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John Stuart Mill and the Right to Die

The consistency of individual autonomy, as Mill outlined, indicates that just as we can live as we wish (with certain constraints), we ought to be able to die as we wish, too.

Today is human rights day in South Africa. This piece seems to me appropriate, given that I think the right to die should be the next step in universal human rights.

A British man, Tony Nicklinson, wants to die. In 2005, Mr Nicklinson suffered a stroke that has left him with “locked-in syndrome”. This syndrome is, according to the National Institute of Neurological Disorders and Stroke, “a rare neurological disorder characterized by complete paralysis of voluntary muscles in all parts of the body except for those that control eye movement.” Mr Nicklinson is only able to communicate through a perspex board, which interprets his blinking. He wishes now to end his life “lawfully”, because he considers it “dull, miserable, demeaning, undignified and intolerable”. He is, therefore, seeking protection for any doctor that aids him in suicide. At the moment, the case is proceeding after a ruling from a High Court Judge

Killing, whether oneself or others, is obviously a difficult topic. We cannot so easily dismiss it as merely a private affair of the individual, nor place it within the domain of government to restrict people from doing so. What we can be certain of is that each case demands its own engagement, looking at the facts, the evidence and the arguments. The imposition of outrage, premised on vague notions like dignity or sanctity, are at best unhelpful and at worst harmful.

What Mr Nicklinson’s case demonstrates though is the inconsistency of state interventions on individuals’ activities. Furthermore, Mr Nicklinson’s reasoning of banality and incapability – as a functioning adult – confirm findings in euthanasia research that indicates these as being the most common reasons for wanting euthanasia (or, in Mr Nicklinson's case, doctor-assisted suicide though I'll use "euthanasia" in this post) – it is not, as many people think, merely physical pain or the inevitability of death.

Destroy your lungs but don’t kill yourself

We’ve noted previously that John Stuart Mill's Harm Principle seems to be tacitly in place in Western societies, when we allow others to harm themselves through personally chosen activities: from smoking to rock-climbing. As Mill noted: “the only purpose for which power can be rightfully exercised over any member of a civilised community, against his will, is to prevent harm to others. His own good, either physical or moral, is not a sufficient warrant.” When it comes to Mr Nicklinson’s case, we have a strange inconsistency: our principle that allows smokers to destroy their lungs disappears when it comes to the idea of ending the life we’ve otherwise allowed to be harmed. We allow a person to slowly or quickly destroy his life, but we don’t allow him to end it – even when the choice is determined by that same person.

Who else, rather than Mr Nicklinson, should decide how he should live or, indeed, whether he should live at all, when he is capable of communicating and contemplating this choice?  It is true that we ought do all we can to provide him with reasons to live, since this amounts to giving more information with which he can make a more informed decision: the more information one has, the better decision it will be. This is not coercion but making available more evidence so that Mr Nicklinson is able to exercise his autonomy.

As we noted, we have no good reason to stop him from performing a self-harming act, unless it unnecessarily and excessively harms the lives of others.

To take an extreme but not uncommon example, a good reason to prevent someone from suicide is because of the young children he or she will leave behind, who cannot look after themselves. Even here, though, we have to ask if we really want children being looked after by a suicidal person. One way of responding that I can see, instead, is a good reason to remove the children from the parent so that he or she can die in peace – safe with the knowledge that his or her children are being looked after.

Indeed, each case where we prevent a rational, competent adult (also assuming this person isn't temporarily insane, depressed and so on) from committing suicide because of loved ones is usually a reason to indicate to that suicidal person that he or she ought to make sure their loved ones are looked after before “exiting”. There is no definitive, all-encompassing response or reason to prevent a rational, competent adult who wishes to commit suicide from doing so. This doesn’t mean we give up, it merely means we accept whatever his or her choice is after, as Mill put it “reasoning with him, or persuading him, or entreating him but not … compelling him.”

Accepting the conclusion

I do not think death is essentially a harm and, indeed, consider Mr Nicklinson’s a benefit, if that is what he wants. Regardless of my or your view, we must remember that we live in societies that allow people to destroy their lungs, livers and lives in general. They can do so because we respect individual freedom.

Why then do we say it’s fine for a person to destroy his lungs, drive extremely fast cars, drink excessively, but not end his life upon his choosing, with his full consent, and painlessly? This is a violation of the very principle that allows us to live freely. We become hypocritical.

If we want our citizens to live as long as possible, then we cannot allow for smoking and these other activities (indeed, we should ban almost all red meat if we want healthier, longer-lived citizens); if, however we say others should be allowed to destroy their bodies, because choice matters more than presumed beneficial paternalism, then we have to ask why an informed, important choice like the right to die is removed.

Mill was aware, as am I, that this principle might be construed as overtly self-focused and unconcerned with the lives of others. But that misses the point. In a later chapter of On Liberty, Mill writes:

“It would be a great misunderstanding of this doctrine to suppose that it is one of selfish indifference, which pretends that human beings have no business with each other’s conduct in life, and they should not concern themselves about the well-doing or well-being of one another, unless their own interest is involved. Instead of any diminution, there is a need for a great increase of disinterested exertion to promote the good of others. But disinterested benevolence can find other instruments to persuade people to their good than whips and scourges, either of the literal of the metaphorical sort.”

It is for the good of all that we assess the consistency of our application of freedom. In cases where we allow people to destroy their lives but not end them, we are incredibly hypocritical if we can provide no good reasons why a private decision, made autonomously, should be impeded. We’ve noted even when there is a possible harm to others, this is also not a definitive – despite it being the most compelling – reason to prevent them from killing themselves.

I predict that many will mount the usual and/or refuted arguments of the dangers of euthanasia. But if you do, I ask you to keep in mind two things. Firstly, ask yourself whether those arguments actually apply to Mr Nicklinson’s individual case and, secondly, whether the choices of others should trump Mr Nicklinson’s choice to kill himself (with doctor assistance).

Image Credit: Zsolt, Biczó/Shutterstock

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