Friday, 3 June 2011

Dr Death Dies

After serving eight years in prison, (Jack Kevorkian has died of a thrombosis at the age of 83)[http://www.clickondetroit.com/news/28118977/detail.html]. For those of you who don’t remember, he’s the doctor who had a special injection machine that helped people to commit suicide when they discovered that they were terminally ill. He was sentenced to jail for second-degree murder. My first thought when I saw the headlines were that it’s a pity he didn’t have the integrity to commit suicide himself using his own machine. At least that would have been consistent. I mean, he was pretty old, and very sick.

Here’s the part I want to debate: helping people to commit suicide. Is it OK? Under what conditions? Nietzsche, the infamous German philosopher from the late 19th Century, felt that suicide, or, as he put it, ‘dying at the right time’, was quite honourable. He admired the Ancient Greeks for exiting at their chosen moment. In fact, he even said: “The thought of suicide is a powerful solace: by means of it one gets through many a bad night.”

I can see three separate issues here. One: ought a person to be allowed to commit suicide? Do they have that right? Two: ought a person to be allowed to assist someone in the process of suicide? Ought it to be legal? Three: is suicide immoral?

Firstly, I will tackle the question of morality. To me, this is a fairly cut-and-dried question. Clearly, if suicide is a form of murder - it’s called “self-murder” in many languages that don’t have a specific word - then suicide is wrong. Indeed, the Bible seems to prohibit it with the Commandment “Thou shalt not kill”, and 1 Corinthians 6:19-20 (KJV), which says that your body is the Lord’s Temple. But there’s no clear injunction - nothing as clear as the injunctions against sex, for example. From a modern moral standpoint, however, people are held to have an inviolable right to life, and therefore, any suicide is wrong from a modern interpretation, too.

I don’t know if this is true, however. If I think about the Utilitarian conception of morality, for example, which takes “the Good” to be the sum of the various possible outcomes, it seems to me that there may be a circumstance under which suicide is better, and therefore the right course of action. Think, for example, of a mass murderer suffering remorse. Would it be better that he lived? Or think of someone captured by a malevolent foreign army, who is certain to be tortured to death. Suppose he has a cyanide pill with him, and if he takes it, he will not be tortured into revealing military secrets. By his suicide, he will spare himself hours of agony and subsequently the defeat of his nation’s army and the deaths of thousands of others. A Utilitarian would say his suicide would be good. But perhaps it’s not so much _good_ as the lesser of two evils. Now take the example a person in a persistent vegetative state, on life support, or someone dying of incurable terminal cancer. Should they be allowed to commit suicide? My intuition says “yes”.

Next, let’s ask whether someone has the right to commit suicide. Let’s think about a common occurrence in our own society. We euthanise our terminally ill or extremely senescent pets. We deem it immoral to allow the animal to continue to suffer with cancer or kidney failure, or dragging itself around on its forelegs with its effluence matting its fur. We give our pets an opportunity to die with dignity, while they are still relatively comfortable. Why not humans? Animals, I argue, have as much a right to life as humans. I do not see them, generally speaking, as lesser beings, disposable like garbage. Why then, while we have the (R/A)SPCA to prevent rights abuses towards animals, do we not acknowledge that maybe the human Right to Life is circumscribed by people’s choices? Surely the right to life entails something about quality of life? I know that if I were in a persistent vegetative state, I’d not want to persist. Remember the huge fuss about (Terry Schiavo)[http://en.wikipedia.org/wiki/Terri_Schiavo_case]?

Life is not just about biological functions. A plant has a circulatory system, takes in food, processes it, grows new cells, etc. Yet we do not hesitate to kill plants, without the slightest regard for their “feelings” or “right to life”. This is why it’s called a “vegetative” state. What really makes a person a person is his or her personality - their ability to interact with others, their conscious mind. If that is completely gone, and is irreparable, what is the point?

Obviously, many people who commit suicide are not in a persistent vegetative state. Indeed, being in that state precludes you from committing suicide, since you can’t make any decisions at all, and suicide is a decision. Most people who commit suicide do it for irrational reasons - such as having been jilted or fired from work or divorced, or even ludicrous things, such as wanting to have their souls taken up by the (Hale-Bopp comet)[http://en.wikipedia.org/wiki/Heaven%27s_Gate_%28religious_group%29]. I think that these cases ought to be excluded by law. This is not hard to work out. A depressed teenager has no right to commit suicide - they have a right to psychological counselling. A person dying of terminal cancer, in my view, does have a right to suicide.

But what about the family, that love the dying person? Surely their rights count too? Surely they have a right to not be put through the anguish of the person’s death? Well, the fact is, if the person is in a vegetative state, or diagnosed with terminal cancer, then the person is either effectively dead or shortly going to be. Insisting that they drag their existence on for another month, six months, or a year, is really just postponing the inevitable. It just prolongs the suffering. If these “loving” people are so loving, and not actually just selfish, they’d want the best for the suffering person - which is an end to their suffering. Just like a dog or a cat that is suffering, they should allow the person they love to choose to end their suffering early.

And what about the argument that it’s cowardly? Well, we’re all going to die. In my view, clinging to life as long as possible is more cowardly than boldly going to face one’s own end. I think that takes far more courage than hanging on as long as possible. Sure, the person fears the potentially lengthy period of suffering that lies ahead, but what benefit, what accolade, will that person gain by enduring it? Admiration? Unlikely - they’ll more likely get people’s pity and condescension.

Lastly, this brings us to the question of assisted suicide. This is the tricky part. Is the person, who helps in the suicide, effectively a murderer or accomplice to murder? Let’s take the case of Armien Meiwes, which I’ve referred to before. His lover volunteered to be eaten. The German courts ruled that Meiwes was therefore only guilty of manslaughter, since his lover had volunteered. The same logic might apply here: the accomplice in the suicide would be guilty of manslaughter. But it also depends on how the accomplice operates. For example, in Kevorkian’s case, he provided the chemicals. I think that if he pressed the button that delivered the chemicals, then he probably was guilty of murder, or at least manslaughter. If, on the other hand, he merely provided the chemicals and the mechanism, and handed the trigger to the person wishing to commit suicide, then he was at most an accomplice in manslaughter, legally speaking.

The point is that governments need to make a decision on this particular series of cases: a terminally ill conscious person, and a person in a persistent vegetative state. Both cases need simple, clear legislation; firstly, to circumscribe the conditions under which euthanasia is legally permissible, and secondly, to specify which methods are legally permissible and exonerate the person performing the euthanasia. It will have to work in a similar way to the logic of an abortion clinic. The medical professional will need to be protected from not only legal ramifications, but also religious persecution. And there will need to be provision for medical professionals to, on grounds of conscience or on religious grounds, to refuse in any particular case, to perform the procedure.

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