Assisted dying is now lawful under some circumstances, in jurisdictions affecting at least 300 million people, a remarkable shift given that it was unlawful virtually everywhere in the world only a generation ago. Lively legislative debates about assisted dying are taking place in many societies, including France, Italy, Germany, Ireland and the United Kingdom. Typically, the question at hand for these legislatures is whether to allow medical professionals to help individuals to die, and, if so, under what conditions. The laws under debate remove legal or professional penalties for those medical professionals who help individuals to die.
Having conducted research into the ethics of death and dying for more than a quarter of a century, I am rarely surprised by how the debates unfold.
On one side, advocates for legalised assisted dying invoke patients’ rights to make their own medical choices. Making it possible for doctors to assist their patients to die, they propose, allows us to avoid pointless suffering and to die ‘with dignity’. While assisted dying represents a departure from recent medical practice, it accords with values that the medical community holds dear, including compassion and beneficence.
On the other side, much of the opposition to assisted dying has historically been motivated by religion (though support for it among religious groups appears to be growing), but today’s opponents rarely reference religious claims. Instead, they argue that assisted dying crosses a moral Rubicon, whether it takes the form of doctors prescribing lethal medications that patients administer to themselves (which we might classify as assisted suicide) or their administering those medications to patients (usually designated ‘active euthanasia’). Doctors, they say, may not knowingly and intentionally contribute to patients’ deaths. Increasingly, assisted dying opponents also express worries about the effects of legalisation on ‘vulnerable populations’ such as the disabled, the poor or those without access to adequate end-of-life palliative care.
The question today is about how to make progress in a debate where both sides are both deeply dug in and all too predictable. We must take a different approach, one that spotlights the central values at stake. To my eye, freedom is the neglected value in these debates.
Freedom is a notoriously complex and contested philosophical notion, and I won’t pretend to settle any of the big controversies it raises. But I believe that a type of freedom we can call freedom over death – that is, a freedom in which we shape the timing and circumstances of how we die – should be central to this conversation. Developments both technological and sociocultural have afforded us far greater freedom over death than we had in the past, and while we are still adapting ourselves to that freedom, we now appreciate the moral importance of this freedom. Legalising assisted dying is but a further step in realising this freedom over death.
we're going to start removing these because they're indistinguishable from low-quality bait.