Leavetaking: In dying, we are denied the right to self-determination

My life is my property. I lease parts of it – selectively – to other people. I share my life with others, but never unconditionally. If someone mistreats me, I have the right to leave – a job, a relationship. When I opt out of any of those, I still have myself, and the right to self-direct.

Except that I don’t, really. Not fully.

A background in philosophy has acquainted me with just what a murky pool the world of moral decisions is. For many people, moral issues are black and white, but, with some unemotional examination, they rarely remain that way. Almost everyone (except, presumably, those people convicted of the crime) would agree that it is morally repugnant to kill a baby. Even those words – kill a baby – will make people flinch.

But when does a fetus become a baby? Is it a baby before it has a brain and a nervous system, or after? Is it a baby when it is the size of a full stop, or only when it might feasibly live independently outside the womb? And at what stage should the rights of the mass of cells growing inside a woman’s womb trump that woman’s right to self-determine?

In Ireland, we have decided that the woman’s right to self-determination is null immediately upon conception. Before the fetus is even a fetus. When it is a zygote – a mere potentiality to life rather than an actualised life (which the woman carrying it is) – we limit the woman’s rights to her own body. No, we tell her. There’s something more important than you going on here.

Myopic mysticism

Perhaps the only other case in our society that meets this extreme comes into play when we are terminally ill. The fact that we are not allowed to choose the mode and timing of our own death is ridiculous. This limitation is laden with the strange, myopic mysticism of our religious heritage. We can’t self-determine because it might be a “sin”, whatever that is. If you remove religious and mystical thinking from the question of euthanasia, what remains is a series of problems that are complex but soluble.

Certainly, terminally ill people need to be protected and given every option of care to ensure that they do not choose to die out of desperation or pain, or for the benefit of others. But the patronising presumption that we need to protect people who are ill from themselves, because they are incapable, or inferior, is deeply insulting. If they are capable of rational thought, if they are compos mentis, then they should be granted the right to self-determine. This is a fundamental aspect of individual liberty that, as a nation, we don't seem to have respect for.

Many of us would choose to clutch on to life until the very last moments, but some of us would not. It is not a less acceptable position for being less common. Often, the wish to self-determine one’s own death is directly related to how monstrous or aggressive the terminal disease is.

When my mother was diagnosed with terminal pancreatic cancer, I had to be practical. Among all of the other instances I felt it necessary to think about was the fact that she might at some point tell me that she wanted to die at a time of her choosing. That time hasn’t come yet, and I hope that it never does.

She has never mentioned it, and I certainly wouldn’t start that conversation. Selfishly, I’m very happy that she seems to want to stay with me for as long as possible. But when I think about what would happen if she does at some point say that she wants to die before her illness kills her, I envisage having to tell her that, no, I cannot help. I’m sorry for the agony you are in. I’m sorry for the fact that you cannot stand, that you cannot use the bathroom, that your every waking moment is spent either in terrible pain or on such quantities of medication that you are absent from the last moments of your own life.

I am sorry, but I cannot help you. If I do, the Irish State will take my liberty in exchange for the liberty I take in helping you to carry out your wishes. I can’t possibly honour your wishes, because your life doesn’t belong to you any more.

No, I tell her. There’s something more important than you going on here.