a flight from mystery
EUTHANASIA
by
MARGARET SOMERVILLE
__________________________________________________________
Margaret
Somerville is Professor of Bioethics in the School of Medicine
at the University of Notre Dame Australia. Until recently, she
was Samuel Gale Professor of Law, Professor in the Faculty of
Medicine, and Founding Director of the Centre for Medicine, Ethics
and Law at McGill University, Montreal. Her most recent book is
Bird on an Ethics Wire: Battles about Values in the Culture
Wars. This article originally appeared in Mercatornet
(www.mercatornet.com).
EUTHANASIA STRIPS DEATH OF ITS MEANING AT
THE TIME WE NEED IT MOST
People
who espouse ‘progressive values,’ who include those
advocating for the legalization of euthanasia, adopt a mantra
of “choice, change and control.”
Choice
maximizes respect for individual autonomy which is the preeminent
value for progressivists. Choice also allows change to be implemented
and progressivists, often naïvely, simply assume that change
is always for the better. And power to
change can give one a power to control or at least an illusion
that one is in control.
Why
only an illusion? There are some things that we cannot control,
or indeed change, no matter how much we might like to be able
to do so. Death is one of them.
It’s
an innate human characteristic to search for meaning and we do
that whether or not we are religious. The questions the vast majority
of us ask, “Who am I? Why am I here?” manifest and
articulate our search for meaning. Many of us recognize that there
is a mystery at the centre of our responses to those questions,
which are asked most powerfully in seeking meaning in relation
to death. Consequently, death involves a mystery which we must
accommodate. We can do that in various ways.
Euthanasia
seeks to take control over death. It does so by converting the
mystery of death to the problem of death and offering a technological
solution to that problem, namely a lethal injection. In doing
so, it destroys the mystery of death and, thereby, the possibility
of finding meaning in the presence of death.
I want
to make clear that I am not promoting religion here, although
that is one way, and until the post-modern era the most common
way, to find meaning, especially in death. Rather, I am proposing
that all of us need to be able to find meaning, if we are not
to
become nihilists and lead lives of despair. Today, many people
do that by devoting themselves to a worthy cause that benefits
others, including future generations, but that doesn’t help
them to find meaning in death.
One
of the serious harms of legalizing euthanasia is the intangible
one of serious damage to our capacity to find meaning in death,
which might be a requirement for finding meaning in life, in general.
This might be caused, at least in part, by euthanasia’s
impact of trivializing death.
We hear
many stories of ‘bad deaths’ told in support of legalizing
euthanasia. Our hearts rightly go out to the people involved and
recognize that their motives of relief of suffering are good.
But if we do not want to set in motion a much wider range of harms
that legalizing euthanasia unavoidably causes, I propose that
we must kill the pain and suffering, not the person with the pain
and suffering.
This
makes it imperative that fully adequate palliative care, including
pain management, be readily available to all who need it.
We should
also balance the stories of ‘bad deaths’ with those
of ‘good deaths’ – or perhaps it’s better
phrased as deaths from which otherwise unavailable ‘goods’
flow, not only to the dying person, but also to many others. These
include conversations that would never have taken place, reconciliations
with family and long-lost friends, and joys such as holding a
first grandchild. French psychoanalyst Marie de Hennezel, who
has cared for many dying people, including President Francois
Mitterand, describes this time and its possibilities as “intimate
death.”
When
we are dying, the vast majority of us also want to be remembered,
to leave a legacy of our presence on this planet, and as Canadian
psychiatrist Dr. Harvey Max Chochinov and his co-researchers have
shown, we can help people to do this through a structured psychotherapeutic
intervention which they call “dignity therapy.”
This
is an alternative to seeing euthanasia as necessary to respect
a dying person’s dignity, a frequent justification of legalizing
euthanasia.
Social
psychologists propose that not just individuals but also societies
have a psyche and that both can experience terror. When we have
a strong free-floating fear of something, for example, death,
we seek to take control of it to reduce our fear
and anxiety. The social psychologists speak of responding with
“terror management devices” or “terror reduction
mechanisms.”
I believe
euthanasia can be seen as such a device or mechanism for managing
the fear of death. We can’t avoid death, but euthanasia
allows those who seek it to get death before it gets them.
As individuals
and a society we hide death away by euphemising the word. It is
almost “politically unacceptable” to use death, died
or dead in relation to a person’s ‘passing.’.
We hide from our fears, which hinders our own preparation for
death. We could also see euthanasia as limiting the capacity of
a dying person to help to prepare others for a ‘good death’
by showing them what used to be called ars moriendi (The
Art of Dying).
Our
conversation about whether it’s a good or bad idea to legalize
euthanasia needs to be much broader and deeper than it is at present.
It’s not sufficient just to focus on an individual suffering
person who wants death inflicted, much as we ought to have the
most sincere compassion for them and ensure that everything possible,
other than killing them, is done to relieve their suffering.
Euthanasia
raises profound issues about how we find meaning in life; its
impact on law and medicine, the two institutions in a secular
society which carry the value of respect for life for society
as a whole; and its impact on one of our foundational values as
a society, namely, that we must never intentionally kill another
human being, except to save human life.
Such
considerations and many more must be taken into account in our
decision making about legalizing euthanasia, if we are to act
wisely and ethically. At present, the debate is very superficial
and narrow and reduces one of the most solemn moments of life
to a mere contractual undertaking.
Legalizing
euthanasia would be a seismic shift in Australia’s foundational
societal value of respect for human life. It is different-in-kind
not just different-in-degree from medical interventions we currently
regard as ethical and legal. It is not, as pro-euthanasia adherents
argue, just another small step along a path we’ve already
taken in respecting refusals of treatment even if that results
in death and requiring full pain management to be offered to patients.
Euthanasia
rebrands killing as kindness, which is very dangerous. In deciding
whether to legalize euthanasia we should keep in mind the axiom
that “nowhere are human rights more threatened than when
we act purporting to do only good,” as that
sole focus on doing
good blinds us to the unavoidable risks and harms also present.
