Suffering and the Human Condition

I’m currently working my way through the recently-released report by the Commission on Assisted Dying – it’s a long and appropriately life-sapping document, but a number of commentators has been quicker than I to get through it.  Douglas Noble, writing at the BMJ blog, isn’t impressed.  Based on what I’ve read so far, I’m tempted to agree – though for different reasons.

Anyway: Noble makes a claim that’s a bit puzzling:

In political terms this issue is a dead duck – so why the continual fascination by a minority of vocal campaigners?  The answers are complex.  Perhaps, though, it is ultimately because of an inability to accept that suffering is an integral part of our world, common to all who share the human condition. Dealing a fatal injection and dressing it up as dignity is not a solution to suffering and pain. High quality palliative care is part of the answer, but so too is the effect of the affection, love, and commitment (sometimes over long periods of time) that we can show to one another when the worst hand is dealt.

He may be right in the dead-duck bit.  But his comments about suffering are odd.

For one thing, suffering is not considered by the Commission as one of the eligibility criteria for assisted dying.  As far as I can see, the very word “suffering” doesn’t appear until page 224 74* of the report.  While some assisted dying statutes around the world, and the defeated Joffe Bill in this country, do specify that a candidate for AD should be suffering or suffering unbearably, the Commission is satisfied that being terminally ill is both necessary and – importantly – sufficient.  At least prima facie, suffering doesn’t play all that big a role in the report.

But the real oddity is the idea that “suffering is an integral part of our world, common to all who share the human condition”.  For one thing, I’m not suffering now, and if I never suffer at any point in the future, that’s just fine by me.  This doesn’t mean that I’m missing out from some part of “the human condition” (whatever that might be), or that I wish to be less than human.  Maybe he means the potential to suffer – but, again, there’s no obvious reason why this should strike anyone as a good thing.  Besides: someone who wants their life to end because they’re suffering is someone who is plainly pretty much OK with the idea of opting out of the human condition wholesale.

And anyway: whatever one thinks of these statements about the human condition (and, to be honest, they always strike me as being a bit… well… jazz poetry**), it’s plain that “suffering is part of the human condition therefore assisted dying ought to be resisted” is a painful non sequitur – yet it’s pretty much what the suggestion here boils down to.

One wonders, too, how far Noble wants to push things.  He is a medical man, and while there might be squabbles about the true end of medicine, the idea that it’s at least significantly, if not overwhelmingly, about the relief of suffering is intuitively strong.  That is to say: medics are quite likely to be properly concerned with the relief of suffering.  And if that’s right, then it seems a bit cavalier simply to wave and insist that suffering is part of the human condition and ought to be met with “affection, love, and commitment”.

This point won’t, of course, demonstrate the permissibility of AD.  Maybe there’s a moral difference between ending suffering by surgery and drugs, and ending it by dying – in fact, I’ll happily concede that there is.  But, in that case, suffering drops out of consideration: it’s not there that the difference resides.  Noble is perilously close to endorsing “nobility in suffering” nonsense.  Irrespective of whether or not they’re successful in the end, there are several arguments against AD that are much better than that.  Aren’t there?

*Ah – I’ve just found it mentioned significantly sooner.  But it still doesn’t seem to me to play such an important role as all that, so the general point stands.

**I remain ever-grateful to Angus Dawson for suggesting this as an epithet for hand-waving vaguery.

  • D. Sokol

    I'm one of those chaps who also read the whole thing and I must confess I was rather impressed by the report (my blog entry on the report is here:….  Doubtless I have tinted glasses, but any actual bias was not apparent to me on a reading of the document.  The authors of the report acknowledge the probably intractable nature of the ethical problem, but they plough on nonetheless with pragmatic suggestions on how to take the matter forward.  It would be informative to hear the reasoning of those who deem it a biased document, preferably with illustrations from the report itself (or notable omissions that may undermine its conclusions) rather than simply pointing out that the Commission was funded by two pro-assisted dying individuals or that some anti-AD groups opted not to give evidence.


    Daniel Sokol

  • Hmmm – I suppose it's impressive for the amount of work that's gone into it; but I remain unconvinced that it brought anything new to the table.  As a learning resource, it's great: all the main arguments seem to be there.  As much more?  I'm really not sold.

  • john

    I can understand why people would want to die when life is often,
    more of a problem than death .I have had ME CFS for all my life since a very
    young person at school .I have often wondered if it was worth surviving the
    thirty years of being horrendously ill and ridicule too have no future no past
    and no hope? If I had to live those hellish thirty years again I would prefer
    death over it any day. As I have Aspersers and I am supposed to be against the mentally
    ill for not accepting ME is psychological this is according to Simon wessely
    from the kings collage London .I am both insulted and angry about his malign influence
    the BBC documentary are you good or evil explains a lot about charisma and
    psychopathic behavior manipulation of language  .I am also angry at the stigmatization
    of ME coming not from the public but also coming from places like three BMJ ,kings
    collage London and others. The treatment of ME in a degrading manner has
    made my life with ME so hard to live with, you cannot win with this
    disease you are not allowed to complain and meet a brick wall of indifference
    when you do.  No one believes you no one cares.
    When you face these obstacles in life death begins to look a better option than
    living as a nobody in hell with pain and sickness with no life and no way out.

  • Bhfrik

    Could one not make the case that the drive to end human suffering is also an innate part of our humanity.  When we suffer we naturally attempt to alleviate that suffering.   Placing ones hand on a hot stove leads to removing the appendage, rather than leaving it there while we contemplate the joy of our human condition.  Why is this natural desire to end suffering not as valid an argument for assisted dying as the argument forwarded by Noble?

  • Nice point!  And it does seem that for every appeal to human nature in favour of p, there could equally well be a corresponding appeal either against p, or to ¬p.

    Though, of course, while all these appeals might be able to tell us why we do something, none of them will be able to tell us to do it.