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The muddy place between personal and public

This false distinction between the public and the private has emerged regularly in the euthanasia debate. But life is not neatly compartmentalised, writes Jannah Dennison.

Recently it was reported that David Seymour is open to changing the requirement in his euthanasia bill that doctors who are conscientious objectors face consequences. In the current wording, a doctor who objects to euthanasia is required by law to refer an interested patient on to a doctor willing to carry it out.

Seymour was quoted as saying that it was important for the select committee to listen to the submissions of doctors and others, as their expertise could help better inform the bill. “But”, he said, “their personal opinions carry no more weight than a plumber's."

Seymour’s odd comment regarding plumbers has raised the hackles of many armchair commentators, and rightfully so. The demeaning of plumbers is not cool; and is telling, from someone who likes to champion the rights of the person on the street.

Some have generously read this as Seymour’s defence of the equal right of anyone to speak into this debate: and yes, the value of expert opinion in matters of life or death notwithstanding, it’s good to hear from everyone in a democracy.

But this is not what Seymour is actually saying. This is not at heart a comment about equality, or the value or otherwise of a plumber’s ethical contribution to the euthanasia debate. This is about the imaginary distinction Seymour is drawing between one’s ‘expertise’ and one’s ‘personal opinion’.

I imagine that Seymour assumes that expertise means the measured, professional opinion of the doctor – his or her gathered weight of experience, research, and evidence, supported by the wider body of professionals. Personal opinion, I guess, is the realm of the private, the subjective, the emotional - and individual moral conviction.

Seeking to separate someone’s ‘personal opinion’ from their ‘expertise’ is utterly misguided. It’s a myth. And for Seymour - the architect of this bill - to make this basic mistake shows how prone he is to discussing euthanasia through a blunt, polarising framework.

To expect doctors to leave their personal opinion at the door when making ethical decisions is to create separate categories where there are none.

Expertise is a complex and nuanced designation. It is far from a detached, ‘professional’, rational state. Yes, it involves research, evidence, collaboration, experience. But also care. Conviction. Intuition. Moral judgements. It cannot be separated out into categories of the public expert and the private individual. True expertise is thoroughly personal, always. And a body of experts is itself a conglomeration of personal opinions. To expect doctors to leave their personal opinion at the door when making ethical decisions is to create separate categories where there are none.

Imagine a patient who goes to his doctor, an expert in the field. His symptoms mostly fit within a particular diagnosis, but the doctor has a gut feeling that something is off. This intuition is based on a range of things: long experience; research into the usual trajectory of this disease; personal knowledge of this patient; extensive reading of the possible variants here. She could take the standard approach to dealing with the on-paper diagnosis, but she is unsettled. Choosing to further investigate, she stays outside work hours to care for this patient. She considers a perfectly legitimate though slightly unconventional approach to treatment. She tells the patient that he is free to pursue the standard treatment, but, in her personal opinion, she wonders if he would benefit more from her proposition. They agree to trial this method. She is thoroughly personal, and thoroughly expert.

The thing is, I want a doctor who will give me their personal opinion. Personal speaks of emotional investment, and care; of moral conviction. And if an expert is acting with integrity, there is no conflict between their expertise and their personal opinion. The personal is inherent in the truly professional.

Seymour’s dichotomy invites the idea that to be truly objective and rational about ethical decisions, we have to leave our emotional investments, our personal caring, at the door. Because caring is messy - it muddies the waters of decision-making. But care should be at the heart of all interactions with patients, and to diminish one’s personal investments in the name of ‘expertise’ is to endanger the place of care in this discussion.

This false distinction between the public and the private emerges regularly in this current euthanasia debate, most particularly from Seymour. This rhetoric states that what you do in private is of no concern to me, that your private business has no impact on our shared public life. What you do is your business.

This may sound appealing: autonomy, choice; an objection to meddlesome and judgemental individuals. My life, my rights. But our public and private lives don’t operate like that. My public, even ‘expert’ life is just an expression of my personal convictions. Note our public outrage at the moral failings of leaders (e.g. the fate of Barnaby Joyce across the ditch). Why should we care, under the rhetoric of public versus private? Because we suspect that, funnily enough, what people do in private says something about who they are; and ‘who they are’ is behind every action they take in the public sphere. Life is not neatly compartmentalised.

With euthanasia, our ‘private choice’ is never just that. The very existence of the choice would impact the lives of medical professionals, family members, youths, elderly – our entire community. Seymour’s distinction between the private and the public is a gross oversimplification. The provision of this private choice will fundamentally change our society.

The myriad ‘private’ choices we make - our collective private decisions - as community members, ultimately affect everyone. Whether I choose to neglect my kids, to recycle, to visit my elderly relatives, or to send my children to private school affects, at some level, all our relationships: our families, our friendships, our community, our environment, our mental health, our economy. We are all in this together.

And actually, I want to be. Not to meddle in your life, as the advocates of a high libertarianism would frame it, but because I care about you. How you live and die matters to me and should matter to everyone – and if you reject that, and say that it shouldn’t, you are rejecting my care for you and for our community life together. It’s confronting, as shared life together is.

And for doctors facing the possibility that their ‘personal opinion’ may have to be shelved in the face of the mythical pursuit of a professionalism untainted by personal conviction, and upheld by law, this is truly a travesty. David Seymour needs to go and do some close reading, rather than take his usual broad-brushstrokes approach. It would be unconscionable and dangerous to expect medical professionals to be forced to act against their convictions in matters of life and death.

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