The Herald published two letters from me during this past week, so I suppose that must qualify me, for the time being, as a frequent contributor. I scribble away. People will be saying, “Not him again!” The most frequent contributors to the letters pages of the Herald tend to write, almost exclusively, on the Scottish constitutional question. Supporters of Scottish independence (the Unionists call them “separatists” because they want to “rip apart” the UK) tend to think that the Unionists are universally morose and consider Scotland “too wee, too poor, and too stupid” to be an independent nation, while the Unionists consider that the “separatists” have a massive chip on their shoulder, an endless and insatiable grievance, and continually deflect criticism of the SNP by using the technique of “whataboutery”, and casting aspersions on Westminster. For myself, I tend to avoid the constitutional question, not because I don’t hold views, but because I always remember the advice of a former President of the Australasian College for Emergency Medicine: “Don’t be seduced into entering an argument with somebody whose views cannot be changed.” Besides, there is much else to write about. For example, the debate about Assisted Dying is back before the Scottish Parliament, which prompted my first letter:
In the ongoing debate around the Assisted Dying Bill currently before Holyrood, it occurs to me that in our age of Artificial Intelligence (AI), it would be theoretically and indeed practically possible to remove human agency entirely from any end of life procedure, which could be undertaken by robots, thus obviating any requirement for new legislation. It is after all not against the law to end one’s own life, merely to assist another so to do. The terminally ill patient, should he or she so choose, would instruct the robot to conduct a home visit, arriving by driverless car, to administer a lethal cocktail. I don’t mean to be facetious about this, far less vexatious. Robotic surgeons already carry out operations far more complex than this.
Of course there would be a flurry of parliamentary activity as our MSPs practised catch-up legislation. Doubtless it already exists in draft form. The science fiction author Isaac Asimov introduced the Three Laws of Robotics in his 1942 short story Runaround (part of the 1950 collection I, Robot), presented in the fictional Handbook of Robotics, 56th Edition, 2058 A.D. The laws are:
- A robot may not injure a human being or, through inaction, allow a human being to come to harm.
- A robot must obey the orders given it by human beings except where such orders could conflict with the First Law.
- A robot must protect its own existence as long as such protection does not conflict with the First or Second Law.
To these three laws, Asimov subsequently and retrospectively added a Zeroth Law:
- A robot may not harm humanity, or, by inaction, allow humanity to come to harm.
The ethical issue that arises is whether or not the termination of a life deemed intolerable by the person living it constitutes a “harm”. It is said that if you chance to see a distressed individual in a railway station about to fall in front of an approaching train, a useful question to ask is, “Is it living, or the pain that you want to stop?” I can’t say I would relish AI moving into the field of thanatology, which sounds like something out of a dystopian novel by Aldous Huxley, but at least the medical and nursing professions could keep their distance, and concentrate on the day job.
I was amused to find that Asimov considered it necessary to concoct a Zeroth Law to precede his Three Laws of Robotics. I suppose he must have modelled this on the laws of thermodynamics, to wit, in brief, that energy can be neither created nor destroyed, there is no such thing as a perpetual motion machine, absolute zero (-273C) can be approached but never attained (thus flouting Heisenberg’s Uncertainty Principle)… and then, in retrospect, something that was first appreciated by James Clerk Maxwell, that if A has the same temperature as B, and B has the same temperature as C, then A has the same temperature as C. I suppose that is why we believe in thermometers. Maxwell’s insight was that this statement is, as our philosophers would say, a posteriori, rather than a priori; that is, it is not self-evident but has to be experimentally demonstrated, and vindicated.
Asimov’s Laws of Robotics are less flippant than they look. The Zeroth Law is the moral equivalent of the fourth pillar of the axiomatic principles of medical ethics of Beauchamp and Childress, justice, itself a kind of zeroth law, added retrospectively after autonomy, beneficence, and non-maleficence. The plight of an individual at the end of life has to be seen within the context of humanity at large. Therefore do not send to know for whom the bell tolls.
I remember being present at the annual conference of the Royal College of General Practitioners – it was either in Liverpool or in Harrogate, I can’t remember which – when the late Margo MacDonald put forward her then proposed Bill before the Scottish Parliament for the introduction of assisted dying under stringently controlled conditions. I remember a GP sitting on my left whispered to me, “She’s not very bright, is she?” I am convinced the only reason why he thought such a thing, was that Ms MacDonald spoke with a pronounced, industrialised West of Scotland accent. I can’t think of any other reason. I reassured the GP, “On the contrary, she is very bright.”
I respected what Margo MacDonald had to say, but as you can tell from my letter, I’m not for it. To be honest, I’m phobic of it. My visceral reaction to it is the same as my reaction to capital punishment. It occurs to me, what would happen if somebody on Death Row in the US requested to be transferred to Oregon for an assisted suicide? Would the prisoner fit the criteria? It could be argued that he had a terminal disease, the condition of being on Death Row, and a life expectancy of less than six months might be valid.
I have another question about assisted suicide. What happens if it all goes wrong? All the hoops have been gone through, all the forms are signed, and the lethal cocktail is quaffed.
But it doesn’t work.
(Just in case you imagine this can’t happen, may I remind you of an adage frequently recited in medicine: show me a treatment that has no side effects, and I’ll show you a treatment that doesn’t work.)
What are the attending doctors to do with a patient who has not succumbed? Do the signed papers still hold good, such that some kind of coup de grace may be administered, or are we in virgin territory, in which a decompensating patient must now be resuscitated? I don’t know.
Bur enough of this baleful topic. Moving on to Herald letter No. 2, it so happened that during the week, a plaque was removed from the base of an Edinburgh statue of Henry Dundas. Dundas, at least according to the plaque, delayed the abolition of slavery to the extent that half a million slaves still got transported across the Atlantic while he swithered. The historian T. M. Devine disputes this interpretation. With this skeletal background, here is my letter. Some of the material has previously appeared in this my weekly blog.
Dr Martin Luther King’s memorable “I have a dream” speech, given before the Lincoln Memorial on August 28th, 1963, contains a remarkable sentence which begins:
“I have a dream that one day down in Alabama with its vicious racists, with its governor having his lips dripping with the words of interposition and nullification…”
All my life I’ve wondered, what are the words of interposition and nullification? I don’t know, but I would hazard a guess that they were the governor’s way of putting a brake on the aspirations of the civil rights movement.
Now I find, by a strange ironic twist, that the words of interposition and nullification are everywhere. They are, or were, on the plaque at the base of the statue of Henry Dundas, 1st Viscount Melville, in St Andrew Square, providing “context”. They are on the frontispiece of the 2023 republication of Ian Fleming’s Live and Let Die, telling us that social attitudes were different in 1953. Duh. An early chapter in that book has been renamed “Seventh Avenue”, and gutted. We can look to the United States to see the inevitable corollary to such interventions, with the banning of books from schools and libraries (Book bans hit record high in US libraries, Herald, September 21). Some of the books in question are To Kill a Mockingbird, The Catcher in the Rye, Huckleberry Finn, Slaughterhouse Five, and the Harry Potter series. They have been assigned to oblivion, as if by that wretched character in 1984, Syme, whose job it was to obliterate the English language. And look what happened to him.
I wish people would stop telling us, you and me, what to think. I am quite capable of reading a book, or looking at a statue, which is after all a work of art, and making up my own mind about its meaning and purport. I can do without the context of somebody else’s interposition and nullification. We only need three words on a book’s frontispiece, or a statue’s plaque:
Complete and Unabridged.
Being in Glasgow yesterday, emerging from Kelvingrove Art Gallery to find it had stopped raining of a preternaturally warm autumn afternoon, we strolled up to the top of Kelvingrove Park to view the statue of Lord Roberts of Kandahar, just to see whether anybody had reapplied in red paint the word “Monster”, or indeed whether somebody had appended a plaque of interposition and nullification. All was well with the statue. However, we did also pass the statues of Lord Kelvin, and Joseph Lister on the way back, both bedecked with traffic cones after the fashion of the Duke of Wellington outside the Gallery of Modern Art. I think it is unfortunate that Banksy allegedly remarked that the traffic cone atop the Duke of Wellington is Glasgow’s finest work of art. Arthur Wellesley’s Glasgow bunnet is, I fear, a permanent fixture. I’m thinking of crafting a plaque to add to the statue’s base, which would provide “context” to future generations:
The traffic cone was a late amendment to this statue, tolerated at a time when people were more resigned to Glasgow’s edginess, its litter culture, Old Firm sectarianism, and anarchic loutishness. Wha’s like us?
jamescalumcampbell 