Synopsis: The book details the journey of a quadrapeligic, Will Traynor, and his hired care giver Louisa Clark. Will, no longer wanting to live due to his condition, has 6 months before his scheduled physician assisted suicide. Louisa is bound and determined to convince Will that life is still worth living, even if it isn’t the life that he expected.
Nothing short of beautiful prose, Jojo Moyes explores the world of the physically disabled and their plights in modern society. But more than that, she grapples with the heavy and divisive subject matter of physician assisted suicide. She presents the various perspectives through her characters, each with their own take on the matter. While her work is moving to the soul and forces one to confront their own thoughts on the matter, the book ultimately leaves more questions than answers. But hey, I would argue that’s the point of literature. I am a little disappointed there was no particular character development in the story (well at least not until the end and it is quite sudden). I want to explore the various character perspectives and the ultimate theme Moyes chooses to focus on related to physician assisted suicide.
Ultimately, Moyes chooses to focus on the notion of choice and personal autonomy through Will. He says, “You still don’t get it, Clark, do you?” I could hear the smile in his voice. “It’s not your choice.” The argument in favor of permitting assisted suicide often invokes one’s personal autonomy and their subsequent right to choose among alternatives. Overgeneralized and succinct, the argument is summed up as “my body, my choice.” But before elaborating on differing arguments in favor and against assisted suicide I would like to note two caveats. First, with regards to this discussion, I want to limit the context of choice to only that of physician assisted suicide (although the argument is fundamental to various other philosophical debates). Second, I want to narrow the context as applied to only terminally ill or “severely disabled” individuals. I will take up the implications of each view toward the end of the post.
Personal autonomy is colloquially defined as a person getting to choose what he/she/they get to do with their body. Here, it’s the choice to ends one’s life. Most of the world does not recognize personal autonomy to include the choice of death. In the countries or states that do recognize such choice, there are a list of stringent criteria one must meet in order to carry out their wish. 1 Most people agree there is nothing more fundamental than one’s decisions regarding what to do with their body. This is found across political theory, morality, ethics and so on. The recognition of personal autonomy can be either rooted in natural law or positive law. Under natural law, it is a self-evident truth of nature that we are allowed to choose what we do with our bodies. 2 The positivist view has a little more work to do. Under the positivist view, government must recognize a fundamental right to personal autonomy (note there must be the presupposition that government/others telling individual what they shall and shall not do with their bodies is “bad”). 3
So, if personal autonomy and to choice is so universal, then why is there this debate? At least in the United States and most western countries we enjoy the privilege of getting to “choose” every major aspect of our life. This includes when to get married, what career we want, when to start a family, etc. Why doesn’t the ability to choose when to die follow? An opponent might cite that the choice cannot be undone; it’s permanent unlike a marriage or a career. In response one might cite practical/legal coercion as elimination of choice. For example, a couple can decide to have a child and the effects from carrying that child cannot be undone and yet couples are still afforded the ability to choose. However, critics would argue that there is the possibility of surrendering that child and thus “in-effect” having a child can be undone. 4
What are the next set of arguments in the debate? The most “persuasive” argument has been that by not providing the choice to die to those who wish to die we subject said individuals to unnecessary pain and suffering. To allow an individual to suffer would be immoral. This argument is most effective because morality is almost universally accepted. However, the crux of this argument rests on the notion that there is either: (1) a universally accepted moral imperative; or (2) there are not superseding moral claims. In other words, if X recognizes that to permit suffering is immoral then everyone else should recognize suffering as immoral. The first point is difficult to refute. Almost anyone would be hard pressed to essentially state “it does not matter if someone is suffering.” Thus, the first sub-point goes unchallenged. The second sub-point, however, is where dissenters “hang their hat.” Dissenters can recognize another individual is suffering while also arguing that when it comes to weighing the choice to die and that of suffering, the choice to die cannot prevail. Valuing all life requires stronger moral adherence (so to speak). Such a claim can be supported by the advent of modern medicine. Often times, an individual can be made “comfortable” until their final nature end. Therefore, since society can alleviate the suffering, there is no need to end a life. 5
Lastly, there is a practical argument that supporters and dissenters may argue. Lets start with the supporters. Here, supporters of choice can argue the undue financial hardship that the individual and the individual’s family may or will experience. By not allowing a terminally ill or “severely disabled” person to end their life, they will acquire the cost necessary to maintain a life one no longer wishes to live. The cost can range anywhere from necessary medical treatment to keep them comfortable to the time off work that family members may need to provide for said individual. Therefore, there is a financial strain not only on the afflicted person but on their family. The dissenters would argue a different practical argument that supersedes the burden of undue financial hardship – that is the legal implementation of assisted death. By recognizing assisted death, legislatures will have to deal with questions regarding the criteria, procedure, and ultimately the uncertainty. What deems someone as mentally and physically fit to make the decision to end their life? Is it to be done the same way as prison executions? Can the lethal medicine be administered at home or must it be administered in a hospital? What is the age requirement? Are there exceptions by which parents can act on behalf of a minor? Ultimately, by which psychological standards can one be sure another wants to end their life? 6
While I hate to end the discussion there, I like many great authors find that an independent mind contrives the best answers. There are two quotes from the Moyes book I want to point out. “I want him to live if HE wants to live. If he doesn’t, then by forcing him to carry on, you, me….. we become just another shitty bunch of people taking away his choices” and “But his parents! They can’t just let him kill himself. What kind of people are they? People who are vulnerable should not be given the chance to do something that they’ll….” Notice the dichotomy between the quotes, or more specifically the viewpoints. One advocating personal choice as above all and the other advocating limitations. I ask, like Jojo Moyes, that you reflect on where you stand. But not only on your consequential conclusion, whether one should or should not be able to chose, but why so? Are there circumstances that you would arrive at a contrary conclusion? Are there contradictions or meaningful distinctions in your conclusion?
— Yours Truly,
Michael A. Westbrook
- https://www.oregon.gov/oha/ph/providerpartnerresources/evaluationresearch/deathwithdignityact/pages/faqs.aspx; https://www.doh.wa.gov/YouandYourFamily/IllnessandDisease/DeathwithDignityAct; https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-019-0367-9
- https://web.nmsu.edu/~dscoccia/376web/376lpaust.pdf
- See note 2
- Here of course an advocate can retort by saying that the mental and physical effects of a child cannot be undone. Women undergo a psychological change when carrying a child. Furthermore, parents develop an attachment to the child that is often life altering once it is broken. However, for the brevity of the blog post, I won’t explore each retort.
- Once more, how one defines suffering is completely a matter of language philosophy and/or personal interpretation. Just because someone is not experiencing any physical suffering does not mean they are not experiencing any mental suffering. Thus, there is an implicit favoring of focusing mainly on physical suffering as opposed to the mental suffering said individual might be experiencing.
- https://www.oyez.org/cases/1996/96-110; https://www.oyez.org/cases/1996/95-1858; https://www.gfrlaw.com/what-we-do/insights/supreme-court-finds-no-constitutional-right-physician-assisted-dying
Ivory Tower 