Yesterday I took a look at part of the United States Conference of Catholic Bishops’ statement on assisted suicide. Note carefully that they persist in the use of the word ‘suicide’ to describe what is taking place when people in unrelievable suffering choose to die, and then they assimilate this to other occasions of suicide, thus mischaracterising as tragic acts of depression or desperation by people in the midst of life, those who act on reasonable grounds towards the end of life to bring their suffering to an end. The continued misrepresentation of what is intended when proponents speak of aid in dying is a deeply cynical aspect of the Roman Catholic campaign to oppose assisted dying. It is fundamentally dishonest, and shows the Roman Catholic Church up for what it is, a bully in the public square, whose only purpose is to ensure that its beliefs, prescriptions and proscriptions are adhered to by everyone, regardless of belief.
The next step in their statement is to accuse those who approve assistance in dying legislation as expressing a false compassion.
True compassion [the bishops say] alleviates suffering while maintaining solidarity with those who suffer. It does not put lethal drugs in their hands and abandon them to their suicidal impulses, or to the self-serving motives of others who may want them dead.
This is a slander, a misrepresentation, and a lie, all in one. Sure, it is possible that there are people who, when people are dying, would wish it to go more swiftly so that they can get ahold of their inheritance. But absolutely no one is suggesting that assistance in dying should be handed over to anyone who can benefit from the death of the person concerned. And, as for solidarity, how much solidarity is there when the person’s own wish to be helped to die is refused and misrepresented, as the late pope did, as a request for others to hope when they are no longer able to hope for themselves? Is this solidarity? No, it is not, it is a cynical manipulation of the truth — the truth that some people do want to die more quickly – in order to affirm and reaffirm its own absolute prescriptions and proscriptions. And how truly compassionate is it to ignore the continuing desperate appeals of the dying to be helped to die? By what verbal magic do the bishops turn this refusal into compassion? The truth is, obviously, that these people are not thinking in terms of compassion at all. They think they know something that others do not know, namely, what God wants, and they are prepared to stick to this false knowledge, which cannot, by any stretch of the imagination be shown to be true, whatever its effect on people who are suffering. This is so deeply cynical as almost to beggar description. How could this group of influential men believe that they are actually expressing the highest and best morality by associating themselves with ideas such as these?
But the cynicism goes even deeper yet. Referring to what they see as a slippery slope in Holland, they say this:
Once [the doctors] convinced themselves that ending a short life can be an act of compassion, it was morbidly logical to conclude that ending a longer life may show even more compassion.
The argument is beneath contempt. The context is this. According to Dutch law, as long as terms of the Groningen Protocol are followed, doctors will not be prosecuted for terminating the lives of seriously compromised neonates. Also, by report, though there is not, to my knowledge any clear indication that this is a common practice, or endorsed by the Dutch authorities, persons with chronic depression, and, in one case, a woman whose pathological grief at losing both her husband and son, was, after much consideration, helped to die. And this is all it takes for the bishops to declare that an unavoidable slippery slope exists, so that they can aver without qualification that compassion in Holland now thinks that the longer the life terminated, the more compassion is shown. If it hadn’t been said, it would be hard to believe that anyone would have had the audacity to say it.
In their conclusion, not surprisingly, the bishops affirm their resolve
to join with … disability rights advocates, charitable organizations, and members of the healing professions, to stand for the dignity of people with serious illnesses and disabilities and promote life-affirming solutions for their problems and hardships.
The inclusion here of the disabled is a red herring. Yes, opponents of assisted dying have encouraged the disabled and those who advocate on their behalf to believe that assisted dying legislation would put their lives in danger. This is nonsense, and it rests on a very simple mistake, a mistake that is made over and over again by those who oppose aid in dying. The mistake is a simple one for those who see moral laws as absolutes. If it is morally right for one person to do something (call it A) in circumstances C, then it is an obligation for anyone in C to do A.
This is well illustrated in the Spanish movie, The Sea Inside, especially in the scene when Ramón Sanpedro, the quadriplegic man who was seeking the right to die with dignity, and who fought for that right for thirty years, confronts the priest. The priest is also quadriplegic, and he had argued on television that giving Ramón the right to die would devalue lives of those, like him, who were also quadriplegic. He added for good measure that the fact that Ramón wanted to die was a reflection on the lack of love and care that his family and caregivers were showing him. This clip shows the confrontation between Ramón and the priest (you may have to go to full screen in order to read the subtitles):
The problem is clear. Ramón wants, as he puts it, to die with dignity (morir con dignidad). Would the fulfilment of this desire, if permitted by law, devalue the lives of everyone who, like Ramón, are quadriplegic, and make it likely that such people would be killed? I think the answer to that question is obviously no, but not to the bishops, who state:
By rescinding legal protection for the lives of one group of people, the government implicitly communicates the message — before anyone signs a form to accept this alleged benefit — that they may be better off dead. Thus the bias of too many able-bodied people against the value of life for someone with an illness or disability is embodied in official policy.
But this is simply nonsense. There is no connexion between my valuing something for myself and others valuing it for themselves, unless of course it has to do with the moral underpinnings of society, when I am making a claim that these values should govern the way all of us ought to act in our relationships with each other. This, of course, is precisely what the bishops are doing. They are making a universal claim, that, since they put an absolute and non-defeasible value on persons, no matter what those persons themselves think about their value, or what they themselves want to do, or how much they are suffering, that everyone else ought to put that value on persons too; so it is, of course, not surprising that they think of advocates of aid in dying as making the same assumption. But they are wrong. The bishops’ prescriptions would bind everyone. But Ramón’s decision to die with dignity binds only himself. Elizabeth, when she went to Switzerland to die, was not saying that everyone with MS, in a condition similar to hers, ought to die or be killed. She was making a choice for herself, and for herself alone, and she did make it. No one else with MS was included in that decision, and there is absolutely no reason why they should consider themselves to be so included. The same thing applies to persons who choose to stop treatment or life support. They are not saying that everyone in their condition must or ought to do so, but that that is right for them. (The parallels between these two cases — assisted dying, and stopping or refusing treatment — are worth considering.)
The underlying premise of assisted dying is personal decision, individual autonomy, and if assisted dying be extended into areas which are more appropriately called euthanasia, where decisions are made for others, it should be based on entirely different principles than those applying to people who can make choices for themselves, whether by way of advanced directives telling their caregivers what they want to happen in different situations, or by way of their own choice at the time that it is made. It is simply scare tactics to suggest, as the bishops do, that there are slippery slopes all around us, and people should be very afraid of being killed against their will.
The bishops themselves do, however, raise serious questions that must be faced by those who are likely to find themselves in the hands of Catholic health institutions, and they should be warned that, in those hands, they may not be accorded the kind of autonomy that they would expect in more secular institutions. If they are happy to put themselves in the hands of institutions which threaten excommunication for anyone who acts in ways that are not strictly according to Catholic moral principles, then all is well, but if not, they should be aware of the danger into which they may be standing. In my view the Catholic moral position is without merit. Any morality that needs to misrepresent its opponents so badly as to amount to lying about them cannot stand. It amounts to ideological shadow boxing. I am quite prepared to say that morality, for me, must be based on secular principles amongst which individual autonomy is, if not primary, at least central. In general, I think, the Roman Catholic Church agrees, but Roman Catholic Morality shades off into absolutism when it comes to areas concerned with matters that they believe, without any evidence, must be left solely to God’s discretion, and to the discretion of his representatives on earth. Here any sane person must issue his urgent non placet!
I would like your thoughts on Robert/Tracey Latimer. She was a severely disabled child in constant pain and he killed her to relieve her of her suffering. I feel he did a wrong thing but only because of lack of consent. People who knew the family in the community felt he did the right thing, an altruistic act. I can’t help but think that legal assisted suicide would help in cases like this depending on the severity of the mental handicap.
Well, Cass, that’s a toughie. From the standpoint of assisted dying, what Latimer did was not that, not assisting to die, that is. However, from a moral standpoint what he did was, I believe, justified. But we need to draw a clear line between assistance in dying and euthanasia. I think there is a place for euthanasia, as in Holland, with the Groningen Protocol (which may have covered the question of Tracy Latimer — I’m not sure), and acts based on mercy and consultation with family and other health professionals, when someone is hastened out of life at the end, even though unable to express his or her wishes. This is done all the time, in any event, even in the absence of appropriate legal controls. But the two things need to be kept distinct. I do not personally feel that euthanasia laws, properly framed, are a danger to us, but others would disagree. I do not think it can be shown, despite the bishops, that assisted dying laws should concern us at all, though of course they too must be framed well and enforced. Life is still a great value, even if not sacred, and needs to be protected, but such protection should not require anyone to suffer the kinds of pain that many people still unnecessarily endure.
By the way, Gary Bauslaugh’s book, Robert Latimer: A Story of Justice and Mercy, is well worth reading for the details of what Latimer did and why. There is also — you may have already seen it — a webpage where details of the evidence given at Latimer’s trials can be read. If you read some of the medical evidence about what Tracy Latimer had already suffered, and what she had yet to suffer, it is hard to believe that her father was convicted of any crime. It was done, I think, in response to the lobbying of disability advocate groups, who have been convinced by religious agitators that their lives would be in danger from laws governing assisted dying. The Supreme Court in the case of Sue Rodriguez held that such laws would constitute a danger. In this, I believe, the Court erred, as the minority judgements held. See http://dsp-psd.pwgsc.gc.ca/Collection-R/LoPBdP/BP/bp349-e.htm
Thank you for your prompt response, I find your writing helps me be more critical of my opinions. Of course you are correct, this is euthanasia rather than assisted suicide and the two are separate. After I spoke to local people I did read up more and realized that I fell for the media version of the event rather than the reality of their lives.
People are funny. When I told my Mom I had signed my organ donor card she asked if I weren’t worried about negative effects (both in health care and afterlife) as if some in the medical profession is just itching to kill. Perhaps that fear gives more credence to religious objections. I can’t tell because I don’t think that way.
Perhaps I should have added something about consent. There are always a number of infants born with conditions which will make their lives short and painful. Like Tracy Latimer, they cannot give consent, and yet there is perhaps more mercy and justice in killing them rather than just leaving them to die. People at the end of life are often not able to give their consent to speeding up their dying process, yet it is not considered morally (or even legally) wrong to act so that, while they are relieved of pain, they are also made to die more quickly.
This is often done under the rubric of double effect. The doctor intends to relieve their pain, although a “secondary” but known effect is to speed up the process of dying. This principle, which originates (I believe) with Aquinas, has been used by the Roman Catholic Church ever since. I do not think it is a distinction which should be allowed to reduce the moral tension involved. A known effect cannot be a secondary intention. If I relieve someone’s pain by means of something which also hastens dying, one cannot simply stipulate that I am not responsible for hastening the dying. If I know that it will hasten dying, then calling it a secondary effect is simply a copout.
Aquinas uses the principle in the context of self-defence, supposing that the outcome is the death of the assailant. But then one might very well not know that the result would be the assailant’s death. If one did, then one would have to take responsibility for it. It might be justified, or it might not be justified. If I use lethal force in a situation where it is not warranted, then surely I am responsible, even though I can rightly claim to be acting in self-defence. So, I don’t think Aquinas’ example makes the point. even though Roman Catholic ethicists have been sailing under this flag ever since.
The point that I am trying to make is that consent is not always required, and even Roman Catholic ethicists agree, even though they try to pull a quick one by talking about double effect. In the case where, as in Tracy Latimer’s case, consent could not be given — since she only had a mental age of a few months, and would never learn to communicate consent or anything else — lack of consent cannot be a reason why the action is wrong. The churches tend to fall back on the sanctity of life principle, but there are good reasons for believing that this principle is not coherent (see Kuhse, The Sanctity-of-Life Doctrine in Medicine). I think it was wrong for Latimer to have been tried and convicted of an offence, given the circumstances, especially the circumstance that there was no legal alternative to what he did, except (i) hand the suffering child over to an institution, or (ii) continue to care for the child, no matter what degree of suffering she was forced to endure. Given her mental abilities, there is no obvious reason why she should be considered to be legitimately covered by laws governing the murder of human beings, which guard the value of life insofar as “having a life” has value. Tracy Latimer did not have a life in that sense, and it was cruel to keep her alive under those conditions. But we do need clarity of law to deal with situations such as this. At the very least any person who can say or otherwise clearly indicate that their life is valuable to them, must be protected by law. Those who deprecate what Robert Latimer did repeat the claim that Tracy liked music and smiled as indicating that she found life worth living. I wonder if that is enough, given the degree of suffering that she unquestionably endured.
I think that Latimer had to be tried because he killed a human and, in our society, that’s a crime. We do have room for mercy or compassion though and he wasn’t shown that at all. I think consent resonated for me because there are no mechanisms to demonstrate that there’s no intelligence available give consent.