When living is a fate

When living is a fate worse than death; the case for voluntary euthanasia

Too many people I cared for have died before their time, killed by cars or cancer. Too many others have lived well beyond their time. With the progress of medicine and the widespread increase in longevity, the second category is likely to increase relative to the first. The issue is not, however, a new one. Job 42:17 reads: “So Job died, being old and full of days”. The Dutch version is rather more direct: Job dies “oud en der dagen zat.”, which is best translated as ‘old and over-filled with days’. The word ‘zat’ – related to ‘sated’ and ‘satisfied’ – has a strong connotation of too much of a good thing. In Afrikaans, the characterisation is ”old and ’lived out’” (‘afgeleefd’).

The three grandparents I got to know well all went through an absolutely dreadful final two years of life – all three were in their eighties when they died. When I say dreadful, I mean dreadful for them, and not just for those who loved them and witnessed their humiliating and undignified decline into pain, incontinence and incoherence laced with flashes of understanding, despair and horror at what was happening to them. The problem of living too long has now reached my parents’ generation. Some day (if I am lucky enough to live that long) it will be my problem too. Unlike my grandparents and my parents, I intend to be ready when that day arrives. Unfortunately, my proposed course of action would be illegal under the laws of most countries (the enlightened Netherlands are an exception), including the UK and the USA. Were I to require assistance to carry out my plan, the person(s) assisting me could be tried for manslaughter or murder.

Here is my position:

Suicide is a fundamental human right. Assisting someone to commit suicide should, subject to proper safeguards and oversight, be legal.

It is clear to me that the right to commit suicide must be restricted to adults who are of sound mind and who are not suffering from treatable but untreated forms of clinical depression. Assisted suicide should, as it is in the Netherlands, be supervised and accompanied by qualified medical personnel, and be subject to clear guidelines and judicial oversight and accountability.

There are risks associated with assisted suicide and voluntary euthanasia. The main risk is that voluntary euthanasia becomes euthanasia (‘good death’) in the eyes of the just the party or parties administering it rather than in the eyes of the person seeking to end his life. From that point, it is but a small step to involuntary euthanasia or murder. Getting the doctor to quadruple granny’s morphine dose to get at the inheritance in time for the summer holidays, is not part of the package. It is therefore essential that full, informed consent be given by the person wishing to end his life, without any external pressure. Only an adult of sound mind, not blighted by treatable but untreated clinical depression, can make the determination to end his life. This means that those in a coma should be kept on life support, unless they have left clear instructions, say in the form of a notarised living will, that they are not to be kept alive under such circumstances. It may be sensible to make it mandatory for all adults to have living wills covering these contingencies.

I believe that these views on suicide and assisted voluntary euthanasia are fully compatible not just with enlightened humanist ethics, but also with the fundamental tenets of the Christian faith I grew up in and confess to this day. I can see no conflict or tension between my views and the moral imperatives emanating from the two great commandments, quoted by Christ from the Books of Moses: “First, you shall love the Lord your God with all your heart, all your soul and all your mind; and, second, you shall love your neighbour as yourself”.

We have no say in how and when we enter this world. We can have a say in how and when we leave it. That freedom – the right to choose and, if necessary, the right to die, and to choose the time and manner of our dying – is a gift of God – a precious gift.

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Maverecon: Willem Buiter

Willem Buiter's blog ran until December 2009. This blog is no longer active but it remains open as an archive.

Professor of European Political Economy, London School of Economics and Political Science; former chief economist of the EBRD, former external member of the MPC; adviser to international organisations, governments, central banks and private financial institutions.

Willem Buiter's website