Is there a duty to die?

Baroness Warnock, a leading British medical ethicist, has publicly asked a question that many people, philosophers and lay people, have been pondering privately: “Is there a duty to die?”

Solidifying her reputation as a “philosopher provocateur”, Lady Warnock, a long time advocate of euthanasia, whose previous work has included investigations of fertility treatments, and special education for disabled students, dares to say what has previously been unspeakable. According to an interview earlier this month in the Times Online:

“If you’re demented, you’re wasting people’s lives – your family’s lives – and you’re wasting the resources of the National Health Service,” she said.

“I’m fully in agreement with the argument that if pain is insufferable, then someone should be given help to die, but I feel there’s a wider argument that if somebody desperately wants to die because they’re a burden to their family, or the State, then I think they, too, should be allowed to die.”

No one could accuse her of being reticent. The Baroness elaborates:

“With 700,000 people suffering, it really is a problem that has got to be faced. The fact is we have to take a fairly unsentimental view. Care may get better, but if so, at huge cost. There’s no point saying we ought to spend more, because we can’t.

“People talk about it as if the only respectable motive for wanting to die is for your own sake. But it seems to me just as respectable to want to die partly for the sake of others, and for the sake of society.”

The Baroness gets to the heart of the matter and does not flinch:

“If society has an obligation to look after them, I really want to know what for? For whose benefit? It’s not for the benefit of society, as the person is not in a position to contribute, and it’s not for the benefit of the person, so it must be something abstract about our being unable to bear saying ‘We can’t do this any longer’.

“If I were in a state of acute misery or pain, or an insufferable degree of dependency, I don’t see why I should feel an obligation to others to let them keep on changing my nappies.

“It sounds very callous, but most people I know dread being kept alive in a state of mental incapacity, more than cancer or anything else. If so, then I don’t see why society should force them to go through with something they fear the most.”

Not surprisingly, Lady Warnock’s comments have ignited controversy. Her comments have been vehemently criticized by Alzheimer’s associations, Right-to-Life groups, and politicians.

I do not agree with the Baroness’ claim that there may be a moral duty to die, but I think she is asking the right questions about the way that the senile elderly are being kept alive at tremendous cost, both financially, and also psychologically, to family members and care givers. She puts is quite succinctly:  “If society has an obligation to look after them, I really want to know what for?”

We need to ask ourselves the same question in the US. Does anyone benefit from our perverse insistence on indefinitely extending the lives of the senile elderly? Are we fulfilling the wishes of the elderly people involved? Would they want to be kept alive, incapacitated, incontinent, and incapable of participating in the most basic tasks or social interactions? It’s difficult to imagine that anyone would want that.

And if we are not keeping these people alive for their own benefit, are we doing it to satisfy ourselves of our own moral values as a society? If so, do we have any right to use other people in an effort to make ourselves feel better?

Does it make any sense to spend a major proportion of the healthcare budget on people who are virtually insensate and will never recover? Does it make any sense, financially or morally, to divert resources from young people, who may not even have access to the healthcare system, to elderly people who have already received a lifetime’s worth of benefits from that same system?

There are no easy answers to these questions, but Baroness Warnock has done a service in raising them. It is long past the time where we should examine the rarely examined principle that the lives of the senile elderly should be extended indefinitely by the continuous use of vast amounts of human and financial resources. The Baroness has gotten to the heart of the matter: “For whose benefit?”