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Should terminally sick individuals be given the right to chose when to die?
It has been fashionable for some time now for people to demand what they want as a matter of rights. During the past few decades, we have heard claims of a right to health care, a right to privacy (embracing also a right to abort or commit suicide), a right to be born, even a right not to have been born. In this context we hear much about the ultimate rights claim, a “right to die”, which has emerged as a result of the changing circumstances in life-sustaining treatment and palliative care.
On both philosophical and legal grounds, I believe that there can be no such thing as a right to die. This new right, grounded neither in nature nor in reason, demonstrates the nihilistic implication of the new (“postliberal”) doctrine of rights, rooted in the self-creating will. The claim of the right to die is a strange claim particularly in a liberal society which is supposedly founded on the primacy of the right to life. Governments exist to secure inalienable rights, first of all, the right to self-preservation; now people are demanding governments to secure a putative right to self-destruction.
A right, whether legal or moral, is not identical to a need or a desire or an interest or a capacity. I may have a need and a desire for, and also an interest in, the possessions of another person, and the capacity or power to take them by force or strength. Yet, I can hardly be said to have a right to them. Moreover, not everything we are free to do, morally or legally, do we have a right to do. Thus the freedom to take my life does not suffice to establish the right to take my life.
The “right to die” through euthanasia or medically assisted suicide is morally different from the right to refuse life-sustaining medical treatment which has become disproportionate. Whereas the former means the right to exercise one’s autonomy, despite disability, suffering or chronic illness, or the right to choose what one considers the most humane or dignified way to end one’s own life, the latter means the discontinuance of treatment to let nature take its course. There is a moral distinction between causing death and permitting to die. I do not believe that life should be extended under all circumstances and at all costs. Far from it! The practice of allowing to die is ethically acceptable, the deliberate killing is ethically reprehensible. I applaud those courageous patients and family members and those conscientious doctors who try prudently to discern, in each case, just what form of treatment or non-treatment is truly good for the patient, even if it embraces an increased likelihood of death. We cannot serve the patient’s good by deliberately eliminating the patient or helping the patient to terminate his/her life. If we have no right to kill others, we have no right to have others do this to ourselves. The very notion of a “right to die” is nonsensical!
Rev. Prof. Emmanuel Agius
is a professor of ethics at the University of Malta
The issue of the right to die usually meets with an emotional response; like the recent case of Diane Pretty. Pretty fought a long legal battle in the courts to win the right to assisted suicide at the hands of her husband, who was a willing party. People often confuse assisted suicide with euthanasia, so it is important to draw the distinction. With euthanasia, the Terry Schiavo case for instance, others decide on one’s future, with assisted suicide one decides oneself. The difference is fundamental. With assisted suicide one wants to die, usually because of unbearable suffering or, in the case of Schiavo for instance, for fear of the kind of death that lies in store for oneself, but lacking the means to commit suicide on one’s own one requires assistance from another willing person. Some argue like Socrates, usually on religious grounds, that suicide itself is always morally wrong because our mortal life is not ours to take away, it is only lent to us so to speak. A more secular morality, however, contends that one’s life is one’s own and claims the moral right to autonomy, to choose one’s actions for oneself in situations where no harm to others is done. Diane Pretty was appealing to this right to decide for herself on the most fundamental matter, her own life. She wanted to die, her husband agreed to help her but the courts forced her to live in mental and physical agony against her will and, finally, to endure the death she had dreaded for so long. Were the courts right? I think not. I am not questioning that they were legally right. But it is a bad law that sanctions the infliction of pointless agony on any animal, never mind the human, or condemns one to what for one is an unacceptable death. I also believe that the principle of autonomy, when no harm is done to others and no appeal to a reasonable principle of the common good is at stake, is a defining political characteristic of a modern secular state. Although a longer life is, all things being equal, better than a shorter one, what counts is the quality of one’s life, and, again all things being equal, no one is better qualified to determine that than the person concerned. I make the last qualification because there are cases where the principle of autonomy may not hold, where individuals are manifestly unable to make decisions in their own best interest (in cases of madness, depression, mental shock, undue pressure by others, etc.). This is where the law should step in, to protect the individual concerned, to ensure the individual’s power to choose rationally is unimpaired by these factors. In short, there should be laws regulating the practice of assisted suicide for those who seek it, their aim being to safeguard the best interests of those individuals, compatible with respect for their autonomy, for their right to choose for themselves how they wish to die.
Prof. Kenneth Wain
is a professor of philosophy at the University of Malta
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