Terry Pratchett – a gifted and prolific writer has Alzheimer’s disease. For him not being able to write (in the sense of communicate his thoughts, ideas, creativity and imagination through the written word – currently he has an assistant who types his dictations) would make life not worth living. He would like to be able to choose when to die.
Assisted suicide is not legal in the UK, so those who wish it have to travel to the Dignitas Euthanasia Clinic in Switzerland.
In seeking to find out more about what choosing to die would involve – Terry Pratchett travelled to Switzerland with two UK citizens who both made this choice and followed it through.
The BBC programme was controversial and thought provoking as it explored the question of what it means to choose to die, which must be one of the ultimate acts and expressions of autonomy. For me it raised the question of whether autonomy is a reality (how much does the context influence the degree of autonomy achievable?) and whether autonomy can result in unethical behaviour? This last question was also raised for me by Adam Curtis’ reference to Ayn Rand’s philosophy of each person for themselves in Episode 1 of his documentary – All Watched Over By Machines of Loving Grace.
In ethics, Rand argued for rational egoism (rational self-interest), as the guiding moral principle. She said the individual should “exist for his own sake, neither sacrificing himself to others nor sacrificing others to himself.” She controversially referred to egoism as “the virtue of selfishness” in her book of that title, in which she presented her solution to the is-ought problem by describing a meta-ethical theory that based morality in the needs of “man’s survival qua man”. She condemned ethical altruism as incompatible with the requirements of human life and happiness
These examples highlight again (as have other examples before them) that autonomy carries with it significant responsibility both for yourself and for those and the environment around you. A pursuit of autonomy must take into account the many possible complex associated ethical considerations.
For me there are no answers – only questions.