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VOLUNTARY EUTHANASIA.
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Moral, practical, historical, religious argument for right to dignified suicide, compared euthanasia.... More...
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Paper Abstract:
Moral, practical, historical, religious argument for right to dignified suicide, compared euthanasia.
Paper Introduction:
The subject of one's death embraces concepts and emotions that are beyond words: it is the ultimate individual experience, lightened in its import only very slightly by the knowledge that it is an inevitable experience for everyone. Artists try to "survive" the terminal experience via their works; the religious attempt to "transcend" death with beliefs in afterlives; philosophers "console" themselves; Everyman drinks heavily of alcohol and sings melancholy dirges.
Medicine, relative world peace and an improved standard of living environments have given us the opportunity to live longer than our forefathers. The lifespan of the average person in Western society is double that of two hundred years ago; a seven decade anticipation, barring accident, war and "acts of God" (the "force majeure" caveat clause in all modern contracts). That
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By grouping voluntary euthanasia with suicide, moralists condemningthe practice use the word "suicide" to evoke powerfully negative emotionalcoonotations in support of their position. The "suicidemachine" of Dr. Jack Kevorkian is another example, a notorious andcontroversial playing out of the debate over active euthanasia in the mediaand courtrooms (Humphrey, Final exit, 1991, pp. The cruel irony: where once the weak and infirm had little hope ofsurviving more than a short while, modern doctors extend days into weeks,weeks into months, months, sometimes, into years - fulfilling theirvocation under the guidance of the 2,5 year-old, semi-mysticalHippocratic Oath (Outerbridge & Hersh, 1991, pp. "Suicide," like "euthanasia," was a term introduced into the Englishlanguage at a rather late date, in 1651; Walter Charleton (Wennberg, pp. "Dignity" is a word bandied about in several social contexts. (1986). The personal decision to do sowithout undue pain, at the time of one's own choice, is the dignifiedresponse of the human soul. In the latter (b)case, we have the situation of the earlier-mentioned severely deformedbaby: there is no way that an infant can make life/death decisions - theact of withholding extraordinary life support systems becomes a personaldecision for doctors, family and the society at large - the receptor is notable to be a participant in the decision. Certainly not in the central text of the Judeo-Christian tradition, for, as philosopher-theologian Karl Barth (1961, p.4 8) notes: "[It is a} remarkable fact that in the Bible suicide isnowhere explicitly forbidden. (1979). The lifespan of the average person in Western society isdouble that of two hundred years ago; a seven decade anticipation, barringaccident, war and "acts of God" (the "force majeure" caveat clause in allmodern contracts). I. 294-312.Humphrey, D. The end of life: Euthanasia and morality. New York: Grove Press.McCuen, G., & Boucher, T. Eugene, OR: Hemlock Society.---. . It is easy to distinguish the differences between voluntary andinvoluntary euthanasia; it is in the realm of non-voluntary euthanasia thatthe borders slide into grey shadings (Nelson, 1984, pp. About involuntary euthanasia, one might well consider the observationof British author and social critic G. New York: Doubleday.Nelson, L. (1986). Chesterton (Wennberg, p. Aren't her mental pains and physical restraints justificationenough for a "merciful" ending to her plight? 3-4). ReferencesAmerican Friends Service Committee. This sounds suspiciously closeto the definition of "suicide" as we know it, and that term must beexamined later in this discussion in order to establish its relationship toeuthanasia. K. From antiquity through to the present day, in our Western traditionwe have sought to control our destiny. Voluntary euthanasia can allow us that control over natural forces.We will die anyway - God's Plan, nature's process - the terminal patienthas no doubt of the close inevitability. N. Augustine confronted thephilosophy and culture of a civilization that had successfully dominatedthe Western world for hundreds of years, the Christian theologian had todraw the line hard and thick between the differences of the new Christianideal and the pagan ethos. Voluntary euthanasia, passive or active, is the attempt of humans tocontrol the course of their lives. 131-141). Medicine, relative world peace and an improved standard of livingenvironments have given us the opportunity to live longer than ourforefathers. Ann Arbor: Servant.Outerbridge, D. C. Death by choice. It is useful to examine thecharacter of suicide for a brief moment to see that - the imageryadmittedly powerful in its picture of negative self-destruction - suicideper se is not condemned in toto by the Judeo-Christian/Western tradition.(It will not be addressed in detail here, but any lengthy discussion ofsuicide and the "value of life" issues should point out that in severalmajor non-Western cultures and philosophies the judgement passed on the actof self-killing carries positive connotations (Rachels, 1986, pp. How do we know the specificsof this Divine Plan? Now science has given us the ability tolinger, fading slowly, dying in tiny, dehumanizing steps. Barring accident or the malevolentintrusion of outside forces upon one's life, the question must be asked:And why not? No longer do we fear the sudden breeze-chill-death ofpneumonia that killed millions more people in 1919 than the Great War hadin the preceding four years. 28-3 ). Having mitigated the Judeo-Christian objections to voluntaryeuthanasia by placing them into a perspective that does not requireoutright rejection of the practice, we are in a position to return to thebasic proposition: is there a justification for voluntary euthanasia? (1984). F. Judeo-Christian morality, the dominant ethic of contemporaryWestern civilization, sets up a standard wherein voluntary euthanasia isgrouped with suicide - and both are dismissed outright as morallyunacceptable. 48-56). 1 6-1 7). Still, physical factors alone can often make the case for this act.Extreme pain, the deprivation of those qualities we call "human" (thought,in particular), the conditions of death itself (isolation, human contactreplace by technological support in extremis) - these are potentialelements of the dying process that might not be addressable by medicalmeans; these are justifications for the quick, merciful, dignified death weall seek. Is it in support of God's Will, then, that certainindividuals die by their own decision/ hand? (1989). The death decision. Clark.Beauchamp, T. We arediscomfited by our mortality in general; we are terrified by the way we diein specific. But "necessary" is a word that fits into the criteria for a justifiedvoluntary euthanasia; the participants - doctors, family, society, patient- do not prescribe to this final remedy as an equal among medical choices:it is the "least worst death," not the placebo (McCuen & Boucher, 1985, pp.18-23). "Deathwith dignity" is a phrase that takes on meaning to everyone eventually.Raging against the end is the primal response - as is whimpering in thedark, alone, passing away in the style of our prehistoric ancestors. Church dogmatics, vol. Oxford: Oxford University Press.Weir, R. Is the schizophrenic patient pounding herhead against a wall six out of seven days a week a candidate foreuthanasia? Easing the passage: A guide for prearranging and ensuring a pain-free and tranquil death via a living will, personal medical mandate, and other medical, legal, and ethical resources. Artists try to "survive" the terminal experiencevia their works; the religious attempt to "transcend" death with beliefs inafterlives; philosophers "console" themselves; Everyman drinks heavily ofalcohol and sings melancholy dirges. Voluntary euthanasia iswith the full consent of the major party. The Romans - and, by extension of practice(though not specific philosophy) - the Stoics, did devalue life cruelly.By rejecting those pagan Roman devaluations, St. No one of sound mind, it is certain, approaches the act without aheightened sense of emotional involvement. Journal of Medicine and Philosophy, 4, pp. But, in the Stoictradition of the dying Roman Empire, when St. . Man's control over birth and death. The definition of euthanasia. (1991). The 3 Spartans at Thermopylae were certainly passivesuicides - the 96 Jewish men, women and children fighting Roman oppressiondied as active suicides; legions of Christian martyrs suicidally decidedfor death over public renunciation of their faith - an Allied spy againstthe Nazis was respected for biting down on a cyanide capsule when capturedby the Nazi Germans, rather than risk betraying his colleagues underGestapo torture. . It is thebugaboo of all ethical, moral and practical considerations of euthanasia,involuntary euthanasia having been heinously used by repressivetotalitarian regimes of recent ilk to justify genocidal policies aimed attargeted opposition groups. (1961). (1974). New York: HarperCollins.Rachels, J. Augustine gave the neworder, entering the uncertain Dark Ages, a life-affirming proposition thatcould not afford to incorporate the real-world ambiguities suicide andeuthanasia embrace (Wennberg, pp. Terminating life: Conflicting values in health care. The distinctions between the threeare not so obvious as may seem on first appraisal. Jesus, indeed, had only to renounce His own divinity to be savedfrom the cross; for a Man who proclaimed His humility, this act of pridewas truly suicidal; for a God Who could rend the skies with His wrath, themessage of self-sacrifice was surely deliberate. For the purposes of this discussion,involuntary euthanasia will not be discussed further; it is outside therealm of moral, ethical and practical considerations that a society of ournature can embrace. New York: Hill and Wang.Barth, K. & T. This is a painful fact to all who havetried to understand and apply the Bible moralistically." Moreover, since a major element of the Judeo-Christian tradition'sobjection to voluntary euthanasia/suicide is based upon the SixthCommandment stricture against the taking of human life, one must call intoquestion said moralists' curious "exceptions" to the rule: there are "justwars," the death penalty has been theologically condoned, duels in the nameof "honor," until recently, were given acceptable nods of approval - not tomention the fact that taking the life of a heretic was rarely questioned atall. "Do notgo gentle into that good night" Dylan Thomas raged, and if poetic imageryis used throughout this discussion to illustrate the primal emotion, it isbecause words of reason can only grasp at the edges of description of what,in the final analysis, is always an act. (1985). 73-81). Only two million dollars a yearthat could feed three dozen families!" These are not the ones to thankcontemporary medicine for the "miracle" of a prolonged life - these are theones who consider euthanasia the only miracle held out to comfort them; amiracle, like most miracles, most often denied believers and disbelieversalike. "Euthanasia" comes from the Greek word meaning "easy or good death;"it refers specifically to the practice of one person taking another's lifefor reasons of mercy - or so it was introduced into general usage in theEnglish language by the British historian W. A passive euthanasia isone in which the suffering individual is allowed to die by "natural" means;that is, the participants (patient, doctors, family, friends, society)agree not to use medical means to prolong the individual's life. Let me die before I awake: Hemlock's book of self- deliverance for the dying. 135)earlier this century: "Some are proposing what is called euthanasia; atpresent only a proposal for killing those who are a nuisance to themselves;but soon to be applied to those who are a nuisance to other people."Involuntary euthanasia, then, is against the informed will of the victim.It is, for all practical purposes, an execution or murder. 17-18) devised this Latin-derived word and incorporated it into his writingsin order to describe a more neutral and less judgmental term for acts ofself (sui)-killing (cide): "To vindicate one's self from extreme andotherwise inevitable calamity by sui-cide (sic) is not (certainly) acrime." Indeed, Charleton was simply naming an act that has had persistentexample displayed in heroic terms throughout the history of Westerncivilization. L., & Davidson, A. (1991). The basis of this condemnation is simple: by Judeo-Christian philosophical axiom, one's life belongs to God, not oneself - Histo determine the fate of; moreover, to willfully destroy one's life iscommit self-murder in open defiance of the Sixth Commandment delivered byGod through Moses, "Thou Shalt Not Kill" (Wennberg, pp. Theissues of selecting criteria to justify non-voluntary euthanasia are toocomplex to write of generally, too individual to address save in anindividual context. Lecky in 1869 (Wennberg,1989, pp. Activeeuthanasia, as can be readily ascertained, is when those same participantsuse direct action to hasten the end; a lethal injection of morphine intothe I.V. (197 ). The remainder of this discussion, then, willconcentrate upon consideration of the justifications for voluntaryeuthanasia - where no amount of nuance, individuality, potential abuse norpractical-administration obstacles can obscure the fact that the majorparticipant, the person who will die, wants to end his or her life in thismanner. J. Hudson, WI: GEM Publications.Maguire, D. 3. 9). E., & Hersh, A. tube of a terminal burn victim would be one example. Final exit: The practicalities of self-deliverance and assisted suicide for the dying. "Thou Shalt Not Kill," it appears, has been one of the TenCommandments that did not survive much beyond Moses' lifetime: hissuccessor Joshua's God-aided assault on the walls of Jericho was marked bya blood-bath conclusion. But what of the less iron-willed, or less fortunate: The woman whoselife centers around mothering, nurturing others, now reduced by progressiveAlzheimer's Disease to watching her own dwindling capacities reduce herfamily's finances to zero and their love to a tattered sense of "duty?" Orthe Hawking-brilliant scientist so twisted by stomach cancer that everyounce of his will must be bent to suppressing screams - unless he wants tobe drugged into vegetable unconsciousness? Stepright up and see how we keep him A-Live! R. And "for reasons above one's own self" is a justification thatbegs the original proposition of the Judeo-Christian moral position againstvoluntary euthanasia. It does not. It is easy to imagine the ethical, moral and practical quandariesembraced by this scenario: choosing priorities easily becomes a social,rather than individual, factor in the equation (American Friends ServiceCommittee, 197 , pp. Death, being the final moment ofthe effort, looms as the ultimate test of that sought-for mastery. Edinburgh: T. The definitions of passive and active euthanasia co-exist alongsideanother aspect for consideration - the attitude of the major participant,the one who is dying: voluntary, involuntary or non-voluntary euthanasiaare the categories (Wennberg, p. When faced with the prospectof imminent death, one person acts with equanimity, another with animalterror. In that nohuman has God-like knowledge of another's soul, then, a judgement in favorof voluntary euthanasia must always be so qualified. Thus, while voluntary euthanasia is linked with suicideby Judeo-Christian moralists as part of the argument against euthanasia,the attitude towards suicide in all in nuances as embraced by the Judeo-Christian/ Western heritage is at best ambivalent. But to what degree? For the strong ofwill, for those whose consciousness is not decimated by the pain or ravagesof the infirmity, these scientific breakthroughs are the lease on lifewithheld from their like for centuries. 22-24). Ethical issues in death and dying. Or the idiot-child with half abrain, no spinal cord and the prospect of existence only as a scientificanomaly, linked to I.V.s, electrodes, oxygen tents - "Hurry, hurry! Non-voluntary euthanasia involves committing the act of euthanasia,either passive or active, without the consent of the receptor (the word"victim" is too loaded to use in this context, while the term "majorparticipant" seems disingenuously neutral) - but under circumstances wherethe other participants (doctors, friends, society) assume that the act iseither: (a) what the person would have wished were he or she able to make a fully-informed, conscious decision on the matter, or (b) the most humane option available.An example of the former (a) case would be where a comatose patient hadmade known to his family a wish not to be connected to life support systemsif he were ever in such a situation, a desire never committed to formalexpression; an unexpected car accident has left his family with this choice- their instruction to doctors to "pull the plug" on the accident victimwould be formally a non-voluntary, passive euthanasia. Grand Rapids: William B. Theanswer is, even within the Judeo-Christian tradition, an always-qualified"yes." The qualification is obvious: no one can know the precise degree towhich fear, knowledge, primal emotion and selfless socialization areintertwined within an individual's persona. Eardmans.----------------------- 13 But these people also think, also reason to a greater or lesserdegree, also have emotions to consider, values of humanity to weigh. 53-57). 86-88). The "Elephant Man," to takean historical example, spent his life as a sideshow freak, then a medicallab specimen - in pain often, eventually dying from the medicalcomplications of his from-birth condition - someone who would have been aprime beneficiary of one hope science has to offer from his plight: aswift, painless release. Instead, it should be noted, it appears that the Judeo-Christian anti-suicide tradition is more of a reaction to competing cultures of theancient world, rather than a positive, life-affirming outgrowth of its ownmaking. 17-19). That improvement in the quality of life should make ushappy. New York: Columbia University Press.Wennberg, R. Ifhumankind has evolved, though, then is not "dignity" a characteristicachievement we can bestow upon our final act as humans? (1977). The words "necessary"and "for reasons above one's own self" are often evoked when justifyingexamples as those given above (Wennberg, pp. Surely the brilliant theoristSteven Hawking benefits from the tubes and tests that keep him sitting in amotorized environment, where other technological wonders tap into hisbrain, stepping around the decaying body that is now down to one movablefinger joint and haunting, roving eyes. Anexample would be the famed Karen Ann Quinlan case, where the comatosepatient, after years on artificial life support systems, was disconnectedfrom those systems and allowed to die as her body functions naturallyceased (Humphrey, Let me die before I wake, 1986, pp. There are older connotations of the word, from the ancientGreeks, and contemporary perversions of the term, via National Socialistpolicy of Adolph Hitler's Third Reich; but the general impression conveyedby usage of the word "euthanasia" basically continues to follow theparameters of Lecky's definition: it is a "mercy killing." Within that definition, as expounded, denounced or debated byadvocates of all sides, there are two major divisions of the term: passiveand active (Beauchamp and Davidson, 1979, p. E. H. Terminal choices: Euthanasia, suicide, and the right to die. 3 4). The doctrine of creation, part 4. The subject of one's death embraces concepts and emotions that arebeyond words: it is the ultimate individual experience, lightened in itsimport only very slightly by the knowledge that it is an inevitableexperience for everyone. Who shall live?
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