Tuesday, March 27, 2012

National Assembly report reads like a pro-euthanasia manifesto

Margaret Somerville was published in the Montreal Gazette yesterday challenging the Quebec government report that calls for the legalization of euthanasia for people who are living with physical or psychological pain. Here is her article.

National Assembly report reads like a pro-euthanasia manifesto.

Before society responds affirmatively to the call in your March 14 editorial (“Assisted dying: it’s time for a discussion”), we will need to provide the public with a more full and open explanation of the case against legalizing euthanasia.

The recent Quebec National Assembly committee report Dying with Dignity fails to do that.

Like the previous report of the Expert Panel of the Royal Society of Canada on this same subject, the Quebec report is not balanced and reads rather like a pro-euthanasia manifesto.

The fact that it strongly recommends palliative care does not negate that characterization.

The Quebec report takes a purely utilitarian approach to the euthanasia question. In the committee’s estimation, legalizing euthanasia will do more good than harm – and that justifies allowing it.

It upholds respect for individuals’ rights to autonomy and self-determination as the overriding value, citing, among other examples, the current approach to abortion as showing this value predominates in contemporary Quebec society.

The committee concludes that legalizing euthanasia will not harm the value of respect for life because euthanasia will only be used in exceptional circumstances and there will be very few cases. And in any case, “La valeur du caractère Sacré de la vie a subi une transformation notable” (“The value of the sanctity of life has undergone a significant transformation”) relative to other values, which means that now respect for life itself doesn’t necessarily take priority.

Finally, the committee argues that allowing euthanasia is merely an incremental change – we all agree with palliative care and so, it says, “aide médicale à mourir” (euthanasia) needs to be seen as just another “palliative-care option.”

How should we respond to these arguments?

First, many people who oppose legalizing euthanasia do so because they believe it’s inherently wrong to kill another person, except when that is the only way in which to protect innocent human life. Euthanasia does not fall within this exception and, therefore, for many people, can never be ethically justified.

The clash of values involved in the euthanasia debate is between respect for life on the other hand and individuals’ rights to autonomy and self-determination on the other. People who reject euthanasia give priority to respect for life; people who support euthanasia give priority to autonomy and self-determination.

“Respect for life” must be upheld at two levels: respect for each individual human life and respect for human life in general. The latter requirement is the reason that the consent of an individual to being euthanized is not sufficient to avoid damaging the value of respect for life. Authorizing doctors to kill their patients necessarily contravenes respect for human life in general. Legalizing euthanasia involves crossing the line established by the fundamental rule that we must not intentionally kill one another. In short, it would unavoidably harm the value of respect for life, which means that legalizing euthanasia involves a radical change in our society’s values.

Pro-euthanasia advocates often argue that seeing life as “sacred” is a religious value and therefore should not be taken into account in the formulation of public policy.

But respect for life is not just a religious value; it’s a foundational value of all societies in which reasonable people would want to live.

Concern over the consequences of legalizing euthanasia raises the question of whether a utilitarian case against euthanasia can be made. Exploring this question shows that the utilitarian case for euthanasia is not nearly as strong as the commission argues it is.

Many seriously harmful consequences from legalizing euthanasia could far outweigh any benefits it might have. Apart from its harmful impact on the societal value of respect for life, it would harm the institutions of law and medicine. Can we even imagine teaching medical students how to kill their patients?

The committee tells us that in accepting, as we do in some cases, the withdrawal of life-support treatment to allow a person to die, we are already practising euthanasia; therefore, legalizing euthanasia is just a small step forward. But these are false and misleading analogies in support of a false and misleading line of argument. It’s legalizing euthanasia through confusion. There is a radical difference between killing a person and allowing them to die of natural causes.

In proposing to replace the word euthanasia with the term “aide médicale à mourir,” the committee is introducing a euphemism that both trivializes and is likely to conceal underlying moral and ethical issues.

If we are to have a discussion about euthanasia, it must be an unbiased one. It’s hard for me to conclude from its report that the National Assembly committee undertook such an unbiased reflection, especially in view of the fact that two-thirds of the submissions it received argued against legalizing euthanasia.

Margaret Somerville is founding director of the McGill Centre for Medicine, Ethics and Law.


Joe P. said...

Thank you for this thoughtful analysis. The fact that the report strongly favors euthanasia although "...two-thirds of the submissions it received argued against legalizing euthanasia" suggests that the National Assembly committee is propagating a pro-euthanasia agenda rather than simply submitting a report. Thank you for bringing this to the public's attention.

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