Dying with Dignity

Service (opening words, reading, closing words). Address was given by Lyn Allison, former Senator and leader of the Australian Democrats. October 5, 2008, Melbourne Unitarian Church

Opening Words

Take away but the pomps of death, the disguises, and solemn bugbears, and the actings by candlelight, and proper and fantastic ceremonies, the minstrels and the noise-makers, the women and the weepers, the swoonings and the shrieking, the nurses and the physicians, the dark room and the ministers, the kindred and the watches, and then to die is easy and quitted from its troublesome circumstances. It is the same harmless thing that a poor shepherd suffered yesterday, or a maid-servant today; and at the same time in which you die, in that very night a thousand creatures die with you, some wise men and many fools; and the wisdom of the first will not quit him and the folly of the latter does not make him unable to die.

- Bishop Jeremy Taylor (1613-1667), The Pomp of Death

Reading

The central ethical argument for voluntary euthanasia — that respect for persons demands respect for their autonomous choices as long as those choices do not result in harm to others — is directly connected with this issue of competence (cp. Brock, 1992) because autonomy presupposes competence. People have an interest in making important decisions about their lives in accordance with their own conception of how they want their lives to go. In exercising autonomy or self-determination, people take responsibility for their lives; since dying is a part of life, choices about the manner of their dying and the timing of their death are, for many people, part of what is involved in taking responsibility for their lives. Many people are concerned about what the last phase of their lives will be like, not merely because of fears that their dying might involve them in great suffering, but also because of the desire to retain their dignity and as much control over their lives as possible during this phase.

The technological interventions of modern medicine have had the effect of stretching out the time it takes for many people to die. Sometimes the added life this brings is an occasion for rejoicing; sometimes it drags out the period of significant physical and intellectual decline that a person undergoes in burdensome ways so that life becomes, to them, no longer worth living. There is no single, objectively correct answer as to when, if at all, life becomes a burden and unwanted. But that simply points up the importance of individuals being able to decide autonomously for themselves whether their own lives retain sufficient quality and dignity to make life worth living. Given that a critically ill person is typically in a severely compromised and debilitated state, it is, other things being equal, the patient's own judgement of whether continued life is a benefit that must carry the greatest weight, provided always that the patient is competent.

Suppose it is agreed that we should respect the autonomous choices of other people. If medical assistance is to be provided to help a person achieve her autonomously chosen goal of an easeful death (because she cannot end her own life), the autonomy of any professional who lends assistance also has to be respected. The value (or right) of self-determination does not entitle a patient to compel a medical professional to act contrary to her own moral or professional values. Hence, if voluntary euthanasia is to be legally permitted, it must be against a backdrop of respect for professional autonomy. Similarly, if a doctor's view of her moral or professional responsibilities is at odds with her patient's request for euthanasia, provision must be made for the transfer of the patient to the care of a doctor who faces no such conflict.

Robert Young, La Trobe University, "A Moral Case for Voluntary Euthanasia", 2008 from a wider from a wider paper on the topic

Closing Words

"A philosophy which does not work as the handmaiden of repression responds to the fact of death with the Great Refusal - the refusal of Orpheus the liberator. Death can become a token of freedom. The necessity of death does not refute the possibility of final liberation. Like other necessities it can be made rational - painless. Men can die without anxiety if they know what they love is protected from misery and oblivion. After a fulfilled life they may even take it upon themselves to die - at a moment of their own choosing. But even the ultimate advent of freedom cannot redeem those who died in pain. It is the remembrance of the them, and the accumulated guilt of mankind against its victims, that darken the prospect of a civilization without repression"

final lines of Herbert Marcuse, Eros and Civilization, 1955