Euthanasia and misplaced compassion?

jacques-louis-david_the-death-of-maratI am relieved to learn that the Victorian Government has, at somewhere near the eleventh hour and yet even then only for a little while, put some brakes on its inchoate proposal to establish assisted suicide legislation for the terminally ill. Plans are still underway to introduce the bill sometime during the second half of next year, but today’s confession by the Government-appointed committee that its recommendation lacked ‘the legal, clinical and organisational detail about the implementation, practicalities and issues related to introducing an assisted dying framework’ is a confession that this Government still has some serious homework to do on this piece of very important public policy and, presumably, on the paper being prepared for public consultation from early next year.

Upon hearing this news, however, I was reminded of these words from Daniel Callahan – words which are, to be sure, not the only kind of words that need to be registered in this discussion, but which nevertheless offer some good reasons to welcome the pause:

We need a healthcare system that can learn better how to meet the abiding human need for care, develop moderate and feasible aspirations for cure, and come to see the value of living within restricted frontiers.

The movement for legalized euthanasia, far from helping us achieve goals of that kind, actually rests upon precisely the same assumption about human need, health, and the role of medicine that have created our present crisis the right to, and necessity of, full control over our fate. Legally available active euthanasia would worsen, not help, that crisis. By assuming that, in the face of a failure of medicine to cure our illness or stop our dying, we should have the right to be killed, the euthanasia movement gives to the value of control over self and nature too high a place at too high a social cost. The contemporary medical enterprise has increasingly become one that considers the triumph of illness and the persistence of death both a human failure and a supreme challenge still to be overcome. It is an enterprise that feeds on hope, that constantly tells itself how much farther it has to go, that takes all progress to date as simply a prologue to the further progress that can be achieved. Nothing less than total control of human nature, the banishment of its illnesses and diseases, seems to be the implicit ultimate goal.

The argument for euthanasia seems to be agreeing about the centrality and validity of control as a goal: if medicine cannot now give us the health and continued life we want, it can and should at least give us a total control over the timing and circumstances of our death, bringing its skills to bear to achieve that end. By making a denial of the distinction between killing and allowing to die central to its argument, the euthanasia movement has embodied the assumption, the conceit actually, that man is now wholly in control of everything, responsible for all life and all death. Allowing a disease to take its course is no longer to be morally distinguished from outright killing. Either way, it is our doing.

There is a clear consequence of this view: our slavery to our power over nature is now complete. Euthanasia is, in that respect, the other side of the coin of unlimited medical progress.

The compassion it seeks is not just in response to pain and suffering. It is more deeply a response to our failure to achieve final control over our destiny. That is why we cannot be rid of the pain.

The compassion is misplaced. It seems to be a way of saying that just as we have a full right to control our living, we should have a full right to control our dying. Even more, the right to control our death offers a saving antidote to our failure to control life; it makes up for the progress medicine has not yet achieved. We design a healthcare system oriented to meeting individual curative needs and then, with euthanasia, guarantee that, when the skills and knowledge of the system fail, medicine can at least give us a decisive control over our dying. The last word, long sought, becomes ours.

– Daniel Callahan, What Kind of Life: The Limits of Medical Progress (Washington, D.C.: Georgetown University Press, 1990), 242–43.