I must be one of the few people in the western world who would not recognize a song by Michael Jackson. No doubt I have heard one or several of his songs, pumped inescapably into a public place like poison gas, but I have spent a number of decades reducing my exposure to this kind of thing to an absolute minimum.
The other people in the western world who would not recognize his songs are my friends.
Michael Jackson is interesting to me in the way that a circus freak is interesting to me: that is to say, a certain morbid fascination attaches to him. By the end of his life, I confess that he put me in mind of those bottles in pathological museums containing six-legged lambs and babies with two heads. He was a monster, in the Eighteenth Century sense of the term, even if his monstrosity was the product of society and culture rather than of nature.
Such monstrosity is now the distinction of the undistinguished, which in Jackson’s case was carried to the nth degree. Recently I saw an advertisement – I can no longer recall for what – showing a man whose heavily-tattooed calves and ankles protruded from the bottom of his trouser legs. The legend of the advertisement was ‘You know who you are.’
This surely suggests a very fragile sense of identity or individuality. And, of course, as more and more people adopt self-mutilation as the means of rendering themselves unique so that they know who they are, so the mutilations have to become more and more extreme. An arms-race mentality develops; and while there may have been a self-mutilation somewhere in the history of the world greater than Michael Jackson’s, for the moment I cannot think of it. Given man’s infinite capacity for innovation, no doubt someone will soon manage something even more extreme.
Jackson was a tragic figure, and my heart is seized by sorrow when I reflect on the little I know about his life. (It is also seized by anger at the culture that produced him and accorded him such undeserved prominence.) Trained to perform from a very early age, he lived and breathed and took his being from extreme vulgarity and bad taste. His life was Las Vegas made biography. I have nothing against Las Vegas, but it is for excursions, not the whole of existence.
Then, of course, there is the self-hatred or contempt that his successive self-mutilations imply. Of course, most of us wish at least some of the time that we had been born in different circumstances, with different characteristics, from those in which and with which we actually were born: but maturity (not Jackson’s strong suit, by all accounts) means trying to make the best of the hand that fate has dealt us.
I want now to turn to the doctors who helped Jackson live out his childish and pathological fantasies. Not to put too fine a point on it, they seem to me (I was going to say prima facie) to have been criminal. For the sake of money they abandoned their professional ethics; they knowingly did what ought not to have been done.
Of course, they might argue that I do not know the case personally; that, for example, they complied with his wishes because they thought that he would suffer unduly if they refused to comply with his wishes. This raises important matters of medical ethics.
The master-concept of current medical ethics is personal autonomy. A person should be free to determine the course of his own life, to choose his path for himself, however unwise it is. Therefore, professional paternalism is impermissible. Therefore, when Jackson wanted to mutilate himself by successive operations, thereby turning himself into a monster, it was no part of any doctor’s duty to prevent or even discourage him from doing so. A further point is that he had the financial means to pay for his own mutilation: he was not demanding public subventions for it.
This seems to me crude and false. There is negative and positive autonomy when it comes to medical treatment. If as a doctor I say to a patient ‘I think you should take these pills,’ he clearly has a right not to follow my advice, which I have no right to enforce, however foolish I may think he is being in failing to take it. (A debatable exception may be in case of contagious disease, though even here coercion is seldom effective.)
But that is not the same as the patient having a right to whatever he chooses. He may, for example, demand treatment for a disease that he does not have, and it would be an irresponsible doctor who simply complied with his wish because it was his wish. The doctor has to consider not only the wishes, but the interests, of the patient.
Not long ago in Scotland there was a surgeon who became known briefly for his willingness to amputate the legs of those few people who desired it for sexual reasons, either personal, or in order to make themselves attractive to that small clientele that found amputees sexually attractive.
The argument in his favour was as follows. Some patients desire an amputation so fervently that, if they do not find a person to do it under proper medical conditions, they will do it informally, on railway tracks or the like, much to their own danger. Or, if they do not obtain the amputation, they will send the rest of their lives in a state of bitter frustration and regret.
Against this might be argued that frustration and regret arise in such a case not from the lack of amputation itself, but from a belief that someone, somewhere could and would do it for them, if only they could find him. The existence of the Scottish surgeon willing to do such amputations would therefore increase, not decrease, frustration and bitterness, unless all surgeons followed suit.
Furthermore, the demand could rise with the supply. If surgeons agreed to carry out whatever patients wanted, patients would want more and more, stranger and stranger, operations.
Against this, of course, the Scottish surgeon could argue that his concern is with the welfare of the individual patient, not with that of society, and if the quality a man’s life can be improved, at least in his own estimation, by an amputation, who is he, the surgeon, to deny him this, especially if the patient threatens suicide or something worse if his wishes are not met?
This, of course, would be the defence of the surgeons who assisted Jackson in his prolonged self-mutilation.
What we see in Jackson is a manifestation in extreme form of modern man’s increasing unwillingness to place a limit on his own appetites, the precondition that Edmund Burke laid down for the exercise of liberty. Jackson, it is often said, was a child who never grew up; ‘I want, I want!’ was the sum total of his philosophy. He was, in extreme form, a very characteristic modern human type, whose life course was that of precocity followed by permanent adolescence. This was tragic rather than enviable or admirable; but it was a tragedy for our times.