“These people are reacting with emotion, not reason,” it was opined on this morning’s Jon Faine show on Radio Melbourne/774/3LO/SigmaSixGuthrieSound, whatever it’s called these days. The talk was of those advancing the “no” case against voluntary assisted dying, a bill for which is now coming up for a final vote in the Victorian Parliament. It will probably pass, though more narrowly than its proponents might have hoped. I hope it won’t, at least for the moment, so that the issue can be debated in a more expansive and comprehensive fashion. Those voting on the bill who are wavering, should err on the side of prudence and vote it down, for the moment.
It is commonly suggested that a pro-voluntary assisted dying (VAD hereafter — hereafter, haha, oh come on … ) position is on the side of “reason”, opposition on that of “emotion”. The “emotion” side is then condescended to as a valuable corrective, safeguard, etc, to what is assumed to be the necessary course of history. I would put it in exactly the reverse: the argued case against VAD is the one employing critical reason. It is the unthinking “yes” case that is not rational, but ideological. It simply reproduces the individualist liberalism that surrounds it as if it were the truth, not a particular and partial way to live.
The liberal assumption is that we are sovereign and separate individuals, selves inside a body, peeping out from it, to the wider society. According to liberalism, we create social life and shared meaning by a series of contracts with other people in which we exchange desires and needs, to mutual satisfaction.
A moment’s reflection will tell you that is utterly false. We are social entities — infants, being en-culturated, en-languaged by others — before we are selves at all, much less individuals. We are embodied beings already in a web of social meanings, before some sort of individual, reflective consciousness emerges. Social and collective processes shape our understanding of what is proper, required, accepted, of what it is legitimate to ask, and to want. In our era, much of that shaping of self is around use — economic use, in particular. Are we a useful entity? Are we pulling our weight? Etc.
The concern many of us have, from a non-religious perspective, about VAD is that it combines those two processes — meaning and expectation as a collective practice, and life as utility — in a way that, when wired into a medical system, could have unintended consequences that will be deeply regretted. In effect we would argue that the form of the end-of-life medical system will become oriented to death-giving, and that the content of it will become oriented to the dying person as a “utility unit”.
None of this will be conscious, and that is why liberalism cannot even talk about such processes. The deep faith “rationalists” have in the individual is, or should be, exposed by the fact that many of the things that happen in our lives are ruled by social, collective and unconscious forces, passions and processes. Over time, a VAD system could reshape doctors and patients within it, to death-orientation.
The defenders of the VAD bill say they have put in many safeguards, and they have. I’m not against some form of semi-assisted dying, which accounts for incapacitation. I’m not against rational suicide in the face of unbearable suffering. But suicide is legal, and suicide should be a difficult thing to do, a momentous step. Life has made it hard for us to kill ourselves; as Robert Lowell said, if you had a switch on your arm that could kill you instantly, most people would be suicides.
But if a comprehensive VAD system is to go ahead there should be one major safeguard: universal, free and unlimited top-rate palliative care, for those who want as much life as possible. And that is simply not the case in Victoria at the moment. The health system is underfunded (especially compared to systems like the Netherlands, which have VAD), the best painkillers are not available to everyone, new techniques are slow to be introduced, and the system is class-dominated – the rich have access, medical professionals and their friendship networks have access, others don’t.
This to me rules out ethical VAD from a left perspective absolutely at the moment. Because there is no doubt that people who want weeks or months more of life, will have themselves killed because the care is not there to support them in that desire. Those people taking that option will be disproportionately poor, indigenous, and disabled. In a system without universal, free, cutting-edge palliative care, a VAD law is suborning murder. It is very much in the character of the Andrews government — technocratic control of the populace within a neoliberal framework represented as progressivism.
The bill should be rejected; universal palliative care guaranteed. And a modified VAD bill re-introduced at a later date. Labor members who retain a class politics ought to think about who will be getting hurried onto death, and the role they’ll play in doing it.
you try living the suffering of others; most of what I’ve heard of the no case, arrogant doctors/religious who want their positions protected for no “intellectual” reason, other than I know best.
I would rather be “emotional” with love and compassion.
Is that the meaning of the endearment ‘luv you to death” – very emotional. 🙂
Unhelpful, unkind, unfeeling.
While I accept ‘most of what you’ve heard’, Aliso, it’s not the argument put by Rundle. I would also hate to try to take the emotion or compassion out of the debate … in fact, I think it would be impossible. What concerns me though is the dominance of the ‘compassion’ response. I think what Rundle is saying is that we need more. If compassion is the basis for our response then other groups and individuals, also deserving of our compassion, are going to say ‘why not me?’.
State sanctioned Homicide comes in defined legislative forms 1 War [carried out by licensed soldiers] 2 Death penalty for Crime [ carried out by state employed executioners]. The death penalty in Australia has been abolished. It is being replaced by Euthanasia a new form of state sanctioned Homicide. Therefore the State should appoint a formal class executioners – perhaps called Euthanasists.
The European experience shows that over 50% of those euthanised DO NOT give consent as we understand legal consent – due to multiple factors ,coma, drug induced decision making or merely that the decision makers are advised by close relatives whose motives are varied [ranging from the stress of seeing the plight of the very ill to merely dealing with an inconvenient problem] but provided the process is complete it is deemed valid.
Once legislated – the process and processing takes over. if the process as regulated is followed no problems. We all know government regulations degenerate into ‘tick & flick’ – just generates more paperwork.
50%?? I call that an outright lie. To receive a retraction, provide authentic source.
Thanks Guy for a fascinating piece. What you say about the construction of the self around (economic) use really strikes a chord. 7.30 featured a story last night on problems in the implementation of the NDIS, and one of the interviewees — a woman with spinal muscular atrophy — said that while she knew her treatment/care was costing a lot, she’d also put a lot ‘back’ (in terms of work, taxes etc.). Clearly it’s important for her self-esteem to think like that — God knows, I’m not criticising her for a second — but it’s sad in a way that we feel the need to justify our existence in such terms.
I also like what you say about the liberal view of human beings as ‘separate and sovereign, selves inside a body’ … I recommend Terry Eagleton’s recent book on materialism (especially the chapter on Marx) to anyone wanting to dig down into/push back against this construct a bit …
Great for Tourism Victoria – a whole new marketing push for the economy- for instance , can have a slogan for number plates – Dying to see Victoria.
The last three paragraphs capture my opinion almost exactly. Proponents of VAD are wont to argue their case on the basis of ‘ personal choice’. However, when not all options are available or equally accessible, personal choice is constrained.