Assisted dying

Content warning: contains discussion of death, suicide, and illness.

There’s been discussion recently – it’s come to my attention in Quaker circles, but in other groups as well – of assisted dying, assisted suicide, or euthanasia. There’s a lot of sadness and uncertainty and compassion for people in difficult situations, which is all reasonable. However, in the discussions I’ve heard there seems to be a big aspect of the moral problem going addressed, and in this blog post I want to outline what I think that is.

The first point is surely that the moral value of assistance depends on what you’re assisting with. Giving food to the hungry is generally agreed to be morally good. Assisting with a robbery is generally thought to be morally bad. Helping an old lady across the road is good, so long as she wants to go.

That being so, assisting in someone’s death may be right or not, depending on your view of the moral standing of death. This is, of course, highly contextual. Death can be a moral good, a timely release, and it comes to us all eventually so there’s no point protesting it forever. However, causing someone else’s premature death is wrong: some people will allow exceptions in wartime, but generally murder is agreed to be wrong. One of the contexts in which the moral value of death is most contentious is suicide. When someone wants to die and chooses to take actions which do in fact lead to that end, is this and can this ever be morally acceptable?

I don’t know. I do think that we cannot address the question of euthanasia without discussing it. There is a lot of talk in the ‘assisted dying’ discussion about people who are assumed to be ‘dying already’ – as if we aren’t all dying already in the long run; as if being under a certain age means you can’t have a terminal disease; as if doctors can accurately predict the course of a disease in a particular case; as if a terminal disease, one which actively kills you, is worse to live with than a chronic disease, one which is always with you until something else kills you. If being in pain, needing care, and knowing that you will die is enough to justify medical help with suicide if you have cancer, why is being in pain, needing care, and knowing that you will die not enough to justify medical help with suicide if you have chronic fatigue syndrome?

Before we can talk about the moral value of helping with suicide, we need to talk about suicide itself. Who is and is not ‘allowed’ to commit suicide? What justifications do we accept? Is there a real difference between emotional pain (caused by life circumstances, or depression, for example) and physical pain? Whose judgements do we accept about the quality of someone’s life? Would you react differently to the same desire for death expressed by someone 20 years old, 50 years old, 80 years old? By someone born with disabilities or who has what you consider normal abilities, by someone who hallucinates or has religious experiences, by someone rich or poor, by someone with children or without? Is it enough for the individual to determine that their own life is not worth living, or does society have to agree that their life is worthless?

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