by David Taylor
from Signs of the Times No. 36 - Jan 2010
Our morning session on this theme was led by the Very Revd Professor Gordon McPhate, Dean of Chester and former pathologist, with special interests in the Science-Religion dialogue and Medical Ethical issues; this was a highly structured, case-based discussion.
The afternoon session was led by Dr Oenone Wollaston, a Christian GP with special interest in geriatrics and end-of-life issues; this was a much more fluid discussion, with contributors being invited to present their own arguments and points of view.
The Dean of Chester began with a rapid survey of the topic as it had been handled in the tradition of Western philosophy, beginning with Plato and Aristotle, continuing with Augustine, Aquinas, Kant, Hume, Camus, Sartre and Freud. Aristotle considered suicide in relation to the community, and criticized suicide as a disservice to it. Plato approved altruistic suicide (i.e. the sacrifice of one's own life for the benefit of the community), but condemned merely personal suicide as a defiance of the gods. Augustine was chiefly concerned to discourage what he saw as the eagerness for martyrdom among some Christians. Kant stressed the notion of the sanctity of life, whereas Hume regarded it as a permissible ending of one's sufferings, which inflicted no damage on wider society. Camus took for granted what he called the absurdity of life, and condemned suicide as a failure to accept that aspect of it, while Sartre emphasized humanity's right to choice, and saw the suicide as merely exercising that right. Freud understood suicide as an attempt by the individual to free himself from the intolerable oppression of the super-ego.
The Suicide Act of 1961 made suicide itself no longer a crime, but assisted suicide was still a very serious crime. It was this second point that Lord Joffe was chiefly concerned with in his Bill, which attempts to distinguish between acts and omissions. Nigel Biggar's Aiming to Kill has proved an important contribution to the debate by distinguishing between biographical and biological life. Here it is the quality of life that becomes important, rather than the sanctity of life regardless of its quality. Some also wish to utilize Aquinas' distinction between the intended effect of one's action and the foreseen effect. This, for instance, would allow doctors to administer doses of morphine whose intention was to relieve pain, even though the foreseen result would be the hastened death of the patient; however, the crimes of Dr Shipman have created difficulties for doctors wishing to make use of that distinction.
Law, particularly in the utilitarian philosophy, protects the greatest freedom of the greatest number; however, it must also protect the needs and rights of minorities. It has to be aware of the danger of the slippery slope: what starts as permissible tends to become routine, and then may even be seen as obligatory. It is all but impossible to establish a threshold beyond which we cannot go. Besides which the acceptance of assisted suicide would alter the whole outlook of the medical profession, and would require a reinterpretation of the Hippocratic Oath.