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May 29, 2024 - 8:00pm
Philosopher and bioethicist Peter Singer has stated that he would be open to assisted dying under the right circumstances.
In a discussion at the UnHerd Club on Tuesday, Singer was asked whether he’d opt for assisted dying if he had dementia or another illness significantly affecting his quality of life. “Yes,” Singer said. “I would, and my wife would as well.”
He added that he supported the practice more generally, arguing that if a mentally competent person makes it clear in advance, then “we should respect that decision”. “You might say on balance that [a] person’s life is a pleasant one, the person is not suffering from any painful conditions,” he said. “But if, when they were competent, they say ‘I don’t want to live like that’ and you have some test like ‘I can no longer recognise my children or know who they are, and I don’t want to live past that point’, I’m inclined to think we should respect that decision”.
Singer, a utilitarian, believes ethical decisions should be made based on which course will maximise human happiness for those affected. He was decades ahead of the curve in his support for a bioethics that maximises personal autonomy and choice, and many of his recommendations, including allowing assisted suicide and surrogate pregnancy, have been implemented in recent years — to a mixed public reception.
The Medical Assistance in Dying (MAiD) programme in Canada, for example, has drawn international outcry in recent years for its liberal approach to assisted dying. Singer was not concerned about Canada’s MAiD programme, arguing that a high uptake might reflect societal problems contributing to poor quality of life, rather than the law itself. “If there were people who had lots of life left, then that would be disturbing,” he said, “not necessarily because the law was wrong, but because we couldn’t make their living conditions good enough for them to want to live right out to the end.”
Singer also maintained his support for surrogacy, saying he would accept the practice becoming universal so long as the women involved gave full consent. However, he expressed doubt about the practice ever becoming that widespread. “If the surrogates were not being exploited in any way…and enjoyed giving birth to a child and creating new life,” he said. “And they were well remunerated for it and it was better than the other options they had, I could accept that.”
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SubscribePersonally, I object to this form of “bioethics.” It is sad and unfortunate that it has come to this. Personal feelings aside…none of this should fall under the purview of “public health” or be subsidized by the general population.
So, in your view, and just to clarify, big state spending on health and social care for elderly people, who may not actually want to be around, IS justified, but the cost of the necessary legal processes, drugs etc for assisted dying (likely to be a rather smaller sum!) is not?
If you have a moral or ethical objection to some form of assisted dying then that shouldn’t have anything to do with the cost per se.
I’m not sure how you have concluded your first paragraph from T Bone’s comment. I suggest you’re strawmanning.
I think the problem is that while T Bone couches his objections in financial terms, they are in fact ethical objections, with those ethics being founded on a Christian belief system. I for my part do not begrudge him his ethics, whatever they may be founded on. However, I point out that his ethics and my ethics differ.
I’m fully aware that you reject my ethics. My argument is made for the purpose of local inoculation. In other words, I don’t want this “value system” in my locale. If people don’t make the argument against these principles than a chaotic blend of Socialist Libertarianism full of positive rights spreads and my family has to live in a community with Portland, Oregon values. I don’t believe a culture is in anyway enhanced by codifying a positive right to “Dignified Euthanasia.”
It’s about stopping the spread. I’ll live in my place. You live in yours and we’ll see what happens with inbound migration. It’s a hypothesis about which set of “principles” will produce a better culture.
I can only speak for America but when you witness people fleeing blue states for red states in droves, there is a cultural reason they are doing so.
I appreciate that we live on opposite sides of the planet, so it is a moot point, but I have difficulty in seeing why, if I should happen to live next door to you, your ethics and morals should prevail over mine. That is particularly so because I wouldn’t dream of forcing you personally adhere to my ethics and morals.
You are getting muddled up between the form and funding model of healthcare and the funding of diecare. Just because we have a stupid system of funding heathcare (the NHS) is not a reason to support diecare to reduce the cost of healthcare! The state should not be involved in either except to ensure children get a minimum level of healthcare. For the rest, we should take responsibility for ourselves – whether to live or die. Establishing the NHS was one of the worst policy decisions ever. We would make healthier and wiser decisions if we bore most of the cost of our own health treatment. (as in the rest of the developed world).
Canada
See you’re doing a Socialist cost analysis on an allegedly Libertarian issue. Why would a Libertarian policy of “Live or let die” require the State to take proactive steps to preserve your “Dignity.” The “Right to Dignity” underlies all Socialist arguments. The argument here is fundamentally Socialist not Libertarian.
Whilst Singer is (to my mind) just another voice with an opinion, it has to be said that his stance is coherent and not just based on prejudicial emotive misgivings. Citing the Canadian example is a perfect illustration of this.
Canadian policy is often cited as the “slippery slope” by those who oppose assisted death, but just because Canada has got it wrong does not mean the principle is wrong. We can learn from the Canadian example.
The principle, as he sets it out, is fully considered and humane. His position as a “philosopher” makes no difference. Philosophers get things wrong. In this instance, it is so right as to be incontrovertible.
Has Canada really got it that wrong though? I haven’t seen anything that convinces me of that. I should point out that I am Australian, and I think the Australian States have “got it right”.
So you don’t believe there could be a principled objection to a “well-run” state sponsored assisted dying program?
A person could have an objection based on their own personal principles, but I fail to see why those principles should apply to everyone else.
Laws are just a system of principles. Those principles shape culture. A sovereign state has the right to develop the culture it desires.
Do you object to tent city encampments in your local park? If so, why should “campers” be bound by your principles that demand clean, quiet public spaces? Since we’re being cultural relativists who is to say your bourgeois needs trump accommodation for the underserved and unhomed?
Now you may say the comparisons is bad because the “campers” are a visible to you and Assisted Dying is invisible to me. And that might be true if the slippery slope wasn’t an infinite regress. At some point the public health option will become a public health suggestion.
I don’t have any “tent city encampments” in my local park. In any event, there is a world of difference between saying “You can’t camp in this park”, and saying “You can’t camp anywhere, ever, because camping is morally wrong”. If it helps, if and when I choose to end my life, I promise not to do it in your local park.
Of course there can be. People can in good faith hold all sorts of opposing views on matters of conscience.
The question is whether and to what extent other people’s principled objections should impose restrictions or duties on those who don’t share those principles.
The issue is why does the government owe you a right to a “dignified” termination of your own life? Why does that need to be codified into law. The issue appears Libertarian on it’s face but its actually a socialist proposition about positive rights.
The government doesn’t owe me a dignified termination, I’m perfectly happy to pay for it myself.* It owes me removing the legal barrier to me exercise my choice of a dignified termination.
As things stand, under the Suicide Act anyone assisting me in any way to end my life in the UK would be at risk of prosecution. That would include a doctor administering or even just supplying me with drugs for that purpose.
The government has decided it knows better than me in what circumstances I would wish not to live anymore. I simply want to take that right back in very specific circumstances.
* There is of course a related debate about whether a publicly funded health service like the NHS should be in the business of assisted dying. But as I say, that’s not a deal-breaker for me. I’m happy to pay for the meds and a clinician to administer if required.
Ok so you qualified there that you wish to take that right back “under very specific circumstances.” So there is a line at which point you would say the government should step in and prevent the practice. In other words, you can see the slippery slope potential. So this isn’t a pure Libertarian argument. State-sponsored or not, you acknowledge that the practice has to be tightly regulated and monitored by a bureacracy to assure strict compliance.
This all seems very burdensome and unnecessary to codify an act that clearly requires little assistance. I’m in no way encouraging but I’m quite confident that you’re intelligent enough to figure it out if you really wanted to. And if somebody isn’t intelligent enough to figure it out or is absent mental faculties, I seriously question the ethics of allowing them to do so.
As I have said before, you live in the US. Even if you don’t own a gun, you can get one easily enough. That is not the case everywhere in the world. Also, what happens if I am in a car crash going home today, and become totally paralysed. How am I going to be able to load and fire my gun then?
“The Medical Assistance in Dying (MAiD) programme in Canada, for example, has drawn international outcry in recent years”
The ill informed screeching of the usual suspects on the far right does NOT constitute “international outcry”!
Define “Far Right.”
The sort of people who engage in ill informed screeching about the MAiD programme in Canada.
Exactly. I have yet to find a reasoned and dispassionate argument as to what exactly is wrong with the Canadian system.
They are offering death as an alternative to medical care and as a solution to homelessness and poverty. You don’t see anything wrong with that?
All I see is a gullible fool who believes everything Fox News tells him
I heard it directly from people who experienced it. in interviews.
Said the gullible whelp who believes everything CNN tells him
I haven’t seen anything that suggests that this is what they are in fact doing. All States in Australia (where I live) now have “assisted dying” legislation, and it seems to be working well. At some point, I guess I will have to compare the Australian legislation with the Canadian legislation to see if there are any material differences.
All States in Australia (where I live) now have “assisted dying” legislation, and it seems to be working well. Well, how many annoying oldies have you managed to eliminate? What’s the target? Cannot it work better? Why not include pollies in your target? I’m sure that would be popular.
I am of course not running the program, but to the extent that I would suggest a “target”, it would be ensuring that anyone who wants to access an assisted death within the terms of the legislation should be able access one. As I am in my 60s, that might even include me in the not too distant future.
You mean the Canadian combat veterans who have been offered death rather than treatment for their PTSD?
Offered death, illegally, by one employee, a ‘caseworker‘. This drew immediate and widespread condemnation (including those supportive clinically, politically of MAID)….oh, and also the frothing ire of those who want to see an absolute ban on assisted dying, and are hunting for examples of bad practice to use in their cause.
https://www.cbc.ca/news/politics/veterans-maid-rcmp-investigation-1.6663885
And it’s being defended by the ill informed (and willfully ignorant) champagne socialists
It’s being defended by me too, and I spent the vast bulk of my adult life as a committed Thatcherite/Reaganite.
Well, duh! Of course! And I agree. Same here.
There are some circumstances under which life, for me, is not worth living, and having dementia is one of them.
Giving me the option to end my life through a dignified process like MAID rather than having to kill myself is a sign of a caring and benevolent society.
I am Canadian BTW, and agree with this.
There may be cases in which the person ppting for this is making a choice I would not make, but it is not mine to make.
What is dignified, benevolent or caring about being killed by your own government?
It is preferable to being left to die a lingering and painful death by your government.
Being left alone by my government seems desirable to me.
I don’t think it is unreasonable for my government to help me out with the odd thing.
Sylvia, in Western Australia you can only apply for Voluntary Assisted Dying if your condition is likely to kill you within six months. Most likely you will be in a hospice near the end. If you convince the panel that your suffering is becoming unendurable to you and you are given the drug, you can have the staff keep it for you until you really need it. Maybe you’ll take it, maybe you won’t need it, you might just have some morphine instead. That doesn’t sound like too much government interference to me.
I also live in Western Australia, and the legislation is relatively new here. I will be interested to see how it operates moving forward.
Utilitarian arguments usually prevail, for they require not only less from us but less of us; conversely, deontological arguments usually don’t, for, alas, most humans—human, all-too-human—would rather do what’s best, as opposed to what’s right.
We don’t agree on “what is best”. The objection to suicide or assisted dying comes from the Christian belief system, which you can overtly support or not,
I don’t see, since I don’t believe in a God, any particular virtue about living as long as possible, in whatever conditions.
Absolutely correct. Various societies, over the years, have had different views on this. In Scandinavia 1,000 years ago, someone might have said “I’m getting old, and won’t be able to fight in many more battles. I will make this my last one”, and then beserker-charged 20 enemy, and been cut down. In Japan 500 years ago, someone might have said “My master is dead, there is no more place for me in this world”, and committed seppuku. The world is a different place now, but surely a good death at the end of a good life is something to be venerated?
That too is a belief system. And you’re only talking about “manly” choices.
Don’t think you think many, many older men (or women), who had a high status job, feel a bit lost when they retire? Feel a bit confronted with the inevitability of decay.
Under the philosophy that you lay out, it would seem tempting to go from top-dog to euthanasia, as one then doesn’t have to reinvent oneself at a time in life when energy and health levels might be seemingly going downhill.
Even though there might be many many ways in which you might still have a meaningfull and happy life and develop a different side of yourself post the loss-of-status anxiety.
It’s not to do with Christian morality, it is also a coward’s way out, a control-mania way out.
At the very end of life, when death is imminent, it is compassionate to ease pain and morphine often leads to death at that point.
But encouraging it at an earlier state has a higher price than the matter of shaking off Christian sensibilities.
Point noted, but I’m simply not interested in your version of “compassion” (although you are certainly welcome to apply it to yourself). All being well, I’m going out my way at the time of my choosing.
Since you don’t believe in God, I’m assuming you believe the material universe is all there is. It’s an interesting catch 22 you’re presenting, since material cosmology would say that not only do you not believe in God, it would say you’ve never heard of things like gods, or even materialism itself. A material brain can’t invent ideas of gods, or materialism, which is why dogs and trees haven’t come up with these notions.
I can’t speak for Andrew Fisher, but I for my part see no Catch 22. There is a lot more to the Universe than there seems, as physicists are continually discovering.
The post-Christian world is gradually shaping itself
Well, that is something to be thankful for!
Not exactly a bombshell; it has been going on now for at least 160 years.
Go for it Singer. The world will be better off.
“Once human life ceases to have inherent sacred value, and it becomes a matter of cost/benefit analysis, we are all doomed. These youngsters will put us down with far fewer tears than they do their pets.”
Didn’t take you long.
“Inherent sacred value”? Sounds a bit too religious for me!
Funny, Mr Singer should also be reading UnHerd, where right now there is an article titled “I was offered assisted dying over cancer treatment”, where a Canadian woman was told to get MAiD right off the bat after getting the diagnosis for the first time, not because societal problems in general, leading to poor quality of life ergo to hopelessness, but because of incompetent (or demoralized) physicians practicing in an inadequate, rigid health care system. Her life was meaningfully extended, and maybe even saved, in the much maligned US healthcare system, for a nice sum of cash, true, but she found the way to make it happen.
She was quite fortunate to have been able to raise $200,000. The US healthcare system is perfectly good if you have the means to come up with piles of money.
So…….the system worked then? It’s interesting how often people who talk about people being fundamentally resilient, independence and self-reliant, suddenly assume that everybody is going to be pressurized into topping themselves because of the ministrations of some minor bureaucrat offering them assisted dying.
BUT …. taking an entire theoretical argument, say NHS treatment of a particular condition is actually poor and ineffective, and I don’t have any money for a (possibly…) better alternative, then I still think it’s legitimate to choose death.
It’s legitimate for you to choose death at any point of your life providing you don’t leave dependents unprovided for.
Sure. Still, if you are dying of a degenerative condition, you’re probably not doing much “providing” (in a financial sense).
Those are aspirational traits that a healthy society promotes. Nobody is claiming life is easy. I’m absolutely sympathetic to the pain and suffering of others. I don’t wish suffering on my worst enemies but the idea of just “giving up” is not something a healthy society promotes. I can’t think of anything more nihilistic and regressive for a culture than elevating tragedy as liberation.
Have you ever had a dog? One you really cared about?
So why should I be left to suffer miserably, incontinent and helpless, while my dogs were permitted to go softly and quietly?
And you miss a significant point; the doctors are reluctant to let go. They might keep me alive, against my will, for years past my natural end of life.
Does my nihilism offend you so much? I never did anything to deserve such torment. And I doubt that our society would benefit from my misery in any way.
I suspect that there is a strong “Christian” thread through this. Christianity is absolutely fine with “torment”. After all, the boss of it was happy enough for his son to be nailed to a cross.
What’s this “giving up” stuff? A life is finite. Some people get a long life, some not.
Hey, I am 15yrs old and confused about my identity and am worried about the planet and humanities future. I think it would be be better for me, everyone and the planet if I ended my life. So can you help, can I do Maid or whatever? And can I take my dog with me Peter?
It should not be beyond our wits to design a system of assisted dying for adults of sound mind who have terminal illnesses, while at the same time prohibiting it for children.
After all we have similar systems for things like permitting adults to drive cars legally while prohibiting it for children.
It’s beyond the half wits! We already know the ‘adult half wits’ failed that test. You know, letting 15 yr old decide if the government should pay and allow for the health service to facilitate gender reassignment.
I certainly agree the half-wits got that wrong – though fortunately in many places the whole-wits appear to be regaining control of the wheel.
But its still possible for us to formulate laws which respect adult sovereignty over themselves while safeguarding children.
Other people can make their own choices, but I’ve watched posterior cortical atrophy (a form of alzheimers) destroy my mother over a decade.
If that’s my fate then one way or another I’m checking out at my own time of choosing. I’d prefer to do it in a safe, dignified, regulated manner which relieves my family of the stress and saves emergency services some work. But either way, I will not spend years dying by inches as my wits collapse.
Once human life ceases to have inherent sacred value, and it becomes a matter of cost/benefit analysis, we are all doomed. These youngsters will put us down with far fewer tears than they do their pets.
And who gets to decide whether a life has “inherent sacred value”? I would argue that there is only one opinion that is relevant.
The problem is that the demented person is often blissfully unaware, and would therefore not want to end it. My father had dementia, probably Alzheimers (it was in the 80s) and vey occasionally could see that he was making a fool of himself, but most of the time he was fine: life was full of surprises
My brother, on the other hand, had fronto temporal dementia, and when he died, everyone said how sad. I said not at all: his life was increasingly intolerable. He was mentally sharp but lost the ability to communicate. Towards the end he could communicate by text, but in the final stages, when I texted him, he looked at his phone and simply deleted the text without reading it. He died instantly of a massive stroke, so neither he nor anyone else had to make the decision.
we can always kill ourselves if we want it enough. Simply stop eating and drinking. You need to be strong enough, of course, and not have anyone force feeding us.
We can always kill ourselves by putting a round of 9mm through our skulls. It seems easier and quicker to me.
If I say now I would rather be dead than have dementia I’m saying not knowing how I’ll feel with dementia. I’m old enough to know what I think I’ll think, feel or act in unknown circumstances is not always close to reality.
So if I change my mind and decide dementia, for me isn’t so bad; what if I quite like looking forward to Tellytubbies and watching bees in the garden?
I don’t know. Mum had dementia and it was horrible. Her death was in part a release for us and maybe for her, too. Certainly I’d lost her already. But maybe it wasn’t a release for her. She fought to the end and was sparring with anyone who’d spar with her up to her death.
As I say I don’t know, but I have problems with the idea that I’m bound by something I said before I knew the reality.
If you have dementia, and like watching Tellytubbies and bees in the garden, I for my part will support your right to do so. However, I doubt I will be joining you in doing so.
Very well put. We are obsessed, to a degree of compulsion, with control. When we give the elderly palliative care, when we give them morphine and they die, that can be compassionate. But all the planning and boundary setting beforehand seems to be an emanation of ever increasing mechanistic thinking applied to human life. We don’t know who we will be when confronted with dreadful prospects.
Some people get lucky (usually, I think, if they have a supportive extended family) and enjoy Teletubbies and bees. Others – from what I can see – live in a terrifying, incomprehensible world that seems to have turned upon them.
The medical form of dementia probably matters a lot. If it’s just the IQ getting bashed out of your cortex due to microbleeds or something, you likely do better than with some systemic disease that destroys central brain systems.
I saw a film called Ibelin recently. If you get a chance see it. It’s about a Norwegian boy with one of the cruellest illnesses you could imagine. You will cry.
There didn’t seem much point to his existence. Except there was, in ways his family had no idea of until after his death.
Would it have been better if he had never been born, or if he had accepted an offer of assisted suicide?
I know the answer to that one. No, it wouldn’t have been.
I haven’t seen the film, so I can’t directly comment, but I will say this: Whether or not the boy in question was born or not is something he had no control over. Whether he accepted an offer of assisted suicide or not (assuming one was made) was his and his alone (assuming he was an adult). I don’t see the relevance of your opinion on the subject.
Do we actually know that “assisted dying” is a quick and painless way out? Some take 24 hours to die and who knows what is going on inside their heads and bodies during that time.
If it takes 24 hours to die, someone has done something wrong.
Miss you in Heaven ….Suicide is not an option. When your number is called you will go. Sit tight and let God decide. You disagree, your call, but you miss the arrival welcome, meeting Peter and negotiating at the Gate. Hanging in the arrival processing area where you learn the “no more body is needed” situation and other cool stuff. Live out life and get ready to really meet enjoyment….
This may surprise you, but some of us have “met enjoyment” in this life.
We’re not the same person 20 years later. We’ve all heard it said “I don’t want to live when I’m no longer recognisably myself.” It matters not whether one ends up with dementia or not, one ought not to be able to bind the different person one will be 20 years hence by a decision made today. Indeed, one cannot do so unless one’s future self does have dementia. One’s future self is not bound by end of life decisions made today, one can change one’s mind at any point. Unless one has dementia. But this is wrong: The contented dementia sufferer ought not to condemned to death by the person who previously occupied the same body.