Euthanasia has always been a controversial topic.
Proponents see it as a simple, logical route to a “good death”, as found in the word’s Greek roots. After all, we all die. Offering a less painful exit (in appropriate circumstances) is simply humane.
Meanwhile, the concept runs contrary to deep religious prohibitions against murder and suicide. (Playing God, if you will.) It runs afoul of the classical Hippocratic Oath – and possibly the modern version too. (For medical professionals who no longer want to “swear by Apollo.”)
Setting religious objections aside, many fear euthanasia risks legitimizing the elimination of unwanted, troubled or ‘surplus’ human life.
After considering a 400-page report on the legalities of the issue, officials in Quebec recently announced that province plans to move ahead with “dying with dignity” legislation. (I can’t find that report in English, but the Montreal Gazette has a summary of its recommendations here.)
Writing on the Globe and Mail, André Picard called the effort “an important step in the evolution of patient rights.”
In contrast, writing in the National Post, Margaret Somerville asks “If it’s not killing, what is it?”
One of the challenges for any right-to-die measure in Canada is the position of the federal government. Quebec officials think they have the authority to address this on a provincial level. Quebec has studied the matter for some time and officials there are ready to try.
Most observers say the move will likely succeed. As Chantal Hébert put it:
It is not so much that on such matters Quebec is systematically ahead of the curve as that Parliament has a well-documented tendency to lag behind public opinion.
Some forms of euthanasia are already legal in Oregon, the Netherlands and Belgium. Earnest, heartfelt individuals and organizations work to allow the practice. Equally well-intentioned individuals, organizations and religious groups work to curtail it.
Belgium’s practices made headlines recently with the news that 45-year-old twins who dreaded impending blindness were granted death by euthanasia. (Identified in some media reports as Marc and Eddy Verbessem.) Already deaf, the prospect of never able to see each other again – or continue to lead independent lives – reportedly made death seem preferable.
Our usual understanding of euthanasia is that of a controlled end when death is (or will be) imminent and suffering is already present. In such circumstances, the thinking goes, why can’t humans expect the same mercy readily extended to a dying animal, or pet? Quebec’s proposal doesn’t stray very far from that framework, focusing on establishing a right for terminally ill adults (emphasis added) to choose death or refuse treatment.
But the heart-rending Belgium case did not involve terminal illness. It was more about quality of life, and raised troubling questions. If fear, unhappiness or misery are all that’s needed to justify euthanasia, (not just impending death) millions would qualify.
This is often dismissed as a “slippery slope” argument. Yet, isn’t that what’s happening? Consider this rather forceful article from 2011 in Current Oncology, which argues safeguards and controls are an illusion:
In 30 years, the Netherlands has moved from euthanasia of people who are terminally ill, to euthanasia of those who are chronically ill; from euthanasia for physical illness, to euthanasia for mental illness; from euthanasia for mental illness, to euthanasia for psychological distress or mental suffering—and now to euthanasia simply if a person is over the age of 70 and “tired of living.” Dutch euthanasia protocols have also moved from conscious patients providing explicit consent, to unconscious patients unable to provide consent. Denying euthanasia or pas [physician-assisted suicide] in the Netherlands is now considered a form of discrimination against people with chronic illness, whether the illness be physical or psychological, because those people will be forced to “suffer” longer than those who are terminally ill. Non-voluntary euthanasia is now being justified by appealing to the social duty of citizens and the ethical pillar of beneficence. In the Netherlands, euthanasia has moved from being a measure of last resort to being one of early intervention. Belgium has followed suit and troubling evidence is emerging from Oregon specifically with respect to the protection of people with depression and the objectivity of the process.
Some will say “Good. It’s about time we reduce suffering.” I have relatives who strongly favor a right to assisted suicide. Their thinking goes: “As long as there is no coercion or fraud, that should be the patient’s decision”.
I get that. Choice is crucial. Explicit consent, as they say. I have a legal/notarized end of life directive with the basic “do not resuscitate” clause for the dreaded vegetative states, etc. I can easily imagine circumstances where I would ask for (demand?) a mercifully hastened death, or hope trusted relatives would seek that on my behalf. But this issue does end up spilling beyond personal choice.
Consider the millions without good access to health care, who have fallen through the safety net – or never had one to begin with. People for whom a better income, a little access to health care, some practical assistance with personal care could make life very much worth living.
How should society address issues of suffering – and personal choice – without devaluing human life, or making it all about money? If it’s not possible to take money out of that picture, are we ready for a society where assisted suicide becomes a logical choice for the very poor?
Countries with very good socialized medicine and support services wrestle with where to draw these lines. Imagine how bitter the choices might be where such resources are sorely lacking, as is often true in the U.S.
What moral code, or protective guidelines, would you want established in this highly-charged issue?