12 July 2010

Assisted suicide: When the people speak...

Had you forgotten? The other day, I summoned up remembrance of Margo MacDonald's End of Life Assistance (Scotland) Bill, which has largely slipped from public view of late. Developments are afoot, however. In general terms, the Bill seeks to legalise physician-assisted suicide. The End of Life Assistance Committee under the convenorship of Holyrood's Captain Mainwaring, Ross Finnie, put a call for written evidence which ran from Wednesday 3rd March to Wednesday 12th May 2010. On the 30th of June, they published the materials received, which ran to an impressive 601 submissions from a range of interested parties. According to the summary paper prepared by the Scottish Parliament Information Centre (SPICe), 521 of these papers are classifiably hostile to Margo's proposal to legalise assisted dying, 39 were supportive. The very first of these submissions (at least alphabetically speaking) comes from one Mary Ainsworth, who sets out her brief objections with admirable brevity.

1. I have seen close relatives dying with dignity without the need for assisted suicide. We have a very good palliative care programme in this country.
2. This Bill communicates lack of worth and value to those who are dependent on others.
3. It raises the rights of family and carers above those of the infirm.
4. I am concerned that it is potentially open to abuse.

For the most part, the documents are heartening, eloquent in their own ways, touching, engagingly personal, often testimonial in tone. (For examples, among others, see Alison Davis; Elisabeth Sammon) Unlike the responses to another consultation which I discussed recently, real time and effort has been put into composing these pieces. An admirable, difficult thing that - since relatively few folk undertake literary argumentation on a daily or even annual basis. Their participation in this way is civic and I salute them for their efforts, however much I might disagree with their substantive points.

Many of the same themes recur, albeit in modified forms, throughout the critical letters and e-mails. The same formulations, even the same examples. Several cite some version of the phrase "hard cases make bad law", curiously using it to imply that Margo's law shouldn't be passed. The notion that the present law might be bad in its own way seems to escape the contributors. More slippery slopes are in evidence than the Alps at thaw, while a distinct whiff of moral panic clings to many of the negative assessments, suggesting that if this Bill is passed, we will be instituting a "culture of death" - whatever one of those is - which will unerringly assume Aztec proportions. Many of them also, in my view quite rightly, criticise the title of the Bill as mealey-mouthed and potentially misleading. Euthanasia or assisted suicide is what it is about. On the space-a-shovel principal, they may have a point. The unassuming title might appear to some to be a less-than-subtle attempt to hoodwink the unwary. Equally, though, there is absolutely no evidence that any of the respondents had the least doubt, in the round, about the phenomenon they were talking about. For instance:

Finally, what exactly is the bill attempting to legalise? Not once does it use the words ‘assisted suicide’ or euthanasia’ but instead makes rich use of highly subjective terms like ‘dignified death’ and ‘finding life intolerable’. If a law is being proposed, there should be no room for euphemism or pink frosting. Is it because the truth in black and white would be too scary? Either way, assisted suicide or euthanasia is wrong in principle. Some moral boundaries should never be crossed.

Yonks ago, I argued that a real debate on euthanasia may become difficult (or indeed, might be impossible) given the fundamentally incompatible premises of those attempting to entertain the discussion. We might not be able to agree enough to engage with one another's basic judgements and presumptions at all. Certainly, the written evidence draws on an astoundingly complex and fascinating series of ideas, judgements, discourses - diagnoses about the ontology of nature, the cosmos, disability. Many of them, needless to say, relate only tenuously to the specific proposals Margo MacDonald has made. Others subject that detail to trenchant critique. For those interested in the sociology of morals and popular philosophising, these documents represent a feast of information. Amazing really. Heaven knows how the Committee will pick their way through them. For myself, I intend to quote a few sections, resolutely cherry-picked from the bunch. They represent my own interest and what caught my attention, rather than any attempt to tot up or represent all of the offshoots of opinion.  Moreover, I've only looked through the first hundred and fifty submissions or so, leaving a universe of documents unscrutinised. To these, I may well return in due course. For those more interested in a quantitative-analytic approach, I commend the SPICe paper to you.

John & Jean Raven, arguing the Bill is "too tightly drawn"
"Like vast amounts of modern legislation, the Bill is preoccupied with envisaging, and introducing unduly heavy-handed measures to forestall, what are likely to be rare happenings rather than with making arrangements to help vast numbers of people to get the assistance they desire. As such, the Bill offers yet another example of an apparently pervasive tendency on the part of those running society to seek to deprive individuals of the right to take their own decisions about matters which crucially affect them."

On the age limit, Leeza Mundaden
I remember being a 16 year old. The main features of someone this age are usually immaturity, impulsiveness and foolhardiness. A decision with such grave consequences cannot be entrusted to someone so young for who even a broken heart can seem like the end of the world. Why is the universal age of maturity not applied?

Maureen Gowans, admirably & modestly fulfilling her Christian duty
As a Christian, I object to a law which is contrary to the principle of the sanctity of human life. I realise that others may not share this view, but as a member of the public, I have a duty to draw the attention of my representatives in the Scottish Parliament to something that I believe to be wrong and potentially harmful.

Ken Cochran, believer in iron-law necessities...
"If doctors are allowed to kill their patients we will begin a downward spiral where right-to-die becomes duty-to-die and inevitably, despite the alleged safe guards"

Mr & Mrs Plaisted, aphoristic, I thought...
"Assisted Suicide is an illusion of care. The very idea of assisted suicide promotes a kind of pity that is incompatible with any appreciation of the sanctity of life."

Alina Armstrong
"Finally, I would personally like to say that this Bill is against the true human dignity of a person, that is, the intrinsic worth of each individual, no matter the circumstances of that person’s life and which is stated in the UN Declaration of Human Rights and which cannot be taken away from them."

Carol Baird
"I totally respect Margo MacDonald's pain in coping with her illness as my sister was buried a year ago today after 5 years of suffering. However, God commanded us NOT TO KILL and the sanctity of life remains in His control."

Elizabeth Duncann 
"Keep to the facts: and if we believe that animals must never be allowed to suffer then it follows that humans -as animals - must also be allowed that consideration."

Dr Graham Keith
"Above all, it will change the perception of a wish to die as something abnormal and something like a cry for help into something that is normal and to be encouraged".

Eileen Mothersole
"Margo MacDonald has my full sympathy, and up until now my support in her unstinting efforts at making our parliament credible."

Fiona Beveridge
I believe that the proponents of the Bill are supporting it with the best of intentions, but I think it de-humanises people to "put them down" like we do with animals. I also think it will not be long before it is badly abused.

One final thought. 

Many of the submissions dwell on the idea that being hostile to euthanasia represents a default position, and accuse those who wish to legalise - or better put, decriminalise - some conduct leading to death -  believe in "One-size fits all" governance and worse, that this legislation is actually an instrument for the destruction of physically non-modal minorities. The plight of those arrested, tried and criminalised under current legislation isn't mentioned and is apparently regarded as minimally important in the resolution of this question. This seems to be to be a pity, since it seems to me to be really is what the whole business is about.

And finally-finally: A roll of shame...

While many respondents played Doomsayers in a manner which I don't believe is justified by the evidence, most of their responses seemed well-mannered, on point, sincere and sincerely determined to treat this serious subject seriously. I disagree with them, dispute their causal determinisms,  would insist they pay attention to the legislation as drafted, reject their religious impositions and their concept of law's proper place in our society. We can and should be able to discuss all of this passionately, vehemently - but also without thuggish ad hominems and simply grotesque allegations being thrown around by the ridigly righteous on both sides. However, I'm afraid there were also a number of infringements of Godwin's Law with the inevitable Reductio ad Hitlerum of greater and lesser stupidity. Here's a selection:

Jim Barbour
If the above bill became law I fear it would not be long until the decision to end a life could be taken by a doctor. In an over burdened Health Service it could become more economic – but this is a supposedly civilised society in the UK – not a Nazi Death Camp!

Barbara Devoti
Normally one to sit back and let world events pass by I feel that this is an issue so repulsing that to say nothing would be as those who stayed silent during the Nazi atrocities.

Alan Dunnett
The very idea raises recollections of Nazi Death camps at its extreme. At best however it would still say to some that they no longer mattered and I am sure that is not the Bill's intention.

Carole Cannon
I really do wonder why my Dad risked his life in the desert helping to rid the world of the evil of the Nazi regime when now in Britain we are trying to emulate a lot of their ideas. Everyone has a right to life and parliament cannot ignore Christian principles and remove that right.

Lucy Cameron
"Rather than wasting time, money and effort on this heinous & frankly evil bill we should be ploughing our efforts into supporting & comforting our sick & dying to make their lives and their families lives more bearable. I find the entire document disturbing and unnatural. This Bill is being sold as a merciful killing but is a means of preying on the most vulnerable people in society. No doubt its true motive is to save money on services to the sick and disabled."

Gillian Smith
"I am sure we do not wish to create a superior race or a situation where some people based on health are classified into inferior and worthless versus this superior group. I believe it is important that we send a clear message to society the life is for preserving not taking otherwise do we get to a stage where it is ok to stab and murder someone?"

"As a first as a Christian the idea of this Bill makes me wonder what Scotland is going to become, the murder capital. Doctors already have enough to contend with, with decisions on life or death, signing abortion papers etc etc, without have to make these decisions. The Bill could easily enter Scotland on the slippery slope to another 1930s Germany, first they came for...."

But I want to single out the egregious submission of one Alma Fraser. Fraser is clearly a noxious canting woman, a latter-day Holy Jeannie, who one suspects wouldn't deign to urinate on the Saviour if he'd accidentally set himself on fire at the feast at Cana. She's about as Christly as Lucifer. For shame, Ms Fraser, for this appalling submission you made:

"Margo McDonald should be trying to help kill the pain, not the patient. She could be trying to promote better palliative care for sufferers of painful illnesses. She should never have even got this far in dragging this preposterous notion of hers as far as it has already come. In her own desires to be free of pain at the end of her life she has been allowed to drag the whole country into a danger zone of becoming a culture of death. What a pity for us all that she has been so selfish and short sighted."


  1. Unfortunately Dr Graham Keith, whoever he is, has encapsulated all of my worries about the bill with his comment "Above all, it will change the perception of a wish to die as something abnormal and something like a cry for help into something that is normal and to be encouraged".

    The idea that terminally ill people could be encouraged to commit suicide is horrific.

    Perhaps that is not what he intended to say but that is how it comes over.

  2. A very reasonable concern, Indy. And if Dr Keith didn't intend to make that argument - there are plenty of his fellow contributors who make the selfsame point exceedingly explicitly.

    Part of the issue here is how we think about law, what law represents. If you take a Durkheimian attitude to law - law as the fullest expression of social norms, the mirror of "culture", the representation of "our shared values" or something loosely similar - then the "moral panic" associated with the Bill makes sense, at least within the logic of the position.

    It is perhaps not accidental that it is committed Christians making these arguments - having as they do a rather different understanding of the cosmological order and hence, access to a different, theologically-situated account of law's ontology.

    Equally of course there are plenty of godless political projects which critically contrast fustian legal strictures with wider, typically changed social attitudes, seeking to supplant the legislation with laws of their own. Margo is likely to appeal to similar arguments during the legislative course (however long it lasts).

    Legislation obviously can change behaviour. However, quite how it will do so is complex and anything but clear or unerring. Peoples' orientations towards legal concepts and the subjectivities law endows them with are anything but straightforward. While I think the idea of sanctifying norms through law is prevalent - and a familiar instrument of identity politics - I'm not sure how plausible or healthsome such approaches to politics or understanding how people make their decisions really are. For myself, I'm not convinced that passing legislation to allow people to make choices without needlessly criminalising their friends and family either (a) is the radical innovation critics think it is or (b) represents a plausible account of the ways law makes its appearances in people's lives.

    I'm not convinced that law is or ought to be the fullest expression of our sociability and sense of justice at all. Not least in the sense that life's contradictions and radical conceptual differences can hardly find expression in legal regulation. Moreover, given the recent history of overwhelmingly negative depictions of illness and disability, it seems a bit rich to me to insist that the legal changes proposed become the uni-causal root of the hysterical reference to an apparently novel Scots "culture of death".