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Is the Choice to Be Killed the Same as Choosing a Car?

07/07/2014 13:37 BST | Updated 03/09/2014 10:59 BST

Who is not in favour of choice? The editor of the British Medical Journal certainly is, having asserted (2 July 2014) that "choice" is now the guiding principle in medical ethics.

Being free to choose is close to being the main definition of freedom that most people work with. Maybe the idea that choice and freedom are synonymous took root during the Cold War when an abundance of consumer durables in the West contrasted with the one-size-fits-all uniformity of totalitarian Communism to symbolise the conflict between political freedom and oppression. "Shall I buy a Ford or a BMW?" was a question in rather a different league from asking "Am I on the waiting list for a Trabant?" And in the difference between those two questions lay the deeper, and darker, differences between liberal democracy and tyranny.

Choice is good. Let's gloss over the fact that it was Henry Ford who said you could have any colour you liked so long as it was black. That policy didn't last long anyway because Ford had to listen to the consumer or go out of business. Making choices in a market place of abundant goods - choice as the prelude to consumption - is the archetypal image that the word "choice" conjures up.

The language of consumer choice now governs our politics, our healthcare, education and much else. Walking the aisles of the supermarket, discriminating between one brand and another, weighing necessity against luxury, is the dominant metaphor for all our choices.

The BMJ's assertion about the primacy of choice is just that - an assertion. Many distinguished ethicists would challenge it strongly as being an example of how a politics of consumerism is leaking across into the way we categorise every thing, person or relationship.

Some psychologists talk about an excess of choice leading to stress, confusion and anxiety. Consumer analysts are starting to recognise that, in some things, people don't especially want choice. I am certainly less bothered about choosing who supplies gas to my house than having a supplier who does it efficiently, safely and at a reasonable price. Life is too short to be making contested choices about every darned thing - I want a life beyond the supermarket.

The philosopher, Alastair MacIntyre wrote a book called Dependent, Rational Animals. Those three words summed up his understanding of what it meant to be human. Rational and animal aren't too controversial - it was the word "dependent" which stood out against the spirit of the age. He makes a good point. Being dependent on others is actually far more characteristic of being human than the stress on autonomy which fuels an anthropology of choice.

No one is born independent and few reach the end of their lives without having to discover how life leaves us dependent on others for all kinds of things that matter. Even in the years between, the image of the autonomous individual, becoming his or herself by virtue of their independent choices, freely made, is illusory.

Apart from needing the labour of others to put the choices before us in the first place, everyone needs friendship, company and someone to enjoy our stuff with once we've chosen it. Even the preferences which inform our choices don't emerge out of nowhere. We are socially formed beings whose choices are never as independent as we might imagine since we learned what to value and how to express our values through interacting with others.

For the historically minded secularist, it is worth noting how far the anthropology of choice has taken us from the Judeo-Christian roots of our society. Whether in the Hebrew scriptures or in the New Testament, there are almost no references to choice as a characteristic of being human. In the Bible, the way human beings experience choice is overwhelmingly the experience of being chosen. Not so much "I choose, therefore I am", as "I am chosen, therefore I am loved".

Of course choice is good. I aspire to more of it and so do people who have enjoyed much less of it than I have. Offer me more choice, at least in theory, and I'll say Yes. I'll answer your loaded opinion poll and tell you I am in favour of this choice and that choice because who, in this culture, can be against more choice without being a heretic? But talk about choice on that day in the future when I am wholly dependent on the people around me, when my life is almost over and I have far more chance of pleasing others by getting out of their way quietly than of making much difference to my own situation, and my choice won't be about me, it will be about them. And those last days of life, surely, are precisely the moment when choices ought to be about the one approaching the end - and no one else.

How many Parliamentarians who will shortly debate the Falconer Bill on assisted suicide are people with wide enough life experience to empathise with those who see more choice as a threat and not a blessing? How many subscribers to the BMJ put themselves, day by day, into the shoes of people for whom consumer choice is someone else's luxury, even if their editor chooses to use his journalistic position to make a ruling on behalf of ethicists everywhere?

Some of them, to be sure - maybe many of them. Will they encourage the rest to dig deep into their imaginations, to empathise with people who are not articulate, who are used to being done unto, and who have lived on the receiving end of other's choices all their lives?

They are in Parliament to govern on behalf of all citizens. The weak. The poor. The vulnerable. The dying. The ones who don't want to be a nuisance. The ones who do not regard choice as an unalloyed good, as well as the people who are used to choosing. And the medical profession too - despite the sweeping assertions of the BMJ about the nature of ethics, are also in business for those people.

Will the Parliamentarians and the medics empathise beyond their own kind? I hope so.

I do hope so.