what we talk about when we talk about the ethics of assisted suicide

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.