Everybody else is more interesting than me

[liv]

Happy Shavuot, people who are celebrating. I know it's fifty days ago now, but jack has written a really funny (and informative) series of posts about being dragged along to Passover stuff:
Part I - why my family are weird, Part II - timing, Part III - food, Part IV - disclaimer, Part V - more of my family being weird, also liturgy.

On a completely unrelated topic, tallguy has written a really beautifully drawn cartoon history of the MMR scare. I kind of want this to be a pamphlet that could be distributed in GP surgeries and schools and anywhere people might get medical information from sensationalist journalism. Thanks to moominmuppet, who included it in one of her many fascinating link roundups.

And on a medical issue which genuinely is controversial, rivka managed to host a discussion about assisted suicide which is actually thoughtful and doesn't just rehash tribal positions. Key point from the comments:

In my line of work I have met many people who clearly expressed their desire and intent to die. Some of them have tried to kill themselves, and have been foiled by an insufficiently lethal method or a rescuer that comes along at precisely the right/wrong time. It doesn't seem unusual or notable to me that a suicidal person would speak positively of suicide, right up until the end.

I think that assisted suicide supporters typically haven't had broad exposure to suicidal people, and so they think that suicidal people who have a profound disability or a terminal illness are somehow different from people who are suicidal for other reasons. But to my knowledge there is no psychological research to back up that claim.

This is really incredibly important, IMO. I'm not necessarily against assisted suicide in abstract principle, but it can't be morally acceptable in practice until we've sorted out a major social problem, which is that a lot people believe that the default state for anyone disabled is "suicidal". An able-bodied person who has suicidal thoughts gets psychiatric help, while a disabled person who has suicidal thoughts gets help with dying (or people agitating for such help to be more legal).

I'm a lot more worried about this than scare scenarios of relatives pressuring someone to kill themselves in order to inherit their money. There will always be some evil people, and we can only do our best to create a legal system which prevents them from carrying out their evil intentions. But a much bigger problem here is entirely well-meaning, ethical people who genuinely believe that suicide is the best option for anyone who doesn't fit their definition of normal, who assumes that disability automatically means bad quality of life. Now, sometimes suicide may be the best option, and sometimes a particular person's life is in fact unbearable. But this is assumed far, far too often. To quote rivka again:

There are many realistic fears/concerns that could lead someone who is terminally ill to think suicide is their best option: fear that pain will go uncontrolled, fear that you will lose your ability to communicate and be subjected to unwanted life-extending procedures, fear of dying alone in the ICU instead of at home surrounded by your loved ones.

It isn't that I think these concerns are not legitimate; I know that they are. It's that I think we need to fix them, not throw up our hands and say "we aren't willing to make our society a better place for you to die in your own time, so the compassionate thing is to help you kill yourself now."

There are a lot of different issues caught up in the assisted suicide debate. For example, the difference between withdrawing treatment or not starting it in the first place, and actually killing someone. The difference between helping a terminally ill person to die in the way they want, and killing someone because they can't face the thought of life at the level of functioning that they expect to have. The differences between physician-assisted suicide by the medical team actually treating someone, and assisted suicide by a relative acting as a carer, and actual suicide clinics. Lots of these distinctions aren't entirely clear-cut in actual practice, but lumping them altogether isn't helping the discussion.

And nearly all these issues are blighted by ableist prejudices. The issue of consent is incredibly fraught; lots of people truly, sincerely believe that they would rather die than live with X illness or X impairment, and are quite likely to be unable to communicate that the actual reality of it isn't as bad as they expected. So the person has to rely on the goodwill of other people who don't have the condition, and who may indeed have witnessed the person concerned stating definitively that they would rather die than [whatever]. I think the only moral way of dealing with this is for everybody to consider very carefully why they have the views about quality of life that they do, so as to make the most moral possible decision. And obviously there is a huge range of views on the topic among people with disabilities, who should on no account be treated as rhetorical point winners rather than actual people.

The thing is that we live in a world where a convicted multiple murderer is regarded as a hero in the cause of assisted suicide. Muddled beliefs about disability and quality of life let people like that get away with quite literal murder. Let alone people who are honestly trying to do their best in a highly fraught and ethically very difficult situation.

Hm, apparently I have more to say about this issue than I thought I did. Thanks to jack for listening to me rant when I first read rivka's post.

Comments

[sunflowerinrain]

Having a sense of some control over a frightening process which is essentially out of our hands does seem very important.