Should people be denied 'choices' at the end-of-life?
It's a loaded question. It's a common reaction that, immediately a suggestion is raised that someone is 'denied' something, that we will feel a mild sense of outrage growing inside them somewhere. 'How dare they!'
But 'choices' are not always possible, no matter how beneficent they may be; no matter how legitimate they may seem.
To suggest, therefore, that people are 'denied choices' is to infer that such 'choices' are, indeed, legitimate.
Some, of course, are a simple matter of choosing between one legitimate option and another. Some, but not all.
A little while ago now, I attended the funeral service for my brother's father-in-law. An impressive staunchly working class man, he had died well. That, for most of us, is what it is all about: we live as well as we can and we die as well as we can. We take both life and death as it comes.
That is not to say that we can't do better; of course we can. We share a mutual debt, one to another, through what we call society to continually improve how we care for people at the end-of-life.
The 'choice' that floored me about this fine man was not in his care but, rather, in his choice of music for his funeral service. Walking past his coffin paying respects to the song, 'Walknam Gangnam Style' was, well, a unique experience. Strangely, after the initial shock, I realised how fitting it was for a man who was constantly making people laugh and who never failed to hold a cheeky twinkle in his eye. It was very much his choice!
His was not a church funeral. I can imagine that, had he chosen a religious service that he might have been denied his wish to go out to the beat of that short-lived dance craze. Competing interests: a 'choice' versus a protocol. Limits to 'choice' are set everywhere around us. I would agree with the libertarian view that limits to choice (read by some as autonomy and self-determination) should be as few as possible. But we need to be mindful of that old saying: before one moves to knock down a fence, a wise person stops to wonder why it was put there in the first place.
When it comes to euthanasia and assisted suicide, the 'fence' is the criminal code prohibitions on killing another person or in helping someone to suicide, respectively. These are prohibitions that have existed since our laws were written and previously, into antiquity, in the laws of nature. We make choices of our own when considering these issues: do we allow ourselves to be swayed by the emotive claims of a 'denial of choice' or do we decide, acknowledging the emotional, to think a little harder. These laws have been around for a long time.
The emotional case is strongly put through the media. The stories of people who are facing a difficult prognosis are heart-rending; they demand our attention. The fact that, like my brother's father-in-law, most of us will die as well as we can with good support and medical attention is rarely news.
Harsh as it may seem, most of the stories we hear in the press are from an elite; well-to-do folk with higher-than-average education and out-of-the-ordinary life experiences who are supported, often, by a lobby that my American friends refer to as the 'four Ws' – white, well off, well and worried.
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Paul is also Vice Chair of the International Euthanasia Prevention Coalition