The South African Civil Society Information Service

The Democratic Right to Die

By Glenn Ashton · 11 Dec 2010

Picture: SACSIS

Death remains a taboo subject. Ending ones own life, as in suicide, in assisted suicide or even in medically supervised termination of life, is seldom discussed. Death and dying is only raised at the end of ones life, at a time of weakness when we cannot properly deal with such a demanding matter. 

Death is so profoundly taboo that the media, if it does discuss it at all, generally takes a partisan view, echoing established dogma, citing tired moral, religious or ethical issues. The media has failed to properly engage this incredibly important issue in sufficient depth. Death is usually dealt with in shallow and sensationalist coverage, rather than more considered, profound examination, by all except specialist publications.

There is also a huge societal divide in how we deal with death itself. Wealthy, first world Northern societies keep death at bay through the application of a rigorous medico-legal system. In poor societies, if one makes it through childhood, death remains a constant companion, disguised variously in the forms of water-borne diseases and food shortages, or as endemic and pandemic diseases like malaria, TB, HIV and AIDS. 

In the first world one’s demise remains an abstract, soi-distant possibility that may strike through accident but that is far more likely to visit only at the close of a fruitful and productive life. In the third world it is omnipresent.

Neither is death - and the right to die with dignity - consistently experienced. There are completely different standards applied in how wealthy nations cushion citizens from the realities of death, while simultaneously ignoring unnecessary and avoidable deaths amongst poorer nations. 

In our globally unequal society death is classist. While western society has rendered our demise into an abstract, arms length and taboo topic, this abstraction is utterly anachronistic. The inevitability of death is avoided as some sort of perverse indication of a failure to succeed or to thrive in our winner-take-all society.

Our reluctance to discuss and embrace death is perhaps an understandable human response. Death remains largely unknowable. Our knowledge and understanding of it is clouded by unsubstantiated beliefs drawn from both religious and secular perspectives. 

It is notable how most of the world’s great faiths - certainly the major monotheistic religions – strongly oppose our individual right to choose when to die. On the other hand choosing to take ones life is acceptable practice in places like Japan where suicide – death by self - is an honourable demise.

Western culture falls into a trap of ostensibly elevating the self above social and personal reality. Suicide is taboo because we have transformed lifelong problems like depression and despair into temporary and surmountable challenges. We have chemical cures for such maladies, even though such 'cures' may worsen ones problems! 

Our taboo on suicide - and even on dignified death from illness – remains because society is scared that people may wish to opt out whenever things get a bit tough. Problems are temporary; death is permanent, goes the trite and poorly framed argument against taking ones life. 

Yet humans, together with all animals, have a powerful instinct for self-preservation and an inherent ability to cling to life in the most precarious of circumstances. People only seek to end it all when things are desperately hopeless. 

But why should we have to wait for death even if terminally ill? Surely we should be allowed to choose even if we are not on our deathbed?

There is a valid argument that unilaterally removing oneself from family and society has a huge negative impact on those left behind. Yet if there was an established, legitimate process that included those to be left behind, the trauma of departure could be far better managed and even dispelled. By persuading friends and family that one no longer serves any useful purpose, or is a burden, or is suffering so profoundly that no relief is possible, then surely the transition to the far bank of the Styx would be far smoother than an apparently random or unilateral termination of life? 

For instance Indian farmers commit suicide rather than face lifetimes of de-facto slavery to loan sharks, after crop failures. These personal tragedies, usually the result of imposition of first world financial models on alien cultural milieu, have undermined traditional coping mechanisms. Death is hard on the survivors but it generally has not occurred in isolation. Families are fully cognisant of the underlying realities.

Christianity, the dominant western religion, has historically claimed suicide to be a sin. Notably, the Bible is largely silent on this matter. Instead, questionable theological gymnastics posit that because life is a god-given gift it is not ours to take. Flawed humans cannot know the mind of god. 

This logic essentially denies our ability to exhibit free will, subjugating us as tools of the divine. Such thinking has long been rejected by all besides dyed-in-the-wool fundamentalists. Following such logic would render us unable to do anything unless granted permission by god.

Conversely, some ancient western philosophers like the stoics concluded that if one is not flourishing then curtailing our life is sensible. Seneca, a leading stoic said a wise person “lives as long as he ought, not as long as he can.” For Seneca, it was the quality, not the quantity that mattered.

It was only post-reformation that dogmatic Christian positions began to be questioned. Yet even today these archaic concepts hobble this important debate, whose parameters have changed utterly with over 6 billion people crowding our planet. Why should we refuse anyone their free, informed choice if they wish to cease living?

The poor, comprising more than half of the human race, live a life that is so uncertain and of such poor quality - compared to western standards - that first world mores about the sanctity of life have limited relevance. 

If life really is sacrosanct, then we must recognise that fact and treat everyone's life as sacred, not only those who live in the developed North. If we can cure illnesses and provide food for everyone, yet fail to do so, then we have clearly abrogated any duty or claim we may make that taking ones life is in any way wrong or immoral.

On the other hand if we do accept that the quality of life of the poor majority is unacceptable and incapable of being rectified, then there is a profound danger of regressing into the dangerous quagmires of eugenics, of racial and classist stereotyping that project less fortunate societies as having a lower intrinsic value and proposing that Northerners and Southerners should be evaluated under differing standards and criteria. Such a stance is clearly morally unacceptable and contradictory.

Perhaps we should turn the argument on its head and say that it is the rich who should be the first to voluntarily surrender their lives simply because they have consumed an inordinate proportion of resources. Any such claim will predictably be met by howls of outrage from the establishment. 

Yet the failure by the first world to provide food and health resources – which are well within its means to provide – is tantamount to genocide. Instead vast resources are wasted on destabilisation and wars triggered by ideologies and geopolitics.

Whatever the details, the badly neglected right to die debate is both profound and multifaceted. Most of the discussion has centred around suicide, the termination of life as punishment and dignified death and euthanasia. Analysis has been shallow and stilted. Little new ground has been explored. Instead we remain politically trapped by the inherent conservatism of the system. 

Why can we not choose to die, when we want? Do we have to be sick to die? If life is existentially pointless, why should we continue? If we feel we have outlived our welcome, or are lonely and isolated, why stay? Surely our rapidly changing circumstances demand a complete realignment in how we deal with death?

Carlos Casteneda, the mystic writer, provided some useful perspective. He said, "We are all going to face infinity, whether we like it or not. Why do we do it when we are weakest, when we are broken, at the moment of dying? Why not when we are strong? Why not now?" 

Staring into the void enables us to empower ourselves through comprehending a critical part of ourselves. Realising our control not only over life, but over death, makes us more complete as humans. If our society is as truly democratic as it claims to be then surely it is our individual right to choose the moment of our death, just as we – people of free will – are supposedly free to chose the way we live our lives? 

Some may feel this discussion is somehow macabre. This is the natural response of being immersed in a culture accustomed to an unnatural isolation from death. Those who have faced death and accepted its presence can assist our emotional and intellectual growth by teaching us how the proximity and immediacy of death can provide a far more profound meaning to our lives – both in how we live our life and in how we choose to end it. 

Is it not natural to want to die in full control of our minds or destinies? Instead of shuffling off this mortal coil, should we rather not fly off it with the blessing and assistance of our families and our communities?

Neither should we close our minds to the twilight existence of the majority, trapped  through dire circumstances. What right do the privileged few have to suck the resources of a medico-legal life support system, designed not to let people die in dignity, but to extract the last possible vestige of pride (not to mention money) from a human dependent upon a machine? The very concept is insane. In the first world life is prolonged because of the commercial imperative.

Surely as free citizens we should be able to cry “Enough!” and end our lives with dignity and hope, surrounded by love not condemnation? We should face the end of our adventure on earth in willing anticipation of the next step on our journey, at a time of our own choosing. Or is god dressed in medical gowns, instructed by lawyers?

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