"The Assisted Suicide Movement Sheds Its Fig Leaf"
Last week I posted here at SHS about an opinion column in the Hastings Center Report urging that assisted suicide be made available to some mentally ill people. I expound on that issue in greater length and detail in this piece published today in the Daily Standard. I conclude:
With the truth now clearly in view, the time has come to have real debate about the so-called right to die. This debate should not pretend that the practice will be limited and rare and it should fully address the societal implications of transforming assisted suicide into a mere medical treatment.
So, let's argue openly and frankly about the wisdom of permitting near death-on-demand as a method of ending serious and persistent suffering. Let's discuss whether "choice" and "individual autonomy" requires that we permit licensed and regulated euthanasia clinics to serve anyone who has made an irrevocable decision to die.
Indeed, let's argue whether or not society owes a duty of prevention to the self-destructive who are not acting on mere impulse. But finally, let's stop pretending that assisted suicide legalization would be just a tiny alteration in public policy restricted only to the terminally ill. That clearly isn't true.
Labels: Death on Demand.
posted by Wesley J. Smith @ 10:37 AM
25 Comments
25 Comments:
Much like the anti-abortion movement, Mr. Smith would have more credibility if he argued as fervently to address the social ills --marginalization of the elderly and mentally-ill--that make his so-called death-on-demand a viable alternative as he does for the limitation of assisted suicide.
So rather than protect the elderly and mentally ill from the ravages that death-on-demand would bring, he should just shut up because he can't fix all their problems? How does that make any sense?
In other words: this, too, is a social justice issue, no less than the "marginalization" you mention. It's the ultimate in marginalization: to the point of death.
woundedduck writes:
... Mr. Smith would have more credibility if he argued as fervently to address the social ills...
Why are you so certain he doesn't? You might want to check out his background a bit more, you might find some surprises.
To me, Wesley does appear to be less than consistent as woundedduck has mentioned.
Where are his books and campaigns against tall buildings, guns, trains, cars and lengths of rope, all of which can be used for suicide? Yes, there will be a cost to society if those things are outlawed, but if he wants to make suicide nigh impossible, it's what he should be campaigning for.
Tony Jones,
That argument sounds like "if Mothers Against Drunk Driving are serious about stopping drunk drivers, they should work to ban automobiles so drunks won't be able to kill others." Or they would have to ban Wounded Duck from slamming a few down so he can come alive or so says his bio.
I'm sure you are missing the point on what Wesley (and others of us) are advocating for. I haven't heard Wesley say that suicide should be illegal. He is saying that we should not allow physicians to assist in suicide.
Under what conditions and and what age should it be illegal for someone to have legal assistance from a doctor to kill themselves? What has to be wrong with someone to justify society consenting to and becoming participants to help them kill themselves? I'm sure you don't believe in rational suicide where children-whom we often hold responsible enough to be charged like adults, should be able to kill themselves with our help if they are severely depressed because their best friends stole their girl or boyfriends, or do you? If not, why not? What has to be so wrong with a person that society throws aside its interest in these citizens and has to get in and help them kill themselves if they really don't want to live?
Wounded Duck... keep your condescension toward pro-lifers to yourself. There are many people who are alive today because we talked their parents out of killing them in utero. You can go argue our credibility with them.
This from a physician reader:
"Wesley,
I still haven't gotten my issue of HCR so I waited to respond. Nice piece. What is so blatantly absurd in this latest iteration of pro-euthanasia sophistry is the simple fact that suicide has always been a natural (inalienable) right. It needs no enabling legislation. We have no shortage of guns, bridges, buildings, ropes, etc. It cannot be outlawed--only the role of survivors in abetting it. Advocacy of legalization is only about mandating profound changes in the role of physicians. Ironically, purists like Derek Humphrey see this as only the first step in bringing widespread access to euthanasia.
The argument is only about legalizing the role of those that kill (presumably) on request. It is not about the "empowerment" of unhappy people but legalization of the self-appointed "mercy" killer. Assigning this role to doctors obviously corrodes the profession and damages the seminal ethical precept of beneficence upon which it was organized 2500 years ago. No trivial change as a profession ceases to be one if its obligation to protect its clients from harm and exploitation goes out the window. Physician becomes bartender.
Imagine trying to use non-physicians in carrying out euthanasia: police? postal workers? family members? On its face none of these models pass the smell test. The clear difference is the ethic of beneficence, which suffuses physician ethos and may or may not be evident in other sectors of society. Of course, it's a stretch to define killing as a beneficent act. Killer-physicians cease to be physicians.
Moreover, two-party "suicide" isn't truly about individualism. It creates a pathological relationship designed to satisfy the needs of BOTH parties. The client wants to be dead; the killer WANTS to kill. The victim is not acting autonomously (or he would have hopped off the Golden Gate), but the killer is the real sick puppy. The willful violation of professional boundaries and norms speaks to a number of psychological disorders foremost among which are narcissism and depression--not rare among the collection of obsessive compulsives that populate medicine.
To agree that his patient's life is not worth living a killer-physician has to be unable to recognize counter-transference (projecting his needs onto patients). Not even a pothead like Nancy Crumpacker would do it without in some sense agreeing with the legitimacy of the patient's wish. If the physician had sex with a patient he would be disciplined whether it's legal or not. Why should legalizing killing be different? Notwithstanding the idealized image the all-caring euthanasia doctor is in fact a sick, incompetent physician in desperate need of a Physician Health Program."
(I'm sure you are missing the point on what Wesley (and others of us) are advocating for. I haven't heard Wesley say that suicide should be illegal. He is saying that we should not allow physicians to assist in suicide.)
Wesley opposes the "radical autonomy" that allows people to own their own lives. That sounds like an opposition to suicide to me.
I think that if adults can refuse treatment without a waiting period, or be sedated until death without a waiting period, assisted suicide should be legal with a reasonable waiting period. Two weeks is plenty.
And here's some food for thought - should people be allowed to deliberately infect themselves with ebola and rabies, for example, and then refuse treatment, even though it will lead to death? Why or why not? Would you consider that to be suicide, even if a disease is killing them?
Last I checked, Ebola was a major public health risk. You can't just have folks injecting themselves with it and spreading it. That's not suicide: it's terrorism.
Seriously, though, treating someone who has injected himself with a disease has, by thus attempting suicide, proven himself to be irrational, because suicide is always an irrational act. Why? Because it presumes knowledge of future states (i.e., that he will always be suffering miserably, that his life will always seem meaningless, etc.), which is outside the realm of the possible. Such persons should thus be treated as incapable of making valid decisions, and given medical attention despite their protestations.
The death penalty is irrational for similar reasons: it presumes that the convicted criminal will be incapable of any good or redeeming act any time in the future.
Hope is more rational than despair.
(Seriously, though, treating someone who has injected himself with a disease has, by thus attempting suicide, proven himself to be irrational, because suicide is always an irrational act. Why? Because it presumes knowledge of future states (i.e., that he will always be suffering miserably, that his life will always seem meaningless, etc.), which is outside the realm of the possible.)
By that logic, suicide is always rational, because those who say "it will get better" are not in a suitable position to judge them.
(Such persons should thus be treated as incapable of making valid decisions, and given medical attention despite their protestations.)
So should all AIDS patients be forced to submit to treatment? After all, suicide involves shortening life, so unhealthy diets should be illegal. Exercise should be made mandatory.
Would you condemn those Jews who committed suicide during the Holocaust? Did they deserve to go to hell for suicide?
The bottom line is this: If you aren't in unrelenting pain, have never been through REAL depression, or so on, you have no right to judge those who wish to die.
And when people get older (over 80), life WILL only get worse. Many people don't want to be in a nursing home where all they get is Bingo once a week.
Tony,
I think you still miss the point. It is nearly impossible to stop a person who is insistent on taking his or her life from doing so, laws or no laws. People commit suicide under suicide watches all the time. What's more, there is no one to prosecute when a person kills him or herself (the perpetrator has already administered the ultimate penalty to him or herself.)
But when you start saying doctors or others can or should be involved in this act, we suddenly bring another party to the act who will still be alive after the act has been committed. I've heard of doctors and family members who have been involved in so-called mercy killings who have killed themselves afterwards because they couldn't live with what they had done. Killing another person, even one who is very ill, is a lot harder for most people than you might think.
I think your argument about the morality of concentration camp victims committing suicide is deeply ironic given that euthanasia paved the way for pro-death mentality that ultimately resulted in concentration camps in Nazi Germany. If euthanasia had been forcefully rejected by the German people, I have serious doubts there would have been any concentration camps.
Tony-I have never heard Wesley say we don't own our own lives.
The radical autonomy you are talking about says I have a right to force people to comply with my wishes-my personal destruction, no matter what impact or stigmatization that has on other groups of people.
The only way we can legitimatize the promotion of death-since we assume life is good and the state exists to protect the lives if its citizens-is to say that people in certain circumstances don't have lives worthy of life. There's no way you can firewall that and keep the rest of the group with the characteristics you think warrants death from being deemed life unworthy of life. That is intolerable. You can kill yourself, but you can't make me or the state complicit in it or believe that groups of people have life unworthy of life.
It's nonsense to say that if you have never experienced a certain condition that you have no right to judge. Please. That's an evasion, not an argument. And besides, we are not judging those who want to die, we are saying our society is not going to participate in their deaths and we do not have to agree with them that people like them don't have lives worthy of life. In addition to that we are telling people that their lives still have inherent value. If that's judgmental, so be it. It's a lot better than you should kill yourself.
The answer for those suffering under the holocaust was not suicide but bombing the regime out of existence which imposed the holocaust on those people. We judged and killed those who imposed such misery on others as to make them want to end their lives.
You are berating or coming close to berating old people, the depressed and people in chronic pain. Just because you wouldn't want to live that way doesn't mean life is not worth living in those conditions.
Life may not get better after 80-however you may subjectively describe "better." But that does not mean it's not worth living. Your comments about people in nursing homes are a clear indication of what you think of their worth, which has nothing to do with their real worth. I think that's more judgmental than anything I've heard coming from our side toward those who want to or do commit suicide.
And should we allow a 15 year old who has been depressed for several months and wants to kill themselves with the help of a doctor, because his or her girlfriend/boyfriend, betrayed him or her and ran off with their best friend? Sounds like depression to me. The person may subjectively believe there is NO reason to continue.
Actually, I don't think we do "own" our bodies, if that means that we should be permitted to do with our bodies anything we wish to do. Example: If we own our bodies, there is no reason we can't sell ourselves into slavery. But we can't, and should not be able to, because we are part of society and owe certain duties to it.
Obviously, we value personal liberty and autonomy. But no "right" is absolute. I also believe we owe our brothers and sisters protection from self harm, be it, suicide, self cutting, cutting off healthy limbs, or etc. Where we draw the line is always up for debate, it seems to me. But that there is ultimately a line, really isn't.
"By that logic, suicide is always rational, because those who say "it will get better" are not in a suitable position to judge them."
That statement doesn't make any sense whatsoever, is not logical in the least, and does not address my position in the slightest. Are you saying that a desire to kill yourself somehow gives you the powers of prognostication?
Everything else you said was similarly nonsensical: a passel of red herrings, and little else.
Referring to Tony's argument, Don Nelson writes:
It's nonsense to say that if you have never experienced a certain condition that you have no right to judge.
By Tony's reasoning, **I** am in a position to judge... and I judge that assisted suicide is a mistake. Any chance Tony will now fall silent on this topic? ;-)
This comment has been removed by the author.
Tony, you said:
The bottom line is this: If you aren't in unrelenting pain, have never been through REAL depression, or so on, you have no right to judge those who wish to die.
Started to respond to it one way then realized what you were going after.. Personally haven't seen people "judging" this issue in that particularly expressed light.. Granted, a fella can only read so much in a day every day, so maybe I've missed it amongst all the discussion going on right now..
From these Shoes, it is NOT about judging those who no longer wish to be for their own personal reasons, it's about saving the Lives of those who will be conveniently, perceivably legally done away with, murdered should assisted suicide become [allowed]..
Period.
As to authority to speak on this, I gots authority.. "Depression".. Been there.. Got FOIA..?
As I think one of my first posts to Wesley's blog stated on some level, could easily mask accountable presence of Mind to the bitter end if everything was in the wrong place at the wrong time and this..... issue.. was legal.
To involve a second person is to give the primary a scapegoat, an excuse to proceed, an easy way out of the guilt that would be guaranteed to some sizable number.. Legalized assisted suicide gives people someone else to blame, be it consciously or subconsciously, for what they would be intending to do during that time between the decision made and the travesty performed..
Under those circumstances where it would involve a third party, can't help but have "accomplice" come to mind.. We'd be throwing the doors wide open for those with power of attorney whose motive would be under the radar but who would be standing to, say, collect money or who would looking to tie up "loose" ends.. Those kinds of things don't just happen in the movies..
And, once again, not to mention (but I will), those abl(e)ists who are pushing this who know bottom line exactly why they are pushing for the same..
:cyber hugs:
(Actually, I don't think we do "own" our bodies, if that means that we should be permitted to do with our bodies anything we wish to do. Example: If we own our bodies, there is no reason we can't sell ourselves into slavery. But we can't, and should not be able to, because we are part of society and owe certain duties to it.)
Why do people owe duties to society (aside from those that prohibit harming others)? I didn't choose to be born, and I certainly won't be asking you for permission if I want to leave this world.
(Obviously, we value personal liberty and autonomy. But no "right" is absolute. I also believe we owe our brothers and sisters protection from self harm, be it, suicide, self cutting, cutting off healthy limbs, or etc. Where we draw the line is always up for debate, it seems to me. But that there is ultimately a line, really isn't.)
No right to self-harm? Well, I guess we better revoke McDonald's coroporate charter, or at least require that they stop selling junk burgers. Face it - you only care about rights you use personally. When it comes to something else, you oppose it with the most intense hatred.
(By Tony's reasoning, **I** am in a position to judge... and I judge that assisted suicide is a mistake. Any chance Tony will now fall silent on this topic? ;-))
So you're a 100-year-old with a multitude of health and physical problems? Why judge for others who might make different decisions? Not everyone has the same pain threshhold.
Tony,
What are the conditions that allow us to say yes to assisted suicide in one instance and no in another?
Should we allow a 15 year old who has been depressed for several months and wants to kill him or herself with the help of a doctor, because his or her girlfriend/boyfriend, betrayed him or her and ran off with their best friend? Sounds like depression to me. The person may subjectively believe there is NO reason to continue.
Do there have to be better reasons to kill yourself with the help of a doctor than your girlfriend or boyfriend ditched you and you are depressed about it and can't see any reason to go on living... maybe despite the best counseling a young person can get?
I wonder if physician-assisted suicide would be less acceptable to those who can countenance it, if we hadn't had physician-assisted execution of criminals condemned to death to desensitize us. Always thought that was a mistake.
So, I'm reading "Forced Exit" by WJS. I'll admit, I'm rethinking things.
Here's a question I'll pose to the group. In veterinary medicine, we can consider euthanizing a suffering animal as "humane." So, why would it not be "humane" to euthanize a suffering human?
Non traditional, yes, but suffering is suffering.
What a compliment, Royale. Thank you. I cover that question in the book and will wait for you to reach it and we can discuss here. Others, on either side, please comment away.
The story about the man who changed his mind about suicide half-way through and the Hemlock Society woman who, instead of caling an ambulance, tied a plastic bag around his head....if stated as you described it, then murder is the correct term.
And I think I will change my living will to specifically request feeding tubes remain.
Royale: That story is right from the book A CHOSEN DEATH by Lonnie Shavelson, who claimed in the book to have witnesses exactly what I described--as you could tell from the quotes. I try to be polite and civil to my opponents in this debate--perhaps Jack Kevorkian being the exception. But I confronted Shavelson when we were on a radio program together--before the show--and he did not deny it, only questioned whether it would actually be a murder. I also note that he went mostly quiet after that on the issue.
My advance directive is as you are thinking of doing.
Tony Jones writes:
Why do people owe duties to society (aside from those that prohibit harming others)? I didn't choose to be born...
But why, if you "didn't choose to be born," would you have a duty not to harm others any more than you have any other duty? Obviously, despite your implications, you do believe that we have duties to society.
...and I certainly won't be asking you for permission if I want to leave this world.
Of course, you're not asking for "permission", you are asking for assistance. Why do we have an obligation to provide it?
So you're a 100-year-old with a multitude of health and physical problems? Why judge for others who might make different decisions? Not everyone has the same pain threshhold.
No, but I have a condition that puts me in a similar situation, so I understand better than most the realities and pressures that are part of it. My sarcastic comment is getting at your frequent implication that none of us who oppose AS/E know what it is really like for people who might consider AS/E, and at least in my case this is flat-out wrong.
Bernhardt, no one has the right to hurt anyone else without their consent.
Self-harm is a different story. I don't see anyone here clamouring to outlaw laziness, alcohol or tobacco.
No one has an "obligation" to assist with suicide - that should be strictly voluntary. But it should not be forbidden. By prohibiting assistance, you're forcing people to die violently, and sometimes they fail, making their situation worse.
Women should not be forced to resort to back-alley abortions if they can't afford to travel overseas.
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