Ethics of Assisted Dying in LIS
This sort of research demonstrating remarkable adaptation is often used by anti-euthanasia lobbyists to argue that assisted suicide and euthanasia should not be offered to such people because they come to value their life. They find meaning. However, that conclusion is not warranted. Some do want to die and should be allowed to die. The lesson that should be learnt is the one authors draw: you should wait to see how you adapt. But, if after waiting a suitable time, you want to die, you should be allowed or helped to die. The authors adopt a similar moderate view. " In our view, shortening-of-life requests by LIS patients are valid only when the patients have been given a chance to attain a steady state of SWB."
But this is too paternalistic. If a competent person does not want to wait, and has been advised of this kind of research and the possibility of adaptation, but still wants to die, he should be allowed to die. It is hard paternalism to keep people alive when they competently and informedly want to die.
This kind of research is also used to call into question the validity of living wills or advance directives. However it provides no grounds for questioning the validity of living wills. It provides reasons to make sure people are aware of the phenomenon of adaptation before completing a living will. Imagine that I know I will be happy some years after having developed locked-in syndrome. Can I now validly ask doctors to allow me to die at the time I have a massive stroke that will leave me locked-in? Yes. I can refuse any medical treatment, even if I am having a perfectly good life. Jehovah's Witnesses do this when they refuse life-saving blood transfusion.
What makes each person's own living hell is a matter for that person. It is subjective. And we can adapt to hell. That is important for all of us to know. But it does not change the rights of individuals to make what they will of their lives, including choosing the conditions under which and the time to end them.
Conflict of Interest:
Stephen Laureys is a collaborator with our Oxford Centre for Neuroethics which I direct