Saturday, 27 February 2010

Assisted Dying.

There is much emotive propaganda against assisted dying and I want to expose here just exactly what the objections really are and the reasons for them.

We have seen recently various individuals talking on television on both sides of the debate. The opposition lobby seem, though, to be much more forceful and appear to have no scruples about the way they represent their argument. Terry Pratchett`s Dimbleby Lecture was incisive, well considered and persuasive, though when up against the thrust of our opponents, I feel the imperatives must be represented with equal strength, even if necessary statements are difficult to deliver.

I find myself wondering why the argument against assisted dying should be more ruthless than the argument for it? I have a sense that with a gathering momentum of public opinion supporting the plight of the terminally ill, the opponents feel considerable threat to their position and react as viciously as possible. After all, they are not only defending their point of view, but their egos and their unconscious guilt.
In this dynamic between the two sides, there is also an element of " parent- child" in the posture of one camp to the other. I have noticed in the last months how those against assisted dying assume the role of "parent" whilst those in favour of the argument are rendered "child" and I think that this reflects the power imbalance of the terminally ill against the healthy (we`ll come back to this in my next blog on this subject).

If you have been following my blogs thus far, you will know that I have discussed the compartmental conscience as a servant of guilt avoidance. I believe that those against assisted dying are in fact deploying their compartmental conscience both to defend themselves personally from guilt and against societies collective guilt in regard to the terminally ill. This guilt arises both because of the guilt associated with the inability to cure the terminally ill and restore their lives, but also because of the very driving argument that disallows the patient the right to determine their own lives.

It is indeed immoral to deprive the terminally ill of rights that are available to the rest of us .... and guilt is incurred serially for societies insistence upon treating weakened people like children who are incompetent to make their own decisions.

Guilt builds upon guilt, though, and personal and societal guilt at not being able to reverse terminal illness leads to disrespect. Somehow, depriving the dying of the right to choose how and when to die is a way of gaining control in a situation where individuals and society have no control at all. This small gain of control palliates the guilt people feel when confronted with the issues of dying. Unfortunately, it is a stance that serves the carer, doctor or health professional against the interests of the patient, whilst masquerading as true concern for the patient.The fittest "animal" dominates the weakest.

How many times have we heard recently that assisted dying must not be allowed because people may wish to die out of a misguided sense that it would make life easier for their friends and families? This is a ruse indeed. What is actually happening here is that the guilt that health professionals feel in regard to the terminally ill, is assuaged a little by being in control of their patient deciding that they cannot choose when to die; their compartmental conscience then kicks in to legitimise that control by persuading everyone that they are not depriving patients of rights, but protecting them. It is, sadly, a reverse of the truth. "Caring for people" as a disguise for not being able to care about them, is not only a sad state of affairs but truly selfish. Undoubtedly, this quasi-caring that we hear repeatedly in the media, does make those health professionals feel better, but this should not be the focus of their attempts at reason!

When we present our argument for the autonomy of the terminally ill and our basis for the ultimate compassion of assisted dying, we need to have an awareness for the lack of psychological awareness displayed by it`s opponents. For, although they are subject to their own inadequacies, and fight their cause based upon them, they think they are motivated by caring, just as parents feel that they need to decide things for their children in order to care for them. We, generally, tend to want to use what we think is our better judgement when we deal with children, and we instinctively see the same situation with adults who face the end of their lives and parallel the vulnerability of children. The crucial thing here, though, is that we are talking about adults and, demonstrably, treating adults like children is not acceptable whatever our own inadequacies may be.

With me so far? I am going to return to this topic very soon.


  1. well spoken. While I haven't been following the debate in the UK, I will take your word about how it is unfolding there.

    I am not sure that I agree about the way you describe the mindset of the health care professionals and how preventing assisted dying is in some way assuaging their guilt by putting them in control of the patient and denying the patient rights. That may be true in some cases but I don't know how you would know it for all (or even most) cases.

    Bear in mind that: 1)Doctors and nurses are taught that they must do everything to keep patients alive. That is their prime duty. I think it is reasonable to think that the vast majority of them carry that out as best they can believing they are doing the best thing for the patient (even if you may argue that they haven't thought this through in the case where the patient wants to die). 2) I think there is a reasonable fear that relaxing the laws about assisted dying may lead to actual homicide. You might argue that safeguards could be put into place to prevent that, and you may be right, but I think that fear of the 'slippery slope' to forced euthanasia is not unreasonable and must be addressed by advocates of assisted dying.

    In short, while your analysis may be correct in some instances, your argument would be far stronger if you could bring actual evidence and not just speculation as to the psychology of those involved. I hope you can expand on this in future posts.

  2. In response to your being unconvinced about my argument in favour of assisted dying becoming legal in the U.K, I would draw you towards what we tend to do, as human beings, when we care for someone else:
    The medical profession is a prescriptive body of people recommending what their patients should do to get well or ameliorate their conditions. By the nature of a practice based upon superior advice, they expect us to follow what they direct us to do. When faced with patients who are terminally ill they are powerless to cure and are only able to offer palliative treatment, this puts them in a position of guilt.This guilt is alleviated by them clutching at their default position of assuming that it is their duty to make decisions FOR their patient and leads to the presentation that "I care about you as my patient, therefore I will decide that you cannot choose that you want to end your life".

    There are no examples necessary here...We are talking about very basic emotions. Most people will feel guilt when they cannot help someone with terminal illness and just about everyone will do something to compensate for this. A doctor will seek refuge in his caring role, and in this situation doctors find it very difficult to care for a patient to the exclusion of their own ego.

    Now, your point (2) voicing concern about the possibility of "homicide" : I think this concern, as voiced by opponents of assisted dying, is also about the possibility of wishing to die as a self sacrifice. So, encompassing all these concerns, a patient`s wish to die at a time of their choosing would have to be safeguarded by perhaps a medical and legal panel. I have to say though, that scare-mongering a scenario where patients die under dubious or mistaken circumstances is virtually the sole weapon of the anti camp who don`t seem to want to think any further than this, lest they lose position. I happen to believe that cutting the thinking process at this point, when you think your big drama wins the argument, is really a sign that any further thought and you`d lose the debate !!!!!!!!!!!!!!!!!

    Thanks very much for your probing comments !