It was with sadness that I read that Professor Sean Davison, the founder of the right-to-die organisation Dignity SA, who recently appeared in court, was charged with premeditated murder and released on bail of R20 000. He is accused of assisting in the suicide of his friend, Dr Anrich Burger, who was left quadriplegic after a car crash.
As we know, (medically) assisted suicide is illegal in South Africa. However, a growing number of people are asking for its legalisation, as it is a human and constitutional right.
Post-modern people, for understandable reasons, want greater control over the duration and manner of their death – especially when such a person is terminally ill or in a state of irreversible and unbearable physical pain. Where this is not made possible for people, they could rightly argue that it affects their dignity, and may be regarded as a lack of compassion for their situation.
They may think that their life, which has actually become a burden because of suffering, is not sufficiently taken into account by lawmakers. Denying assisted suicide can be deemed crueler than to help someone die naturally and supportively.
For proponents of personal autonomy, like Davison and others, a competent person has the moral right to take his or her own decisions on life and death under certain specific circumstances. Such an approach should not be considered illegal, irresponsible or selfish.
We know there are religious objections against assisted suicide, but it’s important to ask: can religious objections against assisted suicide be normative in a secular society? Shouldn’t everyone be given the freedom of choice in this regard?
We don’t live in a religious state, but in a constitutional democracy, which aims to find a balance between individual and societal interests based on ethical reasoning.
Furthermore, not everything contained in legislation is necessarily ethically correct. A situation or situations may arise in which an ethical belief or conviction challenges legislation, which maintains a particular practice, in order to decriminalise it.
Retired United States Supreme Court Justice Anthony Kennedy once said: “Times can blind us to certain truths and later generations can see that laws once thought necessary and proper in fact serve only to oppress … [P]ersons in every generation can invoke its principles in their own search for greater freedom.”
For the last 24 years in South Africa we have been brave and progressive in terms of social reform. Think of the repealing of the death penalty and liberal legislation regarding abortion, despite opposition from different resorts. Why shy away regarding end-of-life decision making?
Is it ethically acceptable to keep life going if that life shows no apparent life function and quality of life anymore? Where there are only biological functions, and no more personal life? Why can such a person under strictly regulated medical-ethical circumstances, in line with a Bill of Rights, not be helped with the dying process?
In this regard, the possible abuse of such practices are often raised, but, all practices are subject to abuse. Just because something can be misused does not necessarily make it bad. It only requires careful regulation.
Willem Landman, executive committee member for DignitySA, points out that, according to research during the last two decades in the United States, people’s initial fears about especially the abuse of end-of-life decisions were unfounded.
We know that life must come to an end, and that someone could get to the point where life is no longer good and death is no longer bad. And where death can be chosen over life. Should the role of medicine under such circumstances not change from healing and prolongation of life to rather aid someone to die in compassionate and respectful ways?
People exercise autonomy over their body and healthcare right through their lives. Why should it be taken away from them if they are dying? No one should be forced to end up suffering.
We have a moral and constitutional right to life, but there is no overriding obligation to stay alive at all costs.
Each one of us has a moral right to a peaceful and worthy death. Free of unbearable (terminal) pain and worries. Consequently this makes certain “end-of-life” healthcare interventions possible.
Why can’t everyone choose his of her own “moment” – the right to decide on the value of life and death for him or her?
Under certain specific circumstances, human beings can claim to be provided with the necessary means to end their life or to have their life terminated. And people who have the need to assist someone with this should be granted the right.
We have nowadays a lot more control over death and life than before. Life does have high, but not absolute, value.
Restrictive legislation in this regard leaves some terminally ill patients in unbearable pain, and supporters of assisted suicide helpless and despondent.
South Africa has a progressive constitution. Can the cornerstone of a civilised society really depend on the upholding of laws that regard meaningless pain and consequent sadness higher than a life to ethically acceptable self-determination and dignity?
If assisted suicide would be legalised, it should of course be in line with strict medical ethical requirements that must comply with international law.
• Dr Chris Jones is an academic project leader in the Department of Practical Theology and Missiology at Stellenbosch University.