I’ve often expressed an interest in dealing with policy from an integral perspective. Theory is fine, but how do we put it into practice?
I was watching a rather moving documentary on TV. It was an examination of the growing movement amongst senior citizens to choose the moment and method of their death. There is a group in Oz called Exit who demand the right to suicide painlessly. It seems that seniors in their hundreds are going to Mexico to buy nembutol, a drug used to euthanase animals, and then smuggle it back into Oz. Apparently nembutol causes a peaceful death. However, a more radical faction of Exit have started manufacturing nembutol illegally in backyard laboratories. What is driving this movement?
The seniors interviewed were quite adamant that they did not want to die a slow, helpless death where they were kept alive just to be kept alive. They all expressed a fear of loosing ‘quality’ of life and rotting away in a nursing home. They were also quite adamant that they would only suicide when they were close to their last years. One man was 91 and still active, but calmly noted he was declining rapidly. All of the seniors interviewed seemed intelligent and very competent. In fact my guess is that many of them were of above average intelligence with many having achieved a lot in their lives. One was a retired doctor. The message I got was that these people feared loosing control and wanted to control the manner in which they died. Some of them spoke bitterly about becoming the victims of the medical profession who would put them in beds and keep them alive without ensuring a ‘quality’ of life. One woman complained that she didn’t want to put in a home to play mindless games of bingo.
Of course, the documentary canvassed the opinions of those opposed to the Exit movement, but I found their objections faulty. This may very well have been a fault of the video researchers for not finding better arguments against suicide. One doctor was an advocate from Right to Life. He was arrogant, patronizing and young. It made me think that anyone under the age of sixty or so should generally be barred from advocating on this issue. He exemplified everything the Exit elders were objecting to – a medical profession willing to remove power from them. This young advocate was like most moralisers, he assumed his moral position was absolute and right – people have to be kept alive even if they suffer greatly.
The second anti position was another doctor. She thought the answer was to understand what the Exit elders feared and solve that problem. I found her argument naive. They fear the gradual loss of control that occurs in old age. They fear decripitude and being infantalized in nursing homes. In a way the doctor was right. A lot more must be done to ensure a dignified old age, but much of this has to do with money. It’s okay if you are rich, but if you are poor you face a life of poverty on an inadequate pension and sub-standard care in a sub-standard nursing home. Some of these sub-standard nursing homes do the bare minimum and are really just ‘parking’ places where old people are hidden away to die.
The problem with people who have retired is that they no longer make an income, so they become an expense on society. The doctor was naive because there is no movement to radically improve aged care, people would rather hide the problem away. It’s an interesting problem. Society is not ready to assist the elderly to suicide, but they are also not prepared to spend the money to ensure a dignified old age.
I would expect to see an increase in the demand for the suicide option as the boomers get older. The boomers will be less likely to tolerate the disempowerment of old age. There will have to be a quite radical rethink of aged care. No more waltzes and Bing Crosby as the music of the 60’s and 70’s takes over. How about prescribing marijuana for use in retirement homes?
Btw, the members of Exit argued that the elderly are suiciding at an increasing rate anyway. The reason they want nembutol legalized is so that the suicide is non-violent. The most common form of suicide amongst the elderly, especially older men (who have lost their partner and are alone) is hanging. The Exit seniors were quite adamant. We will choose our own time, but we want to be able to do it peacefully.
What do you think? Should the elderly and the terminally ill be able to suicide? Is a greater good being served in keeping people who will not recover alive? What would the integral policy be?
C4Chaos commented re: Ray’s suicide thread but somehow it got warped and didn’t show up properly so I went to his blog and copied it to here. You can see the original at http://coolmel.zaadz.com/blog
“Society is not ready to assist the elderly to suicide, but they are also not prepared to spend the money to ensure a dignified old age.â€Â
thanks for posting this. at its root, this is a Pro-life/Pro-choice issue, from the perspective of the “self.â€Â. it doesn’t have a clear answer, yet a lot of people are polarized due to ethical and moral bias.
i think this issue falls under what Wilber calls “basic moral intuition.†so instead of answering your questions for everyone, i’ll answer the question as if i’m the one involved in the situation.
“Should the elderly and the terminally ill be able to suicide? â€Â
personally, i’d like to have that choice. but at this time, my moral and ethical standards is opposed to suicide. but i’ll cross the bridge when i get there.
“Is a greater good being served in keeping people who will not recover alive?â€Â
imho, no. keeping me alive way past my prime and with no hope of recovery will serve no good to me or to anyone.
“What would the integral policy be?â€Â
i think we should start with integral healthcare and integral medicine and see if those cover the bases on this issue. but i really don’t know. any suggestion?
having said that, i wonder how this is different with the stories in Tibet wherein meditation masters who are aware of their impending death go into prolonged meditation to “consciously†die. isn’t that a form of a suicide too? and no, i’m not talking about those creepy rainbow bodies
~C
Interesting topic.
my 2 c.
Opposition to euthenasia has nothing to do with the rights of the terminally ill (whether elderly or young). It has everything to do with fear of death on the part of those who are in control (i mean politicans, the clergy etc). These people in charge have a highly paternalistic attitude that comes from a lack of empathy, and a lack of appreciation of or respect for the rights of others. Hence these conservative politicians, law makers, etc, coming from a fear-obsessed exoteric-religious (if you do that you are not obeying God\’s law!) and materialistic (if you do that you will cease to exist!) point of view. They are unable to recognise how much their policy and judgment is a reflection of their own shadow, ego-defensiveness, and unacknowledged fears, enforce only those rights that agree with their own standards (and this goes for everything!); they will oppose them when it doesn\’t. (ever wonder why the whole world is in such a mess? And why reform in any area is so difficult?)
Once you deconstruct things psychologically like this, the real motives become obvious.
In this way death, the second last taboo (the last taboo is animal sentient rights) really throws these things into sharp contrast.
In short, let the terminally ill, and the aged and infirm, themselves, decide.
\”I would expect to see an increase in the demand for the suicide option as the boomers get older. The boomers will be less likely to tolerate the disempowerment of old age. \”
I agree. And this is what will finally bring about a change in the laws governing these subjects. The baby boomers seem to date to be the single most revolutionary generation in recent history, perhaps in all history.
I would think that a high percentage of educated, secular humanists would demand control over their death. I would also expect a higher percentage of highly developed would also want control. The ‘against’ argument is pushed primarily by Christians, particularly the more conservative and fundamentalist. The Right to Life movement in Oz is primarily a conservative Christian group with links to the Catholic church. As the boomers enter old age they are hardly likely to accept the moral authority of the Church and will get quite angry at any religious argument or interference.
I also expect Gen-X and Gen-Y to support euthanasia. I also note that at the moment it is relatively progressive Western states examining this issue. The Dutch and Swiss have passed pro-euthanasia laws. I also understand some US states have progressive laws. Here in Oz the Northern Territory had passed pro-euthanasia laws, but the conservative federal government reversed the legislation (as the NT is technically a territory and not a state).
I think that in cases where it is clear that there is no chance of recovery that a person should decide a conscious death. Obviously with the elderly their time is limited anyway and recovery is unlikely.
I have seen a moving Dutch doco on the assisted suicide of a man with terminal cancer. He had involved his closest friends in the process and his children and close friends were with him when he ended his life. There was a lot of love in the room when he made the decision. It was a wonderful death, better than waiting in pain and emotional suffering.
There is a spiritual aspect to this. Buddhism and Hinduism both say that a conscious death is the best. The problem with drugs and pain is that death can be unconscious. Isn’t it better to go when you are of clear mind?
The problem with the Abrahamic faiths is that they are often more concerned about imposing their moral authority than they are about the individual. They are legalists who defend a law. I am repeatedly shocked by the callous indifference they have to the suffering of others. In the program I mentioned in my first post the son of one man said that we learn through suffering and just as Christ suffered on the cross, so too must we suffer in death. Honestly, I was so angry. Fine, choose that for yourself, but how dare you choose that for someone else! Fortunately his father completely rejected his son’s views. But then I tend to regard Christians as people who worship suffering and death anyway, some relish suffering in order to be more Christ-like. Perhaps we should offer them drugs to prolong life and increase their pain? Gimme a break!
I’m a secular humanist living in California. Here we have passed legislation that allows us vain Californicators to suicide when our skin is wrinkled and unattractive, but ONLY after repeated botox injections and face-lifts no longer work. I mean why be alive if one is wrinkled, right? (And not tan, for that matter.) Ok I jest, just a little.
But you do touch on an important issue – there has to be ‘good’ reason and that is the most difficult part.
Being a Dutchman I live in a country which has legalised euthanasia since April 2001. The main reason behind this legislation was the fact that euthanasia already happened and it needed regulation. Everywhere, not only in the Netherlands, doctors are helping people to die! But of course doctors cannot be open about this, because they could be prosecuted for murder. The Dutch government wanted to create clarity in that misty area where it usually stays unclear for others what really happened and if the patient died naturally or by the hands of the doctor. In order for the doctor to be safe and able to communicate clearly about what happened, and also for patients to be able to organise their deaths in a self respectful way instead of a sneaky one, legislation was created.
There are six criteria of carefulness for the doctor in the Dutch Criminal Code:
1. He is convinced that the request of the patient was voluntary and well considered
2. He is convinced of hopeless and unbearable suffering
3. The patient has been informed about his situation and prospects
4. Together they are convinced that there reasonably is no other solution for his situation
5. He has consulted at least one other, independent doctor who has seen the patient and given his judgement on the criteria mentioned under 1-4
6. The termination of life or help with suicide has been done with medical carefulness.
Also future euthanasia is possible under Dutch law in the sense that patients can lay down in writing the circumstances under which they want to apply euthanasia in case they are not able to communicate this themselves anymore, for instance after a stroke. But the patient should at the moment of euthanasia still be able to communicate that his writing is still applicable, otherwise it has no legal value anymore and euthanasia cannot be applied.
Strictly legally euthanasia cannot be seen as a right for the patient. A doctor always has the possibility to refuse. In practice this normally means the patient will be referred to another doctor.
Also euthanasia is not allowed when the doctor perceives outside pressure on the patient or when the patient has a psychological disturbance. The patient should be completely able to oversee his disease, the possibilities of treatment and the probable course of his disease.
Do not think that herds of elderly are applying their right for euthanasia. Last year 1,7 percent of the deaths in Holland was because of euthanasia. And of these 80% were cancer patients in the terminal phase.
Children are allowed to apply for euthanasia from age 12, but until they are 16 they need permission from their parents or legal guardian. And at age 16 and 17 they are obliged to involve their parents in the decision making process.
Yesterday on television a paediatrician argued for a wider range of possibilities for euthanasia for children. According to him every year about ten children suffer unbearably which cannot be prevented by palliative care and who cannot legally apply for euthanasia although they sometimes ask for it. He mentioned that in these cases doctors still often illegally help ending the lives of these children.
At the moment we have a Christian dominated government which was in opposition when the law was implemented in 2001. They are against euthanasia but so far have not tried to change the law. But liberal secular Holland is holding its breath to see what will happen the coming years.
It seems to me that in a sense the Netherlands is at the front of evolutionary change in social taboos, like also gay marriage and legally allowed soft drugs. This does not mean however that the structures that are laid down in Holland are the best next step, but I see it more as a testing ground for evolutionary change of which other countries can benefit.
Alan says: “In this way death, the second last taboo (the last taboo is animal sentient rights) really throws these things into sharp contrast.”
Also this social taboo is being confronted in the Netherlands. In the last parliamentary election ‘de Partij voor de Dieren’ (the party for Animals) aquiered two seats in parliament being the first political party in the world that is able to get into parliament on a political program for animal rights.
In Australia some compassionate doctors euthanase their patients to relieve suffering. This is illegal. This has been happening for decades but has been kept quiet. Many doctors will refuse to end life, so it’s a matter of pot luck. Some doctors seem quite happy to keep people alive for as long as possible, despite the immense suffering.
Btw, there needs to be a revolution in palliative care. I think Buddhists would be better at managing such centres. They are far more compassionate, despite what Christians think about themselves. Christians can be cruel.
Marko said:
In the last parliamentary election ‘de Partij voor de Dieren’ (the party for Animals) aquiered two seats in parliament being the first political party in the world that is able to get into parliament on a political program for animal rights.
Wow, that is amazing! Holland is truly leading the way!
Hi, talking about Ethics & Morality read this interesting debate:
http://www.integralworld.net/meyerhoff7.html