Suicide - with or without medical assistance - is now available not only for those with terminal illness but for those suffering chronic conditions, mental illness (to be allowed in Canada beginning in March), or otherwise feel life is just not worth living. Some are against the practice - not just for fear of its overuse, but for its reflections on society. The libertarians are in an uproar. So, who’s right?
Dying with Dignity
Canada, in particular, promotes the practice of self and medical assistance in dying (MAID). Who could object to a group like Dying with Dignity, Canada, promoting such compassionate intervention as allowing dying with dignity? If living with dignity is a prime principle of bioethics (at least the UNESCO version), surely dying with dignity should be. And while relieving suffering sounds honorable and compassionate, for those who have suffered and survived, the concept is demeaning and degrading. Psychiatrist and holocaust survivor, Viktor Frankl, writes in Man in Search for Meaning,
“Certain unhealthy trends in the present day culture…[exist] where the incurable sufferer is given very little opportunity to …consider...[his suffering] ennobling rather than degrading, so that he is not only unhappy but also ashamed of being unhappy.”
Nevertheless, Dying with Dignity, Canada, does an awesome job promoting their agenda. Not a month goes by that I don’t get at least one missive, for example:
“MAID should be available for the person who, at the prime of their life, was diagnosed with a devastating illness that will see their body and mind steadily decline over the next few years — and who want to take back some autonomy and control. [even if the disease is not terminal] …
“MAID should be available for the person who has suffered for years… from a chronic condition that has severely limited their quality of life — and who want a say in how much suffering is enough.
- Kelsey Goforth, Director of Programs, Dying With Dignity Canada.
A social injustice?
Objections have surfaced from all corners. From the Financial Times, a financial objection: The Right to Die Shouldn’t Depend on Your Income. The author claims that if this is a fundamental human right, it should be available to everyone, including the poor. When the practice is outlawed in one’s home jurisdiction, getting the paraphernalia to enable the procedure requires travel – perhaps to “facilitating” Switzerland. [1] That takes money. And that means that the poor are discriminated against.
Indeed, statistics from the Netherlands, with among the most lenient euthanasia provisions, show that poorer patients are just as likely to request euthanasia but less likely to receive it. The structural inequities posed by the system are unfair, says the Financial Times author.
Secular versus Sacred
From the New York Times, Ross Douthat raises more existential concerns, some echoed by the disability rights community, who also protest the Canadian initiative.
“The implication of (Canada’s) law is that a life with disability is automatically less worth living and that in some cases, death is preferable.”
- Theresia Degener, professor of law and disability studies Protestant University for Applied Sciences
Along with “concerns that a meaningful number of people … who apply for euthanasia are driven by poverty or difficulty accessing medical care… [or] that a suffering person who is fundamentally asking for support will get approved for a lethal injection instead,” is the fear of romanticizing, or, in Douthat’s words, “spiritualizing” the practice.
“Rather a society that encourages euthanasia will eventually tend to sacralize it for pre-Christian or post-Christian narratives in which a decision to kill oneself is not just permissible but holy.”
- Ross Douthat
Already we have bioethicists like Julian Savulescu, who feels “being tired of life” is a valid reason for suicide, or Ezekiel Emanuel, who wants to die at 75, idealizing the “disposal” of the elderly as population redundant (a paean to the field of population ethics, where we worry about future generations more than our own). [2]
“[L]iving too long is also a loss. It renders many of us, if not disabled, then faltering and declining, a state that may not be worse than death but is nonetheless deprived.”
- Ezekiel Emanuel, bioethicist.
At the other end of the age spectrum, we have another a ready-market for self-killing assistance: the rising rate of suicide in teens. “Suicide [is now] the second-biggest killer of ten-to-18-year-olds, after accidents.” [3] Making the process easier and socially acceptable is bound to boost that statistic.
Thus far, the pushback has primarily addressed the importance of reigning in the process. Addressing the root cause of dissatisfaction with life, such as poverty, lack of access to medical care, loneliness, and loss of a sense of purpose, would be more compassionate and “human,” opponents argue. [4]
Commodification of Humanity
I agree, but I also suggest the burgeoning practice and acceptance of suicide also reflects the decaying of society – manifested by commodifying human life. If one life doesn’t matter (and the proponents claim its overuse by the young and non-terminally ill accounts for “a few cases” – as if that doesn’t count) – we are a short step from doing in the entire species.
Commodification here implies turning the human into a fungible product such that each individual, unique (and holy) life doesn’t matter to the collective. The “man” becomes “merchandise” to be bought and sold for the benefit of another, like soybeans or pork bellies—dehumanization at its finest.
Commodification made headlines in the savior sibling cases in Britain at the turn of the century. Suddenly it became possible to create a child for the primary purpose of donating bone marrow to cure an existing sick sibling. Opponents, including fertility expert Dr. Lord Robert Winston, described the process as “using an unborn child as a commodity” because the savior child is “brought into the world solely as an instrument, a tool, for someone else’s desires.”
Until now, commodification primarily surfaced in the context of selling organs for transplant. But the ugly specter of commodification is spreading. Just look at some of the latest horrors:
- Indian doctors are performing hysterectomies on cane cutters to increase their productivity – because “cane-cutting contractors are unwilling to hire women who menstruate.” Instead of dealing with the root cause of the problems that impair productivity: persistent infections due to abysmal working conditions and poor menstrual hygiene, doctors lop out an organ.
- Proposals have been raised to use the wombs of brain-dead patients to gestate fetuses, treating the “womb rental” as an organ donor.
Commodified body marketing is the latest trend, including markdowns and sales on surrogacy and fertility. For example, a Ukrainian clinic recently featured a 3% “Black Friday sale offering discounts on babies.” Along with a “VIP surrogacy package” for €1,947 and a “Perfect Chance” IVF package for €447.- Using surrogates and polygenic scoring with IVF by the uber-wealthy to procure today’s ultimate power prop: the designer baby. Not long ago, this process was denied or done in embarrassed whispers. Now its use is proudly proclaimed by the uber-rich.
Providing an exit for those who feel life is not worth living facilitates euthanasia and the evaluation of life in economic terms. This view has bled into medical decision-making; one physician termed it “identifying those most expendable.”
The Talmud teaches that whoever destroys one life is as though they destroyed the entire world. So it would seem.
But what about individual choice? The libertarian laments. Issac Asimov, speaking through his robots, knew the answer to that; even more important than doing no harm to a human comes a more basic law:
“ A robot may not harm humanity, or, by inaction, allow humanity to come to harm.”
[1] Not happy with Switzerland‘s reputation as the death-tourism capital of the world, one Swiss group, LifeCircle, is calling for the legalization of assisted suicide everywhere in the world so there would be no need for sick people to travel vast distances to seek death.
[2] "All Unequal Men Are Equal" The Economist, Dec. 24, 2022.
[3] “Youth suicide, Beginnings and endings,” The Economist, Dec. 10, 2022
[4] Social intervention can make a difference. This year, an innovative program at Israel’s Rambam Hospital prevented 570 repeated suicide attempts in the 571 who attempted it. Suicide in Israel is the second leading cause of death in teenage boys and young adults (aged 15-24) and the third for girls in the same age group.
Late breaking addendum – From BioEdge, Are Canadians having buyer's remorse about euthanasia?
“In 2015 there were no Canadian euthanasia deaths; since then there were 40,000. People have applied for MAiD because they didn’t have housing, couldn’t access mental health care, or were lonely. At least four military veterans were pressured by a caseworker to accept MaiD.”
“Making death too ready a solution disadvantages the most vulnerable people, and actually lets society off the hook… I don’t think death should be society’s solution for its own failures.”
-Canadian psychiatrist, Madeline Li.
