Tuesday, 2 February 2010

Primum non nocere

Terry Pratchett has caught the imagination of thousands by writing fantasy books and he is now using his fame to call for assisted suicide "tribunals". He has been diagnosed with Alzheimer's and would like the ability to end his own life. Last night he appeared on television when he gave the Dimbleby lecture and he used this platform to put forward his view. In fact, according to one poll he already had the support 73% if the question was about those who are terminally ill. It looks like he doesn't need to persuade anyone. If we are to believe this survey then those who need to do the persuading are those who believe that life is important at any stage and at any level of ability.

It is not uncommon for patients to be diagnosed as terminal and then get better, so my first point would be about the difficulties of defining terminal. Once you have done this then how do you define at what stage the ability to end life should begin? Benjamin Franklin told us that "in this world nothing can be said to be certain, except death and taxes". Life is terminal and any other definition of when life becomes terminal has its difficulties.

There is nothing wrong with a happy death and we are all looking for that but the term euthanasia has been used to mean the deliberate taking of life. Each attempt to make assisted suicide legal is an affront to less able people. The bottom line is that Terry wants individuals to have the right to take their own life. He may say that the decision is in the hands of tribunals but this is like saying that abortions are not carried out for social reasons. In fact he gave the game away with the emotive "my life, my death, my choice".

What is certain is that if you tell people that some people with certain medical conditions are less worthy of life than others you will get people feeling less worthy. How does this fit in with our equality laws? British doctors used to take the Hippocratic oath which includes the line primum non nocere which means first do no harm. It seems to me that taking life is fairly harmful. Terry is of the opinion that the community is not affected by allowing choice. My view is that everyone is affected by a moral stance made public. Even more so if that person has status brought about by writing fantasy novels. Life is too important to leave to the general public or even educated authors.

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  1. I think in Terry's case the call is definitely motivated by his own condition, but it isn't terminal so even if there was assisted suicide for the terminally ill it wouldn't apply to him. He's finding himself in the position of a writer who is becoming unable to write. He writes a good joke on page thirty. Then maybe the same joke on page forty-six, and again on page sixty. He has editors to help him remove the duplications, but even so apparently one slipped through in his last book, and it will only get worse with time.

    I would say what he really needs is someone to convince him that writing isn't everything, and that after all those years of writing at breakneck speed he might actually deserve a break, a bit of relaxation, and I'm sure he could afford a round the world trip or two. He should do it now, while he still can. That would be better than ending it all.

    Is your feeling about the importance of life religiously motivated? Terry has been an avowed atheist for quite a long time, so any barring of suicide on religious grounds is likely to be seen by him and some of his supporters as religion imposing its will on those who don't believe. And his opinion of primum non nocere is presumably that there's no harm in the taking of life from somebody who doesn't want it. But he is undervaluing himself. He's seeing himself as something broken, a writing machine that can no longer write, when he is so much more than that. There would be harm in acceding to his mistaken wishes rather than trying to show him how valuable he is as a person.

  2. Thanks for your comment anonymous. It doesn't really matter about my motivation. What matters is that we value life. Christians, Muslims and many other religions don't question my stance so I suppose the 73% belong to other religious groups or none.