How can doctors support euthanasia in a country in which patients have to wait months, or even years, for urgent testing and medical treatments? But ideology ignores all. Apparently the Quebec College of Physicians intend to support a “limited” license for doctors to kill their patients. From the story:
It is common knowledge that physicians often have no choice but to constantly increase medication such as morphine to alleviate the pain and suffering of terminally ill patients. Sometimes, the pain is so unbearable that the amount of painkillers or analgesics used to control it can be fatal. And this, according to the Quebec College of Physicians, can be viewed as a form of euthanasia. “The question here is to decide whether a drop in dosage or an increase in dosage constitutes a criminal act,” Dr. Robert said. “We may go as far as to recommend that in certain cases, where the pain is unbearable, the amount of analgesic required could correspond to a form of euthanasia.”
But this is nonsense. If someone is in such pain that you have to aggressively titrate up the dosage, so be it. That is proper medical care. If a patient dies as an unintended side effect, it is no more euthanasia than if a patient dies on the operating table having heart surgery. Both involved legitimate care, and both had an outcome that was not intended by the treatment.
But that argument is almost surely a mask for something else–titrating up morphine or other drugs beyond what is actually necessary to control pain, or giving other drugs in assisted suicide. That is a different kettle of fish altogether because the intent will be to cause death.
Moreover, because pain can be so effectively controlled, it is very rarely the issue in euthanasia and assisted suicide. Rather, we see from Oregon and other places the primary reasons people want to commit assisted suicide involve worries about being burdens, of losing dignity, and other such more existential matters. These are important, to be sure. But they can be dealt with by appropriate mental health intervention and the love of family and friends.
Pain is the weapon used to scare people into supporting euthanasia. But that isn’t why people want it when it becomes legal. If after three years of study, these doctors don’t know that, they are either ignorant or just don’t care. I suggest it is the latter.
July 18th, 2009 | 4:13 pm
Hmmm … a license to kill. Double-0 Doctor?
July 20th, 2009 | 8:58 am
Whatever the individual’s reason for desiring suicide, the fact remains that “self-deliverance” is the individual’s choice — NOT YOURS. Why is it that we Americans feel compelled to meddle in other people’s business?
July 20th, 2009 | 11:08 am
HW: What people don’t realize is that things like “bioethics,” the “end of life” shibboleth,” “elder law,” and “living wills’ ARE meddiling in other people’s business. As is assisted suicide; it’s not suicide if the person doesn’t do it him- or herself.
July 20th, 2009 | 3:26 pm
Ianthe writes: “As is assisted suicide [meddling in other people's business]; it’s not suicide if the person doesn’t do it him- or herself.”
BUT, where we differ on this is in the definition of assisted suicide. If someone “helps” me by holding a pillow over my face I’d have to question whether I was committing suicide or being murdered. On the other hand, if my doctor leaves a bottle of pills for me and says, “if the pain gets too bad you can take ten of these and you’ll die,” then if I take the pills when, where and under the circumstances I choose I would truly be committing suicide autonomously. The physician’s “assistance” is sufficiently remote from the act that he can be held blameless.
I know Wesley will disagree with this since he opposes suicide under any circumstances — in effect, denying the autonomy of the person. I find this difficult to accept since he is also opposed to abortion because of the fetus’ presumed legal “personhood” and in favor of “human exceptionalism” because he considers the human species to be superior to all other species.
I find it difficult to believe that any rational person could oppose the free choice of an action that harms no one but the actor. And yes, I know the argument that a person’s suicide supposedly “harms society,” however that is an eminently unprovable (not to mention objectionable) thesis. After all, if “society” has a superior claim to my person than I, then I am no better than a slave.
July 20th, 2009 | 7:03 pm
HW: I don’t find the act of the physician who says and does as in the example you cited at all far removed from the person’s death. In fact in your example the physician suggests it and it’s the person’s own action and arm who are secondary. I do wonder why anyone would be concerned about a person’s right to commit suicide. If a person is able to commit suicide and does it on their own, it doesn’t matter whose business it is; they did it on their own, in fulfillment of the actual definition of suicide, and that’s that, and obviously it was their own business. As for not harming others, if that were true the trauma “suicide survivors” suffer would not exist, and that’s by definition harming society. In the larger sense you may mean, it is also harmful to society because society exists to further life, not death (unless it’s the Hemlock Society, in which case there’s your reason for its being an offence to society). People would not live in societies if they did not need to and could survive without them. Therefore any act that is counter to the purpose of society is anti-social and harmful to it. And it’s just not normal or healthy to want to die. Death is going to happen anyway, and is by nature beyond our control, as is being born; it’s no more our right to make it happen than it is our ability to choose to be born. It’s against nature. Unless one is a lemming, and we do find their social urge to die unusual. Because it is.
July 20th, 2009 | 7:16 pm
I will amend that slightly. Yes in the case of someone who commits suicide without “help” it’s their own business. To an extent, more or less depending on the individual and the circumstances. Because while I’d prefer that every man be an island, as HW would seem to prefer as well, no man is an island. Which can be unfortunate, because other people and society are a pain in the neck. But for most, a necessary evil. If suicide were truly one’s own business, though, there wouldn’t be such things as being able to be talked down from a ledge, suicide prevention hotlines that are successful in their efforts to whatever extent they are, and being driven to suicide. Even when people commit suicide for reasons of honor, or are kamikaze pilots or terrorist fanatics, there is a social impetus for it. I also don’t understand why those who advocate the right to suicide are talk rather than action — not that I think they should commit suicide (well, those who push it on others, we could do without), and why it is important to them if they aren’t doing it themselves and it’s really no one else’s business but one’s own. Unless they want to preserve their own future right to do it, in which case it is still their own business and why talk about it; desire for control, depression, cowardice, fear of suffering are all explanations. But autonomy — well that’s suicide, not assisted suicide.
July 20th, 2009 | 7:22 pm
HW, you say that you “find it difficult to believe that any rational person could oppose the free choice of an action that harms no one but the actor.” I think you believe that we must not interfere with people’s choices, including their option of harming themselves. But what if you have a rational interest in keeping someone alive and healthy? For example, I have a rational interest in keeping my mother alive and healthy: Specifically, I would be devastated if she were to die, and moreso if she were a suicide. I’m sure one could invent situations in which I would no longer have that interest, but they are unlikely. At present and in the likely future, I want her alive and healthy, or else I am going to spend my days in tears.
Which, to be explicit, means I think that sometimes we ought to interfere in people’s free choices. They may not be making rational choices (for example, the mentally ill), or they may be incapable of making informed choices (for example, the mentally retarded). Most of the time, interference is unnecessary and actually harmful, and usually I am on the side of less interference. But not in the case of suicide: I believe that it is evil and that we have a moral obligation to prevent it. In the same way, we have a moral obligation to prevent euthanasia, because euthanasia is a euphemism for murder. That we have to coerce people into not killing themselves or others evinces our imperfect humanity; but letting them go through with it would be worse.
July 20th, 2009 | 7:32 pm
HW, the idea of dignity actually runs contrary to libertarian autonomy — or autonomy of the will alone. Dignity, in a sense that has a long tradition, refers to an intrinsic worth that inheres in the person.
But dignity is inalienable. Just as one cannot rightly sell oneself into slavery (I mean slavery proper), neither can one maim oneself out of self-hatred. Nor can one rightly murder oneself or another on the basis that some life is not worth living. And so on …
Now, do you ever reason according to some similar logic? Suppose that you have a friend, whom you love deeply, who plans to harm himself. Let it be something very harmful but not immediately deadly. And suppose you try to talk him out of it. One reason you might give him is that if he harms himself, it will pain you to see him so harmed. The question is this: is the pain you experience from your friend’s harm entirely selfish? That is to say, is it entirely because of some loss you may experience by his self-harm? Or might it be that the reason you love your friend so deeply in the first place is that you have made a judgment that he is, indeed, worth something in and of himself? — that he is worth something more than the worth conferred upon him by other people?
I am not asking whether you think he has a right (in the political sense) to inflict this harm on himself. I’m sure you will affirm that he does. I am, rather, asking whether you think that he has some intrinsic worth.
July 20th, 2009 | 9:52 pm
Ianthe, Kyle and SMatthewStolte: Thanks for your reasoned responses. I understand how you feel about the matter, and appreciate the opportunity to discuss it more or less dispassionately. First I should clarify that in the hypothetical situation in which the doctor gives me the pills, I would have initiated the process by unambiguously requesting them. I think it would be unseemly for my doctor to suggest it to me.
Respecting the matter of the survivors’ emotional pain, I admit that it will be unavoidable in a majority of cases. Our society regards death as “a bad thing” (many if not most doctors regard it as “failure”). It stands to reason that most people will regard doing that “bad thing” to oneself as intrinsically evil. Against the emotional suffering of the survivors an individual contemplating suicide must weigh the physical suffering which he is undergoing, and the options available: palliative care that may result in stupefaction, the loss of dignity that comes of being totally dependent on others for the most personal daily activities, and the prospect of being fully cognizant at the expense of unmitigated suffering — vs. acting on one’s own to bring about an end to the problem. With respect to my value to society, I fail to see how my being kept alive in a state of stupefaction makes me more valuable than being dead. It seems to me that we’re talking only of small quantitative differences here.
I am interested in the subject not because I’m contemplating suicide but because I believe that personal autonomy trumps any obligation I have to society to suffer through a terminal illness. I believe that my doctor should be willing to give me the means, if I request it, to make a successful exit, even if he does not believe in suicide.
By the way, SMatthew, I believe there is a big difference between maiming oneself out of self-hatred and killing oneself out of self-love. Theologians may argue that there is some benefit to be gained from suffering, some nobility that accrues to the sufferer because of his forbearance. But I’m basically a pragmatist who gives very little weight to theology in the decision-making process. If you were to ask me my religious views I’d say: agnostic (lapsed). I don’t expect my life will somehow continue after death. If it does, I’ll may be pleasantly (or unpleasantly) surprised. If it doesn’t I won’t know it anyway, so I won’t be disappointed.
July 22nd, 2009 | 5:23 pm
If enough doctors regarded death as a failure and society regarded death as a bad thing, we wouldn’t have futile care theory and the rest of the bad things that are going on. In fact discounting the value of the lives of laboratory animals has led to what used to be medicine and a healthy society now discounting the lives of humans.
July 22nd, 2009 | 5:24 pm
If enough doctors regarded death as a failure and society regarded death as a bad thing, we wouldn’t have futile care theory and the rest of the bad things that are going on.
July 22nd, 2009 | 5:25 pm
Yes I did and apparently it can’t be said often enough.
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