Mishima's commentary on the thought process of death as a choice is precise: "The evaluation that ultimately produces the decision to die trails behind it a long chain of tempering of one's judgement towards the final decision suggests the long period of tension and concentration that the man of action must endure."
One can recall how Captain Titus Oates of the Terra Nova Expedition to the South Pole in 1910-1913 made his decision to die, so that he would not be a burden to his expedition team. Waking on the morning of 17 March 1912 and recognising the need to sacrifice himself in order to give the others a chance of survival, he walked willingly to his death in a blizzard, to try and save his comrades, beset by hardships. Captain Robert F. Scott, the team leader of the Expedition recorded the circumstance of Captain Oates' decision:
"He has borne intense suffering for weeks without complaint, and to the very last was able and willing to discuss outside subjects. He did not - would not - give up hope till the very end. He was a brave soul. This was the end. He slept through the night before last, hoping not to wake; but he woke in the morning - yesterday. It was blowing a blizzard. He said, 'I am just going outside and may be some time.' He went out into the blizzard and we have not seen him since."
There is a common thread in making a decision to sacrifice oneself, so others can live. It does not involve third parties, only immediate parties, ie, only decision-makers themselves like Captain Oates or decision-makers and their immediate counterparts, ie, enemy troops as in the case of Randy Quaid in the movie, Independence Day, or the Japanese Kamikaze pilots against American warships towards the end of World War II. And I should add what Mishima said about the Kamikaze pilots:
"I suppose some people will say that the Kamikaze pilots, despite their high-sounding name, were forced to die. And certainly these youths not yet out of school were forced by the national authorities to proceed to their death against their will. Even if they went of their own will, they were rounded up into attack forces almost by coercion and sent to certain death. And this is certainly true."
I fully agree with Mishima's assessment. Emiko Ohuchi-Tierney's "Kamikaze Diaries: Reflections of Japanese Students Soldiers" (2006) attests to the student soldiers' agony and dilemma between duty to the country and wanting to stay alive in the poems, letters and diaries featured in the book. Against the history of such a tragic background, I believe any decision to face death as a choice should be completely personal just as any exercise of freedom of choice is personal.
With the enormous advances in medical technology and knowledge, our life span has extended considerably, and at the same time, more of us, thanks to those medical developments, will be diagnosed with terminal illnesses and the need for more complicated medical treatment.
These radical changes will force us to review fundamentally the way we care for and treat people who are either ill or aging beyond their independent life. As longevity becomes prolonged and the aging population increases, these radically changing circumstances force us to rethink anew what is the purpose of life, what is the quality of life, how to maintain the dignity in life, and ultimately, how to terminate one's participation in life.
Lady Warnock's recent interview is such an attempt to redirect the focus of debate: "I'm absolutely, fully in agreement with the argument that if pain is insufferable, then someone should be given help to die, but I feel there's a wider argument that if somebody absolutely, desperately wants to die because they're a burden to their family, or the state, then I think they too should be allowed to die." I agree with her on the importance of respect to the individual's freedom of choice. But she went one step too far in suggesting that there is a "duty to die."
The notion of "duty" is contrary to the notion of freedom of choice; it is inherently attached to a position or condition in which you find yourself. Lady Warnock is utterly off the mark in suggestion such a "duty to die." Nobody can stop anyone who is determined to die unless you are on the spot when suicide is about to be committed.
But the choice of means of committing suicide varies due to the limited range of choice: shooting your head off by a pistol, jumping off the cliff, the top of the skyscraper or bridge, hanging oneself, jumping in front of the incoming train from the platform, taking an overdose of pains killer or sleeping pills, smoking fumes of carbon monoxide by running a car engine, gassing oneself by releasing a kitchen gas pipe, or slit your vein in the wrist. The end result of any of these "means" of suicide is invariably and regrettably messy. There must be a cleaner and simpler way of terminating one's participation in life.
When the law on assisted dying does change, it will include procedural safeguards to ensure that any terminally ill adult who chooses an assisted death is mentally capable of making the decision and understands its consequences. But these safeguards are to be provided because a third party is assisting the patient to die-peacefully. The decision to die comes from the individual, but "assistance" may be offered only when you are not capable of executing that decision by yourself. An instrument of a "living will" is no different; you require somebody else to implement your decision when you are not capable of doing it yourself.
Why wait until one becomes incapable of executing one's decision by oneself? Safeguards needed are for the protection of vulnerable people, and through the third party's assistance or otherwise, the end result is the same: you respect someone's freedom of choice in terminating his/her participation in life. We need to develop a more humane, equitable and simpler procedure to face death as a choice.
Otherwise, we would end up with developing what Lady Warnock calls "a two-tier system" of death: some people will travel abroad to die, others will attempt at messy suicide, or worse, resign to eventual death. I, for one, would like to have my choice respected. I would rather implement that choice while I am capable of doing so. As Lady Warnock says, "[i]n other contexts, sacrificing oneself for one's family would be considered good. I don't see what is so horrible about the motive of not wanting to be an increasing nuisance.