Anything that concerns the taking of life has a societal dimension and everyone is entitled to express a view, writes Margaret Hickey
Euthanasia is edging its way onto the human rights agenda. For many, it is a matter of personal choice, nobody’s business other than the business of the individual concerned and to one degree or other of their nearest and dearest.
However, anything that concerns the taking of life has a societal dimension and everyone is entitled to express a view. Those of religious belief just as much as those of none. In fact, it matters not where someone is coming from in terms of their world view. What matters are the merits of the arguments on both sides and how they serve or hinder the common good.
We have already settled the matter of capital punishment in this country. No one would agree that this should be a matter solely for the victims of serious crime or their families in association with the judiciary, as it is in some countries. Neither do our laws permit reckless endangerment to one’s own life. We are obliged to wear seat belts, helmets and high viz vests. You can be ordered to leave your own home if the authorities deem it unsafe in some way as happens from time to time in our more and more micro-managed world.
Suicidal people are restrained from following their inclinations even to the point of being placed under ‘suicide watch’. You cannot buy prescribed drugs that are potentially lethal except under strict control. You cannot even buy some proprietary weedkillers above prescribed quantities. Why is it everyone’s business to prevent people taking their own lives, or at least the State’s business, when we don’t know the extent of the life-weary wretchedness that may lie behind their recklessness and disregard for their personal safety?
So at what point does the preservation of life as a social good cease to be anyone’s business other than the individual concerned?
This is where the hard-case scenario is presented as the card to trump all arguments.
Hard case scenarios make a compelling case for themselves as the exception to the general rule and that is precisely the problem of making laws around them.
Changing the rule in this instance means abolishing a fundamental principle. The right to take life with social approval and the assistance of others in order to end ‘unbearable suffering’ or because it is ‘in the patient’s best interest’ is necessarily open-ended. This cannot be dismissed as ‘a slippery slope’ argument because the only way is down, progressively but inevitably down. There is no objective way of defining a hard case without jeopardising justice because the concept is subjective.
Cases are as hard as the person carrying the burden says they are. In Belgium in recent years, euthanasia was provided to 45-year-old twins who were going blind, to a 44-year-old woman with chronic anorexia and to a 64-year-old chronic depressive whose family were not even informed until after her death. Yes, they were all flagged through as involving ‘unbearable suffering’.
Checks and balances have not held back the slide towards liberalisation in countries like the Netherlands and Belgium where euthanasia is legal for well over a decade. Not only is it sufficient to be merely ‘tired of living’ to qualify for euthanasia, but in both countries newborns and children are also eligible to avail of this bizarrely termed human right.
The whole concept of ‘informed consent’ goes out the window in such cases as it does in cases of dementia or even depression. Depressed people are generally cautioned about making life changing decisions. There can be nothing more life-changing than the decision to end one’s life.
In an age of rapidly developing medicine including palliative medicine it seems a bit incongruous that the demand for euthanasia is being pressed so determinedly at this point in time.
The other incongruity is that it is in the very part of the world where all branches of medicine are so advanced that this demand is being made. It might be just another facet of our all-pervading desire to control all aspects of our lives, to extend our range of personal autonomy and freedom so that even the great non-negotiable, death, cannot have it all on his own terms.
Changing a societal value has implications for all. It can compromise the life-saving and life-preserving ethic that is at the core of medical practice. It could place each and everyone of us in a situation where the right to euthanasia may become more of an obligation. Just imagine you are old and debilitated, a burden on your family and on the health service how free will you feel to decline what veterinary practice calls ‘ final attention’?
The skills and resources of modern medicine are available in our hospices to alleviate the pain and distress of the last weeks and months of life. In countries like France and the UK, amongst others where euthanasia is illegal, care for the terminally ill has advanced hugely in recent years. Palliative care and the suspension of active treatment for disease is often described as passive euthanasia and hospices do not deny any fellow human as much as it takes to ease their passing from this world.
Dying with dignity is understood in hospices in ways that do not deny either compassion or the capacity of the human spirit to give and receive in ways that can indeed be ennobling and life enriching, in ways that also acknowledge that, in life as well as death, we do not always have control and that acceptance of our lot may be more life-affirming than its rejection.
The fact that suicide is no longer a criminal act does not mean society should canonise it as a legitimate personal choice. When hard cases arise, as they do under every law, we naturally try to bend and stretch legislation to accommodate them. Where we cannot so do, we need to look hard at the unintended consequences of changing a law, especially one that enshrines a fundamental social value. Changing or abolishing law on grounds of compassion may prove a very uncompassionate option by the time we hit the bottom of the slippery slope, as inevitably we will.
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