The Right to Die or a Duty to Live?
The hospital setting… Unsplash
Overview.
Living entitles us to choices, yet the question stands - does dying?
The Voluntary Assisted Dying Act 2022 (NSW) (‘VAD’) came into effect in November 2023, and since then has outlined the choice that humans, who are suffering due to medical illnesses, have in terms of choosing to forego suffering. There is a myriad of requirements that a patient must meet to choose it; it comprises an extensive process to make sure that there remains a line between having access to such a choice and abusing it. This article will explore whether the legal right to die coincides with philosophical ideas of freedom and autonomy.
Philosophical Viewpoints on Euthanasia.
John Stuart Mill states in his book On Liberty, “The only part of the conduct of anyone, for which he is amenable to society, is that which concerns others. In the part which merely concerns himself, his independence is, of right, absolute. Over himself, over his own body and mind, the individual is sovereign.” Mill’s harm principle states that as long as a person’s actions do not cause someone else harm, they are acceptable. This liberalist take on VAD supports a person’s autonomy in a way that would not bring conscious harm to someone else. This goes for patients as well as registered health practitioners, because patients can choose their options freely and registered health practitioners can choose to refuse to participate in VAD; although Mill’s harm principle only applies when the harm is not consensual. Mill’s liberalist perspective allows euthanasia on the basis that it does not harm anyone else.
Ronald Dworkin’s dichotomy of interests, on the other hand, focuses more on the ‘self’ rather than others. Dworkin classifies experiential interests as avoiding pain and getting pleasure, with critical interests as acts that add “genuine meaning and coherence to our lives”. Combined with his view of personhood, emphasising the importance of pursuing critical interests over experiential interests, this highlights VAD as a reflection of critical interests, although it might not seem like that in the beginning. Terminating one’s life to end unabating pain could be seen as an experiential interest where one seems to choose the easy way out. However, the inexorable outcome that awaits one and the lack of choice thereof make it a critical interest because it is realistic and aims to give one some semblance of control back over their life. To be given a choice to alter the narrative of one’s life to minimise harm to oneself adds genuine meaning to life and shapes a person’s values, and more so than that, establishes control and autonomy.
Looking to the spectrum of morality where euthanasia lies, we see that Plato is wildly against active euthanasia and suicide. Yet, even he stated that it is not practical to artificially prolong the life of patients who are ultimately going to suffer and cannot lead a normal life due to said suffering. Opposingly, Immanuel Kant said, “Man can only dispose of things; beasts are things in this sense; but man is not a thing, not a beast. If he disposes of himself, he treats his value as that of a beast. He who so behaves, who has no respect for human behaviour, makes a thing of himself.” This view in terms of suicide compares the choice of termination as one that a beast would make - this differs from euthanasia because patients do not dispose of themselves like one would a ‘thing’. Termination in order to end one’s suffering whilst knowing that their life is not going to be fruitful or even reliable, is, in all senses, moral. Kant said, “It is better to sacrifice life than forfeit morality.” But what are the bounds of this morality? The consensual self-sacrifice of soldiers in war? Or the self-intended end of a life filled with pain?
Autonomy in NSW Law
The question comes around to the presence of autonomy in VAD. It aims to protect and provide as much autonomy as one can be given, ensuring that they are not being given the power to exploit it; autonomy is provided in safe medical parameters and is not absolute. Theories like those of Mill’s and Dworkin’s enthrone self-authorship and support VAD through the point of view of taking charge of one’s own life. On the other hand, whilst Plato and Kant do not necessarily agree with this, they don’t deny the morality of euthanasia. Whilst the former two applaud the pragmatism of autonomy, the latter appreciate the practicality of it. VAD encompasses these philosophical views by a simple balance - it permits autonomy very strictly, thus acknowledging the moral gravity of the act, and it protects people in need of help by giving them a choice to decide. This shows that legal frameworks aren’t just bureaucratic but reflect different philosophies.
Edited by Francesca Martinez