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Speaker 1: You can watch us on seven two five, six, seven,

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Speaker 1: one five sixty seven. You can call any time an

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Speaker 1: O to one four four, six, five six seven. Philosophically speaking, then,

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Speaker 1: doctor Madison, where do we start in this particular one.

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Speaker 2: Let's start on sovereign sovereignty.

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Speaker 3: Right, So, I think the problem is that we do

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Speaker 3: think that we are generally sovereign over our own bodies

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Speaker 3: and our own minds, and we should be allowed to

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Speaker 3: make decisions about our bodies, what happens to you and

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Speaker 3: in them, and so on and so forth. The problem

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Speaker 3: is that euthanasia involves someone else doing the killing. So

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Speaker 3: euthanasia itself is defined as administering the drugs that a

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Speaker 3: person who is voluntarily and competently asked for, and physician

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Speaker 3: assisted suicide is where they provide the means and then

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Speaker 3: the patient themselves ends their life. Now, the reason I

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Speaker 3: was very interested in the Spanish case is that the

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Speaker 3: young woman or she was twenty five at the end

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Speaker 3: of her life, but had tried to take her own

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Speaker 3: life at time twenty two as a result of what

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Speaker 3: she felt was intolerable mental suffering due to years and

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Speaker 3: years of extraordinarily bad circumstances. So in twenty twenty two,

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Speaker 3: she had failed to take her own life and was

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Speaker 3: left as a paraplegic and then asked to be assisted

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Speaker 3: to die by so euthanasia someone else, a physician assisted suicide.

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Speaker 3: Someone else would have to administer the drugs because she

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Speaker 3: was unable to do so. And so there what happens

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Speaker 3: is it's not just her sovereignty, it's someone else being

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Speaker 3: involved in the process. And that becomes problematic because then

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Speaker 3: there's a fine line between one's own right due to

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Speaker 3: one's body what one pleases, and someone else doing to

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Speaker 3: one's body, and we could think of that as assault

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Speaker 3: or murder.

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Speaker 2: Okay, so we talk about assisted suicide, right, Okay, right.

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Speaker 3: So if we think about suicide for many, many, many

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Speaker 3: centuries and decades, and still in some suicide itself was

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Speaker 3: an illegal act and there are a lot of arguments

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Speaker 3: for why you're not allowed to take your own life. Now,

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Speaker 3: in South Africa, assisted suicide is very much illegal and

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Speaker 3: anyone who commits it would be culpable of homicide or

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Speaker 3: guilty of murder. But we don't criminalize suicide in South Africa,

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Speaker 3: and so the question becomes not so much about sovereignty

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Speaker 3: over one's own life, but about the role of someone

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Speaker 3: else in killing one.

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Speaker 2: And we can petition it.

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Speaker 1: We can talk about quality of life of our pets

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Speaker 1: now badly injured. The quality of life is going to

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Speaker 1: be such that it's not worth sustaining it. But we

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Speaker 1: kind of play those same kind of rational and rules

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Speaker 1: to ourselves.

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Speaker 3: Absolutely. I mean, I think that the fact that we

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Speaker 3: euthanize pets to reduce or eliminate their suffering is a

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Speaker 3: kind of really emotional reason why we might support a

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Speaker 3: physician assisted suicide or euthanasia in humans. And the idea

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Speaker 3: that humans don't like to suffer. We spend our lives

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Speaker 3: avoiding suffering, and some kinds of suffering are intractable and

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Speaker 3: cannot be the quality of life cannot be improved with drugs, medication, treatment, etc.

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Speaker 3: And then what kind of a life is that? So

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Speaker 3: many people argue that suffering, whether it's mental or physical,

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Speaker 3: if it's intractable and cannot be eliminated or reduced significantly,

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Speaker 3: that should be a reason why one is allowed or

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Speaker 3: permitted to end their life.

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Speaker 1: In the case of the Spanish woman, it looks as

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Speaker 1: if life was profoundly changed. Was it by way of

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Speaker 1: an accident?

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Speaker 4: Or so.

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Speaker 3: Initially, she had had a lot of mental anguish, She'd

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Speaker 3: been in care homes most of her life, had not

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Speaker 3: had the best family circumstances, had then been sexually assaulted

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Speaker 3: by people on more than one occasion, and felt that

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Speaker 3: life was not worth living, that it was not possible

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Speaker 3: for her to live a life that she wanted to live,

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Speaker 3: and so she tried to take her own life. I'm

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Speaker 3: not sure exactly how, but I suspect it was some

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Speaker 3: sort of jump or something, and ended up not dying,

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Speaker 3: but unfortunately becoming a paraplegic. And so she petitioned the

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Speaker 3: courts to allow doctors to administer the drugs that would

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Speaker 3: end her.

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Speaker 2: Life, and the courts found.

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Speaker 3: The courts found in her favor. Her father, who had

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Speaker 3: not been part of her life and did not support

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Speaker 3: the act, then went to a group of lawyers to

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Speaker 3: kind of try and appeal the judgment and to bar

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Speaker 3: the hospital from administering the necessary drugs, and it got

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Speaker 3: so kind of controversial that towards the end, one of

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Speaker 3: her friends tried to enter the hospital to stop her

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Speaker 3: from doing it, or to stop the physicians from administering

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Speaker 3: the drugs, and the police actually barred the friend from

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Speaker 3: entering the hospital, and their grounds were really that this

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Speaker 3: was something that this young woman really had thought about

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Speaker 3: and wanted to do, and that, as you say, she

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Speaker 3: had sovereignty over our own body and was entitled to

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Speaker 3: decide how she lived and in this case, how she died.

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Speaker 1: I'm trying to think through physical and mental suffering, could

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Speaker 1: it diminish maybe a person's rational autonomy as well.

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Speaker 2: Yeah, at that.

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Speaker 1: Point maybe where they can't make a rational decision.

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Speaker 3: So one of the greatest arguments in favor of physician

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Speaker 3: assisted suicide or euthanasia is the autonomy argument. So if

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Speaker 3: we look at philosophers like Emmanuel Kant or John Christman,

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Speaker 3: some of them argue that, as you said, we should

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Speaker 3: have autonomy over our own life, our minds, and our bodies.

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Speaker 3: But when we are in heightened sensitivities like to pain

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Speaker 3: or suffering, we may not be able to be competent,

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Speaker 3: We may not be able to make rational choices. And

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Speaker 3: so the argument is then that if you're in this

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Speaker 3: incredible suffering or extreme pain, you don't have the competence

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Speaker 3: to decide voluntarily that you want to die. In other words,

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Speaker 3: you are being kind of manipulated. Persuaded, coerced by your

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Speaker 3: pain to make this decision, which isn't rational. The problem

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Speaker 3: with that clarence is that we allow people to refuse

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Speaker 3: or cease medication or treatment when they are experiencing too

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Speaker 3: much suffering or too much pain. So think about a

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Speaker 3: cancer survivor who has had repeated bouts of cancer. It's

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Speaker 3: come back over and over again. They've been through, whether

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Speaker 3: it's radio therapy or chemotherapy or such, and they decide

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Speaker 3: they don't want to continue, and we allow them to

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Speaker 3: do that, even though we know they will die as

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Speaker 3: a result. And so the line then between refusing treatment

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Speaker 3: is passive as opposed to actively hastening death, which is

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Speaker 3: considered to be illegal. Now, many people argue that that

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Speaker 3: distinction between passive and active is actually just a semantic distinction.

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Speaker 1: One instance, you're withholding, you're withholding the pull. In the

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Speaker 1: other instance, you are giving an overdose.

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Speaker 3: Of the poll exactly. But the idea is the result

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Speaker 3: of both of those actions is death, and so what

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Speaker 3: does it matter the means towards the death. So for

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Speaker 3: some philosophers that's not important, and the harm in fact

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Speaker 3: in not hastening death, in allowing the suffering to continue

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Speaker 3: is something that John Stuart Mill, for example, would say,

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Speaker 3: we can't have that kind of harm to people, that

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Speaker 3: people should be We should reduce harm. And so if

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Speaker 3: we can hasten death and minimize suffering, that is a

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Speaker 3: better option than allowing someone to languish in pain for

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Speaker 3: a long time.

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Speaker 1: So you're saying you can find justification for that in

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Speaker 1: the Hippocratic oaths as well.

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Speaker 2: First do no harm.

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Speaker 3: Well, it depends how you determine harm. And different philosophers

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Speaker 3: have different views. So for some philosophers, the very fact

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Speaker 3: of existing is a good thing. So anything we do

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Speaker 3: to stop existence is a harm. So killing would be

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Speaker 3: a bad thing because we're stopping.

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Speaker 2: Is an inevitable part of existing exactly.

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Speaker 3: And some people, some philosophers, some people believe that suffering

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Speaker 3: is part of life. It's what makes us enjoy the

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Speaker 3: good times because we've experienced the bad times.

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Speaker 2: Oh were there with those philosophers who are they?

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Speaker 3: Well, it depends it depends how much suffering we're talking about.

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Speaker 3: I mean, it depends about the life that people are experiencing.

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Speaker 3: I don't know. It might be an empirical survey that

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Speaker 3: we need to talk about people who are in terrible

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Speaker 3: suffering to ask them, is life worth living?

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Speaker 2: Yeah?

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Speaker 5: For sure, my guest, doctor Heidi Haidi Madison's senior lecture

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Speaker 5: at UCT's Ethics Lab. Philosophically speaking, today we're looking specifically

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Speaker 5: at assisted suicide, diving into the thoughts that keep us

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Speaker 5: up at night, from a meaning of life of course,

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Speaker 5: in the nature of happiness, to whether we really have

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Speaker 5: free will?

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Speaker 2: That is where we go on a Tuesday.

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Speaker 1: Also on a Tuesday, sophically speaking, I see that.

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Speaker 2: Flores has as a view on it. Let's take Flores's

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Speaker 2: voice note Joe.

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Speaker 6: Clearly more amun Flora is around Bowster. I don't even

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Speaker 6: want to get involved in this whole topic of utilization

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Speaker 6: for humans.

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Speaker 2: However, I have a.

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Speaker 6: Question, what if someone tries to come much suicide is

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Speaker 6: that person? Can that person be held criminally liable for

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Speaker 6: trying to take he's for her own life? Yeah? I

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Speaker 6: would really like someone w then know how to answer

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Speaker 6: that question. Or if she just you do down to yourself.

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Speaker 7: By bye, and you can bring your thoughts to be

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Speaker 7: your questions to bear, Doctor Hadi Madison, our guest that

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Speaker 7: what's ppen number seven two five six seven one five

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Speaker 7: six seven and you can call and speak to it directly,

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Speaker 7: not to one four four six oh five A six.

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Speaker 1: At thirteen minutes to eleven o'clock. Dr Madison your response.

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Speaker 3: So, I'm not a lawyer, but as far as I understand,

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Speaker 3: in South Africa, at least, suicide is not a criminal offense. Obviously,

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Speaker 3: murdering of someone else or taking someone else's life as

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Speaker 3: a criminal offense, but we don't prosecute people who try

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Speaker 3: to take their own lives and don't complete. Generally, we

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Speaker 3: think we try to help people because we try to

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Speaker 3: understand why they felt that they were that life was

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Speaker 3: not worth living, and so providing them worth physical or

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Speaker 3: emotional support would be a really important way to respond

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Speaker 3: to that. And I support that, and I think if

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Speaker 3: we extend that into what to do about people who

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Speaker 3: ask for assistance in dying, we need to try and

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Speaker 3: understand why it is that they feel that their life

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Speaker 3: is not worth living. So the physical suffering many people

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Speaker 3: are aware of, and we understand that for many people

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Speaker 3: it's the fear of dependency, it's the fear of being

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Speaker 3: a burden, it's the fear of more suffering, of intractable suffering.

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Speaker 3: And I think that we need to take seriously those

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Speaker 3: concerns and ask ourselves what kind of a society are

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Speaker 3: we that we can't provide the necessary support to those

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Speaker 3: sorts of people. So, in Canada, one of which does

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Speaker 3: have a sister dying and quite relatively large numbers of

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Speaker 3: people who do choose to go down that route, we

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Speaker 3: discover that one of the reasons that Canadians give for

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Speaker 3: wanting a sister dying is loneliness. And that really really

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Speaker 3: worries me because it says something not about the person,

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Speaker 3: but about the society in which they live. And so

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Speaker 3: I think loneliness is a very sad reason to want

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Speaker 3: to end one's life, and it seems to be something

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Speaker 3: we can do a bit about physical suffering, where we

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Speaker 3: have shortages in the healthcare system, where we don't have

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Speaker 3: enough palliative care, where we might worry about being a

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Speaker 3: burden to our families, whether it's financial or emotional. There

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Speaker 3: are genuine reasons that people want to hasten death.

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Speaker 1: Are there any protocols when you're engaging philosophically or attempting

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Speaker 1: to at least I think protocols? Can I ask you

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Speaker 1: for your personal view on this particular matter. Do you

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Speaker 1: have a personal position.

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Speaker 3: I mean, it depends what you mean by a personal position.

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Speaker 3: Do I think that I would choose to euthanize myself

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Speaker 3: or ask for assistance in timeicide? Yeah, so in a

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Speaker 3: country where it's illegal, I would never ask someone to

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Speaker 3: assist me with it, because I don't think that it's

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Speaker 3: right to put someone in a position that they would

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Speaker 3: be culpable for my death and so have to bear

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Speaker 3: the consequences if I were able to take my own

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Speaker 3: life and I was I don't have a particular view

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Speaker 3: that life is There is sanctity of life, that life

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Speaker 3: itself is valuable. I think that many people do think that.

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Speaker 3: There are lots of philosophers who think that MY main

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Speaker 3: reason for perhaps being against assisted suicide or itself is

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Speaker 3: Saint Thomas Aquinas's reason where he said that it's irresponsible

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Speaker 3: because we have duties to other people into society. So

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Speaker 3: our responsibilities to care for our children, to look after

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Speaker 3: our elderly parents, to be a good member of society.

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Speaker 3: Those are the kinds of reasons that we should try

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Speaker 3: not to hasten death.

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Speaker 1: But I guess we can't underestimate the pain, and I

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Speaker 1: think there's a subjectivity to that pain that somebody else's

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Speaker 1: suffering is.

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Speaker 3: Isn't that absolutely? And I really I think that it's

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Speaker 3: philosophically it's not right to be too emotional about this,

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Speaker 3: but we do have to take into consideration that we

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Speaker 3: cannot jump inside someone else's shoes and understand the extent

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Speaker 3: of their suffering, whether it's physical, emotional, or psychological. And

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Speaker 3: so some lives. Although I do believe that all lives matter,

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Speaker 3: I do think that some people that the best people

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Speaker 3: to decide the value of their life are the people themselves.

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Speaker 2: There's a couple of voice noting let's go to Dane Joe.

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Speaker 8: Good morning South Africa. Clarence, the listeners, hope you're keeping well.

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Speaker 8: Interesting conversation you guys have got going yet relating to

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Speaker 8: assisted death or whatever the case is, when the people

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Speaker 8: on their last dying beds, and you know these type

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Speaker 8: of things like personally, if you wish to do so,

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Speaker 8: you know it's your life. No one should dictate whether

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Speaker 8: it's a family member, a loved one, a friend, because

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Speaker 8: they always got to have the feeling and the emotional attachment.

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Speaker 8: But if you are no longer wanting to be due

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Speaker 8: to various circumstances of health or whatever it may be.

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Speaker 8: It is at the end of the day, your decision.

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Speaker 8: No one, no one, no government, no one dictates that

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Speaker 8: over any human nor law. That's just my view on it.

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Speaker 8: And also, why would we be taking the wording of

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Speaker 8: philosophers of old? I mean, these days you generally get

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Speaker 8: a lot of philosophers and so forth, and would also

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Speaker 8: not being a bit contradicting because they would maybe want

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Speaker 8: to be talking about wanting to proceed life. Maybe none

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Speaker 8: of the philosophers speaking ever wanted to end their lives

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Speaker 8: due to the pain that they might be suffering, So

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Speaker 8: why would one take wording from them?

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Speaker 1: Firstly, I'd like to invite you around to the township

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Speaker 1: day and there's really decent philosophers out there.

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Speaker 2: Do you want to respond to that?

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Speaker 3: So I agree completely that I don't think it's the

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Speaker 3: government or anyone else's job to decide who can take

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Speaker 3: my life or who can force me to live longer.

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Speaker 3: So I absolutely agree with the listener in that, and

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Speaker 3: that this is my body, my life, and I should

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Speaker 3: have decisions made about that that rest on me. In

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Speaker 3: terms of listening to philosophers, I don't think we have

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Speaker 3: to listen to philosophers. I think they give us the

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Speaker 3: luxury of listening to people who had time and consideration

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Speaker 3: to think about these things. And I think in our

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Speaker 3: daily lives we often rush through and make decisions emotionally,

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Speaker 3: irrationally based on the things we read on social media,

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Speaker 3: which are often not true. And so I think philosophers,

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Speaker 3: like many people, have wisdom to share, and my access

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Speaker 3: is to philosophers. But I think many healthcare practitioners, people

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Speaker 3: on the street all have views and we should listen

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Speaker 3: to all of them.

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Speaker 1: And again, they're not all philosophers have doctorates like doctor Batterson.

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Speaker 1: There are lots of pretty astuid thinkers in everybody's everybody's universe,

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Speaker 1: I have no doubt, and you'll probably be thinking of

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Speaker 1: one right now in your family or your friendship circle.

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Speaker 1: Errol on the line, let's get Errol job.

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Speaker 2: Good morning, Clari and your guests, Clarie.

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Speaker 9: When it comes to cancer, and I listen to what

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Speaker 9: your guests are saying, the medical fertility can if they

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Speaker 9: want to manufacture a drug that will kill cancer, but

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Speaker 9: because of the monetary benefits to the pharmaceutical companies that

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Speaker 9: cancer sufferers bring, they will not do that.

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Speaker 2: Clary. I can never understand.

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Speaker 9: That you can't find a cure for cancer, but you

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Speaker 9: can send a spaceship like Voyager that's going for forty

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Speaker 9: seven years, but you can't find a cure for cancer.

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Speaker 2: I'm feeling it all.

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Speaker 3: I mean, he's not wrong. We could ask the same

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Speaker 3: question about why haven't we solved the problem of malaria,

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Speaker 3: Why haven't we found a vaccine for HIV that's easily

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Speaker 3: roll outable. I mean, there are arguments. I don't think that,

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Speaker 3: you know, the cure for cancer is a simple thing,

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Speaker 3: And I'm not into conspiracy theories that we have one

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Speaker 3: we're just hiding it so that we can make money.

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Speaker 2: I've got one foot in that all.

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Speaker 3: But I think that the problem is that many of

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Speaker 3: the cures for cancer, and we do have cures for

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Speaker 3: many types of cancer, are incredibly tough on the people

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Speaker 3: who experience them. So sometimes it's not the cancer that

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Speaker 3: people want to avoid, it's the chemotherapy, it's the radiation.

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Speaker 3: And so coming back to the euthanasia debate, there are

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Speaker 3: many people who, when their cancer comes back for the

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Speaker 3: third or fourth time, say I don't want to go

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Speaker 3: through treatment. I don't want to have this experience. So

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Speaker 3: it's not even the disease that might be killing them,

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Speaker 3: it's the way we cure or try to cure the

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Speaker 3: disease that they may want to avoid. And the interesting

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Speaker 3: thing is that we allow that. We allow people to

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Speaker 3: say I don't want any more treatment, but we don't

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Speaker 3: allow people to say I don't want to suffer anymore.

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Speaker 1: Yeah, So are you being empathetic when you accede, at

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Speaker 1: least emotionally, to that person's need to not go through

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Speaker 1: that same pain again through maybe another dose or series

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Speaker 1: of chemotherapy treatments.

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Speaker 3: I think we have to be really careful, and we

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Speaker 3: have to It all goes back to really trying to

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Speaker 3: understand what this person is trying to say and what

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Speaker 3: they are genuinely feeling. I don't think we can be

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Speaker 3: empathetic in the sense of understand exactly how they feel.

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Speaker 3: We're not in that situation. But I think when it

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Speaker 3: comes to questions of euthanasia or physician assisted suicide or

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Speaker 3: refusal for continuation of treatment, we have to try and

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Speaker 3: unpack the reasons why that person is saying what they're

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Speaker 3: saying or rejecting the offer of help. And if we

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Speaker 3: can do that, we might be able to offer alternatives.

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Speaker 3: So it may be that someone who tries to take

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Speaker 3: their own life or requests for assistance in taking their

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Speaker 3: own life, could have other means to make their life

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Speaker 3: worth living.

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Speaker 2: Okay, then we've got justines on the line. Let's take

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Speaker 2: a listen.

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Speaker 3: Hi, there such an interesting conversation.

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Speaker 4: My mother would like to end her life becaurse of loneliness.

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Speaker 4: My father died three and a half years ago.

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Speaker 2: She's got three.

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Speaker 4: Daughters, she's got a sister, she's got a couple of

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Speaker 4: friends left still. But she is very frail, and she's

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Speaker 4: in the early stages of vascular dementia. So, for example,

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Speaker 4: when I phone her in the morning and I phone

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Speaker 4: her in the afternoon, she doesn't remember that I called

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Speaker 4: her in the morning, and she says she's had such

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Speaker 4: a lonely day. I take her out once or twice

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Speaker 4: a week. My sister takes her out once a week.

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Speaker 4: She can't remember that she's seen people. She forgets, she's

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Speaker 4: not making any new memories. And she just loved my

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Speaker 4: father with every single part of her, and she doesn't

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Speaker 4: want to be without him. She doesn't want to live

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Speaker 4: without him. She's also getting quite frail, she had a

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Speaker 4: terrible fall and she's in quite a lot of pain.

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Speaker 4: And I'll tell you, if I could help her, I would.

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Speaker 3: So thank you for that. And I'm really sorry to

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Speaker 3: hear that that's a dreadful situation to be in. And

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Speaker 3: I think it's exactly that kind of situation, which means

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Speaker 3: we have to have these conversations. We have to talk

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Speaker 3: about this because as our population is aging, I mean,

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Speaker 3: the reality is she's not lonely. She's surrounded clearly by

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Speaker 3: people who love her. The problem is her dementia and

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Speaker 3: her inability to rem member that she's not lonely. But

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Speaker 3: this is a fact of life, and as we age

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Speaker 3: and as these kinds of experiences become more common, I

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Speaker 3: think we really need to have these conversations, and we

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Speaker 3: need to have conversations about dying and about death and

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Speaker 3: about giving people a death with dignity as opposed to

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Speaker 3: a life of suffering.

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Speaker 2: I think we need to touch on social ethics.

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Speaker 1: We don't have time, but if it is normalized, I'm

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Speaker 1: talking if assisted suicide becomes the normalized, right, then we

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Speaker 1: have issues where people are going to maybe create what

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Speaker 1: a duty to die.

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Speaker 3: So I think that's a real consideration, and I think

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Speaker 3: that there is a lot of We see a lot

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Speaker 3: of elderly abuse, for example, in our country and worldwide,

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Speaker 3: and so the abuse of the right to coerce or

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Speaker 3: manipulate or persuade older people that they're a burden or

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Speaker 3: they be better off dead is something we have to

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Speaker 3: take very seriously. But just because we have a right

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Speaker 3: doesn't mean we have to exercise that right. I do

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Speaker 3: think that there's a lot of evidence from other countries

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Speaker 3: where people have gone through the whole process of getting

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Speaker 3: assistance in dying but not gone through with it. They

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Speaker 3: want the comfort of knowing that if things get really bad,

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Speaker 3: there is a safe and a clear way for them

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Speaker 3: to get out of it. So I think it's a

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Speaker 3: balancing act. I think we can't over we can't underestimate

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Speaker 3: the concerns you have about the abuse of such a right.

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Speaker 3: But I do think that the first thing we need

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Speaker 3: to do is to talk to people, to talk about

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Speaker 3: this issue and to take away some of the emotion

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Speaker 3: from it so that we can have systems in place

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Speaker 3: that it would allow people and safeguards. A lot of

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Speaker 3: safeguards are needed in order to be able to go

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Speaker 3: through with this process