Tuesday, December 26, 2017

Euthanasia: Conscience and Common Sense

This article was published by the Physicians Alliance Against Euthanasia.

One of the most powerful reasons why people oppose euthanasia concerns the enormous significance of taking a human life. Doctors have historically made a solemn and specific professional commitment to respect the lives of those entrusted to them. But the Hippocratic Oath is in fact somewhat redundant, because the universal code of civilized human conduct, from the beginning of history — written and oral — is founded upon a general prohibition against killing. Whether in the religious formulation, “Thou shalt not kill” or in the first written codes of Mesopotamia (Hammurabi) 4000 years ago, this theme serves as a constant backdrop to the evolution of human social behaviour, culminating in our modern concept of physical security as an essential Human Right.

Clearly then, in the make-up of our highly social species there are natural propensities towards respecting, caring, helping and protecting one another, without which we could never have survived the infancy of our race. But there is also another side to this coin: it also seems that killing comes easily to us, and in fact, much too easily. In our biological origins, we are hunters and warriors. The human separation from other animals is often associated with our tool-making capacity, but our first– and most perfected – tools have always been weapons. In the private sphere, it has proven very difficult to prevent human beings from killing one another, despite recourse to the most extreme forms of punishment. In the public realm, history – not to mention current events – is filled with the proof of a human willingness to indulge in the very worst excesses of aggression and repression: killing on a huge scale to defeat the enemy in war; and (in authoritarian regimes) killing on an even grander scale to eliminate dissent. Moreover, it is demonstrably impossible for such horrors to exist without the collusion and willing cooperation of perfectly ordinary men and women: Horror is thus revealed to be perfectly ordinary.

This is the inescapable human moral condition, long recognized by the wisest among us: that good and evil, love and hatred, assistance and violence, compassion and mayhem, are but a knife’s edge apart; coexistent in every human breast ; capable of expression at almost any time. And, the only rampart which exists — between this and that — (if we exclude the divine), is the exercise of rational will, personal and collective, which allows individuals and groups to deliberately seek out the conditions for peaceful life in society.

Such has always been the sub-text beneath the evolution of what we call “civilization”. People were asked to interiorize and express certain essential human characteristics while sternly repressing others. Every political and religious force was brought to bear. All complexity was avoided with a most clear, simple creed. And despite all disappointments, real progress has indeed been made: Very few people today subscribe to the old subtlety of discourse concerning the rightness of privately killing this or that rival or neighbour ; the days when the Roman Paterfamilias could exercise complete and capricious capital authority over all legal non-persons ( children and slaves ) under his roof — are now long gone; and the infinitely varied informal killings current in our primitive prehistory are (if we except the inexpungable criminal element), even farther back in our historical mirror. All this is the result of sober thought based on regret for the past and hope for the future; the result of choice; the result of ever-renewed conviction and tenacity; the result of fixed intent. And after thousands of generations of careful repetition we truly had begun to accept that killing is wrong; to control our own passions and interests; to have confidence, even, that these shared values, defended by the force of law, would protect us, also, from the passions and interests of others.

And then there was euthanasia.

Whether from a settled prejudice of radical ideology, or the mere academic cleverness of stylistic display, in the rarified atmosphere of our Supreme Court, “Right to Life” somehow came to signify a personal prerogative – not merely to die – but to oblige others to affect that killing.

With this extraordinary judicial anomaly, a terrible blow has been struck at the foundation of our social compact. As a society — for the first time in centuries – we are asked to step back from our adherence to a universal and absolute prohibition against deliberately taking life. In this strange defense of freedom for a suicidal few, we are collectively asked to forgo the simple benefit of moral clarity required for the peaceful survival of the many. We are mischievously exposed to the perils of flirting, once again, with the subtleties of lethal appetite and opportunity: we now must explain to ourselves (and to our children) why killing is wrong “except” … why one should not kill “except”… In short, we are asked to relinquish the fruits of our long and painful history. Certainty has been replaced by doubt.

But this is not all. Euthanasia is not only a collective phenomenon. It is personal. We are not affected equally. And therein, perhaps, lurks a certain cowardice in the Honourable Judges’ decision to impose this new reality upon us all. For if society must kill, clearly some individual members of society must kill also. And it is these people who must suffer the full shock of the collision between our deep instincts of love and protection and their darker cousins of lethal imperative and convenience; it is these specific individuals who must live the terrifying opposition between a life-long social inculcation that killing is wrong, and the fact that suddenly it is not merely permitted, but required. It is these people, who will personally pay the price of this extraordinary intellectual, psychological, and emotional conflict.

In Montreal, a nurse was asked to participate in the euthanasia of a patient. She refused, and was excused. But two days later, she was nonetheless asked to “find a vein” that is to say, start an IV, and help transfer the patient to a stretcher — actions which were later judged to be “not directly related” to the procedure ! Being a responsible professional (and a naturally cooperative person), the nurse complied. In addition, she also supported the family. And this trusting member of the collectivity paid the price of her willingness to place her perceived duty ahead of her own principles with acute and persistent symptoms of post-traumatic stress. Moreover, she was denied compensation for work-related injury, as the tribunal determined that the cause of her distress was not the act in which she participated, but her “moral convictions”, represented as a sort of dogmatic caprice unsupported by any deeper reality. And that, because Justice and the State had decreed, in this particular instance, that there was no significance to the fact of killing! In other words: we are asked to believe that the intense, deeply conditioned prohibition against killing, carefully instilled in the ordinary man and woman over long millennia, can be turned on and off like a light switch, with no psychological effect whatsoever, following a simple change of a legal definition, and the establishment of arbitrary norms.

But, what sort of madness is this?

Is it not obvious –regardless of what one thinks of euthanasia – that opening up this Pandora’s Box of human psychology will be fraught with the greatest possible danger, and must therefore be approached with the greatest possible caution?

At the very least, people involved in this practice should be carefully selected (for their own protection and for ours). They should be carefully followed, subject to routine reporting requirements and objective verification of their affective state. And in expectation of inevitable necessity, serious support and intervention resources must be standing by to rescue those unfortunate individuals who are damaged despite our best efforts at prevention. Above all, we would wish to restrain the number of individually licensed practitioners to the smallest dimensions possible, considering the incredible social danger which is implicit in any movement towards the desensitization of persons to the act of killing.

This is, in no way, the prescription of an extreme course of action motivated by ideological purity. On the contrary: It is a pragmatic argument in favour of minimal prudence.

Make euthanasia unimaginable.

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