Wednesday, September 20, 2006

The euthanasia debate, again

Legal safeguards can make euthanasia a legitimate option - Opinion

Peter Singer's pal Leslie Cannold, the pro-choice and pro euthanasia ethicist, has a pro euthanasia article in The Age today.

(By the way, I am a little cynical about any "ethicist" who is exclusively on one side or the other of the big moral "life and death" issues. This is not just a comment against Cannold; it also applies to Australian Nick Tonti-Fillipini, who can always be relied on to present the Catholic view of bioethics on any matter. If you approach ethics from entrenched philosophical positions, your ethical judgments are almost entirely predictable, and paying such a person to be a professional "ethicist" seems rather a waste of money unless he or she is going to come up with something surprising now and then.)

Anyway, Cannold uses this evidence from Oregon as support:

Data from Oregon suggests that the most frequently given reasons for choosing physician-assisted suicide by the approximately 30 people who die this way every year are "loss of autonomy" (87 per cent ), "loss of dignity" (80 per cent) and "loss of the ability to enjoy the activities that make life worth living" (84 per cent). This data, which suggests that mental rather than physical suffering is the main driver of decisions to die, undermines the assertion of anti-euthanasia forces that the effectiveness of modern-day palliative methods obviates the need for legal reform.

But this emphasis on mental suffering is surely a double edged sword, especially that last category "loss of the ability to enjoy the activities that make life worth living". Just which activities do we consider important enough for people to make valid decisions that they should kill themselves? In the case of Nancy Crick, it always seemed clear that she was wildly exaggerating how bad her quality of life was.

In another highly publicised case, Dr Nitschke had no major qualms about helping guide a healthy 79 year old to top herself, just because she was bored with life.

For a conservative, an emphasis on mental suffering being the main reason the people in Oregon wanted assistance to die is probably more of a reason to be against euthanasia, because such suffering would presumably in many cases be amenable to counseling and additional support. (No doubt many -or all - of them had physical suffering too, so I am not suggesting that their cases were as bad as Crick's.)

Just as no sensible person encourages a healthy friend with suicidal ideation to let their mental suffering guide them to action, it seems a dangerous path to say that something as malleable as loss of enjoyment of a certain activity should guide sick people to euthanasia.

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