Dignity In Choice – The Moral Argument for Euthanasia

26 Mar
First things first, welcome to The Catch Paper, click the About section for more information on who I am. Secondly, with euthanasia guidance going to the House of Commons this week (two years after it was set out) and with the case of Tony Nicklinson being given the legal go-ahead, I thought I would publish my thoughts on the matter.

What follows is a blog I did for a different site but is very relevant now.  Later (after the House of Commons) I will give an overview of the current issues and challenges facing euthanasia but I felt this article would set the scene.
 

Dignitas - A euthanasia clinic in Switzerland

I propose two different but very sad situations; the first of which describes a loved family Dog and the second describes a loved one or even yourself. In the first situation your dog is ill, in a massive amount of pain. The Vet tells you that there isn’t any cure and the chances it will get better are non-existent. He advises you to put the dog down and end its agony. Your Dog has been in your life for 15 good years and you can’t bear to see it in pain. With a heavy heart you let the vet put it down. In the second situation you or a loved one is very ill, they (or you) are in a massive amount of pain. The doctor tells you that the disease is terminal and the chances of improvement are almost non-existent. He tells you that all he can offer is morphine to numb the pain. You are in agony, the morphine barely takes the edge off and you can’t do a thing for yourself. Lying in bed unable to go outside, go to the toilet, wash or maybe even remember who your loved ones are you have no chance of dignity. From this there is no relief, the doctor tells you it maybe days, weeks, or months. The only certainty is that it isn’t going to get any better.
 
This situation isn’t only hypothetical. Every day dogs and cats are allowed the dignity in death, the escape from pain that no human in Britain is legally allowed to choose. Why is it that the choice to end the life of an animal out of the desire to end pain, suffering and indignity is given to those that love and care for the animal but the choice to end it in a human life is denied even to the person whose life it is. To not let a dog suffer is seen as the moral and right choice, to end the suffering of a human is seen as immoral and even illegal. Is this situation fair? Is it fair to remove the right to die with the dignity of choice completely? Yes there are people who believe they would be dignified in suffering but should we not be given the choice.
 
Dignity in death is a real desire of most people. You might argue that not all people believe in having their life cut shorter to end incurable pain but that is not what I stated. No one wants to die in agony, no one wants to die alone, no wants to die in a hospital ward covered in sensors and surrounded by people they don’t even know. The ideal death is a dignified one, the type we see and read in movies and books. You make your peace with the people you love and you die at an old age, in your own home and in your own bed, bereft of hideous agony, hospital radio and scores of unknown doctors and nurses. Whilst this a slightly utopian ideal, due to care homes and the fact that old age means dying of some condition, it is still a waypoint upon which all deaths are compared. Dying having lived through days, weeks, months maybe even years of unbearable agony and indignity without out any measurable amount of hope is a long way off our most desirable ending.
 
Whilst the opponents of euthanasia argue it is immoral to end a life whatever the circumstances, surely you must consider the immorality of denying the choice. Is it not free will that defines the very humanity that they purport to be defenders off? I am in no way asking for a complete repeal of law in relation to euthanasia. As many of the anti-euthanasia camp have said, the right to choose death over incurable suffering is open to abuse. Whilst evidence for this abuse is no more in existence than evidence of a bouncy castle on Neptune I do believe an answer to this criticism is needed. The law would be required to bring in regulation to stop any abuse of the vulnerable by relatives maybe fed up of the emotional, actual or time cost or any psychopathic doctors who may have slipped the net (Dr Shipman-esque practitioners). As a man not well versed in legal and medical practices I am sure there will be flaws in the system I am about to propose, however, it will prove that a legal system that allows for the dignity of choice is possible. I propose a system whereby a tribunal would establish whether the stated desire to be assisted in death on their own terms was not as a result of third party pressures and was indeed a personal choice. This system would also stop people using the right to assisted death to commit suicide for what the reasonable person would consider trivial reasons. I propose that the tribunal be made up of a panel of legal experts in the relative fields and medical practitioners. Lawyers who are well versed in whether someone is expressing a true or influenced desire through experience in family matters and doctors who are experienced in terminal situations would be a prerequisite for this panel. The idea that the government can still decide on whether someone can choose to die may feel, as it does to me, draconian and insulting but protecting the vulnerable is a duty the law cannot shirk off. In the case of assisted death compassion has to not only sit alongside the law, it has to be incorporated. This is why a panel of people and not rigid laws must decide whether abuse is being committed.
 
This system is one also desired by the author and sufferer of Alzheimer’s Sir Terry Pratchett. He believes in being able to end his life on his own terms whilst the disease has not destroyed his ability to live it. The kind of living death that many people suffer as a result of progressive diseases like Alzheimer’s leaves people not only in agony but without memory. Memory in this case isn’t just forgetting where your keys are and what that guy’s name is. Instead it is the worst pain imaginable; it is pain felt at the loss of one’s self. The person that they were has already died. Along with not knowing their family and friends they no longer know what they are. The ability to do anything that made them human has gone, talking, walking and remembering are all out of the question. Is it not right that they can choose to end their life whilst they still know what life they had? The endgame of diseases like Alzheimer’s is not a case of will they or won’t they die this way, it is a case of yes they will. It is an immoral degradation that people consigned to this awful fate are denied the right to die on their own terms. They are denied the right to say goodbye because the law decreed the choice isn’t theirs.
 
The matter of euthanasia is a nervous one. Many people say they are against it when it is put to them as the cold question of should euthanasia be legal? But like most matters of life and death the answers are decidedly more mixed if you broach the matter more personally. People will say ‘euthanasia is wrong’ or that they aren’t so sure about it if it put as impersonally as above. However, if you are to tell them of the wishes of someone close to you or those of your own things become very different. They may be nervous around the word euthanasia or assisted dying but will immediately agree with and even condone the sentiment conveyed in these words; “if I am ever full of tubes and drugs and empty of any sign of life please, pull the plug”. People can understand the desire for dignity in death because it is a common desire of humanity. The word ‘euthanasia’ seems to have been so vehemently covered in the dirt of immorality by those who oppose it that it has become separate from the very personal issue it describes. I am not saying that all those condemned to terminal suffering and painful death should be assisted before it happens. What I am doing is arguing for the right to choose.
 
Euthanasia is often portrayed as an acceptable practice in film and on TV. The ‘E’ word is of course never mentioned as this would eschew the morality of the process. Instead it is portrayed as helping someone to end their pain and die with dignity. Many different medical dramas and films approached this theme but the situation is always similar. A person is in pain and getting close to a very painful end, the person will ask the doctor to help them die and the doctor will wrestle his morality against the legality. The correct moral choice to fulfil the patient’s wishes is always pitted against the solidity and coldness of the law. The hero of this situation makes the choice to assist the patient and allow the dignity and relief they want despite the cost to themselves if discovered. This is wildly accepted by the public as heroic but had it involved a trip to Dignitas to commit euthanasia I don’t think the reaction would have been the same. As with the difference between personal situations and the morally tarnished word of euthanasia the world of TV and film places the subject in a real and very personal situation.
 
This stark contrast between acceptance on a personal level and rejection where the ‘Crazy Swiss’ and ‘euthanasia’ are concerned is due to the self-righteous and prolific campaigning of those who oppose the idea. People who desire the right to choose are portrayed as unthinking, immoral, cold and irrational by their opponents. The attacks they make focus on the belief in ‘care not killing’ and draw contrasts to murder and abuse. By using words such as killing, murder and abuse in the same sentence as euthanasia they have polarised the argument as one between the moral and the disgraceful without honestly facing the arguments that the supporters of euthanasia have put to them. I am of the belief that a real, sensible and considered discussion of this matter is needed instead of the media war that we are in right now.
 
Ultimately it comes down to the desire for the dignity of choice. By outlawing euthanasia you deny the one thing in death that gives us humanity in life. The freedom to choose is at the soul and centre of life and so it should be in death. By all means people can choose not to end their suffering but dignity comes from it being a choice. As it stands the choice isn’t even theirs. The people who oppose euthanasia in life can choose to oppose in death. Those who believe in the dignity of choice in life on the other hand have the indignity of being unable to do so in the very personal matter of their own death.
 
~When is right?~
For more information on Alzheimer’s go to www.alzheimers.co.uk and please donate to support the very important care and advice they carry and give out. 

If you want more information on the euthanasia debate you can visit the main pro euthanasia group in Britain at www.dignityindying.org.uk and the corresponding anti group at www.carenotkilling.org.uk

For information on the legal situation regarding euthanasia in Britain go to the Wikipedia page at en.wikipedia.org/wiki/Euthanasia_in_the_United_Kingdom (Wikipedia can be wrong so if desiring actual legal advice always seek a solicitor). 

For the The Richard Dimbleby Lecture that Sir Terry Pratchett gave on the matter go to http://www.youtube.com/watch?v=6qQgWCQESgo.

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