Tuesday, April 14, 2009

Euthanasia: A Right to Death with Dignity or License to Kill with Impunity? (Part 2)

(Part 1)

Before making my case against euthanasia, I think it would be helpful to briefly outline what the modern proponents of euthanasia are advocating. In this post I want to briefly address three questions concerning euthanasia: 1) what is euthanasia; 2) what is the purpose for it according to modern proponents, 3) how do modern proponents make their case?

First, what is euthanasia? The practice of euthanasia is not a new theoretical development within science but is a practice that has been around for centuries. However, the modern understanding of euthanasia is the result of an evolutionary process stemming back to antiquity. The term euthanasia has an ancient Greek origin and is the combination of two separate words. The first word, eu, means good; the second word, thanatos, means death; so when used together they combine to mean "a good death."[1] Although the origin of the word presents a quite simple idea, in recent times the term, and practice, has become more complex. According to The American Heritage Dictionary, euthanasia is, "The action of killing an individual for reasons considered to be merciful." Notice that in this definition the modern notion of euthanasia is not simply to have a "good death," but includes the means by which the death is achieved. Euthanasia is not just about "ends," but is also about "means." So one would wonder, if the death is supposed to be good, does that mean that the means used to achieve that good death are also good? Well, besides the fact that the means used is the action of "killing," when advocates of euthanasia define the practice, they say that euthanasia is the means used to achieve a good death whether that action is positive or negative.[2]

Second, what is the purpose for it according to modern proponents? Modern proponents of euthanasia desire to see an explicit exception licensing physicians to kill their patients in order to relieve uncontrollable pain and suffering inserted into law. They appeal to a range of exceptional cases to show the utility of the practice. The gist of their argument is that there are times when killing the patient is the humane thing to do and in the patient's best interest. They assert that merely letting a patient die naturally is at times cruel and can dehumanize the patient.

Third, how do modern proponents make their case? In order to make this case, modern advocates of euthanasia emphasize two foundational axioms: 1) individual autonomy; and 2) the necessity of mercy/avoidance of suffering. According to Margaret P. Battin, "The moral argument in favor of permitting physician assistance in suicide is grounded in the conjunction of two principles: self-determination . . . and mercy."[3] She describes the moral right of self-determination as the right to live one's life as one sees fit, subject only to the constraint that this not involve harm to others. So fundamental is this principle, that Daniel Jussim asserts that to deny an individual the choice of death is said to be a crime against one's right of self-determination.[4] For the euthanasia advocate, euthanasia should be legalized so that a doctor (or for some any individual) can kill a patient/person, without being indicted for murder, and what makes this killing justified and acceptable is that the individual requested it. As we saw with Jussim, it is not the killing that is the crime, but refusing an individual's request to be killed.

The second foundational principle advocates use to endorse euthanasia is the principle of mercy. According to Battin, the principle of mercy teaches that one ought both to refrain from causing pain or suffering and act to relieve it. Advocates claim that this principle of mercy, or avoidance of suffering, underwrites the right of a dying person to an easy death and clearly supports physician-assisted suicide in many cases. Derek Humphry believes that in a caring society there must be opportunities provided to hopelessly ill patients after all other avenues of care have been exhausted. He asserts that requesting assistance in dying should no longer remain illegal since it provides a compassionate, merciful and noble means to achieve a good death.

Humphrey's statement is indicative of much of the literature promoting euthanasia, which tends to emphasize the subjective nature of a patient's plight, rather than provide a rigorous philosophical defense, since advocates believe that compassion is the best means of persuading the public. Timothy Quill, M.D. suggests the best tactic in the debate is not to argue over positions, but instead to tell stories of the unrelieved suffering of dying patients--to tug on the heart strings. The public is to be persuaded to accept euthanasia not by arguments of right and wrong, but via unthinking compassion for those who suffer.[5] This emphasis upon mercy seems to be more of a tool for manipulation than an actual concern for the suffering. But the manipulation does not stop here, to make their case for "mercy killing," proponents of euthanasia use the "hard" cases approach to attract and create sympathy for persons who are suffering. They admittedly seek to manufacture a universal need that is actually based on rare and tragic situations. Humphry himself admits to manipulating the data to create the appearance that there are a lot of persons suffering to create the facade that there is a great need and demand for euthanasia when the data does not support his rhetoric, "Take note that I have liberally used the word 'some'. Most people die quickly, peacefully, and painlessly. Of that there is no doubt. Physician-assisted suicide is needed for very few dying patients-probably two percent or less of total deaths."[6] No one wants people to suffer needlessly, so it becomes quite easy to use the pain and suffering of others for rhetorical purposes. Are the modern euthanasia advocates being honest about their agenda?

When one looks at the questions concerning the practice of euthanasia, whether ethical, legal, practical, medicinal, etc., it is imperative that one not fall into the trap of believing that medicine and technology are merely means that are value-neutral. The moral questions surrounding the issue of euthanasia are not just about the use or misuse of the means of medicine and technology, but also about the ends that medicine and technology serve. With this in mind, and in light of the stated purposes and axioms of euthanasia proponents, should euthanasia be considered an acceptable means of dealing with the difficult issues of life and death? Will legalized killing (whether to promote self-determination or for supposed mercy) actually result in a society that is characterized by care and mercy for the suffering, or will it create a whole new set of problems?

(Part 3)

Notes:

[1] Derek Humphry, "Euthanasia Is Ethical," in Euthanasia: Opposing Viewpoints, ed. Carol Wekeser, Opposing Viewpoints Series, ed. David Bender and Bruno Leone (San Diego: Greenhaven Press, 1005), 18.

[2] Ibid.

[3] Margaret P. Battin, "Is a Physician Ever Obligated to Help a Patient Die?" in Regulating How We Die: The Ethical, Medical and Legal Issues Surrounding Physician-Assisted Suicide, ed. Linda L. Emanuel (Harvard University Press, 1998), 21-47.

[4] Daniel Jussim, Euthanasia: The "Right to Die" Issue (Hillside, NJ: Enslow Publications, Inc., 1993), 53-54.

[5] Cited in Adam Wolfson, "Killing off the dying?-so-called assisted suicide," [on-line]; accessed 14 April 2009; available from http://findarticles.com/p/articles/mi_m0377/is_n131/ai_20632393/.

[6] Derek Humphry, "The Case for Physician Assisted Suicide and Voluntary Euthanasia," [on-line]; accessed 14 April 2009; available from http://www.finalexit.org/lit-essays.html, [emphasis mine].

[7] Stanley Hauerwas, God Medicine and Suffering (Grand Rapids: Eerdmans, 1990), 97-98.

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