Assistance and Force: Different Things

Imagine a world in which egg sandwiches are illegal.

Given that I really don’t like eggs and that I particularly hate the smell of them, I have no desire ever to eat one; this world is fine by me.  However, I’m aware that some people might, on occasion, express a desire for egg sandwiches.  Some might lobby for their decriminalisation.  Still, I think that the ban is just fine and dandy; and besides, if the ban on egg sandwiches for those who want them were to be lifted, we’d be only a small step from a world in which some people would be forced to eat egg sandwiches, and in which, gradually, Tescbury’s supermarket would remove from the shelves anything that  wasn’t an egg sandwich.  As far as I’m concerned, both of these would be terrible eventualities, and that’s why I’m minded to start a campaign to ensure that egg sandwiches are never legalised.

Absurd?

Well, yes.  Obviously – though I really do hate eggs.  However, it’s not that much more absurd than the Not Dead Yet “resistance” campaign, which describes itself as “a UK campaign for equality of access to healthcare and against proposed Assisted Dying legislation”, as though you can’t have the latter and the former at the same time.  (Yes, it really does call itself a resistance movement.)

It’s even got a “resistance charter“, which it’s asking all MPs to sign.  It’s carried by a whole army of straw men and Aunt Sallies, though.  Here’s what it says:

1. Disabled and terminally ill people deserve and are entitled to the same protection in law as everyone else.

2. I value the lives of all disabled and terminally ill people and the contributions they make to society.

3. I will seek opportunities to ensure disabled and terminally ill people in my constituency have access to the health, social care and other services they need to live with dignity.

4. I believe that disabled and terminally ill people seeking assistance to end their lives should receive the same support provided to any other person with suicidal thoughts and be encouraged to live.

5. I will support palliative care and independent living services in my constituency and work with those seeking to ensure they are available to all who would benefit from them.

6. I am willing to meet with disabled and terminally ill people in my constituency who are fearful of any change in the law on assisted suicide and to take account of their views.

7. I will seek to maintain the legal protection offered by the current law, which is that assisted suicide is illegal.

Most of these ought to be perfectly acceptable to anyone, regardless of their position on assisted dying.  Number 7, obviously, wouldn’t – but it has nothing at all to do with the other six anyway.  It’s trivially true that disabled and terminally ill people have the same moral status as the non-disabled and are therefore entitled to the same legal protection; it’s trivially true that disability tells us nothing about the value of your life or the contribution you make to society; it’s trivially true that the disabled and terminally ill ought to have access to the resources to guarantee the highest possible standard of living if that’s what they want; palliative care is great.

The problem comes with points 4 and 6.

Let’s start with 4.  There’re two components to it: the first has to do with the support offered to the suicidal; the second has to do with encouragement to live.  One  of the premises of the campaign’s argument is that, if an able-bodied person displayed a suicidal attitude, we’d think it right to intervene; therefore it’s perverse to make suicide easier for the disabled.  But this really does miss the point that the pro-assisted dying (AD) crowd is making.  Of course it’s admirable for a second person to be concerned for the welfare of others, and it’s possible that a suicidal orientation is only transitory.  But, of course, noone has ever suggested that assisted death should be as easy to obtain as your groceries.  Every single piece of legislation that I can recall makes provision for psychiatric evaluation, and, of course, the right to assisted dying could only ever mean a right provided a suitably qualified person is willing to provide it: it’s hard to see how it could ever be used to mandate assistance.

The point is that there’ll plenty of safeguards built into any plausible assisted dying scheme to ensure that it’s still fairly difficult to access – though, as I’ve argued elsewhere, I’m not sure that the difficulty has to be as high as all that.  So this brings us to people – able-bodied or disabled – whose desire no longer to be alive isn’t transient.  For whatever reason, they’ve had enough.  They don’t want palliative care, if that’s the alternative.  They don’t want counselling.  They just want it over.  Well, in that case: isn’t it up to them?  There’s a very long tradition of thinkers saying that there are some decisions that may be silly – but as long as they’re taken with a clear head and harm noone else, then that’s all there is on the matter.  To make a point of trying to encourage them to live seems to display a strange kind of contempt for the value they ascribe to their lives, and thereby to them.

There’s two possible responses to this.  First, we could deny that anyone ever decides to die with a clear head.  But there’s no reason to believe that this is true.  Even if – mirabile dictu – every single person who’s sought to end their lives so far has done so based on a mistake about their own life’s value, it doesn’t follow that there’s a necessary link between suicidal thoughts and that mistake.  Second, we could say that, irrespective of how a person values his own life, how others value it is also important, and could potentially be a trump consideration.  But now we aren’t talking about encouraging a person to live, but mandating them to do so; moreover, if that’s the attitude we’re going to take, it looks as though it might be possible that, if enough people hate you, you’d have an obligation to do away with yourself.

So much for point 4.  What about point 6?  Well, one thing to note is that no mention is made of the disabled and terminally ill who don’t fear a change in the law on assisted suicide.  But that’s perhaps a side-issue (albeit one that the campaign doesn’t, and ought to, address).

The idea that an MP should take account of the views of constituents is hardly Earth-shattering.  But the interesting point has to do with the fear that’s talked about.  Whence comes it?  It’s certainly not from AD supporters; by definition, assisted dying is just that – assisted – and no more.  AD ought not to make anyone afraid; the evidence from Oregon, where the availability of life-ending drugs has apparently brought a fall in the suicide rate, would seem to suggest the opposite: that people are less scared when they know they have a way out.  No: the fear seems to be generated by the anti-AD campaigners, who’ve created the chimera that AD is indistinguishable from forcing death on people.  That’s nothing short of a calumny.

The campaign’s spokesperson is Baroness Campbell of Surbiton, who told the BBC that

disabled people need help and support to live, not to die.

“We cannot allow others to speak for us – especially those who seek to offer us the choice of a premature death: it is not a choice, it is to abandon us.”

Well, yes to the first part, about support to live – but that’s wholly compatible with assisted dying.  It’s simply not a zero-sum game; Campbell is trading on a false dichotomy.  And the idea that “we cannot allow others to speak for us” is deeply ironic, given that the whole point of the campaign is to speak on behalf of the terminally ill and disabled, including those who’ve publicly supported and sought assisted dying.

Writing in The Guardian, Campbell says that

If they can make it legal for the life of a single person to be prematurely ended, they will then seek to broaden the criteria. Once early death becomes an “option”, it will gain a respectability that will erode the resolve of many people experiencing personal difficulties. Not only will it enter our heads, it will also enter the heads of our families and friends, those who provide us with health and social care support and, ultimately, those holding the purse strings.

How much more convenient for all if turkeys see voting for Christmas as exercising personal choice. No wonder disabled and terminally ill people are fearful of all attempts to weaken the current law. For any change would fundamentally alter not only how we are seen but also how we are treated and the care that we receive.

Campaigning to keep things as they are, to keep us safe, is not easy to do or explain.

And this seems to provide ammunition for my claim that the fear comes from the anti- campaign.  Let’s ignore the fact that her article runs together euthanasia with assisted suicide as though they’re completely the same thing – a neat but misleading rhetorical trick; note instead the trick whereby the important qualification built into AD arguments about availability is ignored – or possibly just buried under the hints, implications, and baseless fear that’s been sent cascading down the slippery slope.  Campbell makes vague accusations about the motives of unnamed people who – it would appear – just won’t be able to stop themselves killing once they’ve got a taste for it.  Does she really trust her family and friends that little?

Baroness Campbell: we know you’re not dead yet.  You’re missing the point.  If services for the disabled, terminally ill, or anyone else are under threat, then that’s one thing, and I’ll happily go along with a campaign for everyone meriting just consideration irrespective of their health or physical ability.  But it’s utterly different from allowing someone who has freely decided that they don’t want to be alive any more assistance in helping themselves out of the door.

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