Vicky Phelan and the right of terminally ill people to end their suffering

Vicky Phelan’s last wish to the Irish State will be met by predictable resistance, by many of our politicians and a sizeable section of the public more broadly. Securing justice is always an uphill battle, writes Dr Vittorio Bufacchi
Vicky Phelan and the right of terminally ill people to end their suffering

Vicky Phelan was met with a standing ovation when she walked on to the Late Late Show on Friday night. However, it's likely that her last wish to the Irish State will be met by predictable resistance.

Vicky Phelan, the terminally ill cervical cancer campaigner, has urged politicians to pass legislation to give people like her the option to be medically assisted to die. She justifies this request by appealing to the right of a terminally ill person to end their suffering.

Vicky Phelan’s last wish to the Irish State will be met by predictable resistance, by many of our politicians and a sizable section of the public more broadly. Securing justice is always an uphill battle, and no one knows this more than Vicky Phelan. 

Even if Vicky Phelan is successful in this campaign for justice for terminally ill people, it is unlikely that she will benefit from it herself. Moral progress moves at a snail's pace in Ireland, and time is not on her side, as she knows only too well. But that is inconsequential; Vicky Phelan’s latest campaign is in keeping with her immense commitment to civic duty, public spiritedness, and indomitable sense of justice.

Before going any further, it is imperative to clarify a key point: euthanasia is not a disability issue. 

In seeking assisted suicide, a person who is terminally ill is not trying to escape their disability. Instead, this is a debate about the right to choose in the face of death. 

It is also about fundamental equality: someone who is terminally ill has a right to be treated as a moral agent on a par with every other person in society.

To be an agent, or to have agency, is to have the capacity to make choices. This is the essence of our personal autonomy. There is nothing more disrespectful to a person than to have their ability to choose being taken away from them, or to be impeded from exercising their self-rule.

Another way of expressing the same idea is that there is nothing more empowering than the ability to make a choice about oneself, about one’s own life. It is our duty, as a society, to empower people, and that includes those who are terminally ill. Perhaps especially them. 

In certain circumstances and under specific conditions, being able to choose when to terminate our life is to make a statement about our autonomy, our moral agency, our self-respect.

Oxford Philosopher Joseph Raz famously defined autonomy in terms of “being the author of our own life”. Authors write books. Think of your life as a novel, part historical and part fiction perhaps. Your autonomy is what makes it a book about you, it is your book. 

The ability to make choices is pivotal to making our life-book our own original, unique work of art. All books must end. As any author knows the ending of a book is crucial to the success of the book, often the most memorable chapter of our magnum opus.

As American philosopher Ronald Dworkin says referring to euthanasia, “none of us wants to end our lives out of character”; we want the last chapter of our life to be consistent with all the previous chapters. How we die matters to us because we want to retain control over our life, all of it, until the last moment. The ending of any story should be congruent to what came before.

For those like Vicky Phelan tragically forced to contemplate assisted suicide, some of the most pressing issues are about being themselves until the end, and not be forced to write the last few pages of their book out of character. 

Even if Vicky Phelan is successful in this campaign for justice for terminally ill people, it is unlikely that she will benefit from it herself.
Even if Vicky Phelan is successful in this campaign for justice for terminally ill people, it is unlikely that she will benefit from it herself.

They want to maintain their dignity.  They want to be remembered in a certain way, and not in the condition they find themselves in. They don’t want to be degraded into becoming the object of continuing anguish. 

French philosopher Michel de Montaigne, writing in the 16th century, encouraged us to face death head-on, without fear. Today a terminally ill person like Vicky Phelan is being denied the vital character-defining moment of being able to choose when to end her suffering.

Death is the last chapter of our life-book, and we want to be ourselves, and maintain our character, until the very end. This is the reason why euthanasia under certain conditions ought to be a choice. 

To impede or obstruct this choice is to take away someone’s dignity, to subtract someone’s autonomy, and ultimately to disrespect their moral agency. 

That cannot be right. It would have been inconceivable to force Tolstoy to write a different ending to Anna Karenina, and similarly it is wrong to deny a terminally ill person authorship of the last chapter of their life.

After the divorce referendum, the same-sex marriage referendum, and the abortion referendum, assisted suicide for the terminally ill is the next chapter in Ireland’s unfolding history. Exactly what will be written in these pages will shape the future of Ireland’s own life-book.

  • Dr Vittorio Bufacchi is Senior Lecturer in Philosophy at University College Cork, and author of Everything Must Change: Philosophical Lessons from Lockdown

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