A little piece on voluntary assisted dying in The Conversation

 

The Conversation.pngRobyn Whitaker and I teamed up to offer a few thoughts for The Conversation on voluntary assisted dying ‘Voluntary assisted dying is not a black-and-white issue for Christians’.

My longer essay on the subject – ‘Euthanasia: Some theological considerations for living responsibly’ – can be accessed via this link. I am grateful that SAGE have granted free public access to the article until the end of October.

Euthanasia: Some theological considerations for living responsibly

Die Klage der heiligen Zeder

A recent issue of Pacifica includes my article on euthanasia. It can be accessed via this link. Apparently, SAGE have granted free access to the article until the end of October.

[Image: Anselm Kiefer, ‘Die Klage der heiligen Zeder’, 1981]

Physician assisted suicide, euthanasia, and capitalism

There’s a good little piece here by Daniel Fleming, who reminds us of the larger economic context in which debates about physician assisted suicide and euthanasia are taking place; and, should the legislation be passed, of the context in which the legislation will be enacted. Here’s a taster:

Where we make social interventions in our context, we should also remember that it will inevitably become someone’s business to deliver on them. Correlatively, in answer to the first question, we should consider what the impact of private, for-profit, companies which specialise in the provision of euthanasia might be. Such companies would have as their primary purpose profit or return to share-holders. They would, assumedly, be required to increase business in order to produce better annual results. What would their marketing strategies look like? Who would their target market be?

One can quickly imagine a strategic planning meeting whereby the market of those who are dying or those who are close to someone who is dying become the aim of the product, perhaps also particularly those who would not be able to afford other forms of end of life care, or those who are suffering from some form of depression. The current proposed legislation [in Victoria and New South Wales] rests on the possibility of someone making a free and fully informed decision, but freedom and coercion have a tenuous relationship when it comes to marketing strategies – especially those directed at vulnerable groups, and that is something we should consider in this case.

To put it crudely, if we agree to this legislation we should be willing to accept active and aggressive marketing strategies from companies who enact it …

Such companies do not currently exist, but for-profit health insurance companies do, and so we should also consider what the proposed legislation might look like from the perspective of an insurance company which is trying to improve its bottom line. Could it be that insurance companies would direct patients toward the cheaper option instead of agreeing to a larger payout for more expensive care?

In the United States, for example, a physician recently claimed that “insurance companies in states where assisted suicide is legal have refused to cover expensive, life-saving treatments for his patients but have offered to help them end their lives instead.” As anyone who has sat in a budget meeting will know, the logic applied here by the insurance companies is perfectly compatible with the value-set imposed by capitalism.

These are uncomfortable considerations, and they take the debate outside of its typical contours which consider the suffering of an individual and sometimes their family, and whether or not it is right for that person to end their own life with medical assistance. That debate still needs to be had. However we land there, it is crucial to remember that the debate takes place in an ideological context, and if or when the legislation is enacted it will be done in a way that takes it beyond the intent of those proposing it, and into the realm of the value set of capitalism. Any legislation or major social interventions has social consequences beyond its original purpose.

You can read the full article here.

End of Life Choices

The University of Divinity’s Centre for Research in Religion and Social Policy is hosting a conversation on voluntary euthanasia and assisted suicide. The subject is timely, the details are below:Euthanasia-Conversation 2017.jpg

On a related note, readers here may be interested to know that I have an article coming out on this subject soon. I’ll post details about that when the piece is published.

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.