Reaffirming Schadenberg’s standing as a broken record, the National Post has resurrected an old Schadenberg op-ed as a response to the decision of Madame Justice Lynn Smith in Carter vs. Attorney General (Canada). He was wrong then (22nd. March 2012), and, in the light of Madame Justice Smith’s judgement, he is even more wrong now. He continues to play the old fear-mongering song of the vulnerable in danger, even though he has never presented evidence to this effect. This is a remarkable feat for someone who has remained for so many years the Executive Director of the Roman Catholic Church’s star assisted dying vehicle in Canada. It was he who weighed in against the decision of my wife Elizabeth to seek assistance in dying in Switzerland in 2007. His organisation even had the audacity to imply, through its lawyer Hugh Sher, who also acted for the Euthanasia Prevention Coalition (EPC) in the recent Carter case before the British Columbia Supreme Court, that Elizabeth had been (in Hugh Sher’s words) “bundled onto an airplane”, as though Elizabeth herself was unable to make the decision that she made with great seriousness and forethought. This is mistaken. It was, as I now remember, a doctor, speaking on behalf of the Euthanasia Prevention Coalition, who spoke of Elizabeth having been “bundled onto an airplane.” (The effect, however, was the same.) Later denying that the EPC had accused me of wrongdoing in the matter of Elizabeth’s death – which they had in effect, if not in direct speech, done — Schadenberg attempted to mollify an increasingly hostile public opinion that he was speaking in broad general terms, about the danger to society of the practice of assisted dying, and had never spoken directly about one person and her decision to receive assistance in dying from Dignitas in Zürich, Switzerland.

The remarkable thing about religious opponents of assisted dying is their Machiavellian reliance upon lies and half-truths. What counts is convincing ordinary people that they are right. How they do this, whether they are honest, or whether the facts and figures to which they advert actually make their point, seems to be largely irrelevant to their purpose. What counts is making an impression, arousing fear and anxiety about dying, about which people are already anxious and unsure, so that they can carry their main point; namely, that human life has about it an absolute quality of sanctity such that no one may carry out an act which is in any way associated with bringing life to an end. In this the individual plays no part at all. The previous pope, Karol Józef Wojtyła, also known by his chosen title, John Paul II — a practice which hides from us the fact that these are ordinary men with all the faults and foibles of the rest of us, with additional ones (largely the result of their deliberate isolation from ordinary life through their chosen or pretended celibacy) thrown in for good measure – had the audacity in this connexion to say that what the individual wants is irrelevant, and that, even when they are asking for help to die, this is not what they are really asking for. Rather, he said, they are asking for someone to hope for them, when they are no longer able to hope for themselves. This kind of prevarication is the normal coin of this gang of pious thugs, for whom the suffering of individuals at the end of life, and their most carefully and thoughtfully chosen words, are irrelevant to decisions which others make on their behalf. Here, at the end point of their lives, their own wishes count for nothing. Here, when they are at the point of making their last major decision, what they decide is beside the point, and others are given rights over them which, at other points in their life, would be taken as the most egregious violation of their rights and dignity as persons.

I interject at this point the basis upon which my criticism of Sam Harris and others who deny our free will lies. The argument of the present post does not depend on this explanation of my opposition to the denial of free will. The question of free will is largely independent of questions of determinism. The proposition that free will is an illusion, and that the self that makes free decisions is an illusion, is a largely pointless bit of speculation based upon scientific ideas of complexity and strict causal determinism. It does not touch the level at which we speak, in ordinary language, about the making of decisions and taking responsibility for them. To speak of ourselves as automatons is in fact to deny that what we say is of the nature of automatic, uncontrolled speech, for it is to make a distinction that should in strictness — if free will is an illusion – be unable to be made. To suggest that there are things which we should or ought to do, should or ought to believe – as Sam Harris does with abandon in his book The Moral Landscape — is already to step outside the strict causal nexus that is assumed to underlie the actions for which reasons can be given, and it is to deny, to all of us, scope for the making of decisions for which rights are claimed. I can make no sense of those who would say that none of us play a part in shaping our own lives. I acknowledge that who and what I have become is largely dependent on luck, but to suggest that luck itself swallows up everything is to deny, it seems to me, that it makes sense to say that I do things for reasons. It would be to deny that Elizabeth, in any reasonable sense, decided, and made a reasonable decision, to ask for help in dying. It is also, I think, to say that big brains and consciousness are strictly superfluous to the reproductive success of the human species. To me none of this makes any sense. Actually to write down an argument that free will does not exist, is, in effect, to practice the free will that underlies the practice of making arguments and defending conclusions. Meaning itself is the point at which our species, and possibly, to a more limited extent, other species, made the leap from sensory automatism to thoughtful choice. Dennett, in several papers and books, has described the ascent (evolution) from the automatism — what he terms sphexishness — of some simpler animals through various stages of more and more complex choice, to the levels of choice available to human beings at least some of the time. Dawkins remarks that human beings are able to act contrary to the genetic determinism of Darwinian evolution, and by opposing it, to shape society on more humane lines. These considerations underlie my conviction that choice in dying is a plausible candidate for a human right, and rights talk, in my view, makes no sense without them. As A.J. Ayer suggested long ago, talk of free will and the language of determinism are at entirely different levels, and it is a category error to confuse them.

That said, it is vital to note that Roman Catholicism, and many other religious positions, while often basing theology on the capacity of human beings for freedom of choice, often deny human beings the right to make choices about their lives. Women are reduced to baby factories, without any choice once conception has taken place. Many religions deny women the right to determine whether or not they will conceive, determining both that nature of sexual intercourse, and the right freely to decide whether or not intercourse, so undertaken, will result in conception. Dying people have traditionally been denied the right to make decisions regarding the manner of their dying. While we are able to make decisions about our illnesses, and are often provided the means of masking symptoms and curing disease, dying is supposedly something that must be left in the hands of god or nature to decide for us, regardless of the suffering that can be known to be involved, depending on the particular disease process that is causing us to die. And all of us are made ultimately responsible, in a way that a deterministic universe makes impossible, for our ability to believe in a god or gods, and our obedience to that god’s or those gods’ supposed commands. (Some religion, like strict Calvinism, thinks that such belief and obedience is unavailable to us apart from the grace of the god or gods invoked, but this is, I think, a minority religious position, at least in Christianity. Islam, I believe, is fatalistic in some of its forms, as, indeed, are Sikhism, some forms of Buddhism, and other religions that believe in sequential reincarnation and the curse of the wheel of birth and rebirth, and the karmic detritus that plagues our earthly lives and determines our ultimate fate.) It is, I think, noteworthy that Bruce Weller, in his book Against Moral Responsibility, denies that we can bear ultimate responsibility for our actions, something that only the religious believe we are capable of. We are not in any sense ultimately responsible, if that means that it makes sense to speak of human action from the point of view of a god, and this is largely admitted by what Weller calls the “moral responsibility system.” However, we are reasonably thought to be locally responsible for many, if not most, of our actions, and it makes sense to speak of some actions as more or less determined by metal pathology and developmental irregularity.

Back, then, to Alex Schadenberg and his gang of pious thugs — the chief thug of this particular gang of organised thugs being the pope in Rome, though of course there are other, related gangs, led by the leaders of other (chiefly religious) institutions determined to deny our right to determine the manner of our dying. As I was saying, their arguments are not compelling, and are repeated almost by rote, without compelling evidence. Very much like arguments for the existence of gods, arguments regarding assisted dying are often apparently regarded by the media to be largely equally balanced for and against. Thus, Justice Lynn Smith’s judgement in Carter vs. Attorney General (Canada) is said by the Globe and Mail to “thrust” the country back into the debate about legalisation of assisted dying, despite the fact that the judgement itself is, in effect, a judgement to the effect that there are no compelling reasons to deny the right to assistance in dying to Canadians, and that such denial constitutes a offence against the rights of Canadians under Canada’s Charter of Rights and Freedoms. It also neglects to mention the fact that the Quebec Commission on Dignity in Dying has also determined that assistance in dying ought to be recognised as a right. In addition to this, the Royal Society of Canada recently issued the report of an expert panel which recommends, in the strongest terms, the legalisation of a fairly liberal form of assisted dying.

What, then, does Alex Schadenberg and other religious opponents of assisted dying offer in rebuttal of these many claims that assistance in dying is a human right? Their argument is threefold:

First, it repeats the religious claim that human life is sacred. This, despite Margaret Somerville’s claim that there is a reasonable case to be made for what she calls the “secular sacred”, is in principle a religious dogma, and, as such, cannot be the ground of law in a secular democracy. The sanctity of life claim is usually couched in terms of the effect on the general societal respect for life that will be seriously eroded should assisted dying be legalised. Yet it is in response to a claim for respect for the autonmy of the individual that support for assisted dying has become such an important issue of public concern over the last three or four decades. To suggest that such a concern for respect for the individual will automatically erode respect for life seems to be contradictory, and those who oppose assistance in dying have not explained in what sense this is not the case.

Second, it continues to suggest, despite  evidence to the contrary, that the legalisation of assisted dying is to place society on a slippery slope, and that before long what should be allowable only in exceptional circumstances will become the norm. The main defeater for this argument is that, in the jurisdictions where assisted dying has been legalised, there is scant evidence to support the claim. In addition, by claiming that assisted dying should be allowable only in exceptional circumstances, the argument is artificially weighted in its own favour; for there is no reason for suggesting that only exceptional circumstances count. The principal factor to take into account is the free and competent decision of suffering individuals to ask for assisted dying.

In this connexion it is worth mentioning an argument that is often made by the Church of England regarding abortion. When the law permitting abortion was passed in England, the expectation of those in the church who supported legalisation was that abortions would be carried out only in exceptional circumstances. For some reason people thought that women had only resorted to the extreme measure of illegal abortion when in extremis. But that was not true. The fact that more women sought abortion than was initially expected by those who supported reform of abortion legislation led many to think that legalisation had been, in effect, a slippery slope, when it was nothing of the sort. The Church of England contribution to the euthanasia debate, On Dying Well, uses the fact that abortions were more common than expected to suggest that assisted dying would also be subject to slippery slope extensions. But, again, this is only because the Church of England report suggests that conditions that would legitimate assisted dying are so uncommon that the ordinary general practitioner would be unlikely to meet with such a case in a lifetime of practice. This is clearly unrealistic, and slippery slope fears are based almost entirely on this unrealistic sencario.

Slippery slope arguments are often considered to be based on an informal logical fallacy, based on what is termed the sorites (or little-by-little) paradox. How many hairs do you have to add to a man’s chin before it becomes a beard? How many grains of sand do you have to add before it becomes a heap? And so on. Take a heap of sand. Now, take sand away one grain at a time. At what point does it cease to be a heap? The problem is repeated with assisted dying. How many is too many? What constitutes a slippery slope? If 2% of deaths are assisted, and you add 1% to that number, does this show that we are on a slippery slope? As one Dutch ethicist, responding to the claim that euthanasia in the Netherlands is out of control, says:

You cannot do ethics until you know the facts. Therefore, the need for empirical research in ethics is very clear. One of its tasks is to describe the morally relevant facts. … However, facts will not settle a moral debate. When it comes to the euthanasia issue there is much to be learned from studies that the Dutch have performed. But the interpretation of these facts remains largely dependent upon our moral views. Not vice versa. [(Johannes H M van Delden, "Slippery slopes in flat countries -- a response," Journal of Medical Ethics, vol. 25, no. 1 (Feb., 1999), 22-24), 24]

For a Roman Catholic like Alex Schadenberg, one assisted death is already too many, so his interpretation of the facts will differ correspondingly to that of someone who believes that assisted dying is a human right, and is dependent on the decision of individuals, and not upon a classification of conditions under which a person is entitled to ask for such assistance. The illusion of slippery slopes is created largely by thinking that assisted dying defines certain lives as unworthy of life, instead of accepting that some individuals believe that life in the specific conditions of their lives, is no longer worth living.

The third argument has to do with the risk to so-called vulnerable individuals. Relgious groups have claimed that the vulnerable will be placed at risk should assisted dying be legalised, and that as a result palliative and other forms of end-of-life care will diminish, at the same time that relationships between doctor and patient will become degraded with lack of trust. The facts do not bear out this claim. In places like the Netherlands and Oregon palliative care has actually improved since the legalisation of assisted dying, and not only have the vulnerable not been placed at risk, but greater care is taken to ensure that people who might otherwise have asked for assistance in dying are placed in conditions that are such as to make such requests more unlikely. Relationships between doctors and patients have not degraded, but patients often express concern when their own physicians oppose assistance in dying, since they are then placed at greater risk of dying in pain and distress than others whose physicians accept assistance in dying, and are prepared to help their patients die if conditions become such as to make their lives intolerable. It is significant that in the trial of Carter vs. Attorney General (Canada), a group of supposedly vulnerable people who approve of assisted dying were independently represented by counsel, making a lie of the Euthanasia Prevention Coalition’s claim to represent the vulnerable.