in In the news, Philosophy, Suicide

Assisted suicide, Dignitas, Sir Edward Downes

I wrote a post about rational suicide a few weeks ago which attracted a lot of interest, and even spawned a post on another site dedicated to debunking my viewpoint.  This issue and that of physician assisted suicide is rarely far from the headlines and clearly is a subject which excites strongly held opinions.  Most recently conductor Sir Edward Downes and his wife are reported to have died together at the controversial Swiss assisted suicide clinic Dignitas.  For a small organisation it attracts an impressive amount of coverage and its actions may have a substantial influence on future UK legislation.

For many people the discussion of the right to die is a simple one: people should not have to suffer toward the end of their lives and have the right to choose the time and means of their own passing.  This attitude is in line with the increasing emphasis on choice and self determination in our society of which suicide is perhaps the ultimate expression.  There are strong emotions involved and polarized viewpoints, but shouldn’t mean that we shy away from discussion both about philosophical underpinnings as well as more practical aspects.

I am concerned that where assisted dying to become legal in this country doctors would be expected to take a central role and this would sit unhappily with our usual duties.  Psychiatrists would regularly be called up to make difficult assessments about capacity and some of us might find being asked to assist in someone’s death very distressing.  Outside these professional concerns, and more fundamentally, is the message that legalised assisted dying would send out to vulnerable people who are near to the end of their lives.  Elderly people may worry that they are a burden or that their care is costing too much, and with a legal way of reaching a swift resolution may feel a duty to move on.  I cannot see how we could safe guard against this.

Sir Edward was elderly and frail but not terminally ill when he chose to take his life.  Apparently decided that he could not live without his wife and choose to end his life when she was choosing to end hers.  Most discussion about assisted suicide has focused on incurable conditions, which Sir Edward did not have.  Enabling people in similar situations to Sir Edward to take their own lives is disquieting to me.

Addendum 16 July 2009
What I think about Sir Edward Downes’ decision to ‘die with dignity’ Guardian

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  1. Some things said recently about organ-selling seem appropriate. What is the problem with allowing people such an option? Are elderly people any less of a burden or is the cost of their care lower when assisted suicide is prohibited? If you’re discussing “the sorrow of options”, I recommend Sister Y/Curator’s post on the matter.

  2. The argument concerning organ selling being the ‘least worst solution’ is certainly superficially appealing, but if we agree with it we agree that it is appropriate to treat the organs of humans as commodities to be bought and sold – which in my opinion is to treat them as less than they are truly worth.

    Sister Y’s post looks like it might require some digesting, so will leave until later.

  3. My first thought on hearing this story was the sad thing that it said about the state of our social care system that this Sir Downs felt that he would not be able to cope without the help of his wife – the implication being that his sensory impairments were too much of a handicap without his informal carer. That doesn’t mean I’m dismissing the emotional pain of losing a spouse however, which I’m sure was part of what was implied.

    It also struck me that neither of the two needed to choose physician assisted suicide, as they were both physically capable of taking their own lives. They chose something less ‘messy’ – one of the cleanest deaths possible. But legally it is messy. So, it seems to me that they were not so much choosing the timing of their deaths, as the manner.

    If doctors want to avoid demand for assisted suicide in this country, it seems to me they need to influence policy to improve
    (i) Cancer / Palliative services, to provide reassurance on the availability of quality services at the end of life, and counselling for the patient and those close to them;
    (ii) Social care, especially for the elderly who have lost carers/loved ones, or if their health/senses deteriorate, at which points they are particularly vulnerable.

  4. Psychiatrists would regularly be called up to make difficult assessments about capacity

    How is this different from the status quo?

    and some of us might find being asked to assist in someone’s death very distressing.

    Very likely. So what? If assisting is distressing, don’t choose to assist. If merely being asked the question is distressing, that psychiatrist is in the wrong line of work.

    but if we agree with it we agree that it is appropriate to treat the organs of humans as commodities to be bought and sold – which in my opinion is to treat them as less than they are truly worth.

    Should we also prevent people from offering up their time and labor in exchange for base lucre? What about all those forced to take tedious and unpleasant jobs because they desperately need the money? Clearly such people should be removed from such employment and devoted to tasks better reflecting their true worth.

  5. The concern that some individuals may be coerced, indirectly or not, into “choosing” euthenasia is significant. However, does that concern justify witholding that choice from another? I guess it all depends on what one regards as the proper concern of the state, or public interest, and the role of law. Is it to protect those who may be harmed? Or is it to ensure individual freedom? The present situation causes suffering to those who would choose to die if they could, a present certainty, only to possibly protect others in the future from being victimized. If a society believes a certain course of action to be morally right, under what conditions is it acceptable to not pursue it solely out of fear that some individual may commit a wrong?

    I witnessed my Grandmother die from Alzheimer’s and it was an ugly death. There was no possibility of improvement. Would she have opted out of that suffering? I know she would have. Is it a moral right to have such patients suffer solely because others may abuse that choice?

    These are big questions and I don’t know the answers. But I think it’s worth thinking about what our duty ought to be.

  6. What I feel is not considered is how society treats the elderly as ill–outcasts to be put in homes and left, sometimes for years, until they die. As as a culture of youth, the ageing body is positioned as abhorrent reminder of our inevitable end. Thus, it is not surprising that people may want to choose to end their lives when they are ‘frail’ and ‘old’ but not terminal. Their life has become something to get through rather than something to celebrate. I do not wish to imply that some people live wonderful, appreciated, joyous lives well into their old age. I am wanting to point out the desire to end life before death for some elderly is in part produced by our cultural obsession with youth and perhaps we need to take some responsibility.

  7. A friend of mine has M.S., and lives alone. He has asked me to take him to Dignitas, when the desease becomes unbearable for him.
    If I refuse it means he will go by himself, while he has some control over his body, or he will atempt an unassisted suicide.
    But if I do agree to his request, then he can make the decision when he he becomes too frail, so effectively he lives longer.
    Still not a choice I enjoy makeing.