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Well Done To The Dutch For Increasing The Primal Terror Of The Elderly

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It is, clearly, possible to have different attitudes towards euthanasia. Given that different people do have different attitudes this must be so. My own is based upon that logical error of the slippery slope. Once it is accepted that the hastening of death – rather than mere palliative care which might then tip over – is acceptable then death will be hastened without quite enough consideration.

As at Gosport Hospital, where at least 600 were tipped over the edge into their graves shows. Or the Liverpool Pathway did, where even a sip of water was to be denied in order to hasten death by dehydration. Or, where people are more enlightened on this subject, Holland.

We might recall that case from a couple of years back. A woman signed up for euthanasia if ever her mind went. It did. When the time came though she fought back against the injection. She had to be held down, screaming, and then that didn’t work. So, therefore, the doctor spiked her drink, she was then, umm, euthanised.

Yes, OK, compos mentis asked for death if not compos mentis and we can’t take her non-compos mentis feelings as being indicative of her considered thoughts. So, strap her down, or sedate, and kill.

The bit that we might need to consider being that the instinct for self-preservation is pretty hard wired into us, fairly instinctive. It’s very likely to be something that survives non-compos mentis-is. Actually, highly likely that it will survive such. There is also no switch that goes from compos to non-. It’s a process, a Sorites one. It’s actually likely that the considered decision is an early part of the mind to go, the unconsidered and instinctive the one that remains.

That is, the thing that gets killed is likely to be the version that doesn’t want to be killed – the very mental degradation being what causes that.

Anyway, so, the Dutch, given that case changed the law:

Doctors euthanising a patient with severe dementia may slip a sedative into their food or drink if there are concerns they will become “disturbed, agitated or aggressive”, under a change to the codes of practice in the Netherlands.

The review committee for cases of euthanasia refreshed its guidance in response to the case of a former nursing home doctor, Marinou Arends, who was prosecuted for murder and cleared after putting a sedative in her 74-year-old patient’s coffee before giving a lethal injection.

Leave aside my views on this whole process- that it’s an abomination – and consider what now happens. Those confused and degrading minds might well – I would say will but I’m an extremist – fixate upon someone doping their evening cocoa. To the detriment of their remaining lived experience of course – that concentration of the mind upon being hanged in the morning might become somewhat stressful if it lasts for months or years as that mind comes apart.

Which leads to that 16 year old story from Natalie Solent:

However, here is an anecdote, told to me first-hand, which demonstrates that legalised euthanasia on the Dutch model affects the quality of life of old people in ways that the “beautiful death” campaigners did not anticipate.

A decade or so ago a member of my family was living in Holland and working as a care assistant at a Dutch old people’s home. (She speaks Dutch.) She told me that when the time came to give some of the old men and women their medicine they would occasionally react with terror. “No, no,” they would cry, “not the pill!”

What some cried aloud many more, particularly those whose minds were failing, must have feared in silence.

The killing of those without minds creates a long lasting fear in those losing them. This is not a reduction in human suffering.

Discuss.

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17 COMMENTS

  1. Re: the slippery slope, I remember reading about a European country that legalized euthanasia with all the appropriate safeguards – only for those who asked to be euthanized with a terminal illness, terrible suffering, etc. After a few years they found that doctors admitted in anonymous surveys that they were euthanizing patients who didn’t ask, but the doctors thought should have.

  2. Also re: slippery slopes, someone wrote an article arguing that we shouldn’t worry about them (might have been the great Matt Ridley). They gave several examples that went like this “people said if we did X it would lead to Y, but now that we’re doing Y we think it’s fine”. Basically proved that the slippery slope argument was valid.

  3. Looks very plausible to me. In these circumstances it would be more rational to worry that someone is trying to dose you up than not to, and if you’re paranoid already, well how could you not? Provided you can demonstrate the slope is genuinely slippery and hence “the vision you’re arguing for is not what will happen, since there’s no way the line will be held at that point” I’m not even sure the slippery slope should count as fallacious. I don’t think on its own this is an overwhelming argument against euthanasia but anyone who signs up to that agenda needs to mull over just how far they’re prepared to get onboard with.

  4. “Slippery slope” isn’t an argument from logic, it’s an argument from observation and lived experience. Obvious examples from the UK are abortion and homosexual acts, and (currently ongoing) transgender issues.

    • I certainly agree that the slippery slope exists. It’s why I’ve voted no in every referendum since I foolishly agreed to allow the Commonwealth rather than the states to make special laws for aborigines.

      As for euthanasia, naturally most people will most likely change their minds. Must admit I dither on this one. I can think of many conditions in which I would now definitely demand the needle. But knowing me, I’d be bound to balk and scream ‘No, no, a thousand times no.’

      Perhaps it would be kinder to give everyone the option to twist the tap on the morphine drip. You might well feel a little more would make you feel better. But too much morphine is definitely lethal.

  5. Surely though. This is the reason for choosing voluntary assisted euthanasia. That is a rational decision. But the body doesn’t make rational decisions or one could just stop breathing, whatever,. Wouldn’t need the assistance.
    Let’s say you’d gangrene in your leg & needed it amputated to save your life. Now try & saw your own leg off. Not easy, eh? You might want to lose it but your body wants to keep it. It produces the pain signals, deters you from doing it. You need a surgeon.
    If the person’s made a rational decision to be terminated if they become permanently irrational you can’t use the reason that they’ve become irrational to deny. This nothing about their wishes & all about yours.

    • The issue here, as Timmy identified, is continuity of personal identity. Is the “you” that signed up to euthanasia the same “you” that right now is actively objecting to it? And should the wishes of the past-you, who by this stage has been and gone and probably is never coming back, override the wishes of the current you? As Timmy also identified, this is made trickier by the fact “rational” versus “irrational” are not entirely binary, and people tend to slide from one state to the other. Even people with quite severe dementia often have some elements of free choice in what they “want” to do in a day, and if being bumped off isn’t one of them, then well… It’s distinct from cutting off your own leg. Because that leg is still “yours”, still part of “you”. The body resists but “you” know right then it that moment it needs done. And when it’s over “you” will be glad of it. A “you” without a leg, but basically the same “you” for the relevant intents and purposes.

      The question of whether you can make a binding contract with your future self is an interesting one, often studied under the name of “Ulysses pacts”: https://en.wikipedia.org/wiki/Ulysses_pact

  6. The problem with the slippery slope argument is that all sorts of slippery slopes with all sorts of things. You’re effectively at the bottom of another one. That society chooses to deny its members their personal choice if it doesn’t like the choice.

  7. Therefore we shouldn’t put pets ‘to sleep’ when they are suffering in case that’s the start of a slippery slope for humans?

    • That’s a less convincing one, because it’s possible to maintain a society which puts pets to sleep in a rather proactive way that isn’t applied to humans. That’s as weak an argument as saying we should ban eating other mammals in case it’s the start of a slippery slope to eating other humans. To apply the slippery slope argument well, you need to demonstrate convincingly that the slope is genuinely slippery and that the near-inevitable destination is a place we might be more uncomfortable with. If you don’t have any issue with sedating someone who (in that moment) has no wish to be euthanised, so that you can give them a lethal injection, then that “we’ll be uncomfortable with the destination” part doesn’t apply, but that has quite a lot to do with your personal values and others may indeed be less comfortable. If you don’t think it’s inevitable we euthanasia for those actively seeking it is near-inevitably going to be extended to those who don’t, in that moment, want it, then you’re disagreeing that the slope is slippery. But I think Timmy has a reasonably clear case for why he think it will be – dementia being common in the group under consideration, indeed a real cause of fear of not being in control of one’s own death, but also that it’s a matter of degree and possible someone could sign up for euthanasia while “fully sane” and then rescind consent while in a not-quite-sane, not-quite-doollally midway point. That plus the fact we can see this process happening in other countries that have gone down this route makes slipperiness at least a plausible argument, in my view.

      • Thank you for your reply which built well on my ‘argument from absurdity’. I’d point out that even if you accept that there is a slippery slope there is often no debate about how many cases will slide down it. In the end there should be a debate about risk and benefit. How do you balance the individual’s desire to escape unavoidable suffering against the collective desire to avoid (1%, 5%, 10% etc) being blamed for a poor decision? Or against the ‘every life is sacred’ brigade when observation of daily life will show that every life is actually not sacred?

        • An interesting aspect of Timmy’s argument is not so much the harm caused to those who are subjected to euthanasia while unwilling (whose numbers are likely to be limited and where the issue of harm is at any rate disputed) but the harm it does to the many others who will now have greater distrust and fear of the people who are – supposedly – caring for them. Perhaps that’s a hypothetical harm but I for one don’t wish to live in a society where I have to worry about people trying to kill me when I’m not up for it and having the full force of the law behind them. (That’s a point in itself – if a patient was very suspicious and started lashing out, would they call in a security guard or even a cop to restrain them so they could be killed against their wishes? Hospitals do call in the heavy infantry with surprising regularity so it’s at least possible – and again a place I don’t feel comfortable going.)

  8. I sometimes wonder in the case of dementia-type conditions if there is a rational core that is somehow blocked by the demented sections of the brain but the person is fully cognisant of what is happening – a neurological version of the locked-in syndrome. It could explain the occasional interludes of lucidity as the dementia barrier temporarily breaks down.

  9. This article gives examples which prove why legal euthanasisa is essential. People have a strongly held belief that there is a level of suffering that should not be endured and they will kill others in an attempt to assist them avoiding it. In the absence of legel euthanasia, they will decide for themselves who wants to be killed ane people who suspect that this has happened may well help cover it up by ignoring it. Legalistion can make it essential to obey the wishes of the patient.

    The slippery slope is in the opposite direction to how it is usually described. Once you accept the principle that a person’s view on their own death should be disregarded if they say they want to die, it’s so much easier to disregard their view when they say they want to live.

    If you’re afraid of being a victim of involuntary euthanasia you should vigorously support legal euthanasia and declare you don’t want to avail of it.

    • This argument has some strong points – if it’s inevitable that some “mercy killings” will occur, then a legal framework may have a protective effect on the centrality of patient consent. But I think it’s wrong to take an either/or approach to the “slippery slope”. Why not just acknowledge there are two slopes? The fact that outlawing euthanasia can lead to health practitioners doing it anyway in a way that doesn’t respect consent is one slope but it doesn’t obviate the slope that legal euthanasia catends to extend in scope over time in such a way it is not “essential to obey the wishes of the patient”. People who prefer that euthanasia be illegal generally accept a certain amount is inevitable (perhaps desirable!) even if theoretically criminal, but hope/expect this will limit it to edge cases usually very near the point of death by other causes, whereas legal euthanasia means edge cases may be more widespread and often take place years or even decades before death would otherwise occur.

      • I suspect that there were people who know one of Harold Shipman’s many (about 250) victims and suspected their death was unnatural, but assumed it was because of some painful illness kept secret due to the lack of legal euthanasia.

        But ultimately, a person’s life should be their own. We are not slaves or livestock owned by society and should be free to choose for ourselves. When people are sufficiently fit and healthy, they can and there is no shortage of suicides. To take that choice away from those unable to do it for themselves is a shameful and cruel exploitation.

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