Another Swiss "Suicide Tourist" Proves the Euthanasia Debate is not About Terminal Illness
A Canadian woman with MS traveled to Switzerland with her husband for assisted suicide. The Euthanasia Prevention Coalition has demanded a legal investigation. I doubt that will happen, but I post this story because I want y'all to look at the way in which the reporter romanticized family support for the suicide (don't any family members oppose their loved ones' suicides any more?), but most particularly, for us all to ponder the attitudes expressed in the comments section.
Elizabeth McDonald, age 38, was not terminally ill. She was disabled and depressed. (Depression is caused by MS in some cases.) But the fact that McDonald was not dying matters not a whit to the readers commenting on the story. And of course it wouldn't. If one believes that killing (whether of self or by others) is an acceptable response to human suffering, then terminal illness has absolutely nothing to do with it. Moreover, the comments indicate a trend I have noticed in the last decade that among general society the "better dead than disabled" meme is growing increasingly strong--which chills the blood of disability rights activists who see disabled people in the cross hairs of the entire movement. And, of course, the reporter never bothered to contact disability rights spokespersons or suicide prevention professionals about the impact of stories such as this on disabled people generally or people with MS, specifically. Typical of the genre.
So, let's can the smoke and mirrors arguments about assisted suicide being limited to the terminally ill in irremediable suffering, and have an honest debate. The real issue is a "right" to suicide for whatever reason people determine that they want to check out--so long as the desire to die is not transitory. This is sometimes called "rational suicide," about which I have written on several occasions, including here in the NRO. (Along these same lines, recall the post from the other day about The Economist seeming to advocate prevention primarily for the "confused, temporarily depressed or in need of sympathetic attention," but only equivocally for those with a "determined" desire to die. )
Some will disagree, but to me, widespread support for suicide in the face of illness and disability is a symptom of a growing disintegration of mutual cohesion and caring in society. The new attitude seems to be, "If you want to die, go ahead and die. It's none of my business," which masks as respect for "choice" but is actually a form of abandonment. If this attitude continues to proliferate, it is going to be increasingly difficult to be a dependent person in society.
posted by Wesley J. Smith @ 8:26 AM
29 Comments
29 Comments:
"If you want to die, go ahead and die. It's none of my business,"
is precisely the philosophy behind acceptance withdraw of LST.
With the huge differences that one is preventing an offensive touching, which amounts to an assault under the law. Second, that removing unwanted LST is not intentional killing. Sometimes people who have LST withdrawn don't die. And third, if they do die, it is a natural death, not a homicide.
We used to give a damn about suicidal people. Suicide prevention centers proliferated when I was a young lawyer. We still have laws that can force treatment if it is proved beyond a reasonable doubt that someone one is likely to harm themselves. There are many people alive today who would be dead without this level of community care.
But this gets in the way of choice. So, I guess we should just license euthanasia centers and get on with it. Too many people in the world anyway.
Laws that can mandate treatment will do little except reinforce the social taboo on suicide.
Instead of seeking help, they'll hide from family, friends and doctors. The social stigma of suicide is bad enough. Forcing treatment (or the threat of it) will only make them more likely to bump themselves off.
Treatment of what? Depression?
You're arguing, then, that pretty much any reason is a good enough reason to kill yourself, and that a "social taboo" or "social stigma" against suicide is a bad thing. Just so's we're clear.
Doesn't it seem likely that a social acceptance of suicide will lead more people to kill themselves who otherwise could have been helped?
If you want to reduce suicide, a social stigma and taboo is counterproductive.
When there is a stigma on something, as there is on gays in many parts of America, those who fit into that category don't want to talk about it, because they fear reprisals and punishment. Hell (no pun intended), in the middle ages, they had the strongest taboo and stigma possible on suicide. Attempted suicide was punished by death, and all their possessions became the property of the church. Clearly, killing those who attempt suicide do not do much to stem suicide, and condemning people for having suicidal thoughts or depression through social taboos and stigmas is likewise going to backfire.
Gregory: Tony has made it clear that he pretty much believe in death on demand.
Social stigma actually is an effective deterrent to self destruction. This is why the euthanasia crowd is trying to change the terms of the debate. Their polling shows that the "suicide" is viewed negatively by folk, and so they INSIST that assisted suicide be renamed the gooey euphemism, "aid in dying," and make the ludicrous claim that self killing by someone with a terminal illness isn't actually suicide. It is the infection of post modernism: facts don't matter, narratives do.
Social stigma is actually more powerful than any law in maintaining standards of behavior, in my view. Of course it can be oppressive, and that needs to be guarded against. But without societal norms and public expectations on each of us, we end up with social anarchy and a splintering of community, which is the most dangerous environment for weak, vulnerable, and disfavored groups.
Death on the individual's demand is better than a 40-year coma thanks to permanent palliative sedation. I know which one I would prefer.
Social stigma re: suicide has led to premature and horrific deaths by those who are terminally ill, chronically ill, and those who do not wish to endure the ravages of old age any longer.
The trouble with making your preference law, Tony, is that the weak and disabled will suffer from it. Every instance of legalized euthanasia bears out this fact. Do you hold the disabled in such contempt that you'd rather have your preference than let them live without fear of wrongful death?
Do you hold the disabled in such contempt that you'd rather have your preference than let them live without fear of wrongful death?
You've nailed it precisely, Gregory. This is exactly why I and so many other disabled people oppose legalization.
The great irony in all this, of course, is that this is the best time in all of human history to have a disability! The life options of and medical/material support for the disabled are dramatically expanded from what they were even a few decades ago. Yet it's precisely at this time the people seem to fear disability more than ever.
I'm simply glad I have parents who grew up amid hardship and cataclysm, and so could not only deal squarely with my illness but also were able to pass on a solid foundation to me that can weather the vagaries and misfortunes of life. Fewer and fewer people seem to have that these days.
"Do you hold the disabled in such contempt that you'd rather have your preference than let them live without fear of wrongful death?"
I won't speak for Tony, but I imagine he'll agree with it.
It's not the holding of persons with disabilities in contempt, far from it. But rather, let them decide the course of their own lives, including when and how they should die.
I cannot think of anything more enabling, or more respectful, than that.
Royale, let's set aside the "contempt" issue for now. (I would agree, incidentally, that "contempt" is not a fair description.) I ask you:
Do you see any possibility of legalized euthanasia creating a threat to the disabled?
Have you ever taken care of a sick/disabled person long-term, or known someone who did? Have you ever known someone who was dependent in this way? Do you realize the dynamics that go on here?
Do you realize that even medical professionals rate the lives of the disabled as much lower than the disabled do themselves? (See J. Bach, Management of Patients with Neuromuscular Disease for a discussion of this and the related "therapeutic nihilism" phenomenon.) What do you think of the fact that I've had 2 nurses tell me to my face that they would kill themselves if they were in my situation? Do you realize what kind of an effect this can have?
Lots of questions, I know, but the bottom line is this: Be sure you have a full picture of the situation before assuming that euthanasia would be nothing but "enabling". I find it's usually the well and inexperienced along with the newly-disabled who feel that way, not those with more direct experience.
Many disabled individuals are being helped to die by doctors who administer terminal sedation and remove or withhold artificial feeding. That is perfectly legal under existing laws.
What's your point? There's more abuse now, because there are no witnesses.
Bernhardt, you seem to believe that "free will is fine, as long as it's MY will." Such arrogance and paternalism.
1) "Terminal sedation" per se is a myth. There is no need for proper pain care to shorten anyone's life.
2) Removal of feeding and hydration tubes is an act that directly kills and is therefore a form of euthansia.
I stand by the word "contempt:" any able-bodied person who says that he would rather die than be disabled is a bigot. Any able-bodied person who fails to see that the disabled and elderly are at risk from legalized euthanasia (as they already are from the removal of feeding tubes; same difference) is too wrapped up in a spurious notion of autonomy to experience compassion with the weak.
Any glimmer of so-called compassion among such people is bound to be of the killing variety: Oh, put the poor thing out of its misery. That's a refusal of genuine compassion in favor of your own sentiment. Pretty talk about dignity or respect doesn't change the facts.
Bernhardt,
I believe this post was about assisted suicide, not euthanasia. I consider them very different.
For assisted suicide, I am much more liberal of who should receive it (i.e., which medical conditions warrant it) for I don't see the moral difference between that and where we are with the withdraw of LST.
For euthanasia, I would limit it to voluntional and only for people who could not survive very long without medical intervention. In other words, keep it within the field where LST withdraw is applicable. I agree with Gregory, that withdraw of feeding tubes is euthanasia. So long as that feeding tube was volutionally removed, I am comfortable.
On a sidenote - I typically roll my eyes at slippery slope arguments. If you read between the lines, you'll hear "I am afraid of doing what is right now because I am afraid of doing something wrong tomorrow, or even 10 years from now."
Slippery slope arguments are nothing more than rationaled cowardice.
Tony/Winston writes:
Bernhardt, you seem to believe that "free will is fine, as long as it's MY will." Such arrogance and paternalism.
How on earth did you get that idea? If you simply mean, "I want my own position to prevail," well duh, that's what everyone wants, you included. My position on this is based on wanting to protect the vulnerable. You value the very same thing in other areas -- does that make you arrogant and paternalistic too?
"I stand by the word "contempt:" any able-bodied person who says that he would rather die than be disabled is a bigot."
Or they could simply have a different opinion than you.
"Any able-bodied person who fails to see that the disabled and elderly are at risk from legalized euthanasia (as they already are from the removal of feeding tubes; same difference) is too wrapped up in a spurious notion of autonomy to experience compassion with the weak."
Ah, so compassion according to you doesn't exist if they share a different belief or opinion. I get it now.
You're putting words in my mouth, Bernhardt. I'm not forcing anyone to do anything.
You are forcing them to die in horrible ways that can fail, unless they happen to be lucky enough to be a doctor or a vet.
Royale writes:
I believe this post was about assisted suicide, not euthanasia. I consider them very different.
I tend to use "euthanasia" to refer to both assisted suicide and euthanasia as such. I'll start using "AS/euthanasia" instead to avoid confusion.
On a sidenote - I typically roll my eyes at slippery slope arguments. If you read between the lines, you'll hear "I am afraid of doing what is right now because I am afraid of doing something wrong tomorrow, or even 10 years from now."
I typically roll my eyes when someone slaps the label "slippery slope" on an argument, because too often it's a convenient, important-sounding shrugging off rather than an actual engagement with the argument. I oppose AS/euthanasia precisely because it's the wrong thing NOW, not because of vague fears of what might happen in some ridiculously extreme extrapolation of the future.
Again, I ask you: Do you understand the full context of being disabled/ill/elderly and dependent?
Like most proponents, you seem to have an image of AS/E as involving an imperial autonomous self floating in a void, completely free of external influence and concerns, who sits back casually and thoughtfully and after long contemplation decides, "Yes, my life is too difficult. I will end it." I can tell you from personal experience that this is completely naive. There are great demands and pressures -- external and internal, and whether consciously acknowledged or not -- on the ill and dependent that should AS/E be legalized on any significant scale will push people toward suicide. Likewise, the less-than-compassionate motives that incline others toward seeing AS/E as a "solution" will only be reinforced and legitimized with legalization.
All of this is simply an acknowledgment of reality -- a reality that few outsiders seem to acknowledge and understand.
"I typically roll my eyes when someone slaps the label "slippery slope" on an argument, because too often it's a convenient, important-sounding shrugging off rather than an actual engagement with the argument."
Wesley frequently and openly employs "slippery slope" arguments. It is especially strong (and annoying, IMO) in this context.
But if you think it's wrong NOW, then I applaud you because that's all that I'm really willing to listen to.
"Again, I ask you: Do you understand the full context of being disabled/ill/elderly and dependent?"
By your tone, I have the feeling, that unless I were "disabled/ill/elderly or dependent", any answer I could give you would be inadequate.
But since you asked, I watched my grandmother waste away in a retirement home until she finally died. That's a long story, longer than I can get into now.
And I worked at a veterinary clinic, tending to cute, but sick animals, and even held them down to be euthanized. I don't mean to imply an analogy between animal and human life, but I think the experience was fitting in some ways.
As for "choice", I believe that's why we have courts to determine when someone has been improperly coerced.
Tony writes:
You're putting words in my mouth, Bernhardt. I'm not forcing anyone to do anything.
Please point out where I have misrepresented your statements. My argument is that I'm only "imposing my will" to the extent that any rule, regulation, policy, or law is and imposition of will and a privileging of one view over another. You do the very same thing when, say, you oppose environmental pollution. Technically, you wish to forcibly prevent people from freely using their goods and facilities. The question is not whether it's an imposition of will, but rather whether it is a legitimate one.
You are forcing them to die in horrible ways that can fail, unless they happen to be lucky enough to be a doctor or a vet.
Yes, if they decide to kill themselves they may not be able to use a method they would ideally prefer. Since when are we forced to support, aid, and fully expand the options for every single preference and decision of every person, no matter the wider repercussions? You're essentially arguing that we need to expand the available flavors of suicide for those who can already kill themselves even if that puts other people under threat.
Why should doctors be the only ones with access to Nembutal? If you limit suicidal options to violent ones, people will kill themselves earlier. If they can drink a lethal cocktail, they will gain much comfort from that, *and live longer.*
I'm going to remake the movie "Million Dollar Baby" exactly the same, except she doesn't get crippled: she turns into a minority.
There are all kinds of bigotry, and bigotry is indeed an opinion.
And one more time (repeat after me): so-called terminal sedation is a myth. It's not factually valid to trot it out as a justification for euthanasia. So let's just stop bickering over a settled matter, shall we?
Say what you want about terminal sedation. It doesn't change the fact that it is a commonly-used loophole by doctors and healthcare providers to help patients die.
For example, they can simply increase the dosages of morphine until the patient dies, and claim, "I didn't expect this much morphine to hasten the patient's death."
Yes, it is used as such a loophole. But if the aim is truly pain control, there is no need for such therapy to hasten death.
I think we're pretty off-topic by now, so I'll leave this subject aside.
Thanks for acknowledging that, Gregory. I just have one final comment: The fact that it is an easily-used loophole proves that the law is inadequate as it stands. Patient consent is vital, but it is not required.
I would go the other legal direction, though: doctors who use that loophole should be prosecuted for one sort of homicide or other.
"We'll just let him slip away peacefully, hmm?" is so much nicer to say than "This has gone on long enough. Let's kill him with an overdose of opiates." But the balance has shifted away from the preservation of life toward the eradication of suffering -- by means of the eradication of life, if need be. -- Which is where this conversation started, more or less.
OK, Gregory, how would you prove what their intentions were? If they do it over a period of a few days or weeks, it's almost impossible to prove.
Even existential suffering need to be relieved, if that's what the patient wants. Anything else is callous and inhumane.
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