Sophistry and Illusion regarding Assisted Dying
Wesley J. Smith is a well-known American sophist and “fellow” of the sophistical Discovery Institute. When my wife Elizabeth died in Switzerland — indeed, only a few days after her death — without having ever met her, he made statements that were not only inaccurate, but quite straightforward lies. He lied, because only lies will, in the last analysis, support opposition to assisted dying. I pull no punches on this, because I found his statements then, and find them still, libelous and abusive. The post is entitled “Another Swiss ‘Suicide Tourist’ Proves that the Euthanasia Debate is not about Terminal Illness.” (The link is now corrected, and will take you to the post in question!) It was published on 25th June 2007, two days exactly following the memorial service held for Elizabeth in Middleton, Nova Soctia, where I had been Rector for fourteen years of the Anglican parish, and Elizabeth had had a printing and design business. Mark this carefully: only two days following the memorial service! In that blog post, Smith wrote:
Elizabeth McDonald, age 38, was not terminally ill. She was disabled and depressed. (Depression is caused by MS in some cases.)
Since Smith had never met Elizabeth, and did not know whether or not she was depressed (she wasn’t, although, no doubt, depression is caused by MS in some cases), this is an out and out lie. Not just a misrepresentation, mind, but a lie, for he might have sought the truth and did not bother. Of course, he may believe that no one responsibly seeks death unless they are depressed, but his too is untrue. Then, at the end of his post he writes:
The new attitude seems to be, “If you want to die, go ahead and die. It’s none of my business,” which masks as respect for “choice” but is actually a form of abandonment.
Since his post is about “another ‘suicide tourist’,” namely, my wife Elizabeth, who was offended by the term ‘suicide tourist’, Smith is not only attacking my wife’s good name, he is directly accusing me of abandonment, or what the Anglican Church of Canada calls a “failure of human community.” The suggestion is that I had not only abandoned Elizabeth, but that I had washed my hands of concern for her: “If you want to die, go ahead and die. It’s none of my business.” This is so far from the truth that it is hard to justify this as other than a slanderous and untrue accusation directed to me and my part in Elizabeth’s determination to end her suffering. (I have asked Smith to remove this slanderous post, but to no effect.)
Let’s be very clear about this. No, assisted dying is not (and should not be) only about terminal illness. This is a complete misrepresentation of what assisted dying should concern itself with, and the laws which so limit assisted dying are a standing affront to those, like Tony Nicklinson or Diane Pretty in England, and Sue Rodriguez or Goria Taylor in Canada, and my wife Elizabeth, who were not (or may not have been) terminally ill within the meaning of the law in Oregon, Washington, etc., and would have been left to suffer regardless of the degree of their suffering. I have coined the term “terminal suffering” for those whose suffering is such that only death can bring it to an end. That is why I was opposed to Lord Falconer’s (England and Wales) and Margo Macdonald’s (Scotland) and Francine Lalonde’s (Canada) assisted dying bills. It seems that legislators can’t get it through their heads that years and years of suffering are, if anything, far worse than a few days of intense pain at the end of life. Not only can they not get this through their heads, they set themselves up for the inevitable slippery slope that will arise as soon as people justly point out that assisted dying for the terminally ill is not sufficient to cope with the human suffering caused by the refusal to legalise assisted dying for those whose suffering is terminal (as defined above). This means that the reasonable next step, to allow assisted dying for the terminally suffering, will be construed (as Smith does in the blog post linked here) as a slide down what such people believe is the inevitable slippery slope that will be created by the legalisation of assisted dying.
It is important to remember here — something often forgotten — that Switzerland has had assisted suicide provisions in its Penal Code, without precise legal restrictions, since 1941, and no one, to my knowledge, has yet shown that the predicted slippery slope has developed, even with this permissive system. Here is the law governing assisted suicide in its entirety:
Verleitung und Beihilfe zum Selbstmord
Wer aus selbstsüchtigen Beweggründen jemanden zum Selbstmorde verleitet oder ihm dazu Hilfe leistet, wird, wenn der Selbstmord ausgeführt oder versucht wurde, mit Freiheitsstrafe bis zu fünf Jahren oder Geldstrafe1 bestraft.
My own translation:
Encouragement and Assistance to Commit Suicide
Whoever from selfserving motives encourages someone to commit suicide or provides help to accomplish that, if [whether] the suicide is accomplished or attempted, will be punished with a term of imprisonment of up to five years or a fine.
That’s it! Obviously, this is a very permissive law, but no one has yet demonstrated that this has led to a slippery slope, despite the fact that supporters of assisted suicide for the terminally ill alone regularly acknowledge the need for close, and sometimes even claustrophobic, regulation and supervision.
I raise these points, because Jason Rosenhouse, over a Evolution Blog has been having a tit for tat exchange with Wesley Smith, and one of Smith’s Discovery Institute cohorts, David Klinghoffer, and then referred very kindly to my own post about the Falconer Bill: MacDonald on Assisted Dying. Let me try to put the conversation in order. It all began when Smith wrote an online article for the conservative Christian journal First Things, responding to Diane Rehm’s post about her husband entitled My Husband’s Slow, Deliberate Death was Unnecessary. Smith’s article is called How We Portray Suffering and Suicide. Jason then responded to Smith with a post entitled A Human Life is More Than a Heartbeat (though the address line, as you will see if you click on the link, says: “Opponents of Assisted Suicide are Monsters.) Jason received a double-barreled reply, from Smith and Smith’s Discovery Institute friend Klinghoffer. Smith dares to call Jason’s post a tirade: A Tirade by Jason Rosenhouse at Evolution Blog Doesn’t Justify Assisted Suicide. (It’s not really worth your while reading it, but if you want to just click the link.) Then we have Klinghoffer’s So, You Think Someone’s View on Origins Has No Bearing on Questions About “Meaning and Value”? and What We Mean When We Speak About “The Value of Human Life”. This is followed by Jason’s Replies to Smith and Klinghoffer and then his post referring to my own post about the Falconer bill before the House of Lords (linked above). One might fairly conclude that armed conflict is only a heartbeat away!
Obviously, I’m already crowding my word limit, if I want to be read, and I’ve scarcely begun! So, let me throw caution to the winds, and soldier on! Diane Rehm’s point is that her husband’s death by starvation (as he chose to do) was unnecessary, because there should be a law legalising assisted suicide. Smith interprets Rehm’s point in terms of National Public Radio’s profile of her, which, he says, focuses on her support for assisted suicide. To which he makes the inapropos response:
It is a profound disservice to the gravity of this issue that the media give scandalously short shrift to the many stories of people who find meaning and hope in life even as they grapple with the anguish of profound disabilities.
This is nonsense, as Rosenhouse points out. Such stories are very common, especially in defence of the legal status quo regarding assisted dying. Indeed, some, like the former Chief Rabbi of Britain and the Commonwealth, Jonathan Sacks, justified his father’s final suffering by the rich experience and solace that it provided him. (I believe the article is at the London Times, behind a paywall, and I no longer have a subscription.) He did not say how his father regarded his final hours. The point is that the number of people “who find meaning and hope in life even as they grapple with the anguish of profound disabilities” is irrelevant to the question of whether people should be forced to suffer just in case they may have similar experiences of meaning and hope. Suggesting that some people experience meaning and hope in their suffering does not give anyone the right to impose the mere possibility of such experiences on others who feel, like Mr. Rehms, that their meaningful life has come to an end, when only death will end the suffering and existential angst, the living hell, that their lives have become. Indeed, the uncertainty about the end of this living hell may lead some, like my wife Elizabeth, to end their lives much earlier than they would have done had legalised assisted dying been available. I have been unable, since that time, to forgive either the church or my country for her early death.
As an example, Smith uses the life of Mark Pickup, a Canadian who lives in Beaumont, Alberta, and who has suffered with relapsing remitting MS for several years. We are given his list of symptoms and his response to them, his early wish to end it all, but his subsequent pulling through, with, as he says, “the support of his family and, as he describes it, “the love of God’.” And one wants to say: Bully for him! But Mark is not everyone. He is not even one other person. He is himself. Today, Smith tells us,
Mark is a triplegic, with only his left arm unimpaired, requiring a wheelchair for mobility, often in pain from severe muscle contractions. He has lost his artistic ability, his musical talent, his capacity to care for himself independently.
He runs a blog entitled Human Life Matters. I will not link his blog, because I found his contribution shortly after Elizabeth’s death offensive and insulting. His claims about Elizabeth are all untrue. Just to anticipate: She had the best medical attention possible, both from her family doctor and her neurologist. Indeed, she was told by a neurologist in Ottawa that she had a lesion on a pain centre in the brain, and that he was not surprised that she had found no relief for her pain. She used to take over 12, and sometimes as many as 15, 40 mg capsules of morphine a day, and still found her pain unbearable. Not only that, Elizabeth’s control was mind-boggling. She almost never gave a sign, except occasionally at night, when she would awake crying in pain, that she was in pain. At the time of Elizabeth’s death he wrote as follows:
That was the problem with the recent assisted suicide of Nova Scotian Elizabeth Macdonald (38). She had multiple sclerosis. Her husband said she was in excruciating pain since 1999—following her diagnosis. I have had MS for more than 23 years so I think I know a thing or two about pain associated with the disease. It’s easily controlled with proper administration of modern pain management techniques. If Elizabeth Macdonald suffered from excruciating physical pain for eight years, her physicians should be required to update their skills. [He should point that there are different forms of MS and that he knows nothing about Primary Progressive MS. And, as he says next, MS is unpredictable. Having said this does he still have the effrontery to claim that Elizabeth’s doctors need updating in their pain management techniques? And does he know what options were offered and what options Elizabeth accepted or rejected and for what reasons? This man is, in my opionion, an objectionable turd. And that is strong language coming from me. But then, just to offend even more, he says:] From the reports I’ve read, I find myself wondering whether the problem for Elizabeth Marshall [sic] was CONTROL more than pain control. Multiple sclerosis is unpredictable. [There are no publicly available reports which could lead this religious idiot to this conclusion.]
In the interests of maintaining transparency about Macdonald’s death [This is untrue. It was done deliberately to frighten others from seeking an accompanied death in Switzerland. Schadenberg, the self-appointed Grand Wizard of this particular clan, was threatening others with similar police action, and said so], Canada’s Euthanasia Prevention Coalition rightful[ly] asked the RCMP to investigate whether Canadian law against assisted suicide had been violated (specifically Section 241 of the Criminal Code). Without the restraining influence of this law, other vulnerable people are at risk of seeking assisted suicide. Euthanasia Prevention Coalition Executive Director, Alex Schadenberg, was met with a firestorm of criticism from autonomists.
Notice, if you will, Smith’s remark that Mark is “often in pain from severe muscle contractions.” Knowing that MS is unpredictable, how dare he suggest that the pain can be controlled. Elizabeth’s pain from spasticity was such that, less than three months after her first symptom in 1998, she put her pain level on a scale of 1-10 at 12. “When I look down at my legs,” she said, “I expect to see bones sticking out through the skin. That’s what it feels like.” Note also that he carelessly switches her name from Macdonald (misspelled) to Marshall from one sentence to another.
That aside, what gives Mark the strength to get up and face each day? Here’s what keeps him going:
The bridge across my river of grief was the cross. Christ was not merely waiting on the other side of the river: He has been with me throughout every leg of my disability journey. He continues to help me redefine and redevelop my life; Christ is helping me understand where, how and why I fit into the world with my new and evolving realities. [my emphasis]
The truth is that Mark has a religious vocation: to stop people from receiving assisted suicide, to defend the indefensible position of his church, and to pat himself on the back for a job well done. Look what I did! I survived. I received support from my family! I was not abandoned! And now I have a mission in life: to prevent legal change to enable others to end their suffering when they have come to the point that their suffering is, in their own judgement, intolerable. That’s all that Diane Rehm was appealing for. Not for doctors to kill their patients or for families to abandon their loved ones; just for individuals to have the opportunity to end their suffering when their lives have reached a point at which continuing to live has become intolerable. Mark Pickup would like to have been able to force Elizabeth to stay alive, notwithstanding her own wishes regarding the matter, and accuses her of lack of self-control in choosing to die before she was trapped in her body. That’s why Jason Rosenhouse calls Smith and Klinghoffer moral monsters, as they undoubtedly are.
I can tell Mark Pickup, however, just to “cock a snook” at his snotty religious superiority, that Elizabeth was greatly loved and supported by her family, but being a person who was truly in CONTROL of her life, she came to the point where she said, “No further. I am not going to become trapped in my own body. This will happen within a year at the present rate of deterioration, and in less than a year I will be unable to take my own life; then I will be truly trapped, entombed in my body, possibly for years.” (She once said that — sitting down — it felt as though she was sitting on concrete, and it would be as though she had been entombed in concrete had she become totally paralysed, as she was quickly becoming. Just to put her situation in persective, Mark Pickup said, in 2007, that he had lived with MS for 23 years. That is now thirty. Elizabeth’s arms were growing numb, and she was finding it difficult to speak, since her throat was being affected. And she had had MS eight years, nine months, and two days, when she died.) She had known people who were trapped in their bodies, some of whom had tried to take their own lives and had been rescued, and lived in misery. Our neighbour’s daughter-in-law was at that time (2006) totally paralysed because of her MS, with a feeding tube surgically inserted into her stomach. She could not speak or move. Her spasticity was such that her body was as if trying to make a ball backwards! She is still alive! No one knows what she thinks. Elizabeth would not let that happen to her, and she made a decision, despite my urging her to stay a bit longer, to die when she did. She wanted to die in my arms, and she asked me to accompany her to Switzerland. How could I refuse?! She made all the arrangements, even speaking to the funeral director in Zurich. I heard her half of the conversation which ended with, “Well, you will be seeing me, but I won’t be seeing you.” She was joyful and full of life to the very end, for her liberation was near. She wanted to time it with D-Day (as a day of liberation — get it?), but had to settle for the 8th of June instead.
Jason says that Smith thinks that what happened to John Rehm was the morally correct outcome. Smith violently objects:
Of course I didn’t think that self-starvation was the morally correct outcome. But neither would it have been right to have the law allow a doctor [to] have given him a lethal injection or a poison prescription.
I know that Smith will disagree, and have all sorts of sophistical arguments to show that his disagreement makes moral sense; however, if it would have been right for John Rehm to have refused treatment or to have treatment withdrawn, the result of which would have been his death, there is no obvious way in which these acts would differ in any morally relevant sense from a request to be given a barbiturate that would end his suffering. Oh, yes, I know, he will refer here to the Doctrine of Double Effect, an old chestnut straight out of Thomas Aquinas’ playbook. The doctor who withdraws treatment does not intend for his patient to die; death is a secondary effect of the action, and therefore not relevant to the fact that the patient dies. The patient dies of his underlying condition on account of the withdrawal of treatment. Whereas, if he provides a prescription for barbituates, his intention is (presumably — watch what happens to this ‘presumably’) for his patient to die, and he is directly responsible for the death. However, this is not so. In Switzerland, Elizabeth saw a consulting physician, who prescribed the barbiturates which she later used to take her life. However, the representatives of Dignitas, a staff member and a volunteer, who were present to accompany Elizabeth’s death (Dignitas calls assisted suicide an accompanied death), spent nearly two hours trying to convince Elizabeth that she did not need to die, that no one would think less of her if she turned around and went straight back home. And it was Elizabeth herself who set the wheels in motion by saying, at last, “Isn’t it about time that we began the procedure?” Not everyone who receives a prescription for a Dignitas accompanied death goes through with it in the end. So the doctor who prescribes die Medikamente did not know whether or not Elizabeth would actually take her life, and therefore, there was no immediate presumption on his part that she should die. It could work precisely the same with a lethal injection. The prescribing authority need not be the administering authority, who would administer the prescription only at the request of the patient. It is, in the first, place, absurd that the doctrine of double effect is used, since an act of which it is (presumably) known that it is likely to bring about the death of a person is just as much an intentional act of bringing about death as one which “directly” intends the death of the person. Indeed, there is no obviously indirect intention involved here at all. But even if the law of double effect be thought to be valid, there is no reason why intention and administration should not be separated in the way suggested. The prescribing authority’s intention is to prescribe a medication, the administering authority’s intention is to administer the medication, and neither directly intends the death of the patient, even though both presumably know that the underlying cause of the death will be die verordnete Medikamente (the prescribed medications). As I say, the law of double effect is (in my view) sophistical, for there is no way that the intentions involved cannot be distinguished in the way proposed. The problem with Aquinas’ theory is that it depends wholly on the way the acts are described (as he himself says), and it is not difficult to describe the different aspects of an act (such as withdrawing treatment) in a way that either does or does not directly intend the death of the patient (or some other end which directly follows from the withdrawal of treatment). It is also not difficult to set up a train of events in which no one directly intends the death of the patient (except perhaps the patient herself), and yet in which the outcome is the death of the patient. The only outstanding question is the moral status of suicide, and it is generally agreed that there are reasons when suicide is a morally appropriate step to take. The church may not think so, but that is because the church is absolutist with regard to most moral prescriptions, and therefore cannot see that some acts proscribed by the church are morally perfectly legitimate. Yet, again, an act of suicide might intend to bring the cessation of intolerable pain, and not the person’s death; death just happens, contingently, to be the only way in which the intolerable pain or suffering can be brought to an end. The law of double effect is a very elastic tool.
This is already, as you will no doubt by now all agree (if you have made it this far!), much too long, so I will not continue the discussion much farther. However, Klinghoffer thinks he has a clinching argument regarding the value of human life that should, he thinks, at least appeal to Jews. I think the argument is in itself anti-Semitic, but place that on one side for the moment. Here’s the argument (or thought experiment):
Speaking of values, I would ask Rosenhouse the same hypothetical question, derived from Dennis Prager, that I proposed yesterday, to ask of scientific-atheist honchos Sam Harris, PZ Myers, or Jerry Coyne:
Thought experiment: You’re transported back in time to Poland seventy year[a] ago where you are a Jew on the run from the Nazis. In a Warsaw street, two doors lie ahead of you. You have just enough time to knock on one, seeking aid, as the scuff of pursuing boots draws closer. One door belongs to a Catholic priest or nun. The other to a biologist — better yet, an atheist evolutionary biologist. On whose door do you knock?
Or alternatively, updated:
Say you’re a Jew today in a European city, on the run from an anti-Semitic mob that is marching to support Hamas. Two doors lie ahead of you. Seeking safety, you can knock on one and only one. One belongs to a biologist inclined to doubt Darwinism in favor of intelligent design. The other to a New Atheist acolyte and Darwin supremacist.
Which door do you choose? You have 5 seconds to decide. 1, 2, 3, 4, 5. Go.
Klodhopper thinks this is a clincher, but in response, I think, in the first case, it would be best to choose an atheist evolutionary biologist, for he is less likely than a priest or nun to be anti-Semitic. In the second, one should obviously choose the “Darwin[ian] supremacist,” since he is much more likely to have thought carefully about moral values. The ID absolutist obviously is incapable of thinking rationally about values, and is more likely to take his cue from a text that cannot be meaningfully attributed to a supernatural being, but will be so considered by the ID absolutist. His value conclusions will be therefore unpredictable, and might well be based on one of the more anti-Semitic or anti-Judaic passages of the New Testament.
As I say, thanks to Jason for the inspiration, and to the twin sophists from the Discovery Institute for the entertainment!
- Patrick O’Connor’s Business Insider article on atheism and Jerry Coyne’s Response
- Jerry Coyne’s Reply to Michael Ruse and the difficulty of Thinking
- Yes, Kenan, there is something about Islam
- Sophistry and Illusion regarding Assisted Dying
- The Falconer Bill, the Church and the possibility of Christian support for Assisted Dying
- In which I take my leave from the new atheism
- Somerville is at it again!
- Boghossian’s “A Manual for Creating Atheists”: A Preliminary Report II
- Boghossian’s “A Manual for Creating Atheists”: A Preliminary Report
- To judge Somerville by her ideas *is* to judge her by her religion