Euthanasia: What’s your verdict?

BEWARE the reductionists!

When the National Secular Society (NSS) officially, inevitably, endorsed Lord Falconer’s ‘Assisted Dying Bill’ before its second reading in the House of Lords this July, my stomach felt sick as I read their all-too predictable statement. NSS President Terry Sanderson said:

“On assisted dying, as with same-sex marriage, the Church of England is at considerable odds with the country’s Anglicans, and even more the population as a whole. Yet it seeks to justify its establishment, and the anachronistic privilege of its bishops in the House of Lords, on the grounds that it speaks for everyone. This is a self-serving delusion. Its bishops should not only abstain from voting on this issue but consider very carefully before advising peers to oppose the Bill”.

HandsThis lazy and utterly irrelevant contribution reduces euthanasia to yet another excuse to kick the church in the proverbial majestics. The euthanasia debate has nothing to do with established church privilege, but beliefs; and also philosophy, medical ethics, the human experience and the relationship between individual, state and society. Too many people on both sides of the gaping divide are prone to over-simplify this most complex of dilemmas. So, as well as warning against the present direction of travel I want to encourage people to reclaim the debate and refocus it back onto the complexity of the real issues at stake. In doing so, I will use euthanasia as the term that has come to be the most neutral in the contemporary discourse. I will also try to avoid using emotive personal examples; not that I couldn’t but because most people seriously engaged with this issue could. For many this topic hurts – really hurts.

Back in February I took part in an excellent debate on euthanasia organized by Aberystwyth Atheists, Secularists and Humanists. Below I will try to reiterate my main arguments from that night:

  • Euthanasia does and will alter our understanding of life and death in an unwelcome direction. It makes killing socially acceptable. Not killing comparable to homicide, but nonetheless ‘to euthanise’ involves the act ‘to kill’, defined as to ‘cause death of a person, animal, or other living thing’. Proponents of legalising euthanasia would argue that family or friends should not have to be or feel guilty if they euthanise, but if one was to, after deliberation ‘cause death’, the experience really should not be guilt-free. At best taking life should remain ethically problematic. The burden of guilt should be borne, which raises two possibilities; that many of us are required by society to live with guilt that we either did or did not authorise/support the taking and/or take the life of a loved one after the law compelled us to make that choice, or we become dehumanized to the consequences of our most profound actions. Once it becomes accepted, even expected, that the role of a relative of a medical professional could be to terminate one’s life, the dynamic of family and societal relationships has fundamentally changed.
  • The French philosopher and social theorist Michel Foucault developed the concept of Biopower, an omnipresent biological regulation of subjects/citizens by the state through decisions made on public health, allocation of resources etc. You don’t have to agree with Foucault, to accept that the flip-side of the NHS we are so blessed to have, is the tremendous power public healthcare allows the state to wield over us. It must also be understood that this state is not independent of the wider pressures of our society. In a time of diminishing resources available for social welfare, there seems to be just a few logical steps from state and society not being able to bare people’s suffering to not wanting to bare it or them. The commentator Richard Waghorne (who for the record I disagree with on probably everything else) correctly observed recently: “A symptom of corrosive contemporary narrowing of moral reasoning to individuals alone is the failure to consider euthanasia’s wider effects”.

Many opponents of the ‘Assisted Dying Bill’ have warned of the danger the disabled, terminally ill, elderly or otherwise vulnerable will face from being pressurized into requesting the termination of their lives; I agree. Yet the implications could spread further, for as more and more people opt to have their life ended on the basis that it is no longer worth living, it would be naïve not to expect a shift in the normative understanding of when life is worthwhile.

Furthermore, the sufferings of those who the ‘Assisted Dying Bill’ is designed for, agony, permanent inconvenience, loss of dignity and incapacitation, have been experienced by many for all or most of their lives. People whose daily lifelong struggle for dignity and respect will be diminished as both the law and the growing consensus of society deem their existence to be one not worth living; people who until very recently have been denied full rights, even full humanity. This links us back to Biopower – there have been other examples from history of state and society conforming around the idea that some lives are not as worthwhile. None of these have been pretty.

I am actually normally quite dismissive of ‘slippery slope’ arguments, usually the tired first resort of conservatives. However, in countries where euthanasia in some form has already been legalized the ‘slippery slope’ is beginning to be empirically observable. Let’s take Belgium as our example: last year Nathan Verhelst (born Nancy) was euthanized on the basis of being unhappy with his gender and the results of multiple sex-change operations. This is an example of how, just ten years after Belgium introduced laws for very limited and specific circumstances similar to Lord Falconer’s Bill, the scope of when it is acceptable to carry out euthanasia has already been expanded greatly, to now include dissatisfaction with gender.

Earlier this year Belgium changed the law to remove any age restriction on assisted dying, legalizing child euthanasia. Defendants of child euthanasia argue that it will save children who are terminally or permanently ill from lifelong suffering, but it also removes two of the key reasons proponents of euthanasia give for the practice more widely: choice and autonomy. Either because the children, if allowed to make the decision themselves, are not considered legally autonomous in other far less profound areas of judgement, or if it is a decision made by the parents and/or doctors because they are being denied the choice over whether or not, in spite of everything they want to pursue their own future. Child euthanasia may seem humane at the time, but many of us know people who have experienced severe, apparently terminal illness as children and gone on, despite expectation and odds, to live fantastic, fulfilling lives that would not have been thought possible. Many of us have experienced this ourselves. Attempts have also been made and only narrowly defeated to introduce euthanasia for the mentally ill, and in Holland for everybody over the age of 70 regardless of health. These developments show that in a relatively short period after the legalization of euthanasia the boundaries are already beginning to be altered and corroded.

I sincerely hope I am wrong; that these fears can indeed be dismissed as reactionary and melodramatic. But it is the dismissive, reductionist and over-simplifying attitude of the euthanasia vanguard that gives me greatest cause for concern.  If you are a supporter of euthanasia I hope that even if these arguments above haven’t changed your mind they have at least given you cause to reflect on the complexity of the issues as stake. Above all we need the humility to accept the brutal truth: euthanasia or no euthanasia, there will still be suffering.