Euthanasia: Incremental extensions are inevitable.

The following is based on an article written by Margaret Somerville and published in the Calgary Herald on March 3, 2014. 

Margaret Somerville

Margaret Somerville begins her article by comparing the personal concerns of those who oppose euthanasia with the personal stories of those who are promoting euthanasia. Somerville then gets into the meat of the issue by stating:

Advocates of legalizing euthanasia reject “slippery slope” arguments as unfounded fear-mongering and claim that its use will always be restricted to rare cases of dying people with unrelievable, unbearable suffering. But, as the Netherlands and Belgium demonstrate, that’s not what results, in practice. 

The logical and practical slippery slopes are unavoidable and inevitable, because those consequences are built into the act of legalization through its justification of inflicting death. Once we cross the clear line that we must not intentionally kill another person, there’s no logical stopping point. Let me explain.

When euthanasia is first legalized, the usual necessary and sufficient justification for breaching that line is a conjunctive justification comprised of respect for individual autonomy and the relief of suffering. But as people and physicians become accustomed to euthanasia, they ask, “Why not just relief of suffering or respect for autonomy alone?”, and these become alternative justifications.

As a lone justification, relief of suffering allows euthanasia of those unable to consent for themselves. Pro-euthanasia advocates argue that allowing euthanasia is to do good to suffering mentally competent people, consequently, denying it to mentally incompetent suffering people unable to consent is wrong, it’s discrimination on the basis of mental handicap. So suffering people with dementia or disabled newborn babies or children should have access to euthanasia.

And if one owns one’s own life and no one else has the right to interfere with one’s decisions in that regard, as pro-euthanasia advocates also claim, then respect for the person’s autonomy is a sufficient justification for euthanasia. That is, the person need not be suffering to have access, hence the proposal in the Netherlands that euthanasia should be available to those “over 70 and tired of life."

And once the initial justification for euthanasia is expanded, why not allow some other justifications, for instance, saving on health-care costs, especially with an aging population? Until very recently, this was an unaskable question. Now, it’s being raised in relation to euthanasia. It’s anecdotal, but a final year medical student became very angry because I rejected his insistent claim that legalizing euthanasia was essential to save the health-care costs of an aging population.

The practical slippery slope is unavoidable because familiarity with inflicting death causes us to lose a sense of the awesomeness of what euthanasia involves, killing another human being. The same is true in making euthanasia a medical act.

Finally, familiarity with inflicting death and making euthanasia a medical act make both its logical extension and its abuse, in practice, much more likely, indeed, I believe inevitable. We need to stay firmly behind the clear line that establishes that we do not intentionally kill each other.

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

Belgium legalized euthanasia for the same supposed reasons as the Québec government claims to support euthanasia, "to end suffering." But ending suffering can be done without legalizing euthanasia.

The fact is that once killing becomes an acceptable solution to one condition, there will soon be many more conditions that will justify killing. The argument that there is no proof of a slippery slope falls short when one considers the ever expanding reasons for euthanasia.