Raz notes that
I kept the talk style of the paper. It examines a central aspect of the relations between duration and quality of life by considering the moral right to voluntary euthanasia, and some aspects of the moral case for a legal right to euthanasia. Would widespread acceptance of a right to voluntary euthanasia lead to widespread changes in attitude to life and death? Many of its advocates deny that seeing it as a narrow right enabling people to avoid ending their life in great pain or total dependence, or a vegetative state. I argue that the right cannot cogently be conceived as a narrow right, confined to very limited circumstances. It is based on the value of having the normative power to choose time and manner of one’s death. Its recognition will be accompanied by far reaching changes in culture and attitude, and these changes will enrich people’s life by enabling them to integrate their death as part of their lives.He concludes with the comment that -
In contexts other than euthanasia it is common to laud people who committed suicide for the good of others, or for the public good: the person who threw himself on a grenade to absorb the impact of its explosion and save the people hiding alongside him, or indeed the other soldiers in the trench, was one of the heroic, semi-mythical, figures of my youth, and people setting out on suicidal military missions were also admired in many cultures. Similarly, it is acknowledged that there is a limit to the amount of public resources that it is appropriate to spend on any single individual. This view is incorporated most explicitly in the practice, far from perfect as it is, of NICE but deserves a more general and explicit incorporation into public practices.
Now it seems to me that if public bodies are right in limiting the resources to be spent on keeping me alive I should acknowledge that their decision is right, and in appropriate circumstances I should apply the similar standards in deciding for myself how much others should sacrifice in order to keep me alive. It is important, in considering these matters, to remember that most people’s lives are enmeshed with the life of others, and that it is important that decisions of life and death should be, if possible, shared. But that does not diminish the importance of the other-regarding considerations I am discussing, and some of them, by their nature, making a shared decision difficult.
I am saying this in full awareness of the fact that it is a view that does not find much support in public opinion at the moment. This recognition is double edged. On the one hand it points to the fact that the legalisation of euthanasia, if achieved, will be implemented in conditions where the public is not fully in agreement with its true moral justification, and that may be a severe problem in the way the legalised right is administered, and practised. It is the sort of factor that makes one inclined to wonder whether the time for legalisation has arrived? Maybe the underhand, inconsistent and informal practices in various hospitals are the best we can have right now? Yet on the other hand, it makes one wonder whether we do not need a decisive step, like a limited legalisation of euthanasia, with strong protections against abuse, at the present time in order to refocus the debate in ways that would lead to a more radical reorientation of our attitudes to death, and to a saner willingness to integrate our dying as an event in our lives.