I have witnessed a patient being allowed to choose death, and another being prevented from choosing death. The first was sad; but the second was horrible. More to the point: the first was just, and the second was not.
Of all the crucial questions raised by the euthanasia debate, the most fundamental is the least frequently asked. And yet the answer to this question directs the answers to all the others.
Scratch the surface of any clash over voluntary euthanasia and you are likely to find clashing answers to this fundamental question: whose life is it anyway?
Three answers are commonly implied: my life belongs to God; my life belongs to society; my life belongs to me. If my life belongs to God, then it is surely His province to giveth and taketh it away. If my life belongs to society then I might feel obliged to remove its burden on society; or I might feel obliged to endure a painful and hopeless existence to spare society the problems associated with its removal. If my life belongs to me, it is for me to decide whether it is worth living or not – only I have the right to make that judgement.
I invite readers to answer that question for themselves. As for my life, it is not to be treated as an instrument of God’s plan or a cog of society’s wheel – it belongs to me. I respect the right of others to decide the rights and wrongs of voluntary euthanasia or assisted suicide according to their religious or social premises – for themselves. But they have no business using the force of law to impose their judgements on this most personal matter onto me, or onto anybody else. Isn’t my individualist premise rather selfish? Yes it is. Is it compassionate? Yes it is. More to the point, it is the only approach to voluntary euthanasia based on the principle of individual rights.
The slippery slope projected by Bill Muehlenberg, from voluntary euthanasia to a Logan’s Run world, in which individuals have to justify their worth to society or be voluntarily or involuntarily terminated, would be the result of the social premise taken to its logical conclusion. (Or of the Green premise that replaces society with the ecosystem of the planet). No such world could be based on the individualist premise.
There are obviously difficult complications to be worked out when enshrining the right to voluntary euthanasia or assisted suicide in law. As with other rights, this right cannot be invoked by minors or the insane; safeguards against hasty or pressured decisions under stressful circumstances need to be worked out; and the vulnerable need extra layers of protection against malpractice or abuse. But the legal and medical professions deal with difficult complications all the time. And the implementation of prudent and just voluntary euthanasia legislation couldn’t be more problematic than de facto euthanasia administered on an ad hoc basis.
I suspect there are doctors in this country who have to worry that by complying with their desperate patients’ wishes they risk being charged with murder. And I suspect there are law enforcement officers who have to worry that by drawing the line between enforcing the letter of the law and looking the other way in the interests of all concerned they risk being charged with dereliction of duty. Professionals such as these have stresses enough to deal with; it is grossly unfair if they have to deal with equivocal medical and legal practices regarding this life and death matter – especially if they have to be cautious about how they discuss it. And don’t-ask-don’t-tell practices, as Michael Duffy calls them, are inherently dangerous.
As Michael Duffy notes those whose position on voluntary euthanasia is based on religion frequently try to bolster their arguments with practical considerations, but as heartfelt as these may be, they are usually of dubious logic. Tony Abbott’s argument that we owe the terminally ill loving care rather than death dodges the issue. By all means offer palliative care – if it is effective it may convince the patient to stick around. But the patient is the only one who has the right to make that call. In some cases it is the reassurance that they will get help to terminate their life if they need it that convinces patients they should hang on a bit longer.
Of all the thoughts that went through my mind while lying in hospital with a broken neck being fed through a drip and breathing through a tracheostomy, the worst by far was the thought that if I decided, after due consideration and advice, that I wanted to die, they might not let me. I have witnessed a patient being allowed to choose death, and another being prevented from choosing death. The first was sad; but the second was horrible. More to the point: the first was just, and the second was not.
In order to mitigate the cruellest implications of his anti euthanasia stance, Bill Muehlenberg draws fine semantic and medical distinctions. He declares that euthanasia “is about one thing only, the [intentional] killing of another person” – which he equates with murder. And he argues that a doctor who administers a dose of morphine sufficient to hasten death is not committing euthanasia/murder since his intention is to relieve pain rather than shorten life or cause death. Unfortunately the fact remains that the doctor knew that by administering the pain relief he was shortening his patient’s life, i.e. causing his death. In such a circumstance it is a very fine and problematic distinction indeed to claim that it is “the underlying illness” that killed the patient. Furthermore, what if a desperate patient needs help to end his life but there is no convenient course of pain relief medication that would do the job?
The most fundamental rights we all have are to life and liberty; which mean the freedom to live our lives as we choose provided we don’t infringe the rights of others to do the same; which means being free to direct our destinies; which means being free to end our lives. The conflict between this “right to die” and the doctor’s Hippocratic Oath to keep patients from “harm and injustice” is dramatized brilliantly in Whose Life is it Anyway? Presented originally as a television play in 1972, it was re presented as a stage play in 1978, and as a movie in 1981. The adversaries of the drama are a paralysed sculptor who wants to die and an administration that denies him that choice. When I saw the 1972 version as a young man I agreed with the principle the sculptor was fighting for. When I saw the 1981 version recently I still agreed with the principle and appreciated a lot more about what this “right to die” means in practice.
Bill Muehlenberg argues passionately against a “right to die” or a “right to commit suicide” and projects “death on demand” scenarios in which doctors face “denial of death suits”. But just as the “right to life” should not imply that a grocer must feed a hungry customer, the “right to die” should not imply that a doctor must end a patient’s life. If a patient decides he wants to die and has the knowledge and capacity to follow through with the act he shouldn’t shift that responsibility onto someone else. But most patients need a doctor’s advice, and some need the doctor to perform the act itself. A patient in a coma, for instance, needs a doctor to carry out the instructions he laid out in his living will. The doctor must be free to refuse to perform the act; in which case the patient (or his representative) must be free to find someone else who will.
Brian Pollard argues, from a position of considerable experience and concern that: “every law to permit [voluntary] euthanasia will be inherently and unavoidably unsafe.” But no law is immune from violation or “deceit”, they all require the eternal vigilance of the police and the courts and all of us. Is a situation that drives doctors outside the law in order to tend to their patients needs safer? Which situation breeds more “deceit”? The legal tangles Brian Pollard describes are no doubt problematic; but it is the lawmakers’ and court’s job to untangle them and administer just laws based on the principle of individual rights (rather than on the UN declaration of Human Rights).
He argues that euthanasia laws would “fail to respect the principle that all human lives have equal value.” Have equal value to whom? There is no disembodied intrinsic “value” – that concept implies a valuer. Have value to God? Have value to society? Or have value to the individual human being? I’ll leave it to those who subscribe to the religious or social premise to explain how equality of value applies to Einstein and Hitler. On the individualist premise, my life has more value to me than Bill’s, Michael’s and Brian’s have to me – as I trust their lives have more value to them than mine does. But the value we each place on our life implies the values we can achieve and cherish by living it. There can come a time when a rational decision can be made that a wracked life harbouring little hope of achieving anything but the demolition of all one cherishes is not worth continuing.
Brian Pollard argues that voluntary euthanasia laws would “fail to respect the principle that all are equal before the law.” I respectfully disagree. Prudent euthanasia laws would restore to people trapped in helpless situations some of the control over their own destinies that the rest of us take for granted. Those attending to our legal and medical needs must consider each of our lives of equal value – of equal value to each of us. Each of us must have the right to live as we see fit – and that right to our own life must include the right to end it.