The Right to Die Debate – Margaret Somerville
Written by: Margaret Somerville, National Post | Jan 17, 2013
An expert committee, chaired by lawyer Jean-Pierre Ménard, has recommended that the Quebec legislature recognize a collection of rights of patients at the end of life, which include rights to decision-making autonomy, palliative care and pain management, control of the time and manner in which one dies and choice of the place. These rights are to be implemented through “medical assistance in dying,” the euphemism used in the National Assembly committee report on “Dying with Dignity” to speak of euthanasia.
Such developments seem to confirm what a filmmaker preparing a documentary on the euthanasia debate in Canada recently said to me: “Everyone, on both sides of the debate, with whom we’ve spoken, believes that legalization is inevitable.”
What role does labelling the values that favour legalizing euthanasia as “progressive” play in the debate? The implication is those who oppose such values are retrogressive, out-of-touch with current realities, clinging to a long-gone past and its traditional, conservative values. Just such an approach is clearly articulated in the Quebec report.
But is this correct? Many young people are lamenting that long-term, committed relationships and marriage have been made much more difficult for them to realize. Most agree the cause, at least in part, is radical changes, since the 1960s “sexual revolution,” in the values, norms and mores governing sexual relationships. Interestingly, these rest on the same “progressive” values bases as those being used to promote the legalization of euthanasia: intense individualism; a lack of access to a transcendent reality; moral relativism; a complete rejection of authority — “nobody has the right to tell me what to do”; and so on.
I suggest that these same values will, if euthanasia were legalized, cause similar damage.
Legalization gives individual autonomy priority over respect for human life. Its message is that personal control is the primary human good; loss of control is equated to loss of dignity. This is especially dangerous for old or disabled people. If euthanasia is an option, they are likely to perceive themselves as a burden on their families and on society, which they could relieve through euthanasia. They could even feel they have a duty to die.
So, what are the countervailing forces?
Some surveys indicate that young people have more conservative values than their parents. They want to feel they belong to something larger than themselves, and are looking for something worth fighting for in the interests of future generations. For some that’s anti-euthanasia advocacy.
Others might also be recognizing the need for some intelligent restraints on “pure individualism.” The concept of “relational autonomy” — the idea that a person is not an isolated being, but exists in a context that influences their decisions, and that this must be taken into account when judging the validity of those decisions — can operate as such a restraint. So too can recognizing that the impact of individuals’ decisions affects others and society as a whole, which is true of euthanasia.
The case for euthanasia is logical, direct and utilitarian, so it’s easy to make. That against it is much more intangible, indirect and ephemeral, so it is much harder to communicate effectively, especially in a predominantly visual culture. We need to set up “spaces” where all our human ways of knowing, especially our moral intuition, examined emotions and ethical imagination, can function in relation to all aspects of euthanasia, in making a decision whether to legalize it.
If, as I do, we believe legalizing euthanasia is a bad idea, it is not enough simply to argue that the pro-euthanasia advocates are wrong on the facts regarding potential abuses, which is where the debate has been focused so far. We must face the basic question that euthanasia raises: Is it inherently wrong for one person intentionally to kill another?
If something is inherently wrong, the issue of how best to manage it does not arise. We only manage activities that are ethically acceptable; we prohibit those that are not. As writer Peter Stockland says, the central question in the euthanasia debate is not whether the system will work as designed to prevent abuses, as pro-euthanasia activists argue it will, but what the system is designed to do. And that requires us to address geriatrician Dr. Catherine Ferrier’s challenging question: “If it’s not killing, what is it?”
I suggest that the push for euthanasia results from a failure of our ethical imagination both as to what euthanasia involves in practice — killing another human being — and as to where that would lead in the future.
Margaret Somerville is the founding director of the Centre for Medicine, Ethics and Law at McGill University.