Thursday 1 February 2007

Whose life is it anyway?

Although not reaching the front pages, recent news stories from around the world have prompted further contributions to the well-rehearsed debate about the rights and wrongs of euthanasia: an Italian doctor who switched off the life support machine of a paralysed man was cleared of wrongdoing by a medical panel; the British Social Attitudes Survey found that eight out of ten people support a law change to allow doctors to actively end the lives of terminally ill patients who want to die; the Indian Supreme Court admitted a public interest litigation seeking the 'right to die' with dignity of persons suffering from chronic terminal diseases and likely to go into a permanent vegetative state; and Australian Senator Bob Brown plans to introduce a private member's bill to legalise euthanasia.

I find that the debate on euthanasia tends to be conducted between two opposing viewpoints, which can be broadly described as: "euthanasia is ethically valid, and should be legal"; "euthanasia is unethical, and should be illegal". You generally don’t hear anyone say: "in my view euthanasia is an immoral act, but should not be illegal".

My personal view on the morality of euthanasia is irrelevant to my point here which is that arguing that something is immoral should not necessarily lead the speaker to argue that it should be illegal. In debates of this nature I always refer back to J.S. Mill's distinction between 'self-regarding acts' - whose primary effects are on the agent himself - and 'other-regarding acts'. In my view this distinction is key to describing the proper role of the state in regulating social behaviour. In On Liberty Mill argues that:

"The sole end for which mankind are warranted, individually or collectively, in interfering with the liberty of action of any of their number is self-protection. The only purpose for which power can be rightfully exercised over any member of a civilised community, against his will, is to prevent harm to others. His own good, either physical or moral, is not a sufficient warrant."

Making a deliberate choice to end one's own life is clearly a self-regarding act. I would not take issue with the right of opponents of euthanasia to argue that it is an immoral choice, or not in the individual's best interests, and therefore to seek to dissuade people from making such a choice, but it is not appropriate to legislate to prevent it.

I would add that the (incorrect) assertion that euthanasia is unnecessary because palliative care is adequate is beside the point - arguing about the practical merits of an issue is not the same as arguing about the ethics. To say "the Iraq war will not lead to the establishment of a stable democracy in Iraq" is qualitatively different from saying "it is not justifiable to invade a country in order to establish democracy, even if that objective is clearly achievable" - either statement may be true (or false) independently of the veracity of the other. In my experience resort to arguing over practicalities usually indicates a failure to make a convincing case on the ethics: "yes, ok, but it won't work anyway".