Sunday, 22 March 2009

Assisted dying, and Patricia Hewitt

Patricia Hewitt is campaigning for the right to die. She believes that terminally ill people who are mentally competent should have access to assisted suicide, and is calling for a Private Members' Bill in parliament to change the law.

Part of me wants to be cynical; she never said anything about this as Health Secretary, after all, when she might have done something about it directly. But then again, this is a genuinely cross-party issue, and if she can achieve something with her campaign, then all power to her.

I'm strongly in favour of the right of a terminally ill, mentally competent adult to decide to end their own life, as long as they make the choice freely and without being put under pressure. For me, that comes down to the core liberal principle of personal autonomy: my life is mine to dispose of, and not the state's to enforce. I do understand the serious practical arguments against assisted dying (how do we know that it's a genuine free choice?), but I would like to think that they can be overcome with well-drafted legislation and high quality medical care. And is it right to let a question of practicality defeat an argument that seems sound in principle?

Beyond all the political arguments, there's an important legal problem in the mix. Currently the law on assisting suicide is ambiguous. In particular, it's unclear whether a person who travels to Switzerland, to help a loved one get to the Dignitas clinic, is committing a crime. MS sufferer Debbie Purdy went to the Court of Appeal last month, arguing that the government had a duty to make the current guidelines more explicit. The court unfortunately ruled that the guidelines were adequate, so in fact, we're still in the dark.

So far, the CPS hasn't prosecuted friends and family who have accompanied patients to Dignitas, and quite right too. From the point of view of a person wanting to spend those precious last few weeks with a dying husband or wife, this is great news. For the legal system, it's not so helpful: only if a relative returning to the UK from Dignitas is charged and tried will we have a final answer as to whether or not it is a crime to go there to support a loved one.

I'm very uncomfortable with that situation. It seems very wrong for someone to be guilty of a crime if they have no way of knowing that whether their conduct is illegal until it finally comes to court! To me, that seems to be a serious breach of the rule of law, and I hope that if Debbie Purdy takes her case to the House of Lords (or the Supreme Court, as it will shortly become), they will decide to clear things up.

The current saga also sheds light on the cruelty and cynicism of so-called Care Not Killing, the campaign group against assisted dying. They have steadfastly opposed any attempt to clarify the law in this area. In other words, for the sake of their own political campaign, they are happy for an unfair ambiguity in the law to put terrifying pressure on terminally ill people and their loved ones, and potentially to rob them of their last chance to say goodbye. I think that's shameful; and I don't see much that's "caring" about their attitude.


Josh said...

As far as whether practical worries ought to trump principle, surely there are cases where the answer is an unequivocal yes? Capital punishment, for example: even if one accepts that such a punishment can be justified, the fact that miscarriages of justice can and do occur renders the idea of actually having the death penalty on the statute books ridiculous.

Jock Coats said...

Apparently this was Evan's idea and we may be trying to palm the amendment he was proposing off onto someone else to try and stop the tabloids continuing to refer to him as "Dr Death". Or at least that's the inference from a post on Nadine Dorries' blog whom he has apparently also been trying to contact about it.

Charles Wheeler said...

"I'm strongly in favour of the right of a terminally ill, mentally competent adult to decide to end their own life, as long as they make the choice freely and without being put under pressure."

hThat's tge problem though isn't it? Particularly at a time when social care services are collapsing and the media routinely warn of the 'timebomb' of an ageing society, how many more dependent adults will feel obliged to release their hard-pressed families from the burden (or see their inheritance eaten up in care costs)?

And why just the terminally ill? The young rugby player who took his life wasn't terminally ill, he just had decades of dependence and social stigma to look forward to. And who's to say that, just a few months post-injury, he was in the right state of mind to make that decision?

In an era when incapacity benefit claimants have become the new social pariahs, perhaps it's not just coincidence that calls for 'voluntary' euthanasia are on the rise.

Steven Allan said...

Here is a subject that I feel very strongly about indeed, for it has all to do with the Nanny State which goes against the basic principles of democracy.

If I were suffering and knew that no decent quality of life were possible, I would expect a euthanasia facility to be available to me and it angers me to think that human beings who know no more than I do, but have got themselves into Parliament, can preside over me and force me to suffer.

Furthermore, what nonsense it would be for the law to defeat the very principle from which it is derived and there is no reason why it should. The principle accepted, the next job is to look at anything which may or may appear to be connected, and work on it, unwavering, and however long it takes, until it is seen through. It simply requires the strength of conviction.

Sorry, Josh (above), but Capital Punishment is not a principle ; it's a policy/punishment.

Josh said...

Surely a belief that killers ought to be killed is a principle? That, at least, is the principle that I was referring to.

Steven Allan said...

But Josh, a belief that killers ought to be killed goes into the same category as a belief that killers should be flogged or imprisoned, that burglars should be robbed or that vandals should be made to sweep the floor. These are policies in respect of the perpetrator, which must be addressed to prevent the breakdown of society.

By contrast, the freedom of the individual to determine his/her own destiny is a basic human right which some in positions of power feel they have the right to take away ; a very different issue, not the least reason being that the perpetrators in this case are the parliamentarians themselves.

Josh said...

According to Merriam-Webster, a principle can be defined as 'a fundamental truth or proposition that serves as the foundation for a system of belief or behaviour or for a chain of behaviour'. In this sense, the principle that a killer ought to be killed is the foundation for the state's behaviour in executing him. In this sense, yes, the principle that a killer ought to be killed is the basis for the policy of capital punishment, and I would perhaps have been wise to be more careful with my language; I merely wished to make the point.

Such a principle, if one holds it, is not necessarily different from anything commonly called a human right: rights such as freedom of speech have been suspended in times of war.

I'm not seeking to state a view on euthanasia here, but rather clarifying the point I made earlier.

Steven Allan said...

Well, it's a very well written comment and I feel sure that on another occasion we would be in agreement. However, your definition seems to prove my point.

"...a principle can be defined as 'a fundamental truth or proposition that serves as the foundation for..." would in this case presumably be the fundamental that criminals ( including killers ) should be punished, and "a system of belief" then refers to believing in capital punishment, being the self same thing ( in respect of killers ) as a belief that killers should be killed. That is very different from the assertion that capital punishment is the result of the belief that killers should be killed.

This is not a case of being pedantic. It is important because there is no argument here to defeat the premise that a policy should never override the principle by which it is governed.

Josh said...

I think it's possible that that could be split into two different principles: firstly, that criminals ought to be punished; secondly, that killers ought to be killed. To those who hold only the first of those, capital punishment would be only a policy: an administration of punishment. To those who hold the second, it would also be a matter of principle.

I certainly agree with you that for those who have only the first of these two as a fundamental belief (probably a majority of people), capital punishment is only a policy. But for those who believe that killers ought to be killed, it is certainly a matter of principle. However, people who fall into this second group may well be the very people who would not be in favour of suspending capital punishment on my original grounds of miscarriage of justice. I'd be interested to see evidence on both sides. Perhaps, then, we are in agreement after all!

Steven Allan said...

"...two different principles: firstly, that criminals ought to be punished; secondly, that killers ought to be killed..."

But killing killers is a punishment ! One may have a very strong view that killers should be killed, but the latter is still the result of the former.

Again, if you were right in your assertion that killing killers be a principle in itself, then, according to your Merriam-Webster, killing killers would have to be : 'a fundamental truth or proposition that serves as the foundation for a system of belief...' What, then, is the system of belief which results from your so-called principle that killers should be killed ?

The answer cannot be 'capital punishment', for that is not a system of belief and, in any case, in respect of killers, it is the same thing as the 'principle'.

Further to your comment : 'people who fall into this second group may well be the very people who would not be in favour of suspending capital punishment on my original grounds of miscarriage of justice', I would suggest that you are right because such people do not have a principle; they simply want to hit out, regardless of any further considerations.

Footnote : I wonder where Jonny is. Perhaps he has gone to sleep for another 100 years.

Josh said...

Killing killers is a punishment: it falls within the first principle. However, if someone did hold the second principle, that killers ought to be killed, then any other punishment, for the specific offence of murder, would be unprincipled. Just because something is not everyone's principle does not mean that it cannot be someone's.

Also, note that the 'fundamental truth or proposition' needn't result in a 'system of belief', but can also lead to 'a chain of behaviour' or simply 'behaviour'. It is possible, therefore, to see the proposition that killers be killed as the basis for the act of executing them - the behaviour. It needn't be solely belief. Furthermore, the OED defines principle (in one of its nine meanings!) as 'a settled ground or basis of conduct or practice; a fundamental motive or reason for action'. This certainly justifies calling the belief that killers should be killed a principle, since it is the motive for the action of execution. It seems pedantic of me to drag another dictionary into it, but you're right in saying that it's worth exploring properly.

And Jonny has been a while, hasn't he? I'm sure he's a very busy chap, though...

Jonny Wright said...

Not been doing anything majorly exciting, no. Mainly just getting started on my coursework assignment, which is on the pros and cons of jury trials (expect a blogpost on the subject in the next few weeks!). Not planning on another extended hibernation - relax!

I see what you're saying, Steve, and it does make sense to me. But I think there might be a case for saying that capital punishment is a principle, rather than a policy, if you look at it in reverse.

I'm firmly against capital punishment, and if you asked me why, my argument would probably be structured along the lines that the state has no right to confiscate someone's life as a punishment. I think you could say that was a point of principle, rather than a policy.

(Contrast that with what I've been arguing here - that the state has no right to enforce someone's life against their will - that's a similar argument, and we seem to be agreed that that's a statement of principle, rather than just a policy.)

If you accept that my argument against capital punishment is an argument of principle, then surely a support for capital punishment can be a principle in its own right. All you have to do is to reject the principle that the state has no right to take life as a punishment; rejection of a principle must count as an argument based on principle.

I'm not entirely sure if my reasoning there is sound: I'm a modern linguist, not a philosopher, and if you disagree, then fair enough! But I think, on balance, that I might have to concede the point to you, Josh: there may be some times when a principle could be right in theory, but impossible to put into practice safely.

Then again, I suspect that if the practical arguments against (eg.) capital punishment were serious enough, you could start to use that as a point of principle in its own right. For example, you could say that the state has no right, in principle, to take life, when it's obvious that there's a certain risk of making mistakes. That sort of argument seems to blur the lines between principles and policies a bit, and I wonder if it isn't a bit of an artificial distinction in the first place.

My main reason for thinking that assisted dying should be legal, despite the practical issues, is that there are clearly some people (such as Debbie Purdy) who so obviously want to end their lives painlessly that they're prepared to fight a long, expensive and frustrating court battle to be able to do it. I don't think I could look her in the face and tell her that, instead of a painless and quick injection, she had to wait for a horrendous and debilitating disease to kill her - and that it was in the public interest for her to die like that.

Steven Allan said...

Welcome back to your own blog, Jonny.

"I'm not entirely sure if my reasoning there is sound"

No. It certainly isn't.

Now you're doing it as well, and worse still, as you suggest that a negative view of a specific policy is a principle.

If you are both suggesting that a policy can be a principle in its own right, then I very much disagree. Only a complete ignoramus would adhere to a policy without reason, the reason that is the principle. Maybe it is the lack of that in LibDem circles that causes them to want higher income tax one day but lower the next. I would only ever want to reduce it, as I hold to the principle ( or fundament ) that indirect taxation is the honest way.

"I might have to concede the point to you, Josh: there may be some times when a principle could be right in theory, but impossible to put into practice safely."

Citation needed !

Maybe it's the word 'principle' that is causing the problem, so let's put it this way : There must be a fundamental belief behind any political policy. That, surely is how we know which political party we belong with. ( I call that fundamental belief a principle, but if others are going to use it to mean other things as well, such as policies , then maybe I'd be best avoiding it )

There is a principle behind the euthanasia issue too; that everyone has the right to determine his own destiny. For that reason above all others, I totally agree with you on that issue, Jonny.

Oh - and Josh, does that conclude our very amiable and highly philosophical debate ?

Jonny Wright said...

Cheers Steve. This is starting to make my head spin! I said I wasn't a philosopher ...

Taking it back to where we started: Josh seems to accept that you could, legitimately, believe that assisted dying must be allowed, but then suggests that perhaps the practical dangers are so great that it should be banned anyway, despite that.

I think this does pose a problem for my argument. Like you Steve, my underlying reason for supporting assisted dying is that everyone owns their own life and destiny. But an elderly person who's pressured into an early death, by relatives who don't want their inheritance spent on care fees, is clearly not controlling their own life, are they?

To me, assisted dying is a definite yes in the light of really clear-cut cases like Debbie Purdy - how can you deny her the right to a dignified and painless death, which she clearly wants, on public policy grounds?

But I don't want to make light of the genuine difficulties that exist in trying to draw up a proper system for allowing assisted dying in clear-cut cases, whilst protecting vulnerable people from being put under extreme pressure.

We need to come up with some such system, I think, for the sake of people in Debbie Purdy's situation. But I don't envy the person who would have to get their head round the practicalities. It must be the most horrendous responsibility - and I wanted to try and make it clear in my article that I didn't take that issue lightly.

Josh said...

I think Jonny has summarised the situation, and my original comment, very well - perhaps why he's the blogger and we're commenting!

Steve, I certainly agree that policy in itself is not principle, and that adhering to a policy blindly would be asinine. Insofar as capital punishment is a policy, it is not a principle; whether a specific principle lies behind it, or it is one possible expression of a more general belief in punishment, is probably hard ultimately to resolve. But that seems a logical conclusion to reach - and amiable philosophical debate seems to me a fine justification for the internet!

Steven Allan said...

Those are two very nice and worthwhile comments and it seems that after all, we appear to agree in principle.

However, there is a fundamental difference between us, in that you're both willing to forego a belief in the light of some difficult side-effect. I would never do that. With the strength of conviction of ones fundamental belief, a policy derived from it must be carried. I consider that I have made the job of law-making far easier by taking this stand, too.

Taking away ones rights is criminal in itself, so it becomes automatic that there must be no law in respect of self-destiny. If there are people who would persuade the old or vulnerable to die early, then that is where the law must come in because that is blatantly criminal. It's that easy.

As for Jonny being the blogger, Josh, I think he's brilliant. Here I am, as a Conservative, deliberately coming to his blog, praising his well written articles, and normally agreeing with them, except when he's weak at the knees as in this case.

I do, however, feel that you or I would be quite capable of running a blog too. I've been impressed with the standard of our debate.

Jonny Wright said...

Cheers for the compliment - much appreciated! Sorry for being weak at the knees. (In my defence, I don't think it's weakness to recognise a potential difficulty in putting my views into practice. It'd be much weaker if I ignored the problem and hoped it would go away.)

If either of you decide to start blogging, let me know. I think you'd be very good at it, and I'd definitely want to read and comment.

Steven Allan said...

"... It'd be much weaker if I ignored the problem and hoped it would go away"

It certainly would, but it would be stronger if you stuck to your principles.

The trouble with starting a blog is the commitment. If a few weeks were to go past when I didn't feel like writing a post, I'd lose my readers. No. I think I'll stick to reading yours for the time being. Keep up the good work.

Josh said...

Thank you both for your kind remarks. As with Steve, I think I lack the perseverance to get a decent blog going. It's an aspiration, though: maybe one day...