Is Assisted Dying Narcissism?

Is Assisted Dying Narcissism? September 14, 2015

In a milestone, the California legislature approved an assisted-dying bill last week. Gov. Jerry Brown hasn’t said if he’ll sign it, but if he does, the state would become the fifth and by far the largest to allow doctors to prescribe life-ending medication. Like its counterpart laws in Oregon, Washington and Vermont, the California version requires doctors to certify that the person is of sound mind and has less than six months to live.

But even if Brown vetoes this version of the bill, it seems clear that the push to legalize assisted dying has gathered momentum and won’t go away. The death of Brittany Maynard may have come at a turning point, as polls now find that a huge majority of Americans support assisted dying, including majorities among all age groups and across the political spectrum. The U.K. Parliament rejected an aid-in-dying bill this month, but as in the U.S., polls find that the British public backs the idea by large margins.

As I’ve argued before, the right to aid in dying flows from core humanist principles. It stems from the principle that each person is the owner of their own life and that we choose for ourselves what makes our lives meaningful and worth living. It’s deeply wrong and deeply inhumane to keep anyone alive against their will, forcing them to endure the agony of terminal illness, the slow psychological torture of the disintegration of the self, or the humiliation, loneliness and misery of losing the ability to participate in life and pursue the things that bring us happiness. Of course, no law can stop an able-bodied person from committing suicide on their own, but without legality and state recognition, people who choose to end their lives are often denied the chance to say goodbye to their friends and family, to safeguard them from prosecution for aiding and abetting. In the name of compassion, the opponents of assisted dying are advocating appalling cruelty.

Still, I have to admit that there are stories that make me hesitate. Take Gill Pharaoh, a retired U.K. nurse who ended her life this year at a Switzerland clinic at the age of 75. She wasn’t terminally or incurably ill; in fact, she was in relatively good health. But age and increasing infirmity had made it more and more difficult for her to do the things she enjoyed. Her work had made her intimately familiar with the indignities of aging, and she didn’t want to experience them for herself, as she explained on her blog:

I have always suspected that an ideal shelf life for many people is about seventy years. So often, people say that until the age of seventy they always felt very well indeed. After seventy their health began to deteriorate…

I want people to remember me as I am now – a bit worn around the edges and not quite at my peak, but still recognizably me!

She acknowledged that, at the time of her writing, her age-related health problems were “comparatively trivial” and that she was still enjoying life day-to-day, but insisted, “I simply do not want to follow this natural deterioration through to the last stage”. She argued that it’s “a most selfish and unreasonable view” to expect family members to devote their lives to caring for aged relatives, nor did she want to thrust that burden on poorly paid carers.

I do not promote this action for anyone who does not want it. I do not want the right to euthanize the mentally ill or physically handicapped. I ask that the Lawmakers should listen to, and respect, the views of people like me, and I am not alone in holding this view. We are being ignored by the law, which originates from a god in whom we have no belief, and which is upheld and enforced by people who have no proof of the existence of any god at all and yet still seek to impose their views on everyone else.

The case for assisted dying for the terminally ill is straightforward and undeniable, but the question is harder when it comes to people who aren’t dying but are just tired of life. I admit it gives me a tinge of unease to contemplate someone ending their life for that reason.

On the other hand, I don’t believe my comfort level should be the determining factor. I did, after all, just write that I believe each person is the owner of their own life. If someone has made up their mind that they don’t want to continue living, by what right can I or anyone else tell them that their reasons aren’t good enough? Who am I to override their will and take that decision away from them? I can’t imagine wanting to die simply because I’d gotten tired of life, but that doesn’t mean that no one could ever feel that way. People make all kinds of other choices that I find incomprehensible, but that they seem happy and content with.

I think the source of my discomfort is that, when a person is terminally ill, the decision to die has been made for them, and they’re just exerting control over the time, place and manner. But when a person chooses to die who might otherwise have lived for a long time, it’s easier to see how that decision might be mistaken. Even if a person is fully convinced that life holds nothing more for them, how could they know that? People grow and change throughout their lives, usually in ways they didn’t foresee. If they make the irreversible decision to die, how could they know that they’d never have come to terms with their situation, that they’d never have found a new equilibrium they’d never have imagined possible?

And yet, again, I come back to the principle of autonomy. People change, people grow; but at the same time, no one is more likely to know what matters to me than me. No one is better placed to be the custodian of my interests than I myself. I wonder if it might be a reasonable compromise to say that, if a person isn’t suffering from a terminal illness but maintained a desire to die, the law could institute a longer waiting period – say, a year? – to ensure that their desire is durable and not a fleeting impulse that they’d have come to regret.

But while there’s plenty of legitimate room for debate, there are also people who feel the need to weigh in with nasty, judgmental arrogance that adds nothing to the conversation. Such is this vitriolic article by Kevin Yuill, who argues that assisted dying should be forbidden because it’s “narcissism” and “a religion of the self”. He asserts, without any argument, that the choice to die comes from a mindset “that feels no obligation to the previous generations that struggled to make life easier and leave a legacy for future generations”.

Every sentence of Yuill’s post betrays a hopeless incoherence. If narcissism means anything, it means overvaluing one’s self to an extreme degree – and if someone believed that, wouldn’t they want to live as long as they possibly could, whatever the cost? If anything, it’s easier to see how the charge of narcissism would apply to people whose goal is to live forever through cryonics, although I emphasize I’m not making that argument myself.

Similarly, the usual argument against assisted dying is that people will feel pressured to die so as not to be a burden on their relatives, but Yuill asserts the opposite, that the choice to die betrays a lack of concern for others. (As people including Gill Pharaoh have pointed out, it’s actually more common for family members to urge a dying relative to fight to stay alive no matter what, even if the person no longer wants to endure more medical intervention.)

Contrary to both these contradictory arguments, I think it’s neither selfish nor self-negating to choose to die; again, for the reason that my life is no one else’s property, and the choice of whether to continue it is rightfully mine alone. No one else has the right to demand that I continue to live or that I choose to die for their sake, just as no one has the right to demand that I do or not do anything else solely because it pleases them.

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