During the discussion, I argued that it would be irrational for the Scottish Parliament to support the legalisation of state assisted suicide while at the same time supporting the Scottish Government’s Suicide Prevention National Action Plan.
This seeks to reduce the very high number of suicides in Scotland including amongst relatively young persons. But during the question time, at the end of the debate, one of the students commented that she could not understand or accept how I could consider the prevention of suicides amongst young people as being similar to the prevention of suicides amongst elderly or disabled persons. On hearing this comment, however, I must confess that I was quite shocked and dismayed. I had never expected such a blatant ageist and ableist statement from a university student! Was this how many young people now considered elderly or disabled persons in Scotland?
In addition, I could not comprehend how the student had come to such a conclusion. Was it because modern society only recognises a good life by the amount of pleasure and lack of suffering it experiences? If it is, then the belief that a life can become unworthy of life and should be ended is indeed rational.
The expression of a life unworthy of life was coined in Germany in 1920 by the law professor Karl Binding and psychiatry professor Alfred Hoche. It then became a slogan used between the 1930s and 1940s in this country to defend the belief that if a person becomes unable to enjoy life, then his or her life could be ended. But when the German government, at the time, also accepted the principle that certain lives were unworthy of life and that all lives were no longer absolutely equal in value, this then had catastrophic consequences. Indeed, it meant that some lives could be seen as having less worth than others, which eventually resulted in barbarity and the killing of many different kinds of persons. As a result, Scottish society through its parliament should avoid being naïve or gullible when considering the consequences of accepting that some lives are unworthy of life and that assisted suicide should be legalised.
Of course, because a life is seen as belonging to an individual, it could be argued that he or she should be able to decide for himself or herself whether it is a life unworthy of life. But for state assisted suicide to be possible, those around this individual (including society as whole) would also have to accept that this life is indeed unworthy of life so that they can assist in ending it. In other words, it would mean that the equality of all human life is, for the first time, no longer accepted by society. Thus, if a parliament legalises assisted suicide, the very basis of the equality of all lives on which this parliament is built would become a thing of the past. It would also mean that the protection in compassionate care of those whose lives are difficult or who experience suffering would become meaningless. Instead, it would be seen as preferable if the lives of such persons, considered to have unworthy lives, were ended even though appropriate palliative care may be available.
In conclusion, Scottish society can choose between absolute autonomy (enabling persons to believe whatever they want about the value of their lives) or absolute equality (enabling person to believe that all lives are equal). But it cannot have both.
Dr. Calum MacKellar, Scottish Council on Human Bioethics