>Euthanasia: A Right to Death with Dignity or License to Kill with Impunity? (Part 5)

>(Part 4)

So far in this series of posts I have been arguing that legalizing euthanasia will have a negative effect on society by creating a culture of death in which death will become the accepted means for dealing with life’s difficulties, it will lead to abuses that will endanger the weak and elderly, and it will result in other forms of euthanasia (such as nonvoluntary and involuntary) that can endanger everyone; and, therefore, euthanasia should not become an acceptable means for dealing with the difficult end-of-life dilemmas, for rather than promoting death with dignity, it will provide a license for killing with impunity.

In the post yesterday I defended this thesis by arguing that euthanasia proponents have stated in their literature and demonstrated in their practice that promoting euthanasia as a means for mercifully dealing with persons who are terminally ill and suffering with pain is not an end in itself but a means to other ends. Today I want to continue to defend my thesis by arguing that even some euthanasia advocates acknowledge the great potential of abuse by their own stated need for strict limits.

Humphry realizes that the unqualified legalization of euthanasia will lead to serious abuses. In order to attempt to prevent those abuses, he provides a detailed set of criteria that must be met. He states that this practice should never be used on someone to assist them in suicide for mental health or emotional reasons. Rather, it should be restricted to persons who have a physician-verified hopeless diagnosis of an advanced terminal illness that is causing unbearable suffering (combined physical and psychic), including being a burden to others. The person should be experiencing a total loss of quality of life due to protected, incurable medical conditions, or have a grave physical handicap which is so restricting that the individual cannot tolerate such a limited experience (notice here that his sounds more like mental and emotional). the person should be a mature adult and clearly demonstrate that he is making an informed decision himself and not under coercion; euthanasia should be a last resort that is not practiced at the first knowledge of the illness so that time can be spent pursuing treatment. Also, the person’s physician is to be informed to make sure that the individual is not mistaken about his diagnosis.

The reason Humphry provides the criteria is precisely because he knows that if left unqualified, the practice of euthanasia will broaden beyond providing relief to those who are suffering unmanageable pain and on death’s door, to include others who are not. His provision for criteria to prevent abuse is itself an admission that the slippery slope argument is a valid argument, especially given what we saw in the proposals of Quill and Kevorkian yesterday.

In fact, one advocate admits that this is true, but although it is true, she confesses that she is just not convinced that it must become a reality. Marcia Angell who is an advocate for euthanasia claims that the slippery slope argument is unpersuasive, yet admits that, “We cannot avoid the slippery slope; in fact, . . . we are already on it, like it or not.”[1] She suggests, however, that just because the slippery slope is a reality and that we are already sliding down it, we don’t have to go all the way. The way to avoid a headlong slide downhill is to draw a distinction between euthanasia and physician-assisted suicide (henceforth PAS) and to allow the latter but not the former. She believes that PAS should be legalized because it requires the patient to act and allows the patient to retain ultimate control (he can always change his mind). Euthanasia, on the other hand, should not be legalized because the death is not caused by a direct act of the patient, which takes control away from the individual. To support this distinction, Angell also posits that a headlong slide downhill could be resisted by drawing a line between voluntary and involuntary.

Yet, despite Angell’s proposed distinctions as means to avoid a headlong slide down the slippery slope that we are already on even prior to legalized killing, she says, “No system of safeguards for any workable endeavor is absolutely foolproof.”[2] Angell concedes, then, that because of the potential of great abuse, the present reality of abuse and the reality that it is going to get worse, there needs to be limits put in place to try and guard against abuse. This call for limits, then, and her admission that we are already on the slippery slope justify the slippery slope argument. But, as she has admitted, there are no safeguards available to resist the headlong slide down the slippery slope that we are already on. The best we can do is to hold off the abuses for a time, but they will eventually become realities since no safeguards are foolproof.

Isn’t this exactly the concern of the slippery slope argument? If you allow any form of euthanasia at all, it will necessarily lead to abuses and other forms of killing. Angell, then, in stating that there is a slippery slope and that we can hold off a headlong slide down it but only for a time by establishing some safeguards, that will not work completely and will eventually give way demonstrates the validity of the slippery slope argument. She is so convinced of her position to legalize euthanasia, or at least PAS, that she refuses to change her position in spite of her belief that it will lead to abuses. But the fact that she will not heed her own conclusions does not negate what she knows to be true; legalizing euthanasia will lead to abuses that will endanger the weak and elderly, and it will result in other forms of euthanasia (such as nonvoluntary and involuntary) that can endanger everyone. It will provide a license for killing with impunity.

Notes:

[1] Marcia Angell, “Voluntary Euthanasia Shows Compassion for the Dying,” in Euthanasia: Opposing Viewpoints, ed. James D. Torr (San Diego: Greenhaven Press, Inc., 2000), 51.

[2] Ibid.

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>Euthanasia: A Right to Death with Dignity or License to Kill with Impunity? (Part 4)

>(Part 3)

In the previous post I introduced the slippery slope argument set forth by euthanasia opponents and noted that euthanasia advocates discount the argument on the grounds that they believe that it is based unnecessarily on fear and on fatalistic assumptions that are mere logical conjecture and not rooted in fact. However, opponents of euthanasia are not just projecting the eventuality of abuses based on logical implications, but on realities that are found in association with actual statements and intentions communicated by certain advocates of euthanasia.

Before I begin to show those present realities that justify the use of the slippery slope argument, let me first address more specifically what I mean by the slippery slope argument. I would note here that there are basically two different types of slippery slope, or wedge argument. The first type is based on moral reasoning and the logic of distinctions between different acts. For example, when one asserts that legalizing euthanasia will result in a lack of trust between a patient and his doctor, it is actually very hard to verify and is certainly not necessarily going to be the case. It might be the case, and it certainly has potential to become the case, but it will not necessarily be the case in every instance. When euthanasia advocates reject the slippery slope argument of euthanasia opponents, this is the type of slippery slope argument they reject, and thus, discount the argument by asserting that the concerns are not necessarily going to become reality and are mere logical conjecture.

Yet, there is a second type of slippery slope, or wedge, argument that is not merely dependent on logical conjecture or possibilities, but is concerned with empirical data that establish and back up the argument. For example, when one argues that the removal of certain restraints against killing will lead to probable moral decline, such as authorizing the killing of a patient for his own “benefit” because he is suffering pain and has a bleak future (no quality of life or dignity) and could open the door to a policy of killing patients for the sake of social benefits, such as reducing financial burdens, the more efficient use of diminishing resources, or the supposition that euthanasia will open the door to involuntary euthanasia. These concerns are not difficult to verify for they are empirical by nature and can be measured and documented. I will use this second type of slippery slope argument to establish that the concerns of euthanasia opponents are not mere speculation or conjecture, but are in fact, rooted in reality, and therefore, warranted.[1]

For many euthanasia advocates, the legalization of euthanasia is not an end in itself, but a means to achieving a further end. Although some say that it should only be used for persons who are suffering and about to die, some advocates desire to broaden the utility of euthanasia. As for who is eligible for assisted death, Quill proposes that it should initially be restricted to the terminally ill; but he also suggests that it should eventually be made available tot hose who are not terminal but have incurable or debilitating conditions associated with severe, unrelenting suffering.[2] In this statement, Quill acknowledges that the practice must start out narrow, but then be broadened. The difficulty in this statement, however, is that Quill is unclear by what he means by “suffering.” He argues that “suffering” can include difficulties like the fear of future suffering (before real suffering actually begins), loss of dignity, and other subjective elements. For instance in his account of his assistance in the death of a patient he calls “Diane” who had a history of alcoholism and depression and who had been cured of vaginal cancer and was diagnosed with leukemia, he says that she asked him to kill her, not because she was suffering with uncontrollable pain, but because she did not want to linger until death in relative comfort. She was convinced she was going to die, so why not get it over with now.[3] As her doctor, Quill did as she requested and killed her.

Kevorkian has also indicated his desire to extend “suicide rights” beyond rare terminal cases or cases dealing with so called unmanageable pain. In an address to the National Press Club in Washington, D.C. on October 27, 1992, he asserted that “every disease that shortens life no matter how much is terminal.” For Kevorkian, terminal cancer patients with less than six months to live are a very small minority of patients for whom euthanasia is needed. Those whom he would include in the larger majority of cases include quadriplegics, people with multiple sclerosis, and sufferers from severe arthritis. But once again, not only is his criteria a problem, but the reasoning behind it. Kevorkian has a disdain for disabled persons. He once called quadriplegics and paraplegics who were not suicidal “pathological,” and exposed his sympathy for eugenics in a court document asserting, “The voluntary self-elimination of individual mortally diseased and crippled lives taken collectively can only enhance the preservation of public health and welfare.” Once again, the criteria for beginning the use of euthanasia is narrow to begin with, but with the purpose of becoming ever more broad.

Yet, with Kevorkian, he admits to even more heinous plans for euthanasia. Instead of wanting to help the suffering and the dying, he candidly acknowledges that euthanasia is a means toward pursuing his own obsession. For him, euthanasia is a distraction to get the public to accept it as a morally viable option for end of life issues, but as the first step that would eventually “open the floodgates” of the equally momentous benefits to humankind of human experimentation and the serious investigation of the phenomenon of death. He calls euthanasia “medicide,” a specialty to be practiced by medical technicians at designated “suicide centers.” His “ultimate aim is the creation of a new specialty and a new institution he calls “obitiatry,” to which assisted suicide is but a means. “Obitiatry” is “the unfettered experimentation on human death” in pursuit of useful knowledge as well as knowledge into what death itself is. But to fulfill this preternatural aim, Kevorkian needs dying patients. His original plan was to use death-row inmates, but since that was shot down, he then sought to accomplish his goal by experimenting on patients who opted for euthanasia.[4]

For Kevorkian, then, getting euthanasia legalized and morally acceptable to the public is a front to his ultimate end of human vivisection. Kevorkian appears to have a three-step plan for achieving his dream. First, popularize assisted suicide and make it seem acceptable for helping the dying and the suffering. Second, give society a utilitarian stake in assisted suicide by using the victims for organ procurement. Why not give the good organs to those who contribute to society rather than leach off it. The third step is to gain permission to conduct his death experiments on the sick and disabled persons he would be allowed to kill. This plan was not just on paper, but was actually being practiced by Kevorkian. For instance, contrary to the media descriptions most of Kevorkian’s known victims were not terminally ill. Of the known 130 or so “suicides” that he facilitated, about 70% of the persons involved were disabled and depressed, and the majority of them were women.

So what does this all mean? There is a slippery slope from assisted suicide to voluntary euthanasia to involuntary euthanasia. As Kevorkian argued, the diseased and crippled who don’t voluntarily seek self-elimination are pathological and society needs to see the benefit of being rid of them and using their good organs for the producers in society, and heck, they make the best test subjects. There is a slippery slope from the terminally ill to those who are incurably ill but not terminal, and to those who are just not happy. And according to two of the biggest proponents of euthanasia, Quill and Kevorkian (both medical doctors), this slippery slope is by design. The way that the argument moves from terminal illness to meaningless life, results in a position that anybody with a suicidal impulse will qualify, with the purpose of acclimating society to death, in order to pursue broader and worse forms of killing with impunity. This slippery slope is no figment of the imagination of euthanasia critics, it is rooted in the very language, practice and goals of euthanasia activists.

(Part 5)

Notes:

[1] For a good discussion on wedge arguments, see Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics (Oxford: Oxford University Prss, 1983), 120-26.

[2] Timothy E. Quill, C.K. Cassel, and D.E. Meier, “Care of the Hopelessly Ill: Proposed Clinical Criteria for Physician-Assisted Suicide,” New England Journal of Medicine 327 (Nov 1992): 1381-385.

[3] Timothy E. Quill, “A Case of Individualized Decision Making,” New England Journal of Medicine 324 (March 1991): 691-94; and idem., Death and Dignity: Making Choices and Taking Charge (New York: Norton, 1993).

[4] Kevorkian, Prescription Medicine, 214-240.

>Euthanasia: A Right to Death with Dignity or License to Kill with Impunity? (Part 3)

>(Part 1)
(Part 2)

There are many different reasons that opponents of euthanasia provide for rejecting it as a viable option for dealing with the difficult end-of-life dilemmas created by modern science and technology. But one of the most prominent arguments is that it does not solve any of the difficulties, and, worse yet, will necessarily create a whole host of new ones. Opponents hold very strongly that euthanasia is a detriment to society rather than a benefit. The legalization of euthanasia will result in a culture of death that will endanger the weak members of society, rather than promote a culture that is genuinely concerned for their welfare. In opposition to the claim that euthanasia is the best means for showing mercy to the weak, opponents argue that it will do the opposite and become a means for justifying cruelty.

The danger of legalizing voluntary euthanasia (killing upon request of individual because of his right of self-determination) is that it will lead to acceptance of other forms of euthanasia that are not voluntary, but are rather done either without the consent of the individual or even against the individual’s consent. Once society is conditioned to accept death as a legitimate means of social engineering, it will become a culturally acceptable way to deal with those in society that no longer contribute to its progress but only “waste” its resources. Human life could become objectified and snuffed out if killing offers an advantage to the national or individual interest. Advocating euthanasia could result in the government, which once derived its ratio essendi (the reason for its existence) from its granting protection to the underprivileged to abandon that goal and reserve all rights to its stronger and fitter members.

Health, efficiency, and beauty are quickly becoming the supreme values in our youth driven culture, which can create a perspective of indifference that presents a threat for the weaker members of society. Those with a lesser “quality of life” could be encouraged to view themselves as insignificant, a burden to their family and society, and not possessing a quality of life worth living. As the physically and mentally handicapped, the elderly, the impoverished, etc., are deemed a burden and undesirable constituents of society, then there could be great pressure placed on them to see themselves as society does, and hence, utilize euthanasia to “self-determine” themselves out of society’s hair and to stop wasting society’s precious resources. Once killing on demand has softened the ban on active homicide, victims are soon likely to be killed without their consent, rather than waiting for them to request it. When society begins to give some individuals the power to end others’ lives, it cannot prevent the principles underlying that permission from being applied to ever more broadening circumstances.

Opponents and proponents alike refer to this argument as the “slippery slope” argument. The slippery slope argument rests on the reality that ideas have consequences, for example, practice A will lead to practice B and then C, etc. Many proponents of euthanasia, however, discount this argument for they believe that it is based unnecessarily on fear and on fatalistic assumptions that are mere logical conjecture and not rooted in fact. However, when one looks at the literature advocating euthanasia, it becomes quite obvious that the advocates of euthanasia embrace the idea embodied in the slippery slope mode of argument themselves. Here are three brief examples:

Example #1: Euthanasia proponents are taking advantage of “slippery slope” logic to move from abortion rights to suicide rights. Derek Humphry, long-time activist for “suicide rights” and author of the bestseller Final Exit has said that the reason there has been a recent increase in momentum for euthanasia is because of the effects of Roe v. Wade. That court case and subsequent right to abortion on demand, which was predicated on the “right to privacy” and the “right to choose” (right to self-determination), has resulted in a view of death and a person’s right to individual autonomy that have led to advocates pushing now for death rights. Jack Kevorkian has also stipulate that “just as birth control and abortion are no longer generally seen as harmful, so, too, should the emotional stigma of taboo be stripped away from the completely moral concept of euthanasia.”[1]

Example #2: Euthanasia proponents also utilize the slippery slope argument with reference to reaching their goal of legalized euthanasia through incremental steps. Humphry suggests that since suicide is no longer a crime, then neither should assisting someone in sucide. He also states that he believes that euthanasia will eventually be legalized because, “with the inevibtability of gradualness, as the idea takes hold amonst rising generations, reform will undoubtedly come.”[2] Kevorkian also argues for the incremental progression to towards legalized euthanasia (A will lead to B, which will lead to C, etc.),

I feel it is only decent and fair to explain my litimate aim. [Euthanasia] is not simply to help suffering or doomed person kill themselves–that is merely the first step, an early distasteful propfessional obligation. . . . What I find most satisfying is the prospect of making possible the performance of invaluable experiments or other beneficial medical acts under conditions that this first unpleasant step can help establish.[3]

In an article supporting euthanasia as the ultimate civil liberty, Barbara Dority utilizes the slippery slope argument in order to argue for euthanasia as protection against the tyranny of doctors. She asserts that there is a rising problem with doctors not fully honoring living wills. Because she champions individual autonomy as a foundational principle for death decisions, she argues that if the medical environment does not change, individual’s rights to self-determination with regards to death will progress to the point of oppressive tyranny. She suggests te best means to keep this potential tyranny from becoming reality is to check the doctor’s authority with the legalization of euthanasia.[4]

Example 3: A final example concerns the desire to see euthanasia become an acceptable practice because of the growing acceptability of what is called “passive” euthanasia. Many ethicists have created a distinction between active and passive, and voluntary and involuntary euthanasia. According to one of the leading advocates of euthanasia, “There is thus a distinct difference between passive–or indirect–euthanasia, where death is induced by suspensions of treatment, and the so-called active or direct euthanasia, wehre death is brought about by a definite act.”[5] John Frame believes that subdividing euthanasia this way is a deceptive and dangerous use of language. He agrees that there is a distinct difference, but it is more than merely a terminological difference, but is inherently a difference in content and action. Active euthanasia is the intentional killing or taking of life that is not otherwise in the prociess of dying, whereas passive euthanasia is allowing one who is already dieing to die. It is inappropriate to label two completely different actions under the same heading. To do so creates an illegitmate moral equation between two distinct issues, and becomes a way to lead persons who are prone to accept passive euthanasia to become willing to accept active euthanasia–not based on the concepts that lie behind the words, but simply because of the similarities of the words.[6]

Frame is correct in his assertion that euthanasia advocates are attempting to sway public opinion to accept the one because of the other. This argument has been used by J. Rachels through what he calls the “equivalence thesis,” which teaches that ther is no “bare difference” between killing and letting die, since both have the same motive and achieve the same end. Since the two are morally equivalent then they are morally indifferent; so since passive euthanasia is seen as an acceptable practice, then so should active euthanasia.”[7]

Euthanasia advocates, then, utilize the slippery sloope argument themselves to get society to embrace euthanasia by emphasizing a proposed progression from abortion rights to death rights, by using it as the initial step in achieving further ends, and by asserting the moral equivalence and indifference between killing and letting die. The purpose of pointing out these examples is to suggest that it is illegitimate, inconsisten, and ultimately hypocritical for advocates of euthanasia to casually brush off the concern that legalizing euthanasia will lead to abuses that will threaten society rather than promote mercy, simply by labeling it a slippery slope argument, since they themselves engage in this mode of argumentation to achieve their own ends.

But the fact that euthanasia advocates use the slippery slope argument does not legitimize the position of euthanasia opponents. Are euthanasia advocates correct in their assertion that the slippery slope argument of euthanasia opponents is based unnecessarily on fear and on fatalistic assumptions that are mere logical conjecture and not rooted in fact? The remaining posts will seek to vindicate the concerns of euthanasia opponents as not being logical flights of fancy, but in fact rooted in reality.

Notes:

[1] Jack Kevorkian, Prescription Medicine: The Goodness of Planned Death (Buffalo: Promethius Books, 1991), 181.

[2] Derek Humphry, “Why I believe in Voluntary Euthanasia and Assisted Suicide.”

[3] Kevorkian, Prescription Medicine, 214.

[4] Barabara Dority, “The Ultimate Civil Liberty,” Humanist 57.4 (1997): 16-20.

[5] Christian Barnard, Good Life/Good Death: A Doctor’s Case for Euthanasia and Suicide (Englewood Cliffs, NJ: Prentice Hall, 1980), 64-65.

[6] John M. Frame, Medical Ethics: Principles, Persons, and Problems (Phillipsburg, NJ: Presbyterian & Reformed Publishing, 1988), 68.

[7] J. Rachels, “Active and Passive Euthanasia,” The New England Journal of Medicine 292 (January 9, 1975): 78-80. For a fuller treatment on euthanasia by Rachels, see The End of Life (Oxford: Oxford University Press, 1986). For a similar perspective see Leslie Burkholder, “Nancy B and Nancy F,” Journal of Applied Philosophy 18.2 (Aug 2000): 193-96.

>Euthanasia: A Right to Death with Dignity or License to Kill with Impunity? (Part 2)

>(Part 1)

Before making my case against euthanasia, I think it would be helpful to briefly outline what the modern proponents of euthanasia are advocating. In this post I want to briefly address three questions concerning euthanasia: 1) what is euthanasia; 2) what is the purpose for it according to modern proponents, 3) how do modern proponents make their case?

First, what is euthanasia? The practice of euthanasia is not a new theoretical development within science but is a practice that has been around for centuries. However, the modern understanding of euthanasia is the result of an evolutionary process stemming back to antiquity. The term euthanasia has an ancient Greek origin and is the combination of two separate words. The first word, eu, means good; the second word, thanatos, means death; so when used together they combine to mean “a good death.”[1] Although the origin of the word presents a quite simple idea, in recent times the term, and practice, has become more complex. According to The American Heritage Dictionary, euthanasia is, “The action of killing an individual for reasons considered to be merciful.” Notice that in this definition the modern notion of euthanasia is not simply to have a “good death,” but includes the means by which the death is achieved. Euthanasia is not just about “ends,” but is also about “means.” So one would wonder, if the death is supposed to be good, does that mean that the means used to achieve that good death are also good? Well, besides the fact that the means used is the action of “killing,” when advocates of euthanasia define the practice, they say that euthanasia is the means used to achieve a good death whether that action is positive or negative.[2]

Second, what is the purpose for it according to modern proponents? Modern proponents of euthanasia desire to see an explicit exception licensing physicians to kill their patients in order to relieve uncontrollable pain and suffering inserted into law. They appeal to a range of exceptional cases to show the utility of the practice. The gist of their argument is that there are times when killing the patient is the humane thing to do and in the patient’s best interest. They assert that merely letting a patient die naturally is at times cruel and can dehumanize the patient.

Third, how do modern proponents make their case? In order to make this case, modern advocates of euthanasia emphasize two foundational axioms: 1) individual autonomy; and 2) the necessity of mercy/avoidance of suffering. According to Margaret P. Battin, “The moral argument in favor of permitting physician assistance in suicide is grounded in the conjunction of two principles: self-determination . . . and mercy.”[3] She describes the moral right of self-determination as the right to live one’s life as one sees fit, subject only to the constraint that this not involve harm to others. So fundamental is this principle, that Daniel Jussim asserts that to deny an individual the choice of death is said to be a crime against one’s right of self-determination.[4] For the euthanasia advocate, euthanasia should be legalized so that a doctor (or for some any individual) can kill a patient/person, without being indicted for murder, and what makes this killing justified and acceptable is that the individual requested it. As we saw with Jussim, it is not the killing that is the crime, but refusing an individual’s request to be killed.

The second foundational principle advocates use to endorse euthanasia is the principle of mercy. According to Battin, the principle of mercy teaches that one ought both to refrain from causing pain or suffering and act to relieve it. Advocates claim that this principle of mercy, or avoidance of suffering, underwrites the right of a dying person to an easy death and clearly supports physician-assisted suicide in many cases. Derek Humphry believes that in a caring society there must be opportunities provided to hopelessly ill patients after all other avenues of care have been exhausted. He asserts that requesting assistance in dying should no longer remain illegal since it provides a compassionate, merciful and noble means to achieve a good death.

Humphrey’s statement is indicative of much of the literature promoting euthanasia, which tends to emphasize the subjective nature of a patient’s plight, rather than provide a rigorous philosophical defense, since advocates believe that compassion is the best means of persuading the public. Timothy Quill, M.D. suggests the best tactic in the debate is not to argue over positions, but instead to tell stories of the unrelieved suffering of dying patients–to tug on the heart strings. The public is to be persuaded to accept euthanasia not by arguments of right and wrong, but via unthinking compassion for those who suffer.[5] This emphasis upon mercy seems to be more of a tool for manipulation than an actual concern for the suffering. But the manipulation does not stop here, to make their case for “mercy killing,” proponents of euthanasia use the “hard” cases approach to attract and create sympathy for persons who are suffering. They admittedly seek to manufacture a universal need that is actually based on rare and tragic situations. Humphry himself admits to manipulating the data to create the appearance that there are a lot of persons suffering to create the facade that there is a great need and demand for euthanasia when the data does not support his rhetoric, “Take note that I have liberally used the word ‘some’. Most people die quickly, peacefully, and painlessly. Of that there is no doubt. Physician-assisted suicide is needed for very few dying patients-probably two percent or less of total deaths.”[6] No one wants people to suffer needlessly, so it becomes quite easy to use the pain and suffering of others for rhetorical purposes. Are the modern euthanasia advocates being honest about their agenda?

When one looks at the questions concerning the practice of euthanasia, whether ethical, legal, practical, medicinal, etc., it is imperative that one not fall into the trap of believing that medicine and technology are merely means that are value-neutral. The moral questions surrounding the issue of euthanasia are not just about the use or misuse of the means of medicine and technology, but also about the ends that medicine and technology serve. With this in mind, and in light of the stated purposes and axioms of euthanasia proponents, should euthanasia be considered an acceptable means of dealing with the difficult issues of life and death? Will legalized killing (whether to promote self-determination or for supposed mercy) actually result in a society that is characterized by care and mercy for the suffering, or will it create a whole new set of problems?

(Part 3)

Notes:

[1] Derek Humphry, “Euthanasia Is Ethical,” in Euthanasia: Opposing Viewpoints, ed. Carol Wekeser, Opposing Viewpoints Series, ed. David Bender and Bruno Leone (San Diego: Greenhaven Press, 1005), 18.

[2] Ibid.

[3] Margaret P. Battin, “Is a Physician Ever Obligated to Help a Patient Die?” in Regulating How We Die: The Ethical, Medical and Legal Issues Surrounding Physician-Assisted Suicide, ed. Linda L. Emanuel (Harvard University Press, 1998), 21-47.

[4] Daniel Jussim, Euthanasia: The “Right to Die” Issue (Hillside, NJ: Enslow Publications, Inc., 1993), 53-54.

[5] Cited in Adam Wolfson, “Killing off the dying?-so-called assisted suicide,” [on-line]; accessed 14 April 2009; available from http://findarticles.com/p/articles/mi_m0377/is_n131/ai_20632393/.

[6] Derek Humphry, “The Case for Physician Assisted Suicide and Voluntary Euthanasia,” [on-line]; accessed 14 April 2009; available from http://www.finalexit.org/lit-essays.html, [emphasis mine].

[7] Stanley Hauerwas, God Medicine and Suffering (Grand Rapids: Eerdmans, 1990), 97-98.

>Euthanasia: A Right to Death with Dignity or License to Kill with Impunity? (Part 1)

>The explosion of ideas generated during the scientific revolution has created vast changes and seemingly limitless potential for innovation in the different fields and practices of science and technology. In the field of medicine, advances in technology and medical knowledge have occurred so rapidly that health care possibilities have outgrown their moral and ethical mores. The appearance of near limitless possibilities and capabilities of medicine and technology have created a conundrum of knowing how and when to set limits to that which seems to be limitless. Many patients expect doctors to do everything possible to cure their ailments; doctors (often out of fear of litigation) oblige this expectation by utilizing every possible medical and technological means available; yet, they endure blame when they fail and complaints by those who accuse them of going to far. In some cases these “heroic” efforts are genuinely therapeutic and life-extending, whereas at other times they simply prolong the process of dying. The result is that the lines between preserving life and prolonging death have become blurred, which has created a “host of complex issues for society, the medical profession, and the dying individual and his family.”[1]

The practice of euthanasia has been heralded by right-to-die advocates as a legitimate and humane means for dealing with these new problems. However, it has engendered much scrutiny and debate because of its radical digression from traditional views of life and death. The autonomy of the self and the necessity of mercy are the championed axioms that are replacing the traditional values of the intrinsic value and inviolability of life and society’s duty to protect human life.[2] To make the situation even more difficult, there is debate even among right-to-die advocates about how euthanasia should be understood and what practices should be allowed.[3] I have decided to provide a series of posts that will argue that euthanasia should not become an acceptable means for dealing with these difficult end-of-life dilemmas, for rather than promoting death with dignity, it will provide a license for killing with impunity.

However, before I begin, let me put my cards on the table concerning my approach. As a confessionally Reformed Presbyterian, my ultimate reasons for rejecting euthanasia is for biblical, for as the answer to Q.3 of the Westminster Larger Catechism states, “The holy Scriptures of the Old and New Testament are the Word of God, the only rule of faith and obedience.”[4] However, given that everyone does not live in light of biblical authority, I am approaching this conversation on euthanasia from a natural law perspective, and I do so for two reasons. First, I desire to attempt to better communicate with my neighbor who does not accept biblical authority as I do. I realize that not everybody accepts biblical authority as I do. I do not desire for this to cut off communication, so utilizing natural law argumentation seems the best way to keep the communication channels open. Peter J. Bernardi states my concern well, “Ultimately, the religious conviction that life is a gift from God that we are not free to end on our own terms is the most effective motive for remaining opposed to doctor-assisted self-killing. But what effect would that argument have on someone who does not believe in God?”.[5] With an issue like euthanasia, it is imperative to open lines of communication with which persons from throughout the community will engage no matter their religious convictions.

A second reason I have decided to attempt a natural law argument instead of an explicit biblical argument comes from my understanding of the nature of biblical ethics. The ethical commands of scripture seem to be directed to the covenant community and not towards those outside the covenant community. For example, when one reads the Decalogue in Exodus 2o.1-17, one finds an indicative-imperative structure to the commandments. The commandments are built upon the foundation of the prologue that God has saved his people from bondage in Egypt. God’s salvific action on behalf of his people provide the necessary foundation upon which his ethical demands for his people are founded. When one seeks to place those ethical demands on those outside the covenant, who have not been the recipients of God’s salvific “indicative,” then it would appear that one is using scripture in a way not intended by God. The ethical commands in scripture do not seem to be designed for the world at large. Rather, the purpose of scripture’s ethical commands seems to be to regulate and define the lifestyle of God’s redeemed covenant people.

Natural law, however, does provide a common ground for those in the covenant community to engage in dialogue over public issues with the unredeemed (those who are members ob both the city of God and the city of man interacting with those who are only members of the city of man). David VanDrunen writes,

Natural law is God’s common moral revelation given to all people of whatever religious conviction. A common moral realm, in which all of created humanity enjoys membership, is rightly governed by a common moral standard that is revealed to all of crated humanity. The civil kingdom is for human beings insofar as they are created and sustained by God; natural law morally obligates human beings insofar as they are created and sustained by God.[6]

This understanding of natural law is not built upon the false notion of human autonomy but is grounded in God’s own nature and the creation of human beings in the divine image, so that it is ultimately grounded on the authority of God the Creator. In fact, as VanDrunen argues, “natural law is taught in Scripture,”[7] and the scripture actually teaches that when those in the covenant of grace are dealing culturally with those not in the covenant of grace, that natural law rather than special revelation is the basis for moral reasoning.[8]

By making my case according to a natural law argument, I am not jettisoning God’s authority or even his communication, rather, I am making my case with two proper, God-centered presuppositions: he is there and he is not silent. His communication is not just found in the scripture, however, but also in his created order; there is a place for general revelation in addition to special revelation. My attempt at a natural law argument is grounded in God’s general revelation. Now I acknowledge that my understanding of general revelation has surely been shaped by my study of God’s special revelation (the Bible). Yet, I am not making a case for how I have come to my beliefs on this subject as shaped by the Bible; I am attempting to make a case that reflects my beliefs as they are found in general revelation, or natural law, since that is the common language for the sphere of the city of man. Let me be clear, I am not arguing for a common ground or neutral ground of knowledge, but a common ground of communication. I hope to appeal to the law that is written on man’s heart because he is created in God’s image, which he suppresses in unrighteousness (Rom 1.18), yet which he does not suppress completely.

With an issue as important and controversial as euthanasia, we must engage in the conversation by doing more than simply talking to ourselves (or preaching to the choir). If natural man will not receive the indicatives of the gospel, why do we think we can hoist upon him the imperatives and get a better outcome?

In this series of posts I will be arguing against euthanasia on natural law grounds: legalizing it will have a negative effect on society by creating a culture of death in which death will become the accepted means for dealing with life’s difficulties, it will lead to abuses that will endanger the weak and elderly, and it will result in other forms of euthanasia (such as nonvoluntary and involuntary) that can endanger everyone. Euthanasia should not become an acceptable means for dealing with these difficult end-of-life dilemmas, for rather than promoting death with dignity, it will provide a license for killing with impunity.

(Part 2)

Notes:
[1] John Jerfferson Davis, Evangelical Ethics, 3rd ed. (Phillipsburg, NJ: Presbyterian & Reformed Publishing, 2004), 183.

[2] And as will be discussed in more detail in a later post, the intrinsic equality of all persons is also being replaced with elitist notions of equality that are based on “quality of life.”

[3] For the purpose of this series of posts, I will be discussing euthanasia with specific reference to the practices of active-voluntary euthanasia and physician-assisted suicide. Since both actions involve intentional acts of killing an innocent being, I understand them to be morally equal, and hence, I deal with the two of them the same way and at the same time. I realize that not everyone agrees with this moral equation, but for the practical considerations of these posts it is expedient.

[4] For fine discussions of euthanasia from a biblical perspective see Davis, Evangelical Ethics; John S. Feinberg and Paul D. Feinberg, Ethics for a Brave New World(Wheaton, IL: Crossway Books, 1993); Millard J. Erickson and Ines E. Bowers, “Euthanasia and Christian Ethics” Journal of the Evangelical Theological Society 19 (1976): 15-24.

[5] Peter J. Bernardi, “Dr. Death’s Dreadful Sermon: From Roe to Final Exit, there really is a slippery slope,” Christianity Today, 15 August 1994, 30-32. [emphasis mine]

[6] David VanDrunen, A Biblical Case for Natural Law(Grand Rapids: Acton Institute, 2006), 38.

[7] Ibid., 2.

[8] Ibid., 37-54. For further arguments in favor of the biblical case for natural law and its use in public moral discourse, see Stephen J. Grabill, Rediscovering the Natural Law in Reformed Theological Ethics (Emory University Studies in Law and Religion)(Grand Rapids: Eerdmans, 2006); Markus Bockmuehl, Jewish Law in Gentile Churches: Halakhah and the Beginning of Christian Public Ethics(Grand Rapids: Baker, 2003); David Novak, Natural Law in Judaism (Cambridge: Cambridge University Press, 1998); and John Barton, “Natural Law and Poetic Justice in the Old Testament,” Journal of Theological Studies, N.S. 30 (April 1979): 1-14.