The Committee room is quiet now. No more clerics or academics, campaigners agin or for Margo MacDonald's
End of Life Assistance (Scotland) Bill will be heard from, at least at the first
(and potentially last) stage of the Scottish Parliament's collective hesitation over her Bill. Today, the
Committee meets in private to meditate on a draft report on the evidence they've taken. Parliamentary rules define Stage 1 deliberation as:
Rule 9.5. 1(a) "consideration of the Bill’s general principles and a decision on whether to agree to them"
When they began listening to oral submissions and round-table discussions in September,
I suggested that the Committee's task was unenviable, requiring "
Herculean subtlety and open-mindedness" to try to fairly reconcile the diverse, incompatible epistemologies, moralities and systems of technical knowledge they were invited to consider. Even if they prove virtuoso cartographers, able to bracket their own particular attitudes to the landscape, better to track the rhetorical terrain of their witnesses, eventually the whole parliament will find itself slurped into mire of assessing just how these diverse, antagonistic claims to expertise and ethical insight ought to interact.
As those following my scribblings on the subject will be aware, I'm in general sympathy with the purpose of Margo's Bill and have been left deeply unconvinced by the insistence that if it passes into law, it will transform Scotland's
metropoleis intro
necropoleis and enthrone some sort of Aztecesque
culture of death. In all honesty, even proponents of this view hardly seem convinced by it. It is reminiscent of debates one sometimes falls into with Christians, who suddenly, less than ardently, deploy the
ontological argument for the existence of God to shore up their piety. They don't persuade, largely because
they're not Christians because they happen to have convinced themselves one morning that the ontological argument was well founded. Regurgitating the contention is a form of backwards justification and by consequence, only tenuously relates to the foundational reasons for
their faith in a higher power. So too with assisted dying. The whole
culture of death line is an attempt, in my view, to escape from the
cul-de-sac of personal piety and deflect the real difficulties assailing a Christian cosmology, attempting to squeeze into
the theoretically egalitarian, Godless space of the public sphere. Its a bizarre transmogrification, but by transforming themselves into modernist sociologists, bustling with metrological metaphors, challenging questions about the imposition of religious values on a faithless public are slipped. Speakers are then able to claim they've identified eminently detectable law-like generalisations, which iron causality leads to social ruin, degeneration in the fundament and the corruption of the Scottish polity. And all that, without a breath of the Pentateuch.
While in general I don't find these arguments terribly convincing, I did want to raise one objection I find it far more difficult to dispense with, concerning what I'll call the social production of the intolerable life. The draft Bill includes eligibility requirements, proposing to limit who could lawfully request and receive assistance to die. These are set out in section 4(2). Specifically, "the requesting person" must have:
(a) "been diagnosed as terminally ill and finds life intolerable" or (b) be "permanently physically incapacitated to such an extent as not to be able to live independently and finds life intolerable".
The debate has tended to emphasise the subjectivity of assessments of intolerability. Some folk, day in day out, tolerate what other people imagine they can't endure, and lead lives full of interest and significance. Take the particularly challenging instance of Daniel James from 2008. Dying in a Swiss clinic at the age of only 23 years old, James was a rugby player who experienced severe spinal injuries in the collapse of a scrum.
His mother explained:
“He couldn’t walk, had no hand function, but constant pain in all of his fingers. He was incontinent, suffered uncontrollable spasms in his legs and upper body and needed 24-hour care. While not everyone in Dan’s situation would find it as unbearable as Dan, what right does any human being have to tell any other that they have to live such a life, filled with terror, discomfort and indignity?”
While we're all embodied, its crucial to recognise that the experience and importance of physicality isn't the same for every person. However, the idea that assessments of intolerability are purely subjective, abstractly moral, ethical and
only an expression of your particular ensemble of sensibilities and staminas seriously risks overlooking a brutal material truth. Resources matter. Poverty, abandonment, isolation and despair are acutely involved in the production of an intolerable life. Pam Duncan of
Inclusion Scotland emphasised just this point in her evidence to the End of Life Assistance Committee, arguing:
Pam Duncan: The issue of choice is really important. As we are absolutely against the bill, we have been asked by others, "What about choice?" The crucial point, however, is that we live in quite an unequal society in which not everyone has access to the same level of autonomy and choice as everyone else. Disabled people are disempowered and do not have the same autonomy as non-disabled people. They face huge discrimination and this disempowerment impacts on and limits their choices. I also argue that this is completely the wrong time for us to ask society to make such a choice, because with the current economic circumstances the very services that support independent living and make life tolerable are being cut. With those services being cut, we are at risk of again limiting people's choice—and when one's choice is limited it can sometimes be skewed.
Is it fair to accept that we all have equality of choice in a society with such deep-rooted inequalities? I say no and argue that disempowerment limits our choice. We also have to consider the value that society places on disabled people's lives. Only the other night I saw on television the cricketer—forgive me, but I cannot remember his name—
Sarah Wootton (Dignity in Dying): It was Chris Broad.
Pam Duncan: Thank you. The circumstances were slightly different, in that his partner took her own life, but, when asked about her choice in that respect, Mr Broad said that they had discussed what would happen and had agreed that she was not "the type of person who would be pushed and fed". Well, I am that type of person and I do not think that it is fair to place such limited value on my life or the lives of disabled people who need the support to live independently—support that, I should add, is under threat in the current economic climate. In that respect, we need to question the intention with regard to choice and autonomy.
This is no trite Mystic Meggery premised on woozy Durkheimian ideas about the social life of the community. It brings the debate crashing back to earth, to small places close to home and the practical, material politics of disability in our society. It implicates all of us, through our politics and our parsimony, in the social production of intolerable lives.
