Wednesday, April 22, 2009

Euthanasia: A Right to Death with Dignity or License to Kill with Impunity? (Part 4)

(Part 3)

In the previous post I introduced the slippery slope argument set forth by euthanasia opponents and noted that euthanasia advocates discount the argument on the grounds that they believe that it is based unnecessarily on fear and on fatalistic assumptions that are mere logical conjecture and not rooted in fact. However, opponents of euthanasia are not just projecting the eventuality of abuses based on logical implications, but on realities that are found in association with actual statements and intentions communicated by certain advocates of euthanasia.

Before I begin to show those present realities that justify the use of the slippery slope argument, let me first address more specifically what I mean by the slippery slope argument. I would note here that there are basically two different types of slippery slope, or wedge argument. The first type is based on moral reasoning and the logic of distinctions between different acts. For example, when one asserts that legalizing euthanasia will result in a lack of trust between a patient and his doctor, it is actually very hard to verify and is certainly not necessarily going to be the case. It might be the case, and it certainly has potential to become the case, but it will not necessarily be the case in every instance. When euthanasia advocates reject the slippery slope argument of euthanasia opponents, this is the type of slippery slope argument they reject, and thus, discount the argument by asserting that the concerns are not necessarily going to become reality and are mere logical conjecture.

Yet, there is a second type of slippery slope, or wedge, argument that is not merely dependent on logical conjecture or possibilities, but is concerned with empirical data that establish and back up the argument. For example, when one argues that the removal of certain restraints against killing will lead to probable moral decline, such as authorizing the killing of a patient for his own "benefit" because he is suffering pain and has a bleak future (no quality of life or dignity) and could open the door to a policy of killing patients for the sake of social benefits, such as reducing financial burdens, the more efficient use of diminishing resources, or the supposition that euthanasia will open the door to involuntary euthanasia. These concerns are not difficult to verify for they are empirical by nature and can be measured and documented. I will use this second type of slippery slope argument to establish that the concerns of euthanasia opponents are not mere speculation or conjecture, but are in fact, rooted in reality, and therefore, warranted.[1]

For many euthanasia advocates, the legalization of euthanasia is not an end in itself, but a means to achieving a further end. Although some say that it should only be used for persons who are suffering and about to die, some advocates desire to broaden the utility of euthanasia. As for who is eligible for assisted death, Quill proposes that it should initially be restricted to the terminally ill; but he also suggests that it should eventually be made available tot hose who are not terminal but have incurable or debilitating conditions associated with severe, unrelenting suffering.[2] In this statement, Quill acknowledges that the practice must start out narrow, but then be broadened. The difficulty in this statement, however, is that Quill is unclear by what he means by "suffering." He argues that "suffering" can include difficulties like the fear of future suffering (before real suffering actually begins), loss of dignity, and other subjective elements. For instance in his account of his assistance in the death of a patient he calls "Diane" who had a history of alcoholism and depression and who had been cured of vaginal cancer and was diagnosed with leukemia, he says that she asked him to kill her, not because she was suffering with uncontrollable pain, but because she did not want to linger until death in relative comfort. She was convinced she was going to die, so why not get it over with now.[3] As her doctor, Quill did as she requested and killed her.

Kevorkian has also indicated his desire to extend "suicide rights" beyond rare terminal cases or cases dealing with so called unmanageable pain. In an address to the National Press Club in Washington, D.C. on October 27, 1992, he asserted that "every disease that shortens life no matter how much is terminal." For Kevorkian, terminal cancer patients with less than six months to live are a very small minority of patients for whom euthanasia is needed. Those whom he would include in the larger majority of cases include quadriplegics, people with multiple sclerosis, and sufferers from severe arthritis. But once again, not only is his criteria a problem, but the reasoning behind it. Kevorkian has a disdain for disabled persons. He once called quadriplegics and paraplegics who were not suicidal "pathological," and exposed his sympathy for eugenics in a court document asserting, "The voluntary self-elimination of individual mortally diseased and crippled lives taken collectively can only enhance the preservation of public health and welfare." Once again, the criteria for beginning the use of euthanasia is narrow to begin with, but with the purpose of becoming ever more broad.

Yet, with Kevorkian, he admits to even more heinous plans for euthanasia. Instead of wanting to help the suffering and the dying, he candidly acknowledges that euthanasia is a means toward pursuing his own obsession. For him, euthanasia is a distraction to get the public to accept it as a morally viable option for end of life issues, but as the first step that would eventually "open the floodgates" of the equally momentous benefits to humankind of human experimentation and the serious investigation of the phenomenon of death. He calls euthanasia "medicide," a specialty to be practiced by medical technicians at designated "suicide centers." His "ultimate aim is the creation of a new specialty and a new institution he calls "obitiatry," to which assisted suicide is but a means. "Obitiatry" is "the unfettered experimentation on human death" in pursuit of useful knowledge as well as knowledge into what death itself is. But to fulfill this preternatural aim, Kevorkian needs dying patients. His original plan was to use death-row inmates, but since that was shot down, he then sought to accomplish his goal by experimenting on patients who opted for euthanasia.[4]

For Kevorkian, then, getting euthanasia legalized and morally acceptable to the public is a front to his ultimate end of human vivisection. Kevorkian appears to have a three-step plan for achieving his dream. First, popularize assisted suicide and make it seem acceptable for helping the dying and the suffering. Second, give society a utilitarian stake in assisted suicide by using the victims for organ procurement. Why not give the good organs to those who contribute to society rather than leach off it. The third step is to gain permission to conduct his death experiments on the sick and disabled persons he would be allowed to kill. This plan was not just on paper, but was actually being practiced by Kevorkian. For instance, contrary to the media descriptions most of Kevorkian's known victims were not terminally ill. Of the known 130 or so "suicides" that he facilitated, about 70% of the persons involved were disabled and depressed, and the majority of them were women.

So what does this all mean? There is a slippery slope from assisted suicide to voluntary euthanasia to involuntary euthanasia. As Kevorkian argued, the diseased and crippled who don't voluntarily seek self-elimination are pathological and society needs to see the benefit of being rid of them and using their good organs for the producers in society, and heck, they make the best test subjects. There is a slippery slope from the terminally ill to those who are incurably ill but not terminal, and to those who are just not happy. And according to two of the biggest proponents of euthanasia, Quill and Kevorkian (both medical doctors), this slippery slope is by design. The way that the argument moves from terminal illness to meaningless life, results in a position that anybody with a suicidal impulse will qualify, with the purpose of acclimating society to death, in order to pursue broader and worse forms of killing with impunity. This slippery slope is no figment of the imagination of euthanasia critics, it is rooted in the very language, practice and goals of euthanasia activists.

(Part 5)


[1] For a good discussion on wedge arguments, see Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics (Oxford: Oxford University Prss, 1983), 120-26.

[2] Timothy E. Quill, C.K. Cassel, and D.E. Meier, "Care of the Hopelessly Ill: Proposed Clinical Criteria for Physician-Assisted Suicide," New England Journal of Medicine 327 (Nov 1992): 1381-385.

[3] Timothy E. Quill, "A Case of Individualized Decision Making," New England Journal of Medicine 324 (March 1991): 691-94; and idem., Death and Dignity: Making Choices and Taking Charge (New York: Norton, 1993).

[4] Kevorkian, Prescription Medicine, 214-240.

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