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.