“These people are reacting with emotion, not reason,” it was opined on this morning’s Jon Faine show on Radio Melbourne/774/3LO/SigmaSixGuthrieSound, whatever it’s called these days. The talk was of those advancing the “no” case against voluntary assisted dying, a bill for which is now coming up for a final vote in the Victorian Parliament. It will probably pass, though more narrowly than its proponents might have hoped. I hope it won’t, at least for the moment, so that the issue can be debated in a more expansive and comprehensive fashion. Those voting on the bill who are wavering, should err on the side of prudence and vote it down, for the moment.

It is commonly suggested that a pro-voluntary assisted dying (VAD hereafter — hereafter, haha, oh come on … ) position is on the side of “reason”, opposition on that of “emotion”. The “emotion” side is then condescended to as a valuable corrective, safeguard, etc, to what is assumed to be the necessary course of history. I would put it in exactly the reverse: the argued case against VAD is the one employing critical reason. It is the unthinking “yes” case that is not rational, but ideological. It simply reproduces the individualist liberalism that surrounds it as if it were the truth, not a particular and partial way to live.

The liberal assumption is that we are sovereign and separate individuals, selves inside a body, peeping out from it, to the wider society. According to liberalism, we create social life and shared meaning by a series of contracts with other people in which we exchange desires and needs, to mutual satisfaction.

A moment’s reflection will tell you that is utterly false. We are social entities — infants, being en-culturated, en-languaged by others — before we are selves at all, much less individuals. We are embodied beings already in a web of social meanings, before some sort of individual, reflective consciousness emerges. Social and collective processes shape our understanding of what is proper, required, accepted, of what it is legitimate to ask, and to want. In our era, much of that shaping of self is around use — economic use, in particular. Are we a useful entity? Are we pulling our weight? Etc.

The concern many of us have, from a non-religious perspective, about VAD is that it combines those two processes — meaning and expectation as a collective practice, and life as utility — in a way that, when wired into a medical system, could have unintended consequences that will be deeply regretted. In effect we would argue that the form of the end-of-life medical system will become oriented to death-giving, and that the content of it will become oriented to the dying person as a “utility unit”.

None of this will be conscious, and that is why liberalism cannot even talk about such processes. The deep faith “rationalists” have in the individual is, or should be, exposed by the fact that many of the things that happen in our lives are ruled by social, collective and unconscious forces, passions and processes. Over time, a VAD system could reshape doctors and patients within it, to death-orientation.

The defenders of the VAD bill say they have put in many safeguards, and they have. I’m not against some form of semi-assisted dying, which accounts for incapacitation. I’m not against rational suicide in the face of unbearable suffering. But suicide is legal, and suicide should be a difficult thing to do, a momentous step. Life has made it hard for us to kill ourselves; as Robert Lowell said, if you had a switch on your arm that could kill you instantly, most people would be suicides.

But if a comprehensive VAD system is to go ahead there should be one major safeguard: universal, free and unlimited top-rate palliative care, for those who want as much life as possible. And that is simply not the case in Victoria at the moment. The health system is underfunded (especially compared to systems like the Netherlands, which have VAD), the best painkillers are not available to everyone, new techniques are slow to be introduced, and the system is class-dominated – the rich have access, medical professionals and their friendship networks have access, others don’t.

This to me rules out ethical VAD from a left perspective absolutely at the moment. Because there is no doubt that people who want weeks or months more of life, will have themselves killed because the care is not there to support them in that desire. Those people taking that option will be disproportionately poor, indigenous, and disabled. In a system without universal, free, cutting-edge palliative care, a VAD law is suborning murder. It is very much in the character of the Andrews government — technocratic control of the populace within a neoliberal framework represented as progressivism.

The bill should be rejected; universal palliative care guaranteed. And a modified VAD bill re-introduced at a later date. Labor members who retain a class politics ought to think about who will be getting hurried onto death, and the role they’ll play in doing it.