. But, as it hasn’t fallen in Switzerland in the last 70 years, I see no reason to believe that it is likely to fall anywhere else.
So, considering that Palmer acknowledges that it would be “horribly cruel” to force Martin to go on living, when he has asked to be able to die, he needs to provide very good reasons for doing so. And he’s right, it is horribly cruel. It is also, I warrant, a violation of Martin’s right to autonomy, even though the philosopher Onora O’Neill thinks that autonomy is widely misunderstood and much more complex than we think it is. This being the case, the reasons for forcing Martin to go on living must be exceedingly strong, and in my opinion they are not. This is abundantly clear, if we take Palmer at his word, even from a cursory reading of his piece. Does he have other, more forceful reasons, to justify being horribly cruel? If so, he has not provided them. But the reasons that he does provide do not justify horrible cruelty. What he gives us is a tissue of “what-ifs”, but he has not shown — nor do I think that he can show — that his imagined fears are anything more than that — imaginary. This is not enough to justify horrible cruelty. I suggest that so-called natural law reasons are not enough either, but that is another story.
The following interview with Chris Larner about his ex-wife’s journey with MS and finally to Dignitas in Switzerland, and the about the play he made of Allyson’s experience, and his experience with her makes things very clear. But the most important thing is the point that Palmer keeps ignoring, namely, the fact that this is something about which people can think and make decisions for themselves and not for others, and reduces Palmer’s “argument”, and the “arguments” of the Church of England and the Archbishop of Canterbury to cases of special pleading. (Thanks to Michael Fugate for the link. It deserves to be more widely seen.)
Thanks to the Guardian, here.