More Precious Than...

I suppose that there is a renewed debate on physician assisted suicide taking place in the United Kingdom. Early this month, BBC news ran a story about a Dutch woman who elected to die die to severe psychiatric illness, and The Economist has been grappling with "The Case For and Against Assisted Dying" in its Open Future feature.

The arguments are well worn; autonomy versus the sanctity of life, unbearable suffering versus the potential for abuse. In this sense, it seems like a waste. You could find an accounting of pro and con arguments in the BBC's archive of old pages, and learn everything you may want to know about the topic. The current debate seemed to cover the same ground, just in the form of essays of varying quality.

Be that as it may, this excerpt from one of the essays in The Economist, stood out for me:

Being a burden is an important consideration but not a reason for taking this action. A group in Britain which opposes any weakening or repealing of existing laws against euthanasia or assisted suicide, “Care Not Killing”, has as one of its principal tenets that: “Any change in the law would put pressure on vulnerable people to end their lives for fear of being a financial, emotional, or care burden on others.”

What nonsense. Such burdens are created by families who no longer want—or are able—to care for vulnerable family members. They are caused by costly nursing homes offering drug-induced sleeping days, where the highlight of your week might be being wheeled out to be left in a courtyard garden or worse, a “memory-lane” sing along. They are not caused by any laws.
Patients alone have the right to decide whether to end their lives

My ex-girlfriend's mental health took a sudden turn for the worse, and for a time, I was her primary support mechanism. She would constantly lament the burden that this placed on me, tell me that she understood how hard it all was for me and ask how I was doing with all of it. I understood; it was her way of attempting to make recompense for what I was doing on her behalf, but from time to time, I would admit to growing weary of her continuously going on about what a burden she was. "I am choosing to be here," I would tell her. "After all, I can simply walk away." (And I will admit to there being a couple of times, early on, where I was going to do just that. My ex-girlfriend could be good at burning bridges, and she set the one to me alight on more than one occasion.) I mention this, because the anonymous author of "Patients alone have the right to decide whether to end their lives" touches on the unspoken factor in the whole assisted suicide debate; the role of family and other caregivers.

The whole point of laws against assisted suicide is to deny the person a choice to request assistance in taking their own life. They don't necessarily criminalize the act of suicide itself, although here in the United States, some states to have anti-suicide (or self-murder, as some places term it) laws on the books. Rather they simply leave the suffering person with poor options, to a certain degree in the hope that they will seek help to live, rather than to die. But while we can strip them of the choice to die by certain means, the law does not guarantee them the choice to live as they might like. Families, paid caregivers and insurers are under no obligation to do what they can to alleviate a person's suffering. And laws that mandate that a person cannot seek aid in dying don't generally mandate the provision of resources to allow them to seek material aid in living. In nations like the United Kingdom, where health care is provided as a service of the government, this is somewhat ameliorated. But here in the United States, being left to one's own devices is a real risk.

One cannot legislate into existence a willingness to see things through to the bitter end. And while we can perhaps force a terminally ill or suffering patient to endure the slings and arrows of their condition until their body simply fails them. we can't force the people around them to stick around for the duration. They always have the option of walking away. We can, in effect, force a person into bankruptcy in order to fund treatments that turn out to be ineffectual, but we cannot force their community to value sick persons' lives above their own material well-being. They always have the option to keep their money, and leave the patient to whatever charity might be available.

While it's certainly true that in a regime that allows for a person to seek the end of their own lives, they may attempt to preempt that choice, to ensure that their family and community don't have to grapple (or not, as it were) with the dilemma, maybe the problem is that we're not having the discussion over whether they should have to. And perhaps that's the problem with being able to simply outlaw assisted suicide. It allows for reassurances that life is valued, but doesn't concern itself with who values it, or what they should be willing to trade for it.