A Debate We Won't Have Soon

I'll be guest blogging again at Effect Measure -- and do get over there if you aren't scared enough already. The gloom and doom thing is getting a bit out of hand, but I suppose we'll just have to push through it and hope to emerge wiser and better on the other side.

Meanwhile, a subject which is difficult but not, at least to me, so depressing but rather, in a paradoxical way comforting if we make the effort to confront it, the United Kingdom will shortly be considering new legislation to permit physician assisted suicide, or perhaps even euthenasia, as the Netherlands has already done. I say comforting because here we are talking about death that occurs at a normal rate and, in most cases, after the span of life we are given, and it's best to consider what control we can and should have over it.

Rather than offer any opinion of my own right now I invite you to consider the pro and con positions in the British Medical Journal, where you will also find additional background and a less tendentious analysis by the Swedish philosopher Torbjörn Tännsjö (who does give his own opinion at the end). Tännsjö's essay is helpful because he presents arguments based on the three kinds of ethical reasoning I have often discussed here: deontological, principled (in this case, a principle of moral rights), and utilitarian. Understanding the differences among these three frameworks is essential if people are not to talk past each other.

There are important distinctions among the kinds of terminal acts at issue as well, which often confuse the discussion. In the U.S. and the U.K., it is already permissible to withdraw life support from people who decline it, including non-communicative people who are presumed not to want it (viz. Terri Schiavo). Competent adults do not even need to be terminally ill or suffering to avail themselves of this right. We can refuse medical treatment.

Physician assisted suicide means that a physician provides someone with the means to actively take his or her own life. This is illegal everywhere in the U.S. except Oregon, but when Dr. Kevorkian practiced it, juries repeatedly refused to convict him. A jury finally convicted the good doctor when he took the next step -- performing a positive act on his own part that brought about a person's death, even though the individual clearly, unequivocally, and competently requested it on videotape, which the jury saw. The moral distinction between the latter two kinds of acts seems almost trivial to me, especially when the subject is paralyzed and unable to carry out his or her own wishes, as was the case with Dr. Kevorkian's crime. But it is obviously very important to most people.

Make up your own mind. The comments around here are getting to be better than my posts anyway, so I hope we'll get some.