The weak and ill constituted shall perish: the first principle of our philanthropy. And one shall help them to do so.
– Nietzsche, The Antichrist
The National Post reports that, in the first year or so of Quebec’s assisted suicide regime, approximately a hundred people have already been “helped to die,” at least two of them in the McGill University Health Centre conglomerate. I am distressed by this extension of immoral killing, even at my own university. (I say “extension” because abortions are also carried out within the MUHC. I say “immoral” for reasons I will try to clarify.) No one will maintain, by the way, that none of these people could have been helped by proper palliative care. Almost certainly, every one of them could have been. But that is rapidly becoming irrelevant, for suicide and euthanasia are increasingly deemed to be acceptable responses to suffering.
Acceptable by what moral standard? It is time we admitted that, when we set up such regimes, we affirm either that there is no moral law or that the moral law does not forbid suicide and euthanasia. The only other alternative is to say that it belongs to the state to act outside the moral law.
Who will try to defend the first of these options? And why, if there is no moral law, ought we to listen to him? Why ought we to do anything? No, the first option is self-defeating and altogether dehumanizing.
As for the third, it is really just a variant of the first. For if the state operates outside the moral law, it belongs to a different universe than that of its citizens, which is absurd. Besides, there is no state in the abstract. Every action of the state is determined and carried out by citizens who are by nature subject to the moral law. And because the moral law limits or directs citizens, it limits or directs the state also. From this it follows (as we insisted at Nuremburg) that citizens must be prepared to defy the state if it requires of them something immoral.
That leaves the second option, which, even if it can be defended, has not, in fact, been defended—at least not in any fashion commensurate with the present change in law and policy. It was not defended by the Supreme Court in Carter v. Canada. It was not defended either in the House or in the Senate. It has not been defended in public debate about C-14, which cleared its final hurdle yesterday. All that has been done is to assert that assisted suicide and euthanasia are autonomy rights—case closed.
That assertion is incoherent, both prima facie and in its underlying logic, as I have tried to show elsewhere. But let us leave that aside and ask about autonomy itself. What is autonomy? Is it self-rule according to the moral law or is it self-determination according to no law at all? And is autonomy a good that stands apart from other goods, or alone at the top of a hierarchy of goods, such that whatever belongs to autonomy is ipso facto good? Or is autonomy somehow a right that can be separated from the good, as if there were no intrinsic relation between rights and right, or between what is good and what is right?
These questions have not been properly asked, much less properly answered. Nor has any case been made, in the political arena, that it is morally right to take one’s own life—without which it is rather strange to find ourselves saying that it is right to take or help take the life of another. It does not follow from the decriminalization of suicide (as the Supreme Court seems to imagine) that suicide is morally right, nor was suicide decriminalized because we had decided that it is morally right. Certainly it does not follow from the decriminalization of suicide that assisted suicide and euthanasia are right.
Now it will be objected that it is not our collective business to settle moral arguments, and that law and policy ought (there’s that problematic word again) to avoid any attempt to do so as far as possible. But how then can it be argued that suicide is a good thing or at least a morally neutral thing? And without consensus about that, what argument can be made that the state should get behind suicide and support it by way of assisted suicide regimes?
I know, of course, that we are talking only about suicide that is intended to end suffering; but what other kind of suicide is there? Those who want to expand C-14, as the Senate tried to do, have the better of the argument about that! On the other hand, they have not made the case for viewing suffering, rather than death, as the last enemy. Nor have they explained why the state should back those who say that when one dies, suffering comes to an end. What if it doesn’t? What, indeed, if there is some truth to the traditional claim that suicide, at least in some cases, begins a suffering that will never end?
There are those who will pounce on this allusion to Judeo-Christian belief as evidence that what I am saying is not fit for the public square, because it is certainly not our collective business to settle theological arguments. But wait a second. If it is not our collective business to settle theological arguments, why are we creating statutes and committing state resources in support of a practice that rests on the opposite assumption—the assumption that there is no God, or at all events no God who would object to suicide, assisted suicide, and euthanasia? That is hardly theological neutrality.
In point of fact, there is no such thing as theological neutrality, just as there is no such thing as moral neutrality. There are many things, to be sure, both morally and theologically, that the state does well to leave to civil society, neither legislating nor making the basis for legislation. Unfortunately, assisted suicide and euthanasia are not among them. They were criminalized for good reason, as things repugnant to respect for the God-given sanctity of human life, and they ought to remain criminal. They were criminalized out of respect for the link between the rule of law and the supremacy of God, a link that is broken the moment we officially approve of taking (innocent) human life into our own hands, determining its boundaries for ourselves.
Truth be told, in Canada we broke that link back in 1969 with C-150, and though we gave lip service to it in the Charter we are again acting in denial of it with C-14. But the rule of law detached from the supremacy of God is a rule grounded in what, exactly? Certainly not the moral law. No, it is a “rule” grounded in nothing more than our whims, or in some perverse notion of autonomy that sets the human will on a par with the divine, indeed, above the divine.
Here there is no moral law to constrain the human will. And if there is no moral law to constrain the human will, there is no moral law to constrain the state either. When the state promises its assistance to those who wish to end their own lives, it necessarily commits its own agents to complicity. Where will this end? It will end with the state—emulating those citizens who are already doing this to family members—killing those whom it chooses to kill. Such will be its philanthropy, justified by prudential concerns related to the populace as a whole, and by sober determinations that those being killed are either in agreement or insufficiently autonomous to make any valid objection.
Baroness James got this right in her 1992 novel, Children of Men. Others saw it coming long before that. Malcolm Muggeridge, for one, speaking at the University of San Francisco in 1978, pointed out the inevitable pressure on the state to take advantage of euthanasia regimes. For all the high-sounding talk of autonomy and dignity and compassion, this isn’t really what states are about. States are about economics and defense and public order; they are about taxation and regulation and international relations. They are all too prone to view citizens chiefly in that light. But if, says Muggeridge,
people are only considered to be economic entities whose value is measured by the quality and/or quantity of their productivity, then what conceivable justification is there for maintaining, at great expense and difficulty, mentally and physically handicapped people and elderly? . . . [G]overnments will find it impossible to resist the temptation . . . to deliver themselves from this burden of looking after the sick and the handicapped by the simple expedient of killing them off. Now this, in fact, is what the Nazis did … not always through slaughter camps, but by a perfectly coherent decree with perfectly clear conditions. In fact, delay in creating public pressure for euthanasia has been due to the fact that it was one of the war crimes cited at Nuremberg. So for the Guinness Book of Records you can submit this: That it takes just about 30 years in our humane society to transform a war crime into an act of compassion. (Religious Life, May-June, 1996, p. 9)
Those Canadians who rely on the Charter to protect them from such developments are being played for fools. Why? Because the Charter has been used and will be used to read the moral law out of the Common Law and to read in a doctrine of autonomy that represents an incoherent anthropology of unfettered self-determination, incompatible with the Common Law. That anthropology will give way to a more oppressive politics and a more tyrannical state than we hitherto imagined possible in a democracy. In fact, it is already doing so. For top-down politics is the only way, in an inherently chaotic moral universe, to achieve social order. Witness the present clamoring against conscientious objection to participation in euthanasia regimes. Witness the transformation of the medical profession—indeed, its redefinition—by the legal profession and by the state. Witness (to provide a different illustration) the draconian moves being made in education policies across the country, right down to the control of pronouns, not to mention powder rooms.
It ought to shock us that people are being killed deliberately, even in venerable university hospitals, in compliance with the law—not the moral law, but positive law detached from the moral law. There are no details, of course, for in Quebec the details are deliberately hidden. What cannot be hidden is the fact that law has become lawless, and unworthy of respect.
It is the case, thankfully, that many doctors and institutions do not, in this matter, respect it, which has helped keep a low body count in Montreal and in the MUHC, something the Post flags as a puzzle. (Quebec City has a very much higher body count.) Its report highlights the intractability of the controversy by quoting people on both sides, including Jean Pierre Menard, a Montreal lawyer who objects that McGill’s protection of its palliative care unit from the impact of the new law is “completely unlawful.” According to Menard, that unit “does not belong to the doctors, it belongs to the Quebec state,” and must in any case abide by Quebec law.
Well, I want to say to my McGill colleagues who resist Quebec law in this matter, and who intend to resist the new federal law as well: You are right to do so. There is indeed a moral obligation to do so. In doing so you are fighting not only for your patients, and not only for medicine as such, but also for freedom from lawlessness and tyranny. You stand in a noble tradition of conscientious objection and of civil disobedience. You have my support and the support of those who have not embraced the myth of autonomy or its political twin, the illusion of neutrality. Stand firm, for it is you, and not your opponents, who are showing “active sympathy for the weak” (to borrow the Nietzschean phrase without adopting the Nietzschean critique); and you also, not your opponents, who are defending lawful law and the moral foundations of civilized society.
Douglas Farrow is professor of Christian thought and the current holder of the Kennedy Smith Chair in Catholic Studies at McGill University. His most recent book is Desiring a Better Country (MQUP 2015). He maintains a webpage on the euthanasia debate in Canada.