It's been a while since I wrote a blog post, and so I thought I'd return with a relatively light subject. I was recently discussing with friends whether I believe individuals have the right to end their own life. This is following some of the UK Governments proposals of bills that would:
allow adults who are terminally ill, subject to safeguards and protections, to request and be provided with assistance to end their own life
Reasons for Living
I hold three key tenets in my own definitions of a fulfilling life:
- To experience happiness.
- Maintain and develop personal relationships.
- To learn and retain new knowledge.
Clearly these are not all continuously being maximised (I'm no Gandhi), but I aim to address at least one each day (otherwise I recede back to the Buddhist maxim of 'Existence is Suffering'). These provide me with personal satisfaction (and may be very different to your own).
However, say over the next few months I develop an aggressive form of cancer that ravages my body and leaves me hospitalised with no self-sufficiency. The doctor hands me a notice while I lay strapped to a gurney declaring I have one month left to live with a 0.001% chance of recovery. In this state, I'm unable to focus with the blinding pain of my dilapidated body, and my contribution to the world is to sap it of its finite resources, which enable me to cling on to life with an array of drugs and machines. While my family gather round to provide compassion in my husk-like state, I feel pitied and weak.
I would argue this is subsistence, not existence. We don't let our most beloved pets go through this kind of suffering, but when it comes to humans we collectively cling on to every second of life, as painful as it may be. I have endured this with loved ones, and it can almost feel inhumane at times.
Loss of Self
Beyond physical suffering, the principle of autonomy compels us to consider conditions that don't just cause pain, but dismantle the very essence of who we are. From this I believe the proposed bill should also encompass scenarios where an individual faces the irreversible loss of their selfhood. For me, the 'self' isn't an abstract concept; it's a lifetime of experiences, relationships, and memories - the narrative that defines my identity and continuity. When diseases threaten to unravel this completely, the question of a dignified exit becomes profoundly relevant.
Take Alzheimer's. It slowly corrupts those constructed neural pathways, almost deleting memory addresses at random from your brains storage. However, at what point does an individual no longer match the person they were previously? If tomorrow I receive a concussion and no longer remember what I did last week, does that mean I am no longer the same person I was prior? For these cases I like to defer to Derek Parfit's view of psychological connectedness and continuity. Although a concussion may lead to reduced 'connectedness', there is still continuity linking memories together, ensuring the 'self' remains. With severe neurodegenerative diseases, both connectedness and, eventually, the entire chain of continuity can be irrevocably broken.
This in turn leads to my (personal) belief that in the case of Alzheimer's or other debilitating neurological diseases an individual should also have the ability to end their life of their own volition, before their condition progresses to a point where the self they identify with is irretrievably lost, and they lack the capacity for autonomous decision-making.
Slippery Slope
"Support this and depression will eventually be on the menu". Does this really hold up though? Quintessentially, if the robust safeguards are correctly in place, a non-terminal illness will be correctly identified and the appropriate path to recovery can be advocated, and this is where I personally hold the line.