The late Jack Kevorkian enjoyed an ambivalent relationship with the wider pro-euthanasia movement. Like Australia’s Philip Nitschke, he single-handedly focused national attention on the euthanasia issue. Yet the presence of an eccentric, media-loving “Dr Death” had become an embarrassment to pro-euthanasia groups desperate to be taken seriously on a public policy level. “A lightning rod”, is how Oregon’s Death with Dignity National Centre eulogised Kevorkian:
Firebrand, hero, crazy man, renegade, zealot. No matter how you describe him, Kevorkian got all of us to think about something we never want to face.
Unfortunately, we are well beyond the “think about it” phase of the euthanasia movement’s agenda. These days the movement is all about encouraging, and advocating on behalf of, the public demand for “death with dignity”. Thus we have Oregon and Washington’s Death with Dignity Acts, a defeated Dying with Dignity bill and organisation of the same name in Australia, the British Dignity in Dying, and the infamous Swiss group Dignitas.
With all this talk of dignity, it would be nice if someone could actually define it. But the word remains ambiguous and the concept is—perhaps intentionally—left undefined in the human rights arena. Yet there is a very straightforward understanding of dignity that can be gleaned from the word’s linguistic roots. And while the roots of a word do not necessarily give us the word’s contemporary meaning, when dealing with words as mysterious and ambiguous as dignity, tracing the roots may indeed lead us to the outermost branches.
Dignity entered the English language as a French word, in turn derived from the Latin dignitas meaning “worthiness.” “Dignity,” then, is an alternative to good old-fashioned “worth,” itself derived from the old-English weorð meaning “to be equal to.” “Worth” is to “dignity” as “want” is to “desire”, and in the absence of fancy French alternatives we English speakers would probably still be wanting worthiness rather than desiring dignity. If dignity is originally just the Latin equivalent of our worth then we have an excellent basis for understanding what our thirteenth century ancestors were on about when they co-opted the term, before it became so deeply enriched with a wealth of cultural and historic associations.
So “human dignity” is more or less synonymous with “human worthiness” which in turn means “the worth of a human being.” What is a human being worth? The answer might depend on the culture and society at the time. “Life is cheap” we sometimes hear from war-zones and poverty stricken communities. But historically we in the West have decided that the value of a human being is actually very high, priceless in fact. How do we arrive at such a high estimation of human worth?
The key lies in knowing that worth is a matter of relative value, the weighing of one object against another. Yet human beings are not the same as any mere object: we are, uniquely, subjects. While I might be willing to trade you my car for three thousand dollars (I think it’s worth at least that much to me), I cannot logically trade myself to you for any amount of money. How much am I worth to myself, after all?
Any attempt at trading a human being implicitly objectifies that which is no object. It is no more legitimate than a con artist “selling” properties that are not his to sell. The logical impossibility of selling a human being (either oneself or another) effectively drives any question of relative worth out of the market. The question of relative worth is therefore given an absolute answer: human life has infinite value. Put away your credit cards, these items are not for sale.
I described dignity as a fancy word for worth and it should be apparent by now that human worth deserves a uniquely fancy word. We do not ask about the dignity of objects, except in an anthropomorphic sense. We humans are uniquely subjects rather than objects, possessing infinite value, which is in turn reflected in the esteem with which we regard the word dignity itself. Dignity as the infinite, intrinsic, inviolable worth of a human being cannot be won or lost, revoked, conferred, promoted or demoted. In this sense, every death is a death with dignity.
Yet the “death with dignity” trope remains potent because life doesn’t always show us the respect that our dignity deserves. There is some truth in the pro-euthanasia claim that the circumstances of death do not reflect our worth as human beings. We all, almost inevitably, will suffer unworthy treatment and circumstances, the harsh indignities of life.
People fear these future indignities as much as future suffering itself, but euthanasia is a false response to the threat of unworthy conditions. Euthanasia encourages us to destroy ourselves rather than endure conditions beneath our great worth. Yet what could be more unworthy of a human than to kill himself to avoid an indignity? This euthanasia mindset confuses dignity of circumstances with the dignity of the self. It mistakes the expression of dignity for the substance. For in the end, it is we-the loved ones, carers, and the dying themselves-who bring dignity to death, not its circumstances that confer dignity on us.
Zac Alstin works part-time as a research officer for the Southern Cross Bioethics Institute in South Australia, and is a freelance writer for the online magazine MercatorNet.
Comments:
May be our culture could use some good media education even , of real persons , who at times have to struggle in the last hours of life , how families and friends help them , to entrust the moments of pain , to be united to that of our Lord on The Cross , to thus bring in His power , not just into their lives , but even those of many others !
We often hear how there are enemy agents with their claims , esp. at the moment of death, trying to instill despair ; eutahnasia would seem to play right into their schemes of denying one's choice to trustingly surrender esp. life's last moments ,and thus even all of one's life , unto God.
The Chaplet of Mercy and the Litany of Mercy chanted at the bedside -
http://www.scborromeo.org/prayers/litanydm.pdf
that would be the dignity that the dying deserve !
Your examination of human dignity reminds me of this quote from Chesterton:
“Unless a thing is dignified, it cannot be undignified. Why is it funny that a man should sit down suddenly in the street? There is only one possible or intelligent reason: that man is the image of God. It is not funny that anything else should fall down; only that a man should fall down. No one sees anything funny in a tree falling down. No one sees a delicate absurdity in a stone falling down. No man stops in the road and roars with laughter at the sight of the snow coming down. The fall of thunderbolts is treated with some gravity. The fall of roofs and high buildings is taken seriously. It is only when a man tumbles down that we laugh. Why do we laugh? Because it is a grave religious matter: it is the Fall of Man. Only man can be absurd: for only man can be dignified.”
Well done
great article man. interesting line you have taken. In regards to the ideas themselves, as you know already I cannot agree. To me, there is an implicit authoritarianism in this which seems frightened of people taking control of their lives to the extent that they may end them. I often get the idea from reading anti-euth arguments that the argument isn't about dignity, life and worth at all but something far more sinister, the fear of god perhaps? the fear of personal sovereignty? It's also very easy to throw around ideas about worth and dignity, but in the real world, terrible and unbearable pain is always terrible and unbearbale pain, and the humane choice lies in the real world, not in abstract ideas, as much I generally prefer to deal in the latter, notwithstanding that fact that often abstract ideas will inform the real world (something you have taught me to take much pride from). But unfortunately, here, I can't agree with your logic. Nietsczhe once wrote that the idea of suicide has saved many lives, for it has reminded people that would have otherwise killed themselves in tragedy that there is still at least one thing they can be in control of, and that is their own life and death. What a tragic world, then, the anti-euths are proposing
My sister came around and thanked me for saving her life. Was their science really that flawed, or did a philosophical agenda exist?
Since then I have asked myself over and over why Washington State was one of the first in the United States to embrace euthanasia, and I'm convinced that a major factor is the Scandinavian influence (many Scandinavians settled in Washington after arriving in America). I say this because in Scandinavia there is much pride in being neutral on life and death issues, residing in what one can easily discern as a superior detachment from issues that drive other countries crazy and sometimes into war: "Let a person freely choose - it is not my place to choose for him/her." And the problem in this is that there is a very thin line between detachment and indifference. And history has taught us that neutrality and detachment can easily slip into a violent form of indifference. And it was the genius Danish filmmaker, Lars von Trier, who explored this best in his film “Zentropa”.
And finally, I don't believe the problem is ultimately about people being forced to live in pain (pain management has made tremendous strides; plus, there are thousands upon thousands of witnesses in history that their lives had become more complete through pain and suffering). The real problem is that more and more people are living in isolation. It is not the disease of physical illness, but the disease of loneliness in a more rabidly selfish world that we need to look more deeply into.
The fact is that euthanasia is not really about pain, and many pro-euthanasia groups will agree with me on this. For example, the South Australian Voluntary Euthanasia Society website states: "There are still cases in which pain cannot be satisfactorily controlled, but of greater concern is the loss of faculties and descent into total dependence on others over a lengthy period as a miserable prelude to death."
In the worst cases of pain, sedation is an appropriate response. 'Unbearable pain' can be alleviated with good palliative care. It is notable that in countries with euthanasia regimes, palliative care services are reportedly in bad shape.
You've mentioned that there's something authoritarian about the anti-euthanasia movement. But there is evidence of doctors in the Netherlands and Belgium killing significant numbers of patients who have not consented to euthanasia - because they are not able to communicate their wishes. This is technically illegal in these countries, yet no action has been taken, presumably because the public and government have accepted the more general direction of euthanasia as a solution to problems.
This is a huge debate, but I'd like to touch on the final point that medicine has historically been about treatment of illness and injury. With scientific rigour, western medicine has striven to find and apply appropriate treatments for illnesses etc. But euthanasia is a departure from this. It is not a 'treatment' but a choice. There are no illnesses or injuries to which it is the specific and objective response. It is therefore - potentially - a response to *any* condition. For this reason, many of us forsee that once euthanasia is accepted by the community, it will gradually expand, influencing our future morality and behaviour both directly and indirectly.
It should come as no surprise that the Netherlands has gradually expanded its criteria of who may be killed. From memory, patients had to be at least 16 y.o. but now 12 to 16 y.o. may choose to be killed with agreement from a parent or guardian. Euthanasia may be requested in writing, to be applied at a future point when the patient is no longer mentally competent. Outside of the legal regime, doctors have been killing disabled infants with parental consent. They have also been killing incompetent patients with family consent. A recent petition has initiated parliamentary debate over extending euthanasia to people over the age of 70 who are 'tired of life' but not otherwise ill.
Okay, one more point - the last, I promise! A recent euthanasia bill put forward in South Australia would have allowed anyone with any permanent medical condition to receive euthanasia. Think about it for a moment...If I tell someone that I want to end my life, people will (hopefully) try to stop me, tell me life is worth living etc. But if I had a disability, suddenly there would be a legal and medical regime offering sympathy and compassion for my 'unbearable' life, and helping me to end it. Why the double-standard? Is it because we implicitly agree that for people who are ill or disabled life is not worth living?
Anyhow, that's a diverse set of points and only scratching the surface, but I hope you can see there are good reasons to be fearful or concerned about the introduction of a euthanasia regime. The matter is not as simple as 'letting die' people who are in 'unbearable pain'.
Some people consider this a cheap shot, but I think it wholly relevant in the context of 'authoritarianism' to point out that in 1939 Hitler gave personal permission to a father for his disabled infant son to be euthanised. This is credited as the starting point for a euthanasia campaign in which thousands of disabled people were murdered. It's worth bearing in mind that what looks like 'compassion' is not necessarily so.
Sadly, I think you are right about a philosophical agenda, though the doctors themselves are reliant on the quality of their education. It worries me that the focus on patient choices in end-of-life treatment is eroding confidence in good medical decision-making.
There's definitely something rotten in the state of Holland...
I agree also with your point about isolation and loneliness as a contributing factor. Our problems with death reflect our problems with life.
Zac
