Medicine, morality and magnanimity in death

Paul Monk / 12 November 2014

Three stories show there is a civilised way to bring about a dignified death through voluntary euthanasia.

Source: Medicine, morality and magnanimity in death

In May this year, in these pages, Peter Short wrote a forthright opinion piece declaring he was dying of oesophageal cancer, had a supply of Nembutal and would end his own life at a time of his choosing. In January this year, his doctors gave him six months to live. He is still very much alive and is campaigning vigorously for the passage of legislation that would make it easier for people to do what he declares he will do: choose the manner and timing of their own deaths over medically protracted indignity and suffering.

I am writing to add my voice to the chorus calling for this serious matter to be addressed in such a way that we can create a new and better code of civilised norms around suffering, medicine and death. I am not terminally ill and I do not have a supply of Nembutal. I do, on the other hand, have metastatic melanoma. That means that my health and general viability are an ongoing experiment, at the cutting edge of current medical science. The debate about euthanasia hovers – and must be conducted – at the cutting edge of moral philosophy.

We dwell, I think, more in stories than in systematic arguments when it comes to death and dying. When I contemplate the possibility of freely embracing and actively triggering my own demise, three stories are foremost in my mind. Two of them are historical and of those, one far better known than the other. The third is from a highly popular work of fiction by a devout Catholic writer and all the more remarkable for that reason.

The first story is that of the death of Socrates, in 399BCE. (I write BCE, Before the Common Era, not BC, before Christ, since this is a moral dialogue in which only some of us are Christians). He was condemned to death by the state for corrupting the youth and encouraging atheism. His friends urged him to escape and flee Athens. He chose instead to take his hemlock and pass away. Was he wrong to do so? He famously remarked, as his vitality ebbed away, that he owed a cock to Asclepius – as if his death had cured him of an illness. Certainly, he died with lucid dignity. Bettany Hughes provides a fine account of both his life and death in her 2010 book The Hemlock Cup: Socrates, Athens and the Search for the Good Life.

The second story is one related by the Roman historian Tacitus in Book XI of his Annals of Imperial Rome. It concerns the death of a wealthy Gallo-Roman aristocrat, Valerius Asiaticus, whose opulent villa and gardens were coveted by the dissolute Messalina, mistress of the Emperor Claudius. She had false charges of treason brought against him and he was condemned to death, but was permitted to choose the means of his own demise. The historian recounts "he took his usual exercise, then bathed and dined cheerfully and ... opened his veins, but not until he had inspected his funeral pyre and directed its removal to another spot, lest the smoke should hurt the thick foliage of the trees. So complete was his calmness even to the last."

The third story is buried in Appendix A to J. R. R. Tolkien's The Lord of the Rings. It concerns the voluntary suicide of Aragorn, 120 years after the fable ends. Having lived a long life, he announces to his beloved Arwen that the time has come to lay down the gift of life and leave the throne to their son. She begs him to linger with her and not go before his time. His response is remarkable: "Not before my time," he answered. "For if I will not go now then I must soon go perforce ... Take counsel with yourself, beloved, and ask whether you would indeed have me wait until I wither and fall from my high seat, unmanned and witless. Nay, lady, I am the last of the Numenoreans and the latest King of the Elder Days; and to me has been given not only a span thrice that of Men of Middle-earth, but also the grace to go at my will and give back the gift. Now, therefore, I will sleep."

That phrasing is worth dwelling upon: "the grace to go at my will and give back the gift". That, I suggest, is the tone in which to think about our ends – not a tone or language of fear, anxiety and a ban on choice. But all three stories inform my sense of what it could mean to voluntarily bring an end to one's own life and to do so in a dignified manner. Should I reach the point where an ending seemed more dignified than enduring, it is stories such as these that I would bear in mind.

The chief source of our ban on voluntary euthanasia  is in the Catholic tradition, dating back not to scripture, but to St Augustine. He rejected the Stoic and the Epicurean approach to free death. Yet Tolkien, a deeply moral Catholic, had one of his most exalted figures choose to lay down the gift of life simply in order to avoid the infirmities of old age. He was being neither frivolous nor sinister. He plainly conveys, in his telling of the story, the sense that this was a lofty freedom available to the "latest King of the Elder Days" and that it made good sense.

The need, in whatever set of laws we frame around medicine and mortality, is for civilised norms. All three of these stories, I believe, show that voluntary death can be experienced and conducted according to civilised norms. At the very least, they exhibit norms in which the emphasis is on choice and dignity, not a fearful ban on freedom of action. That is the spirit in which we need to frame our laws. That is the calmness and dignity we need.

All the more reason.

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