[Paleopsych] spiked: Ten myths about assisted suicide

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4.12.17

    Ten myths about assisted suicide
    The flaws in the arguments that end lives.
    by Kevin Yuill
    The campaign for assisted suicide seems to be picking up a head of
    steam in the UK, with the Mental Capacity Bill's stormy passage
    through the House of Commons on Tuesday 14 December. It is certainly a
    step in the direction of the legalisation of assisted suicide, despite
    the protestations of its defenders. According to some readings of this
    bill, a patient may request that he or she is deprived of food and
    water in certain circumstances, and a doctor must obey this request or
    face a possible five years in prison. In addition to this, Lord Joel
    Joffe's Assisted Dying for the Terminally Ill Bill is currently under
    review in the House of Lords.
    It is worth picking apart some of the arguments for assisted suicide.
    1. This is just about individual autonomy
    According to the Suicide Bill of 1961, individuals already have the
    right to commit suicide. Nobody today could be hanged for attempting
    suicide, as was the case in the nineteenth century - nor would they be
    imprisoned for their unsuccessful attempt.
    Lord Joffe's bill would remove the penalty, outlined in the Suicide
    Act, of up to 14 years imprisonment for aiding a suicide. As the
    psychiatrist Thomas Szasz has pointed out, '(s)trictly speaking,
    assisted suicide is an oxymoron' (1). The only people who would be
    'empowered' by this bill would be doctors, who would decide whether or
    not the patient is 'competent', certify that the patient's illness is
    'terminal' and '[conclude] that the patient is suffering unbearably as
    a result of that terminal illness'.
    2. We all need the 'right to die'
    We all have the right to die, with or without its sanction in law. All
    the 'patients' of Dr Jack Kevorkian, currently in prison in America
    for having gone a little too far in assisting the suicide of Thomas
    Youk (which was videotaped and shown on CBS's 60 Minutes), were
    physically capable of bringing about their own deaths.
    Anyone, with a little forward planning and much determination, can
    kill themselves. The Assisted Dying bill will instead place an onus on
    doctors and carers to help individuals to commit suicide. One of the
    most ugly arguments to come from the Voluntary Euthanasia Society is
    that disabled people should have the right to die, too. We must be
    clear that we are being obligated to give the proverbial man on the
    bridge a push (or perhaps to make the bridge wheelchair accessible).
    3. Those opposing assisted suicide are a 'small religious minority'.
    It is true that many religious groups vehemently oppose the Joffe
    Bill, but they are not the only ones. They unite with medical
    representatives and disabled groups, who fear that doctors' judgements
    about 'quality of life' may imply that their own lives are not worth
    living.
    This is no abstract fear voiced by philosophers such as Baroness
    Warnock, as Jane Campbell, writing recently in The Times (London),
    discovered. Campbell, who suffers from spinal muscular atrophy, a
    muscle-wasting illness that means she cannot lift her head from her
    pillow unaided, was hospitalised for a case of pneumonia. The
    consultant treating her said that he assumed she would not want to be
    resuscitated should she go into respiratory failure. When she
    protested that she would like to be resuscitated, she was visited by a
    more senior consultant who said that he assumed she would not want to
    be put on a ventilator. According to the Disability Rights Commission,
    this was not was not an isolated incident. As Campbell says, these
    incidents 'reflect society's view that people such as myself live
    flawed and unsustainable lives and that death is preferable to living
    with a severe impairment' (2).
    In fact, it is those calling for legalisation of assisted suicide who
    tend to espouse New Age religious values. 'Self-deliverance' is the
    term favoured by Derek Humphry, former Sunday Times journalist and
    author of the best-selling suicide bible, Final Exit. Delivery to
    where, Mr. Humphry? Dr Timothy Quill, who admitted in an article in
    the New England Journal of Medicine that he had helped a patient die,
    has written a book called A Midwife through the Dying Process. To an
    atheist (like myself), death is not an 'experience' but the end of all
    experiences. Do assisted suicide advocates wish simply to replace
    rituals formerly carried out by priests?
    Finally, you need not be Christian to agree with the Archbishop of
    Canterbury that 'the respect for human life in all its stages is the
    foundation of a civilised society'.
    4. Allowing the right to die is the hallmark of a civilised society
    To break the taboo against suicide would be a sure sign of societal
    breakdown. Though the disintegration of society and the disappearance
    of socially integrating institutions receive much attention, there is
    little recognition of the relationship with the right-to-die movement.
    The sociologist Emile Durkheim made the point that 'Man is the more
    vulnerable to self-destruction the more he is detached from any
    collectivity.' Is suicide not the most awful manifestation of the
    'drop out' society? To encourage it is a celebration of alienation and
    anomie. The taboo on suicide marks the recognition of our
    interdependence. We should maintain it.
    Even Mary Warnock pointed out, what sort of society tells its members
    that it values their right to starve to death, especially if they are
    a burden on society? Surely a mark of civilisation would be to offer
    people in despair some sort of argument that their lives are valuable,
    that they do have some worth. Instead, right-to-die advocates project
    their own gloomy estimation of the worth of human life on to these
    poor souls.
    5. The central issue is pain
    Not according to any available study. In 1995, an update to the
    authoritative Remmelink Report on euthanasia in Holland, where the
    practice has long been accepted and is now legal, showed that pain
    played a role in only 32 percent of requests for euthanasia. In no
    case did pain represent the sole reason for requests. In Oregon, USA,
    under right-to-die legislation that is seen as a blueprint for Lord
    Joffe's bill, only 28 out of 129 physician-assisted deaths in the
    first five years cited pain as the most important factor (the primary
    reasons was fear of what the future might bring) (3). The suffering
    occurring at the end of life is real enough, but it involves fears
    rather than simply physical pain.
    6. This is all about 'dignity'
    What sort of dignity? Right-to-die campaigners condemn the lives of
    the disabled as bereft of dignity, apparently associating dignity
    solely with control over bodily functions. According to this
    definition, if someone loses their bodily 'autonomy', they no longer
    have human dignity. In my mind, dignity comes from bearing up under
    suffering we meet throughout our lives rather than letting it destroy
    us, and from facing fears rather than caving in to them.
    7. Many are forced into 'lonely, back-street suicides' because of our
    restrictive laws
    The good news is that fewer people are actually committing suicide
    today. In spite of the case of Mrs Z (see [2]A ticket to die), very
    few Britons become 'suicide tourists'. In six years, only 180 people
    took up the option of assisted suicide under Oregon's right-to-die
    law, which is less than one percent of those requesting information
    about it. Even in Holland, where assisted suicide has been legal for
    some time, the numbers are low. Prominent campaigners for the right to
    die such as Timothy Leary have backed out of suicide at the last
    minute. In most polls, those who are keenest advocates for legalising
    assisted suicide are the young. The elderly, whom one might imagine
    have most cause, tend to shun it.
    The real power behind the right-to-die campaigns is fear. Imagine,
    campaigners say, if you were trapped, forced to live a life you no
    longer wanted, unable to end it yourself. But as Elizabeth
    Kubler-Ross, pioneering author of On Death and Dying, noted, the
    attraction of assisted suicide is really about the projection of
    present fears about life on to dying.
    We must ask what a person is saying when they ask for assisted
    suicide. If an individual was determined to die, they would hatch a
    plan and tell nobody about it. By asking for an assisted suicide, an
    individual is expressing their despair about their prospects, their
    fear for what the future holds. Why would they express despair unless
    they wanted some sort of connection with others? Why would someone
    with a true wish to alienate themselves from human contact forever
    tell someone about it? We ill serve those who express hopelessness by
    agreeing with them and, worse, cheering them on.
    8. Amending the Suicide Act to allow assisted suicide would restore a
    right enjoyed by classical societies
    In fact, approving of suicide as a therapy would be unprecedented in
    human history. Assisted suicide advocates often justify their beliefs
    by invoking ancient societies, especially Athens, where apparently
    rationality reigned and suicide was tolerated. Yet in fact, at that
    time suicides were buried away from other graves; the suicide's
    self-murdering hand was cut off and buried apart. Ancient Greeks and
    Romans often took their own lives for reasons of grief, high patriotic
    principle, or to avoid dishonor, but these deaths gained meaning by
    emphasising societal values. Plato allowed that suicide might be
    permitted for reasons of painful disease or intolerable restraint, but
    he argued that the subject had first to plead their case before the
    Senate.
    The solipsism of today's suicide advocates stands out. Suicide for the
    reason that an individual's life is wretched puts aside relationships
    with others. It ignores the union between the dead, the living, and
    the as yet unborn. To throw away a life for such paltry reasons mocks
    those who, in the past, sacrificed themselves to extend and enrich
    life, and risks demoralising those who are just entering our world.
    However, one precedent for a tolerant view of suicide exists. Germany
    between the years of 1900-1945 presupposed many of the ideas of the
    assisted suicide movement (4). Depends on your view of 'classical', I
    guess.
    9. The real problem is modern technology's ability to keep people
    alive indefinitely
    Did someone invent a cure for death that I didn't hear about? The
    blurb on one book notes: 'As medical technology advances to the point
    when any human life can be maintained almost indefinitely, questions
    related to the "quality" of that life inevitably arise.' (5) It is
    instructive that the authors chose not to celebrate the triumph of
    medical science but to look for potential problems.
    10. It is best to die as you choose, surrounded by friends and
    relatives at home rather than by tubes and monitors in a hospital.
    We cannot control when and how we die; to give the 'right' to do so is
    as meaningful as giving people the right not to die of heart attacks
    or accidents. The holistic, back-to-nature view, apparent in many
    medical ethics books, imagines that we have become alienated from
    death and over-reliant on trying to extend life by technological
    means. It is understandable that many people would prefer to die away
    from a hospital, but the search for a 'good death' will forever prove
    elusive. Every death is ugly and undignified, as life is wrenched
    away, leaving an inanimate, waxen corpse. Those who seek the security
    of a good death seek to inure themselves to uncertainty, perhaps
    because they have witnessed the prolonged death of a close relative or
    friend. But this is a projection of our own technophobic fears on to
    the dying person.
    So shall we project our own cramped and gloomy worldview on to those
    who are most sensitive to counsels of despair? Or shall we continue to
    view all human life as valuable, doctors as curers of physical disease
    (rather than prescribers of death for therapeutic reasons), and life
    as worth living?
    (1) [3]Killing to be kind?, by Thomas Szasz
    (2) 'A right to die? I'm more concerned that everyone has the right to
    live', Jane Campbell,
    The Times, 2 December 2004
    (3) Statistics available at the [4]Five years under Oregon's assisted
    suicide law section of the International Task Force on Euthanasia and
    Assisted Suicide website
    (4) See Death and Deliverance: 'Euthanasia' in Germany 1900-1945,
    Michael Burleigh, Cambridge University Press, 1994
    (5) Quality of Life: The New Medical Dilemma, ed James J Walter and
    Thomas A Shannon, Paulist Press, 1990

References

    2. http://www.spiked-online.com/Articles/0000000CA7EE.htm
    3. http://www.spiked-online.com/articles/00000002D3C8.htm
    4. http://www.internationaltaskforce.org/orstats.htm
    5. http://www.spiked-online.com/Articles/0000000CA82B.htm