Illuminating the Dilemmas of Assisted Dying - The Clarity Afforded by Orthodox Systems Theory

In English law, s. 2(1) of the Suicide Act 1961 prohibits rendering assistance in dying to a person, even at their behest. Societal debate and petitions to law reveal agitation for legal change that often is championed in the field of medical or bioethics. Challenges also are mounted via human rights assertions and arguments from personal autonomy. Legal challenges frequently are withstood, though, because the implied changes or reinterpretations of law most often are matters for Parliament, not courts, although some procedural clarifications lately have been produced. So the current impasse remains and analysis of the head-on conflict of principles and opinion might be neither apposite nor offer promising routes to reconciling the difficulty. Other methods of exploration then become desirable, especially if they are more dispassionate, can offer novel perspectives and help clarify the ways in which contemplations can be regarded. The central problem then can be reconsidered by means of a new framework for thought.

Viewed through an orthodox Luhmannian systems-theoretical approach, decriminalizing assistance in dying would involve transposing a social action from one side of the lawful/unlawful divide to the other, which is to expect a great deal. The problem amplifies the very conditions of legal autopoiesis.

Morals and ethics promulgate ideas both pervasively and persuasively over assisted dying but what would be their conceptual home if systems theory is adopted as the mode of considering the central problem? While seemingly ethereal entities at present, can morals and ethics be characterized convincingly? Should they be relocated and re-contextualized within systems theory and what form could that take? Depending on the answer, what rôle would they then have in the discourse and what prescriptive authority, if any, over action?

Medicalization of assisted dying accords clinical medicine a rôle in end-of-life decision-making but on what basis can it exercise this responsibility, viewed via systems-theoretical perspectives? Importantly, what is the nexus of the epistemological underpinning of medicine, its curative function and as an arbiter of ‘desirable’ social action?

The abstraction of systems theory allows illumination of issues germane to the central problem, adds clarity and permits their exploration without external contagion. It is offered methodologically here as a study that also disabuses some misconceptions about rôles and responsibilities in the critical problem of assisted dying and helps to nurture useful contemplation.