10 February 2024.
Campaigners to legalise assisted suicide invoke the principle of arbitrary autonomy. This threatens to give us a libertarian society at the expense of a humane one.
“There should be a booth on every corner where you could get a martini and a medal.” No doubt the novelist Martin Amis was exaggerating for stylish effect, but he wasn’t joking. After watching Alzheimer’s disease reduce Iris Murdoch to spending her days gazing at infantile television, and after witnessing his stepfather dying “very horribly”, Amis’s support for legalizing assisted suicide has stiffened. “There should be a way out for rational people who’ve decided they’re in the negative”, he said in a 2010 interview in The Sunday Times Magazine. “That should be available, and it should be quite easy.”
Pressed by the relentless stream of cases of ‘rational’ suicide and mercy killing recently publicised by a story-hungry, analysis-shy British media, even long-time defenders of the legal status quo can be forgiven for weakening and wondering if Amis isn’t right, after all.
The truth is that some of us face dreadful ways of dying. Sufferers from motor neurone disease, for example, might have to look upon the prospect of suffocating to death. Others with obstructive tumours might have to contemplate spending their last days vomiting their own faeces.
But it is not just the dying who have reason to fear. Some of the living are burdened with lives that are severely restricted. Among the clients of Dignitas (the Swiss clinic for assisted suicide), in recent years, was the chronically disabled Irishman who could not swallow, whose only means of feeding was a tube inserted into his stomach, and whose capacity to communicate was very limited. Another was Daniel James, the young victim of a rugby accident, who refused to reconcile himself to life as a tetraplegic. And then there was Sir Edward Downes, the frail octogenarian who had no appetite for soldiering on alone after the death of his wife.
Under conditions as difficult and miserable as these, how can human life be worth persevering in? Why on earth should we endure it to the bitter end? What could possibly be the point? Yes, palliative care can relieve the distress of most of the terminally ill, but there are always some cases beyond its reach. And it cannot relieve the frustration of the chronically disabled or the despair of the bereaved.
Surely therefore compassion obliges the law to let us seek an efficient escape from unbearable suffering, whether through help in killing ourselves (physician assisted suicide) or through someone else killing us upon our request (voluntary euthanasia). And besides, don’t we have a right to autonomy? After all, an individual’s life is his own property, for him to use as he sees fit. He is the sole arbiter of its worth, and he alone is competent to decide when it has become intolerable.
As for opposition to changing the law, that’s mainly based on a dogmatic obsession with the absolute ‘sanctity of life’, which makes sense only to the dwindling minority of religious believers. To shore up their case, opponents manufacture the fear that legalising assisted suicide or voluntary euthanasia will send us down a slippery slope to murder, but hard empirical evidence from Oregon and the Netherlands now shows this to be irrational.
In a nutshell, we have a real problem, to which there is a rational solution: give mentally competent individuals the legal right to decide that their lives should end, give medical experts the legal right to assist in ending them painlessly, and then put in place strict procedural safeguards against abuse.
So, at least, runs the liberalizing story. The problem it identifies is real enough, but its solution is not so deeply rational. Closer inspection reveals several flies stuck deep in its ointment …
By Nigel Biggar. Originally published in Standpoint, March 2010.