reprehensible. In the context of this debate, three points on this scale are used: the ‘normative’, to indicate an act that unambiguously reflects the principle under review, the ‘non-normative’, indicating an act that does not unambiguously reflect the principle but that may still be either acceptable or permissible because it does not contradict the principle and the ‘anti-normative’ to indicate an act that, in effect, contradicts the principle and, consequently is unacceptable. For example, if the principle were ‘Thou shalt not kill’, a normative application might be a policeman arresting an armed thief at gunpoint, having first issued a warning, a non-normative application may be represented by a policeman shooting and killing a thief in selfdefence after the thief drew a gun and aimed it at the officer while an ‘anti-normative’ application may be represented by a policeman ‘shooting first and asking questions afterwards’. Finally, before identifying the salient principles and suggesting an order of precedence, it is important to emphasise that what we are talking about are principles that ought to lie behind communal responsibility and legislative decisions, not principles that will necessarily be adhered to by individuals in other areas of life. For example, while the principle of protecting life will play an important part in most people’s lives, it may, in certain circumstances, be less important for some individuals than other principles such as altruism or honesty or, in the case of many religious people, loyalty to God or to their Faith. Individuals may choose to die rather than compromise their beliefs or they may choose to risk their lives in undertaking work in hazardous conditions in order to provide for their families or to care for others. Individual choices like these are subject to individual conscience and, within limits that prevent such choices from harming others, they cannot be legislated for. What we are discussing in the context of assisted suicide, however, are principles that ought to be binding for society as a whole, that underpin legislation and that are communally applicable. Few people, if any, have argued during the course of the debate that there ought to be no regulation with regard to assisted suicide, or that it is not a matter of communal as well as of individual concern. By definition, assisted suicide involves more than one person and while society does not insist in regulating all aspects of individuals’ relationships it does, rightly, intervene in situations where relational actions have the potential for causing harm. The law now, correctly, recognises such evils as marital rape and domestic violence; actions that were once thought to lie outside the remit of legislation. In this context, the onus is very clearly on the person who wishes to argue that assisted suicide ought to be free from all regulation to demonstrate precisely and convincingly why this ought to be so. In the absence of such a convincing argument we shall continue to explore the grounds for principled legislation. What then are the salient principles that have undergirded the debate on assisted suicide and what ought to be their order of precedence? In the language of the debate, so far, they are: protection of life, protection of the vulnerable, societal responsibility and individual autonomy. For reasons that will be outlined below, these may be better stated for the future development of the debate as the principles of affirming life, caring for the vulnerable, building community and respecting individuals. While few people will object to these four guiding principles, the proposed order of precedence is more controversial. The rationale behind this suggested order ought, however, to become clearer as we look at each of the principles in turn.
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Journal of Observational Pain Medicine – Volume 1, Number 1 (2012) ISSN 2047-0800