I’ve been laughing all morning at the blatantly empty rhetoric displayed in this piece.
two had Crohn’s disease, an inflammatory bowel disease; two were tetraplegics; three had kidney disease, which can be usually treated by dialysis or a transplant; and one had rheumatoid arthritis – all conditions which doctors say are not terminal.
No one takes their own life because their life can’t be prolonged; that would be an utterly meaningless position. No one says, “I’m going to kill myself because I’m going to die.” They kill themselves because the quality of their life is not acceptable to them. “Oh, but you could have lived in complete horror and misery for another 15 years!” is therefore neither a helpful nor an appropriate response.
It also seems to camouflage an even more inappropriate response, which goes: “Your duty is to bear your suffering. Our duty is to decide when you have suffered enough to purify your soul. We decide (after due consultation with your local pastor, Parish Council and the Women’s Institute) when your life has become too unpleasant to bear, not you. Until then, take the drugs and do the needlework. You’re only the patient.”
This is 2009, not 1947. When will the NHS get off the “life at any cost” standard and substitute something more humane for those who don’t subscribe to it ? It is a bad value assumed without thought, and it sustains the steep power gradient between the care industry and the patient.
I can stomach a “palliative care” argument, though I don’t agree with it (mainly because palliative care is simply never palliative enough). But, palliative care or not, the decision as to when, where, and how one will take one’s own life is something to be decided privately by the patient, with emotional support from a close friend or relative. That’s why this quote is so insulting–
Dr Tony Calland, chairman of the ethics committee at the British Medical Association, the doctors’ union, said: “This list raises considerable concern. There are some conditions such as Crohn’s disease and rheumatoid arthritis that, whilst extremely unpleasant, are eminently treatable and many of the symptoms can be relieved. To go off and commit suicide simply on the basis of these conditions would be premature and unreasonable.”
Note the classic use of “extremely unpleasant” and “many of the symptoms”. This is code for, respectively, “fucking unbearable” and “just not the ones you so desperately want to escape”. While “premature and unreasonable” is code for, “We’ll let the doctor decide what’s reasonable and what isn’t, dear, shall we ?”
Underneath the argument this is simply a power grab.
Other than to safeguard the patient’s point-of-decision, there should be no public input into the point-of-decision. God forbid that we should have “a new legal right of assisted death to render the growing British use of Dignitas unnecessary”. That would put the power squarely back into the hands of the UK medical bureaucracy, not to say the care industry. There would be plenty of forms to fill in, plenty of interrogations and moral hoops to jump through. There would be an attempt at a properly quantified suffering scale. Everyone would get a slice of your business. Your life would not be your own. Come to think of it, your death would not be your own either.
Dignitas is exactly what’s needed.
11 Comments
June 22, 2009 at 11:57 am
I can understand the raw sentiment but your life is not your own in any case – the state will meddle, that’s all there is to it; the other way that the state might meddle is to take the stance of lebensunwertes Leben. On balance, I would rather live in a state that ostensibly even for its own reasons wanted to keep me alive, rather than one that sought grounds for my termination.
99.99999 etc. % of the time dignity of death will not be possible; you will have no control over that badly wired socket, careening car, the fact that you mistook heroin for cocaine, and so forth.
I have known enough mental anguish to have contemplated suicide very seriously; I have never known the sort of physical pain that could drive one to consider the same option, and would not care to have anyone live in prolonged suffering just to prove any point of mine.
But without some kind of moral force about the rightness of the continuation of life, then my view is you are quickly going to find yourself living within a very stark utilitarianism, and, understanding the mercenary nature of public bodies, corporations, states and governments, I wouldn’t personally want to end up there.
June 22, 2009 at 12:11 pm
Hi, MikeM.
I take all your points: except that now, at this very moment, Dignitas exists as a possibility for those who need it; and the arguments put forward in the Guardian piece seem precisely calculated to take it away.
While I agree that my position could be used to achieve the kind of dystopia you describe, I have to say that your position seems to me equally fraught with danger–Disch’s 334 makes the argument better than I can. & I don’t see a direct, unbroken, inevitable line of causality from individual responsibility in this matter to a condition of state-forced euthanasia.
(I wrote “authanasia” there. Oops.)
The privilege of having, and making decisions from, “raw sentiment”, by the way, is exactly the thing I am trying to defend.
June 22, 2009 at 12:48 pm
“Raw sentiment,” indeed. This has just surfaced on YouTube:
http://www.youtube.com/watch?v=VwKvtcJk2fU
Behind the “endemic facetiousness,” something very serious is being played out: Johnson killed himself a fortnight or so after this was made, and his sub-Milligan antics over “why are we here” gloss a much deeper anxiety.
Skip to part 5, and you find a very uneasy piece of film: Johson addressing a half-buried mirror, trying to make sense of an episode in his life which defies any neat, rational precis. It now appears as the tip of a monstrous illogicality – one which was about to help wreck his life and sink him completely.
June 22, 2009 at 4:29 pm
I’m always surprised at the attitude of doctors to anyone who doesn’t want to keep their heart beating as long as science will allow. It’s not just about suicide: they’re also dismissive of anyone who refuses medical treatment for whatever reasons. The presumption seems to be that your reasons for not wanting your life extended at any cost must be highly suspect, and they’ll override your wishes if there’s any chance of doing so.
June 23, 2009 at 8:44 am
Very, very well put.
I think the right to die is of vital importance. Considering how often those who – in perfectly good health – make the choice to die and become martyrs or heroes, because of the presumable sacrifice involved, death is important. It’s a defining factor of your life.
Do you want someone else making that choice? I’d prefer not. They can inform it, lodge opinions, and otherwise make themselves generally involved in the process. But if I determine to die, it should be my right to do so.
‘Extremely unpleasant’ symptoms’. You can survive decades. And, depending on who you are, you may decide to survive for decades. Honestly, compare the usage of Dignitas to, say, suicide rates. Most successful suicides are not terminally ill.
Really, it strikes me as being a bunch of greedy bastards if we insist on people living until we feel it’s reasonable for them to die. Giving someone a pain free way out into whatever may or may not come after? That’s generosity. We may someday beg for such a mercy, unheard.
June 23, 2009 at 9:49 am
Just a small PS: this for me underlines the hope (misplaced, it’s possible) in technology – personally I have to say that I am not terribly keen to be shaped by the defining moment of death. I don’t want to get wistfully sci-fi on anyone’s ass but anything that would allow consciousness and personality to continue sans original body in such cases of physical suffering would seem like good news.
Also, as a further aside to the right to die, which I would still allow (each person makes their own pact with the gods, after all), there’s also the trend whereby personal desperation leaks out and takes other life with it; parents that kill children who then attempt to take their own lives spring to mind. It’s not so much the ‘right to die’ argument I am bothered about, it’s the potential for the institutionalization of despair that nags at my conscience.
June 23, 2009 at 10:18 am
MikeM: I don’t see it as despair.
What’s factual now is that we get old & sick & die. If we want to get out from under that, we should have the right. Actually, we do have the right, in that anyone can get hold of some heroin & stick it in their arm. Anyone can commit suicide. The problem is that if they have a friend to watch over them while they do it–someone’s face to look at as they go, someone to say goodbye to–that person risks fourteen years in jail.
Julian, TechSlave: Quite.
Sara Wootton isn’t much use, either–
http://tinyurl.com/np8lve
She pays lip service to the idea of individual control, then qualifies it into an absence of control–typical British political weaseling. I suppose this might be a softly softly stance intended to encourage by-degrees change. That’s not much use for someone who needs help now. Luckily, as she says, those various interested bodies can’t control “foreign” suicide clinics. Interesting word choice.
None of this is about changing UK law in favour of the dying; none of it is about making the process safer, or saving people from themselves (I think her comment about suicides “motivated by despair, hopelessness, mental health problems or other concerns that could be treated or resolved” is, frankly, as stupid and patronising as the Ethics Committee’s). It’s about the state & legal apparatus getting full control back–Dignitas has taken some of their power off them.
Let me be quite clear: as far as I’m concerned, the couple who jumped off Beachy Head were alive. My heart goes out to them. To be driven to despair by the death of your child is a fully human condition. It is not something that can–or should–be cured. It is not the province of medicine or law. It is your life at the point of being lived.
When I said that I’m in favour of decisions made from “raw sentiment”, outside of rationality, outside of sensible behaviour, outside of politics, that is exactly what I mean.
& now you all know that about me, I can go back to being cheerful old running & writing chap.
June 23, 2009 at 2:34 pm
The death of an individual equals one less consumer. The system is as addicted to its constituents as its constituents is to the system; the machine dependent on the fuel to work, the fuel dependent on the machine for purpose. Whenever there is a large body of individuals, an majority and minority opinion is formed, and naturally the opinion of the majority is the proper, correct opinion.
People don’t like death. We have forgotten how to approach the end with dignity and consideration, and instead quiver with abject horror at losing all that accumulated materialism to the point where the sentiment is projected onto others. Thought transmitted diseases, of sort.
Nothing is true. Everything is permissible.
June 23, 2009 at 4:22 pm
I’m in favor of the Right to Die, (Several of my older friends have copies of Final Exit on their bookshelves) but suicide out of, say, despair, strikes me as a separate issue, just as abortion is a seperate issue from infanticide (although not everyone agrees with that distinction either). Ten years ago my life seemed pretty hopeless and I came very close to killing myself. I didn’t (obviously) and now my life is a pretty cheerful experience, so I’m grateful to those aspects of rationality and sensible behavior that kept me around. The Apollonian has its virtues, including the fact that I’m still around to enjoy the Dionysian. In response to zxvasdf, there are reasons for wanting persons to live other than a desire to keep the engine of commerce going full throttle.
P.S. A friend later gave me what I consider to be the best reason to refrain from suicide: “Why should I give ‘em the satisfaction?” This may not pertain to the critically ill, but it does pertain to me.
P. P. S. After I chose to go on living, Spaulding Gray came to town and did a monologue which taught me how to find the joy in daily life. Later he suffered brain damage in a traffic accident; later he committed suicide. I felt really fucking betrayed, but I credit him with being a good guide before he lost his way.
P. P. P. S. Speaking of despair, I wanna thank fellow Ambient Hotel poster Josep for turning me on to Thomas Ligotti, who extends the nihilism of Lovecraft in compelling directions.
June 23, 2009 at 5:38 pm
Aaron:
You’re welcome. I’m glad you like Ligotti. He can also be very fun at times. If you haven’t read it yet, let me reccomend you “My Work Is Not Yet Done”. It’s darkly hilarious.
July 6, 2009 at 11:23 pm
Hi Mike,
Perhaps you remenber meeting Eva,my wife.
Both her parents died of cancer within eigth monts time. Her father Antonio was reciving treatment in a very posh conservative hospital and the doctor in charge keep telling us that there was a good solid chance of success. There was a catholic priest in the hospital but we never got around to see him.
Her father was taking radio therapy in the hospital and then going back homes. He got very bad suddenly and was brougth to another hospital were a very blunt young woman doctor said that Eva´s father was dying and She tough that he should be home.
He was brougth to the original hospital and the original doctor said that he was absolutely sure that the treatment would work.
Three days later, her father refused to talk, to eat or to get dressed.
Back in the hospital the doctor said that well, things like that happened some times. And what was needed was an antidepresant drug.
Problem was that that drug took about 15 days to work an the patient refused to eat.
Two days later Antonio´s mind was in shambles the only thing he said was that he wanted to go back home with his wife.
And then the doctors did a complete volta face meet with the family and said that they could not force a patient to take treatment against his will.
By now It was absolutely clear that they had dangled the possibility of treatment in front of the family as long as they could – and a very expensive hope it was-and now they didn´t want to loose the patient and spoil their statistcs.
Never in my life I´ve so angry.
I pointed out to the doctors that Antonio´s was not capable to know if it was day or nigth. And if they didn´t keep up the treatment I was ready an willing to bring criminal charges on them.
Antonio died a week later. Four days before Christmas.
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