New on OnlySky: The future of dying


I have a new column this week on OnlySky. It’s about the future of dying, and whether we should be able to take the decision into our own hands.

New York could soon be the eleventh U.S. state to legalize medical aid in dying, or MAID, for the terminally ill. Polls show the general public supports it by huge margins. However, it’s faced opposition from special interests: religious groups are against it because they believe our lives belong to God (by which they mean themselves); and disability-rights groups are against it because they fear people will be pressured to end their lives as a cheap alternative to costly medical treatment and social support.

The religious objections are easily dismissed in a secular society. The disability-rights objections, less so. Their fears aren’t frivolous, not in a capitalist society that values people primarily for how much they can afford to spend. Nevertheless, I argue that there’s a fundamental and overriding question of autonomy to consider. Can we be forced to do what others think is best for us? Do we own ourselves, and thus have the right to choose how we live our lives, including the choice to depart on our own terms – or do we not?

Read the excerpt below, then click through to see the full piece. This column is free to read, but paid members of OnlySky get some extra perks, like a subscriber-only newsletter:

If we have a freedom, we can choose how to exercise it. That choice necessarily includes the right not to exercise it. Freedom of speech implies the freedom to remain silent. Freedom of religion implies the freedom to be an atheist.

Just the same way, freedom to choose what we do with our lives implies the freedom to stop living. It’s the ultimate declaration of self-ownership and autonomy.

No one other than me can tell me what my purpose is, what brings me joy, or what makes my life worth living. If I decide—with clear mind and heart—that I no longer wish to continue, shouldn’t I have the right to make that choice? Is it fair or just to deny all people their liberty because it might be misused or abused in some cases?

Continue reading on OnlySky…

Comments

  1. Dunc says

    Do we own ourselves

    This really sets my teeth on edge every time I see it. Have our minds really been so thoroughly colonised by propertarianism that we can only conceive of personal bodily autonomy through the lens of property rights?

    We don’t own ourselves, we are ourselves. People cannot be owned. Bodily autonomy is the most fundamental right there is, without which all others (including property rights) are meaningless.

  2. Katydid says

    I agree that “owning” ourselves is giving off sovereign citizen b.s. vibes, but I understand the context you’re asking it in. As a longtime owner of a number of animals, I’ve spent quite a lot of time at the end of their lives thinking about whether an unassisted or an assisted death would be in their best interests, given the circumstances of their age/ill health. This has given me the certainty that humans should have the same rights to determine the time and manner of their own passing.

    You also didn’t cover the fundagelical insistence that God sacrificing himself to himself in the form of Jesus to atone for humans behaving in exactly the way God designed them, therefore means that humans belong to God, not themselves. That goes doubly for women, who are not only the property of God, but also the property of their father/brother/husband.

  3. billseymour says

    Like Dunc and Katydid, I’m not comfortable with the implication that people can be property; but that doesn’t refute your main point.

  4. John Morales says

    “It’s about the future of dying, and whether we should be able to take the decision into our own hands.”

    We are already able to do so, so presumably it’s about whether it’s legal in one’s jurisdiction.

    cf. https://www.iasp.info/wspd/references/

    “An estimated 703 000 people die by suicide worldwide each year.
    Globally, suicide is the fourth leading cause of death in 15-29-year-olds.”

    • Silentbob says

      Yes, Captain, the “legally” was so obviously implicit it needn’t be stated.

      What sort of monumental fool would think that sentence means ending one’s own life is impossible?

      Not for first time I ask you to think before you post.

  5. Snowberry says

    In response to Adam’s recent “AI and the post-truth era” article I made a mention of a fictional future I developed in my head (long before the current AI boom) where the ease of anyone faking evidence resulted in the development of “permacams” in the late 21st century, primarily for verifying consent and insuring that proper procedures were followed. I didn’t develop exactly how the tech worked, only that they were considered highly reliable, virtually unalterable and near impossible to counterfeit, even through the year 2156 (the “present day” from the perspective of this particular sci-fi scenario).

    However, as a side effect this resulted in a number of new ethical headaches, related to the fact where consent-related issues which resulted in blanket bannings in previous eras due in part to verification issues were now potentially on the table. Most relevant to this article, whether one could truly consent to be permanently and drastically altered or even killed in service of desires which most people would find bizarre or depraved. As an example of something which is essentially both: during the early-to-mid 22nd century there were many failed attempts to develop reversible vitrification or plasticization as an alternative to cold sleep for long-distance space travel (and cold sleep research wasn’t going so well either). One form of plasticization was not remotely reversible, but allowed people with the right brain augmentations the ability to be half-conscious and dimly aware of everything going on around them, so long as they receive a continuous weak electrical current. But this was not permanent; there was a very gradual decay in one’s mental state, becoming effectively brain-dead in 25 to 30 years.

    There was obviously some question whether that consciousness was really the same person, but even so, the technology held a lot of interest for the tiny minority of people for whom existing as an inanimate yet semi-aware object held a strong appeal. Partly in response to things like this, there was also the development of “deep brain scans” to determine whether the sort of people who would consent to such things were both truly enthusiastic and not prone to disordered thinking. (It had other uses, this is just most relevant to the subject at hand.) And if you’re wondering, the answer to both turned out to be “yes” in most cases; this particular technology ended up being banned in some countries (due to much of the public still being “unready” for such a thing to be allowed), and allowed only with rigorous permacam and deep scan verification in other countries, both of which must be filed with the government records office or equivalent. And also, in most places, required proper post-existential property transference, as someone needs to consent to taking possession to what is effectively one’s “corpse”, but getting into the issues *that* touches on would be going way off topic.

    Admittedly, this is all highly speculative. This fictional future involves a fairly specific path of technological development, and specific discoveries about the human psyche which are uncertain/unknown today – all of which may turn out to be unrealistic or wrong. A lot of the issues I explored in this setting are not relevant today, or at least not yet possible to draw any objective conclusions about. But so long as Adam continues to post articles where it’s at least semi-relevant, if no one here objects, I thought I’d share bits of it, since I may never make use of it otherwise.

  6. says

    @Dunc:

    This really sets my teeth on edge every time I see it. Have our minds really been so thoroughly colonised by propertarianism that we can only conceive of personal bodily autonomy through the lens of property rights?

    I’d argue that our bodies and our selves are the only things we truly own!

    Unlike libertarians, I don’t believe that ownership of property is some kind of natural or inherent right that predates civilization. It arises from the social contract. Nothing gives me the “right” to control a plot of land, and exclude others from using it, except that society says I can. It follows that individual ownership can (and sometimes should) be altered by democratic decisions.

    But ownership of my own body is a natural right. No one else is “in there” but me, and no one else inherently has a say on what I do with it. That’s ownership as the term is traditionally understood. I use the word on purpose because I think it effectively conveys the point to those who wouldn’t otherwise be predisposed to agree with my argument.

    More thoughts on this:
    http://www.daylightatheism.org/2022/05/if-we-dont-own-ourselves-we-own-nothing/

    @John Morales:

    We are already able to do so, so presumably it’s about whether it’s legal in one’s jurisdiction.

    Yes, as well as whether others can be prosecuted for helping you carry out your decision. That’s especially important for people who are disabled in a way that would prevent them from doing it on their own.

    • Snowberry says

      Expanding on your older writing (apologies in advance if I’m hijacking with another off-topic post) most religious fundamentalists seem to believe in what I refer to as a “chain of ownership”. If it has an actual name, I’m not aware of it. You are owned by your parents, if they’re still alive. You own your children, but in a sense they’re also not truly yours, as you’re expected to create and guide them according to the dictates of the higher levels of the chain. If you’re a woman, you fall between your husband and children, assuming you’re married and bred. Above you or your husband or your parents is the community, however that is defined. Above the community is whatever religious institution(s) claim control over that community. Above that, ideally in their view, would be the government, which is why some of them are so keen on creating theocracies (with the bonus of being able to force “unclaimed” individuals and communities into a chain). At the top is God or Allah or Brahma or whoever. No one and nothing truly owns themselves, aside from maybe the being at the top.

      So when the fundies talk about people usurping God’s role in their life or trying to be one’s own God or whatever, they’re talking about putting yourself at the “top” of your own chain. Which is not meaningfully a chain if you’re the only one in it. I would argue that this is projection; “God” is little more than an extension of their own ego, so on some level most of them do still exercise themselves as ultimate self-owner, they just really want/need to believe otherwise.

  7. Dunc says

    @Adam, OK, from reading that link I see we’re basically in agreement on the principles, we’re just disagreeing about terminology. I still think using the term “ownership” is a mistake because of the connotations it carries, but I’m not going to get into a big argument about it.

  8. Katydid says

    @7: Same. The term “ownership” for me brings up fundagelical “headship”, which is the chain Snowberry refers to–the fundy God over top of a man, and then the man, then the woman, and then the children (at least until the boys reach a certain age, where they’re above the woman). Or the sovereign citizen idea that they are free to do anything they want to including (especially including!) harming others and enriching themselves at others’ expense, yet are exempt from society’s laws and requirements.

    I also agree with John Morales that people do assert their ownership of their own bodies through suicide, which may be one reason the fundies are so against it–it violates “headship” aka Snowberry’s chain. And that might be driving the desire to prosecute anyone helping a person to exert their ownership over themselves.

  9. KG says

    Yesterday I demonstrated outside the Scottish Parliament in Edinburgh, in favour of the first stage of a bill to legalise assisted dying for terminally ill adults in Scotland. (It was passed 70 to 56 with one abstention). Later this week a similar (more restrictive) bill is coming up for another vote in the Westminster Parliament – it would cover England and Wales, and a final vote is likely in June. There were disabled people among those demonstrating alongside me, although disabled campaigners on the other side like to give the impression they represent all disabled people. AFAIK, they can’t produce any significant evidence that their fears have been realised in any of the jurisdictions where assisted dying is already legal. Many of the arguments against are so weak I find it hard to believe they are the real reason for opposition: for example that: “We should be improving palliative care instead” (why instead, not as well? – no proponent of the right to die that I know of opposes improved palliative care), and alleged worries that people will choose to die because they don’t want to be a burden on others – why would this be an illegitimate reason for doing so? And many are plain dishonest, such as the claim that sufficiently good palliative care could eliminate “bad deaths” altogether, when it is abundantly clear that it could not. In many cases in the UK, I think the concealed reason for opposition is the religious belief that your life belongs to God, and you’ve no business dying until he’s quite finished torturing you – expressing this belief would be poor strategy in the UK, although I have seen one or two examples.

    • Snowberry says

      Seems to be a very common thing in concern politics, or arguments from concern in general. It’s all new to me, so therefore it’s all new period, here are a bunch of hypothetical ways it could go really wrong… maybe we should, like, put a moratorium on things until we know it’s really okay? But in most cases, it’s not remotely new, there has already been decades of real-world testing and those concerns are overblown, incorrect, or even the opposite of true.

      Sometimes, it may not even need to be on the scale of decades to be obviously incorrect. Witness, for example, how some people kept referring to the Covid-19 vaccines “experimental” or “untested” even long after the Phase 3 studies concluded and there was massive amounts of data on how the vaccines functioned in the real world. (Though that’s not the best example, as the majority of that was people refusing to update their facts rather than suddenly becoming aware of the vaccines existing.)

      If they don’t lose the plot early on, then there will be a call to set aside what is already known, because they did not witness it becoming known, so they can’t trust the “known” to be legitimate. Or maybe it’s only known in the context of some other culture(s), we can’t be sure it’d be the same here. At least that’s what they say, but the moratorium which is called for is suspiciously lacking any real means of testing their concerns, except by accident. Some of it is genuine ignorance and fear, but said ignorance and fear is stoked by the people who *aren’t* sincere. There exist people who desperately need their concerns to be validated regardless of the truth, because being knowingly wrong means experiencing the distress of their worldview being assaulted and damaged. And there exist others, for whom the “concerns” are fake, but they know their real reasons won’t fly with the general public, so they lie… in service of some “greater truth”.

      It’s easy to say “it would be different if it actually was something new”, but not really. Giving “concerned” people as much regards as they would like still means there never being any good way to test them.

  10. Katydid says

    In the “this is why we can’t have nice things” department:

    Guy Edward Bartkus, 25, a self-proclaimed “nihilist” and “pro-mortalist” blew himself and an IVF clinic up. While the debate we’ve been discussing is whether someone should have the right to end their own lives, this guy decided if he didn’t want to live, well, nobody else should have the right to live, either. And since he had an opinion, anyone (like people wanting fertility treatments) and not hurting him in any way needed to pay the price for his displeasure. Anyone want to place bets that this is a white guy?

    He says:

    “I figured I would just make a recording explaining why I’ve decided to bomb an IVF building, or clinic,” he said at the beginning of the recording. “Basically, it just comes down to I’m angry that I exist and that, you know, nobody got my consent to bring me here.”

    Link to story here.

    • says

      That’s wild. I assumed the bomber was some anti-choice nut. I wouldn’t have guessed that he was one of those Voluntary Human Extinction types.

  11. flex says

    It’s been mentioned above a couple times that some suicides, and even medically assisted suicides, could be motivated by altruism. That is, a person feels that eliminating their own life would benefit others more than continuing to live.

    There is direct evidence that people do occasionally reach that decision, in the anti-suicide clauses in life insurance policies.

    When life insurance became popular, well over 100 years ago, the idea was that by paying a premium for many years when a person died someone received money. Originally it appears to have been intended as a kind of survivor’s benefit. If I pay $10/month when I die my wife gets enough money to live for a while, hopefully for the rest of her life. But life insurance rapidly morphed into other forms. If A loans B money, B may take out life insurance on their own life, payable to A when B dies. For example, Alice might loan Ben $20,000. A collateral, Ben agrees to take out a $200,000 life insurance policy payable to Alice or Alice’s heirs. As long as Ben makes the payments, Ben doesn’t have to pay Alice (or their heirs) back.

    But it is easy to understand why life insurance companies do not pay in the case of suicide. Because for the cost of a single premium payment, their relatives could be paid a tremendous amount of money. A man in good health in his thirties could take out a life insurance policy for, say, $200,000, for maybe only $100/year. With the expectation from the insurance company that they will collect enough over the man’s lifetime to offset the payout. This is why actuarial tables exist, to determine the risk to life insurance companies and to allow them to set their payment schedule properly.

    But if the person raises enough funds to take out a policy, makes a single payment, then commits suicide, the insurance company is out most of the money. But their beneficiaries, whoever they are, get a lot of money. The reason suicide negates the payout is because this type of self-sacrifice occurred.

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