Euthanasia and the permissibility of moral debate

One should, in general, be able to discuss controversial moral topics without it being assumed that you support the worst possible consequences of the topic under debate. I add the “in general” because it’s rather difficult to imagine someone arguing in good faith when they ask that we debate whether one race is superior to the next, or some similarly prejudiced proposition.

And, there’s a distinction worth retaining between stating that something is right or wrong, and having sympathy for someone who is placed in the position of having to make a difficult or controversial moral choice – whether or not that person ends up making the choice that you’d make, or hope that they would have made.

Recently, a public representative of a large South African political party posted a tweet regarding how difficult it is to imagine the “strength and courage Tania Clarence had to euthanise her children”. Her choice of words was poor, in that “strength and courage” can easily be read to imply a positive judgement on the action itself – but I think it fairly clear that the tweet was intended to signal sympathy for Clarence, who made a choice that we should all hope we’re never in a position to entertain.

That choice was to end the lives of her three children, two 3 year-old sons and a 4 year-old daughter. If you think euthanasia impermissible, or a euphemism for murder, you’d (rightly, on your view) condemn this as murder. But if you think that there are situations in which ending a life is permissible, you’d (rightly, on your view) want to discuss whether this case falls into the “permissible” set or not.

It’s no good to simply assert that euthanasia is always murder, as conclusions are not (or shouldn’t be) persausive – arguments are. And the argument that euthanasia is always impermissible is in my view a weak one, as I regard cases like Tony Nicklinson’s as a clear example of a situation in which euthanasia is not only permissible, but the morally correct decision.

Nicklinson was an adult who had expressed his wish to die, and this is one clear difference between his case and that of the Clarence children. Informed consent is easier to obtain in a case like Nicklinson’s, despite the extreme difficulties he had with communicating. One might want, as a point of principle, to insist that euthanasia is only ever permissible with the consent of the person who is to die – Belgium has done this, [as has the Netherlands] for children over the age of 12.

In the case of the Clarence children, informed consent is unlikely to impossible, even if some version of weak consent is possible. So if consent is required, one might think that euthanasia is (or, was) morally impermissible in their case. But that still wouldn’t make Tania Clarence a monster – she might still have been doing what she thought best for her children, even if she was wrong, and even if her husband resents the choice she ended up making.

Why might she have thought it the correct choice? Because, she might have foreseen a life of unendurable suffering for her children, despite the fact that many sufferers of type 2 spinal muscular atrophy (SMA) go on to raise families, have full lives and so forth. Many also don’t, and the ones that do are no argument against the fact that their chances of reaching middle-age are small, and their chances of great suffering fairly large.

So, one can imagine cases where a decision like Clarence’s is a cop-out. A painful cop-out, to be sure, but nonetheless, a capitulation in the face of the demands made on her as a mother, both emotionally in terms of watching her children suffer, and in terms of the resources that would be required to raise three disabled children.

But one can also imagine cases in which there is a significant degree of medical consensus that a child, or three children, will suffer enormously and live very short and unrewarding lives. The twins in this case “needed to have medication hourly, were tube fed and incapable of independent movement“, and weakness with SMA increases over time. Each case is different, and each case would no doubt be enormously difficult – but such cases would surely exist, and in such cases, you’d be more sympathetic to Clarence’s choice, and you might even think it morally permissible (regardless of what is legal).

Even if you think it’s never morally permissible to end a life – whether that of a non-human animal, a child or an adult – persuading people of this requires that they hear your arguments, and they won’t hear those arguments if you simply yell “eugenics” and “Hitler” at them, or if you take your case of SMA as representative of the whole.

As I said at the top, the “strength and courage” Tweet created the wrong impression, and led to some sustained abuse towards the person who tweeted it. My response was to say

and I’ll stick with that, even though I’m now getting a fair amount of abuse myself. Nobody’s mind will be changed through lazy caricatures of their arguments, or through asserting contrary conclusions as if they are fact. These are difficult issues, which means that we should expect the arguments to be difficult also.

Also published on Medium.