some ethical thoughts

morality, evidence and secular thought

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A(nother) Bad Argument Against The Right to Die

Another post that was too long to publish at my blog at BIG THINK. There are many bad arguments out there, but if I’m going to dismantle them, it ought to be done in a way that adequately caters to the problems

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The right to die seems to draw out bad arguments from otherwise reasonable people. As I’ve already done with Jonathan Jones’ article, and as my friend Iain Brassington did with another article, I will examine and point out why yet another post gets this discussion wrong. In The Independent, Laurence Clark has written a reply to fellow comedian Doug Stanhope. Clark objects to Stanhope and his supporter’s vitriol aimed at journalist Alison Pearson and Nicki Clark who oppose assisted-dying. 

Firstly, to oppose Mr Clark as I am is not to agree with the horrible treatment Pearson and Nicki Clark endured. We must be able to disagree without vitriol, since if all we can muster is venom, then we are poisonous to the process of inquiry; we become no better than censors. And those who censor are, for thinkers like John Stuart Mill, almost always performing an evil, since censorship undermines acquiring greater clarity, better arguments, better ideas and therefore a better society and life. If argument is not forthcoming, the emotive and vile responses imply a cornered beast rather than a fellow person. How reasonable can your view be if all you all have to defend it is bitterness?

Thus, though I disagree with Pearson and Clark, I more strongly oppose the abuse they’ve received. I would not want people fighting for such an important cause to be considered allies, even if we share the same goals: when you too quickly reach for the gun instead of the pen, you’re more likely to suffer friendly-fire and collateral damage.

However, Mr Clark is wrong about just about everything else.

What is the Right to Die About?

Clark tells us the “Right to Die movement has … pre-occupied itself with trying to legalise assisted death for just one particular section of society, namely disabled people”. Clark doesn’t list which organisations or people do this. I do not doubt that this is the case for some, but that ignores the broader and more important point: Do we or do we not have the right to end our lives, at the time of our own choosing, with dignity and professional medical help? That people with disabilities tend to often be the focus of the campaigns – as happened with Tony Nicklinson – is no accident: often these people are in a position where, though they are not terminal, they wish to no longer endure the life they currently have. This makes the debate more potent, since, at least with the terminally ill, there is some kind of solace in even the worst outcome: they will eventually cease to suffer (soon).

Though Clarke does not support the view, he does think it fairer that we “legalise suicide and give everyone this same choice and control”. I agree, but this is precisely what he, I think, opposes. 

But we should be aware characterising the right to die “movement” as targeting a specific group – which Clark belongs to – misses the entire point. Do we, as rational adults, who are able to destroy our bodies without State intervention, also have the right to completely end our lives at our own choosing? Clark does not provide a response. Instead, he keeps focusing on being part of the “particular section of society” – since he is a person with a disability – and bases his claims on feelings alone, as demonstrated in his continuing caricature of the debate.

Caricaturing the Right to Die

Clark asks us to think what it would be like to find yourself enduring horrible moments of your life. To imagine “times in your life when things haven’t been going your way. Maybe you’d just lost a loved one or your relationship has broken down?”

And so on, going on, at unnecessary length, into examples of terrible life moments.

“Wouldn’t it have been easy to say ‘sod it’ and put an end to it all? Particularly if the country you lived in openly endorsed people doing this? Or indeed was even willing to help you commit the act itself?” 

“Easy” is hardly a term ever used in these discussions, yet for some reason Clark employs it – indicating again how he caricatures the difficulties and complexities of the situation. If I wanted to keep my neighbour’s dog quiet, wouldn’t it be “easy to say ‘sod it’ and put an end to it”? If I wanted to stop my CEO, my wife, my husband, my children from yelling at me, would it not be “easy” just to kill them? If by “easy”, we mean offer a quick end to the current aspect that plagues us. Then yes: it is “easy”. But that does not make it morally right or reasonable (or legal). Clark seems to miss this point and also that this is how legalisation does and would work! Merely legalising assisted-suicide does not mean societies end up with an increase in suicides. Clark is making the common fallacious claim that legalisation implies increase of that which is legalised. It may, but not necessarily so – especially for things, like euthanasia, we have long monitored when they are legalised (and which do occur anyway, but without legal protections of the medical staff or family that assist the patient).

Easier does not mean right, warranted, or permitted even when it is legal. That Mr Clark misses this and continues undermines his whole assertive post.

Secondly, what does Clark mean by “openly endorsed” in the society? I doubt Clark means that we are happy to end the lives of patients. To a minimal extent, doctors will tell you that they’re glad the patients stop suffering, but are never glad to receive them. Almost no one is glad that people die from horrible diseases and conditions.  Does Clark merely mean legalise? Then why call it “openly endorsed”? Being legal does not mean being liked: most people in South Africa, I think, oppose abortion yet it is legal. I want drugs and prostitution to be legalised – or maybe decriminalised – but I despise many aspects of both (not all, especially how marijuana relieves pain and significant side-effects of many patients; and sex work for those unable to find erotic engagement with others). If he means not ashamed of having something legalised/decriminalised, I don’t see how that factors into committing suicide – since, again, there’s no evidence that legalisation makes it more likely someone will do so, or that legalised euthanasia works like this. 

We will return to Clark’s unfounded and unjustified response to this.

Leave Emotions Out of It

No one is a robot. We are enveloped in feelings, in a spectrum of emotions, that mark us out as non-psychopaths. But what is essential for intellectual inquiry, especially about matters that evoke such strong emotions – and for good reasons – is to allay emotions during the inquiry process. Otherwise, we are merely using this as a platform to express personal sentiments, outrage and repugnance; not working toward solutions, not providing reasonable and evidence-based responses, the outcome of which can impact on social structures. Emotions should as far as possible be acknowledged but for the sake of debate, be put aside so we can assess it as reasonable persons – even and especially if we disagree. I find killing repugnant, as does Clark – but that’s not a reason to be against someone’s right to do it to themselves (given a number of factors that Clark glosses over to create his caricature).

Clark does the opposite.

In the previous section, we saw him asking us to imagine enduring these horrible life moments and contemplating suicide, in a society that “openly endorsed people” doing it. After this he asks:

“How are you feeling? A little uncomfortable all of a sudden? Well now you know how I and many other disabled people feel when we read articles about our ‘right’ to die.”

Is the ‘our’ here referring only to people with disabilities or all people? Clark believes himself to be part of a specific aspect of society, so perhaps he means only people with disabilities; as we noted, this is too narrow a view. Even then, the assertion is fine, I suppose, but hardly important to the debate: do we or do we not have right as adults to end our lives? Since we’ve already seen that Clarke has thoroughly mischaracterised endorsing the right to life – it’s not about hurt or spurned lovers, it’s not premised on only disabled people, there’s no evidence of increased suicide upon legalisation, etc. – it means he’s reacting to what is not real.

If it were the case that the Right to Die was only about ending the lives of disabled people and no one else; if it was the case that access to lethal medicine was easy and accessible to anyone without examining her personal history; if legalisation did lead to increased unjustified suicides, then we’d have reason to take Clark seriously. But even when asking us to tap into our emotions – which by itself is not a good way to conduct inquiry – he’s asking us to do so based on a caricature, not reality. So, yes, Clark would be right, given those fictional premises

But even then: so what? So what if that is how you “feel”? Why is it wrong? Is it wrong because it is insulting? Because of the threat and intimidation? These would be legitimate if Clark told us – but even here, there is nothing indicating what we’re supposed to take from this, aside from something like being a constant target for medical assassination. 

Why Trust Medicine

Perhaps the most remarkable aspect of his piece is his disparagement of the medical establishment.

“I find it amazing that our society still puts such unquestioning faith in the opinions of doctors when it comes to issues like this.” 

What are “issues like this”? Bizarrely enough, they’re health issues. Clarke is essentially saying “I find it amazing that our society still puts such unquestioning faith in the opinions of cosmologists when it comes to questions of the universe”.

True, doctors are not the only aspect of health, but they are a vital [excuse the pun] aspect. Their purpose is to alleviate our physical suffering where possible. Their gathering of evidence to support claims of counter-measures is essential, since they are trained to know more about the body, about diseases, about treatment than the average person. Who else are we supposed to rely on for large aspects of “these issues”? Priests? Astrologers?

I also find it strange that he talks about the “unquestioning faith” of “society” in the medical establishment. This is undermined by even recent history and facts. Would a society that has “unquestioning faith” in its medical establishment abandon vaccinating their children, despite nearly every doctor and health administrator saying otherwise? Would a society that has “unquestioning faith” have a huge industry of pseudomedicine like homeopathy, despite various colleges and medical institutions openly opposing these?

Secondly, if doctors are going to present a loved one with reasons to kill herself, is there anyone who wouldn’t – even in a knee-jerk sense – do everything they can to ascertain the doctor’s evidence? If you or someone you loved was told they had certain horrible conditions, wouldn’t you want second-opinions? Many won’t obtain it, of course, but that’s a reason to encourage second opinions, not throw out all medical advice.

Mr Clark’s antagonism stems from doctors telling his wife that she ought to be wheel-bound, to give up work. “Eight years later she’s still on her feet and in work!” Additionally, Clark’s mother was told that Clark would “have severe learning difficulties and incontinence. The doctor even said I’d be a ‘vegetable’. They were wrong on every count.” Furthermore, Clark talks about a report [no citation] that claimed “institutional discrimination” “among doctors and nurses in causing or contributing to the deaths of at least 74 patients with a learning disability in the last decade!”

Was the learning disability part of a terminal disease? Were any of these patients so severely handicapped, their proxies thought the patients’ lives better off ended? We’re not told. Furthermore, what does “contributing” to the deaths mean? It does not mean “cause”, since he lists it separately. Finally, the number one question we should always ask when given a raw number is “out of what?” or “what is the context?”: how many patients who had learning disabilities were not “killed” by medics? 

It should also be no surprise to anyone in the medical profession that such acts occur. Even, for the sake of argument and in an unjust way, considering malicious intentions on behalf of every single medic that killed (caused or contributed) these 74 people, how do we extract from this a sufficient reason to disparage all doctors, medical science in general, medical expertise and, therefore, legalised assisted-death? Yet that is precisely what Clark does. This enormous leap in logic can only occur with the wings of a Strawman and on the hot air of caricature. 

While no one is denying that many people won’t seek a second opinion, since they would trust their doctors; and while no one is denying that misdiagnoses occur, this is not sufficient to conclude: “the idea that doctors’ diagnoses should play such an important role in end-of-life decisions sends a cold shiver down my spine”. What else could be more important than having an evidence-based, scientifically accurate assessment of your condition? This makes no sense to me (and I struggle to conclude that Clark really thinks this but that’s what he wrote).

The Myth of the Golden Mean

Fellow BigThink blogger, Adam Lee has written about ‘the myth of the golden mean’, to highlight the problem with the news media’s terrible habit of putting asymmetrical parties on equal footing. For example, having a medically-trained professional (who Clarke would apparently disparage?) and a grief-stricken mother of an autistic child on the same platform to talk about vaccinations and autism is no way to make inquiries: as was typical of the campaign to undermine vaccinations, the mother’s grief and emotions were more powerful than the boring scientist with her facts. 

It encouraged people to think: Sure every proper study shows no link, but can I be sure? Just look at her tears. Look at her grief. Would she be so grief-stricken if it wasn’t true? I don’t understand scientific studies nor why I should trust them, when medicine often leads to horrible things, like the Nazi scientists. I understand tears, I understand grief, but I don’t understand complicated studies.

Tears do not equal truth no matter how many of them you shed. There is no serious evidence to back up the claims of anti-vaccinator groups; their ideas will and have done incredible harm to children and families. Indeed, if it’s tears you’re swayed by, know more will be shed if such anti-vaccinating advocates have their way.

So when Clark ends his post by saying “There’s always two sides to an argument and both need to given fair hearing” – he’s also saying a mother with no facts to backup her claims is on equal footing with a doctor trained in the literature; he’s saying astrology should be given equal time as astronomy; alchemy should be given equal time with chemistry; creationism should be given equal time with biology; shamanic healing should be given equal time with heart surgery. I doubt Clark would agree with these, but then that undermines his point about there “always” being “two sides”. Is there any side to the debate of the Earth’s shape? I think not. Secondly, this assertion is both too excessive and too narrow. 

There are many sides to important issues, since reality does not conform to monolithic or binary human categories: what is the best way to govern? What is the best way to organise the economy? Though euthanasia is moral, should it be legalised? I can think of instances in which this might be a better option, but that’s a complicated discussion. Thus, even to this debate of wanting “sides”, Mr Clark aids no one in this very narrow assertion.

Articles like these worry me, since if we wish to engage in a more robust debate about the actual concerns of euthanasia, we can’t keep having to overcome such narrow views. The debate is important and having to point out caricature, fear-mongering and appeals to emotion should not still be happening at this stage. Though I appreciate Clark’s concerns, they are unfounded. 

Filed under right to die Doug Stanhope Adam Lee euthanasia argument debate medicine bioethics disability tony nicklinson

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