The Myth of the Muttering Madman is a project in self-realization.

Saturday, January 27, 2007

Right to die?

Excuse the equivocal nature of the title of this post.

This morning the papers are awash with a story concerning the euthanasia of Dr John Elliot in a Swiss clinic last Thursday. This is a well written, objective article. It had me in tears.

Then we turn to a opinion piece titled "The line that must never be crossed" in which the author makes his intention clear very early:

However, emotion cannot be allowed to cloud the ethical and practical principles that must inform the euthanasia debate. Whatever the circumstances of Dr Elliott's case, the principles remain the same. So, too, is the conclusion to be drawn from those principles: the law must continue to prohibit euthanasia.

Fair enough - state your position up front. But let's look at the article. What reasoning is given? Does the author successfully steer clear of emotional motivations and arguments? Does the author make arguments that could be applied universally? Does the author argue from a utilitarian perspective? If so are contradictions avoided? Is the author simply justifying a stance (stated at the outset) or are we seeing an example of clearly reasoned, logical thought?

The author seems intent on drawing a distinction between euthanasia and other avenues of hastening death.
Yet a string of surveys here and overseas suggests doctors are readier than ever to administer pain-killing drugs or to withdraw or withhold treatment even when that will hasten death. Such relief for the terminally ill is to be welcomed, and the law's application is appropriately sensitive to this need. Such surveys of doctors' actual practice undermine the common argument by euthanasia advocates that patients suffer unnecessarily because doctors fear criminal prosecution. How often are doctors criminally prosecuted? Patients who suffer pain at the end of life can expect an easeful death, and that the law will not stand in the way.

It seems clear that the author is agreeing that some doctors are already hastening the death of certain patients in some cases. We should note carefully that the author justifies this by stating that the law is "sensitive" to such cases; that is, the medical practitioners in question won't be prosecuted, and that "Patients who suffer pain at the end of life can expect an easeful death, and that the law will not stand in the way."

What's wrong with the argument pointing out that swift death at the behest of the patient is more humane? How is forcing someone who wants to end their life to live in pain and take expensive pain-killing drugs, more ethical than giving them the freedom to end their life? We're not talking about people who aren't judged fit to make such a decision. We're talking about people with terminal illnesses in excruciating pain making a clear-minded and considered decision about their situation. From a consequentialist perspective what is the difference? In the former case, the patient undergoes severe pain. Family members, rendered helpless, stand by and watch. We have a course of action that results in substantial pain for the patient, considerable distress for the family and the potential shortening of patient life due to medical treatment or lack thereof. What about the latter case? The patient and family, along with professional medical advice make the decision to end the person's life. There is no more physical pain for the terminally ill patient. The family is saved the distress of watching their loved one suffer avoidable pain. In short, the patient is empowered to make a decision which allows death with dignity.

The whole argument which outlaws euthanasia almost smacks of typical authoritarian reasoning. "We" know better than you. What if you regret it? I'll make the decisions about this on your behalf, because it'll be better for you in the end. Just hold on tight, denying you the right to end your life is the "ethical" thing to do. If the patient were to ask why, the answer is simple. You're not in a "correct" state of mind. You can't be thinking clearly. I wonder how much of this attitude is motivated by society's deep seated need to control its citizens?

Why doesn't an autonomous, sentient person have the right to end their life? For that matter, why is it ok to deliberately keep the area "grey" and allow ad hoc decisions to be made by patients and doctors to use treatments which may shorten their life or to not use treatments that could extend it? What moral code makes this ok? Is it just because the whole situation is then somehow distanced from a black and white ethical decision? Are we supposed to feel ok about this approach because it dilutes the reality of hastening someone's death? What about the benefits of opening the issue up, and clearly attempting to demarcate it?

I think we need stronger arguments than:
There is no knowing where euthanasia law would take us once it had a foothold in the statutes. Overwhelmingly, families wanting to hasten the death of loved ones are motivated by love and compassion. But removing existing criminal sanctions could leave little to inhibit family members conniving with compliant doctors to end a patient's life for other, unacceptable motives such as greed or impatience. And cash-strapped health systems will surely find it cheaper to institutionalise death than care for the physical and emotional wellbeing of the old and frail.

And what stops that from happening now? How is this an argument against euthanasia, but not against procedures which could shorten a persons life substantially and keep them in a semi-comatose state for the rest of their "life"? Surely this is a non sequitur.

I think there needs to be open and logical debate resting on current ethical theory, rather than proposing hypothetical "doomsday" situations which obviously support a given view. To my mind this is another clear example of the author "justifying" a stance, rather than reasoning about it.

Honestly, it's disgusting to consider such sub-standard pseudo-intellectual drivel is/could become the modus operandi of a paper as widely read as


Dutchy Hollando said...

well put.

snarkyboojum said...

Thanks Tiger!

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