Legally Assisted Suicide. A response to Jim.

The tomb of  William Larnach, the builder of Larnach's castle. He was a Member of Parliament who shot himself because of financial and family difficulties. His tomb is based on the design of First Church, Dunedin. Late last century this tomb was vandalised and Larnach's skull stolen. The skull, complete with bullet hole, was later found in a student flat. The tomb has since been restored.

My friend and colleague Jim White has made a thoughtful submission on the petition of Maryanne Street's and others to legalise medically assisted suicide. Much of what Jim says I agree with. He bases his argument on the morality of suicide, saying that while suicide is usually regarded as morally repugnant, there are times when it is not. He mentions, for example, Father Maximillian Kolbe who, in Auschwitz, willingly went to his death in order that another man could be spared. Indeed, Jesus says that the greatest expression of love is to lay down one's life for one's friends, and the basis of our faith is that Jesus does precisely that, in going willingly to the cross on our behalf.

F Scott Peck defines love as “... the will to extend one's self for the purpose of nurturing one's own or another's spiritual growth... Love is as love does. Love is an act of will -- namely, both an intention and an action. Will also implies choice. We do not have to love. We choose to love.” I have never found a better definition of love. Love is giving ourselves for others. The noble suicide can be seen as the ultimate expression of this: Captain Oates wanders off into the Antarctic Blizzard, giving his life in the, unfortunately futile, attempt to enable the lives of his comrades; Jesus stands at the tomb of Lazarus knowing that to call Lazarus forth will cause such publicity that his own death at the hands of the temple officials will be a certainty.

The very antithesis of love is the desire to diminish others in order to further our own ends. And the ultimate expression of this anti-love is murder whereby we extinguish someone else's life in order to further or protect our own. So we bump off our spouse to collect the insurance or shoot the shopkeeper to facilitate our escape, and at the extremes of this continuum of love and not love it's fairly easy to assess the good or otherwise of the action. The trouble is most of the times when we wish to make such a moral judgement the circumstances are not so clear cut. And making a call as to when we should assist someone to carry out their determination to end their life (for their own good or the good of others) is usually one of the most ambiguous circumstances of all.

Jim submits that  "...it should be legally available to any individual who is terminally ill who makes a rational and sustained decision that they want to end their life." But here is the rub: how easy is it for a dying person to make a rational and sustained decision?

Dying sometimes happens quickly, and in these cases there is no argument. But death sometimes doesn't come quickly, and it is in these cases that the need for assisted suicide is under debate. Death is a process of surrender. Over a long time, usually far longer than we recognise, people begin to end their lives, piece by piece. Our bodies betray us and we stop doing things that once gave us pleasure and meaning. There is a last time for everything, and as we give up our treasures one by one, our horizons get smaller. Some of the things we give up - say, the ability to run or turn cartwheels or our capacity for international flight - cause us regret but some of our surrenders -for example the loss our sight or hearing, or our sexuality, or our ability to remember - are so great that they diminish our very sense of self. These endings are often incremental and so gradual that they do not overwhelm us; but over the years they can give us a creeping sense of diminishment and cause us to question the worth of life.

For most people these diminishments are not suffered in isolation. We live in the network of friends and family and as we give up control and autonomy it is picked up by those around us who gradually take on the responsibility for our own decisions, including some so intimate (when and what we eat, when we go to the toilet, what we wear) that the exercise of them is a burden for all concerned. So the mechanism of making a rational and sustained decision is seldom the sole preserve of the dying person. It belongs to the community of those who surround the terminally ill person, and is subject therefore to complex and conflicted self interest.

So when is the medically assisted suicide loving? That is, when is it the willed extension of oneself for the nurturing of one's own spiritual growth or that of others? When is it not loving? That is, when is it the diminishing of another in order to free myself of a burden, or to facilitate the advancement I may receive upon the other's death? My own experience of dying, by which I mean the imagined  contemplation of my own death and the witnessing of the deaths of others, tell me that in the overwhelming majority of cases, these issues are so complex and so entangled that it would be impossible to make the call. Sometimes the motives are crass. I know of the staff of one Dunedin rest home, for example, who were asked if it would be possible to speed up the impending death of an aged parent in order that their child might attend an overseas wedding. Sometimes the motives are subtle and longstanding. A family wearied by years of caring for the dying, and the dying person themselves, ashamed of the weight they place on those dearest to them, are in no position to make this call.

On the face of it, it seems just to allow people to make a reasonable and sustained choice for death. But the circumstances in which we find ourselves at the end of life are usually so fraught that such choice is impossible.