The following is a re-post of an article in the UK’s The Guardian and is by Giles Fraser first posted on 28th August 2015
Politicians may have inadvertently stumbled upon a radical new way to address spiralling NHS costs. It’s called assisted dying, and it’s back before the House of Commons again next month. Though, in fact, it’s not a new way at all. Euripides had the same idea 500 years before the birth of Christ: “I hate the men who would prolong their lives / By foods and drinks and charms of magic art / Perverting nature’s course to keep off death / They ought, when they no longer serve the land / To quit this life, and clear the way for youth.”
We have an aging population. Globally, the number of over-65s will triple by 2050. Currently there are four people of working age supporting each pensioner in Britain. By 2050 that dependency ratio will be two to one. As the number of elderly people rapidly expands, so a far greater burden of care will fall on the young. Taxes will rise to meet the demand of pensions and NHS costs. Conflicts over intergenerational fairness will intensify.
No politician will ever come out and say that those who “no longer serve the land” should choose suicide. No, assisted dying, its current proponents insist, must only ever be a personal choice in a very specific set of circumstances. But let us not pretend that this “personal choice” is unaffected by wider economic realities. For as a rapidly expanding elderly population makes increasing demands on healthcare, so the pressure to ration “expensive” treatments will grow – with what counts as expensive being continually recalculated downwards. And here the wider pressure – cultural, social, economic – will inevitably press towards a greater take-up of the suicide option. Yes, it will be a “personal choice”. But it will be a “personal choice” in the same way poorer people have a choice in supermarkets – a choice with few options.
And that’s hardly the sort of freedom that this slippery word choice evokes. You don’t have to go back as far as Euripides to see this in action. In modern day Greece, austerity has led to a 35% increase in the suicide rate over the last two years. Was this a “personal choice”? If we structure society in such a way that many people have desperate, miserable lives, what sort of choice is it when people choose to kill themselves?
Maud lives round the corner from me in south London. She is 90 and on her own. She remembers a time when everyone knew everyone else, and when there was genuine community solidarity. Nowadays people come and go, she says, and young people can’t be bothered with the elderly. She is often lonely. “Even the doctor came round to see me and asked me if I wanted to commit suicide,” she says.
This is the shadow side of liberal freedom. It’s a young and healthy person’s ideology, suited for the well-off. It amounts to the renunciation of our obligations to each other and to the vulnerable. As everyone is encouraged to make their own individual choices, strong and stable communities are dissolved. From this perspective, even ethics gets done in the first person singular not the first person plural. It’s the freedom to do what you bloody well like and sod the rest. Caring for each other is just another choice, just another option. It’s up to the individual to decide. And whatever the choice they make – to care or not to care – it is inviolable precisely because it is a choice.
When Maud was young her generation fought a war for freedom. To borrow philosophical terminology, it was a war for negative freedom – a war against external oppression. But in the late 20th century, particularly under the influence of the liberal economics of Thatcherism, the sort of freedom we began to value flipped from negative freedom to positive freedom – the freedom to realise one’s own individual goals. It became all about self-realisation, all about me and what I want. And assisted dying is its ultimate expression. For by eroding the long-term mutual obligations we have to each other, in sickness and in health, we have arrived at the existential equivalent of a zero-hours contract with life, a contract that can be terminated at will.