Tuesday, December 8, 2020

What is the "Good" of Euthanasia?

Gordon Friesen
By Gordon Friesen, EPC board member

Combining incompatible moral systems: “subjective” vs “objective”

Throughout what follows, we must never lose sight of one simple fact: Euthanasia was not legalized because legislators, judges, doctors -- or society at large -- have agreed that any form of voluntary death is good and proper; in and of itself; in all similar cases; for all people; in the way we naturally understand the meaning of “right and wrong”. On the contrary, euthanasia was legalized in the clear understanding that no such agreement exists.

Moreover, as long as these differences in opinion were judged according to objective standards of net benefit, assisted dying was uniformly rejected. For presented in this way (Rodriguez, 1993 ; C-384, 2010), the net harm to society was considered far too great.

On the other hand, the Carter case (2014) and Bill C-14 (2016), which eventually decriminalized euthanasia, were decided by a very different logic. It was claimed, then, that the right and wrong of euthanasia should be a private matter, not to be judged objectively, but according to the subjective choice of each individual person; and that such assisted deaths should be allowed in spite of possible, likely, or even inevitable harm to others.

In other words, not only were the outcomes of Rodriguez and Carter different, but the moral systems used to produce those outcomes were different also: an objective view of morality for Rodriguez (supporting interdiction); a subjective view for Carter (demanding permission).

There is obviously matter here for heated debate. People who believe that euthanasia is simply wrong (categorically), or those who believe the decision should at least be objective (in the common good), remain thoroughly disgusted with the decisions cited. However, the situation -- as they say -- is what it is. Therefore, it is not my intention to argue, in this place, for or against the actual morality of euthanasia. The much more modest (though perhaps more immediately useful) goal which I have set myself, is merely to examine whether the limited moral justification actually provided for the legalization of euthanasia, is capable of explaining, of sustaining -- is indeed consistent with -- the institutionalized regime, of maximal recourse to euthanasia, which we observe developing in Canada today. (Because it would, of course, be madness to create a larger euthanasia practice than any reason might demand.)

And on that score, I believe we can rigorously demonstrate that a real disconnect – in fact a truly monumental mismatch -- already exists between the moral justification offered (that is, the “Why?” of our present policy) and the universal institutional implementation (being the What?) which has actually emerged.

Specifically, I will attempt to show that the problems revealed are the consequence of carelessly mixing, and confounding, the two distinct and utterly different moral systems outlined above -- in the same breath, in the same sentence, and ultimately in the same text of law.

And because the only humanly verifiable value of a moral system lies in its internal consistency: capriciously mixing discordant systems results, quite simply, in nonsense. A nonsense which is clearly evident in the law itself; and a nonsense which is clearly evident, also, in the implementation of that law.

These facts, moreover, are of the greatest practical import. Because much real harm has already been caused; and much good may still be achieved by resolving the moral incoherence at its root. 

Practical harms progressively revealed.

There are two main problems that come from mixing subjective and objective moral systems together. One is bad. And the other is worse.

The first, comes from deliberately entertaining an illusion that objective limits and “safeguards” can in some way restrain the operation of a subjective freedom once granted.

It is often maintained, for example, as the Federal Counsel did indeed maintain in the Truchon-Gladu case (Quebec Superior Court, 2019), that we must look for some sort of “balance” between the competing interests of the individual (subjective) and those of greater society (objective). It seems so simple and so reasonable! (And on a practical level it may even be true.)

But there is nothing either simple or reasonable in the resulting legal framework. For although subjective personal choice is assumed supreme at the outset (since euthanasia would never have been legalized otherwise), it is still maintained that objective criteria must be employed to enable (justify) that choice!

But what an incredible claim! One might suspect that its authors had hoped to prevail in debate by sheer boldness of deception. And indeed, succeed they did! Yet, (and here is the rub) any practical application of objective criteria, to selectively restrain choice, can (and will) be disputed by those individuals whose choice has been denied; for they will claim that the defined nature of specific criteria results in unfair discrimination, practiced against them; and the internal logic of fairly conceived objective criteria forbids any such discrimination.

Or more prosaically : If you give one kid an ice cream cone, you are going to have to give ALL of the kids ice cream cones.

A democratic solution.

This, then, is the first error in attempting to combine subjective freedom with objective restraint: It is an impossibility on the face of it.

You may start out with strictly limited exceptions to the criminal code, but unless those limits can be artificially (and permanently) canonized, you will end up with death on demand. And that is because the courts will faithfully follow along their given path (of whatever theoretical absurdity), until they have been firmly instructed to stop.

In practice, all that might still be done, therefore, is to arbitrarily set categorical limits to euthanasia access, presumably through legislative use of the “notwithstanding clause” (Section 33 of the Canadian Charter of Rights and Freedoms); to simply draw a hard line in the matter, saying: “thus far, and no farther!”; or “Veto!” (as roman Tribunes were privileged to cry), “I forbid!”

But our legislators have, to date, shown no willingness to take that necessary step. And unfortunately, there is worse.

Two forms of the virus, and two distinct remedies.

As presently defined, assisted death (Maid, Mad) has a double moral nature -- both subjective and objective -- which can not be resolved, just as proverbial “water and oil” do not mix.

As merely Medically Administered Death (MAD, aka “death on demand”) euthanasia is a purely subjective choice.

As Medical Assistance in Dying (MAID), however (which is the much more dangerous variant), assisted death becomes an evil hybrid that also demands recognition as an objectively justified act in response to defined medical indications. This is no more than the inevitable effect of declaring euthanasia as a benign medical procedure: Medical ethics are at once arbitrarily perverted, and then, substituted for ordinary morality; while presto! the unsettled moral status of euthanasia is magically converted to a positive “good”!

The attentive reader will thus notice that our starting assumption -- in fact the entire moral basis claimed for allowing euthanasia -- has been brazenly subverted. For to repeat the obvious: no form of assisted death would ever have been legalized were it not for a public understanding that those deaths were to be justified by subjective choice alone. Never was it suggested that certain patients should be “expected” to die in prescribed circumstances.

And yet, defining euthanasia as a benign medical procedure leads, immediately, to the clinical normalisation of that practice in terms of objectively verifiable conditions. And that, in turn, logically leads to applications which are far beyond the limits of choice, or even, of consent.

Plainly: this mistaken principle (of positively crediting the objective moral value of euthanasia) has the potential -- has in fact a virtually inevitable necessity -- for enabling the most horrific of abuses. And in this case, the remedy (if remedy there be), must be sought in tenaciously rejecting any objective moral justification for euthanasia, whatsoever.

In sum, it is my believe that the outer limits of choice can only be established (and should so be established) by iron-clad rights-proof legislative privilege.

But in what remains, that is among the population who are nonetheless deemed eligible for euthanasia (however that group might eventually be defined) we must insist on an access to assisted death whose moral authority derives SOLELY from subjective choice. (For even in the worst of scenarios, the social effects of subjective suicidal choice remain subject to limits arising from its own nature.) Never, to be clear, should we allow the intrusion of objective  justifications.

Furthermore, I believe that if the case be fairly made, a democratic majority will always support the wisdom of this view.

-- to be continued.

The previous series of articles by Gordon Friesen:

  1. Who really wants to die? Part 1: A brief quantative analysis of the purported "need" for euthanasia (Link). 
  2. Who really wants to die? Part 2: The popular impact of celebrity suicide (Link). 
  3. Who really wants to die? Part 3: Life choices of the common person (Link).
  4.  Who really wants to die? Part 4: The true scale of demand for euthanasia in Canada (Link). 
  5. Who really wants to die? Part 5: The absence of suicidal desire amongst the survivors of catastrophic injury. (Link).  
  6. Who really wants to die? Part 6: Aids in the Eighties and Nineties and the literary ritual of assisted suicide. (Link).
  7. Who really wants to die? Part 7: The justification of Canadian style euthanasia cannot be found in any rational dynamic of market economics (Link).

Gordon Friesen, December 6, 2020


mellie said...

There is never any "good" of Euthanasia. The word is a euphemism for what it really is: willful murder, on the part of a butcher-nazi doctor or the poor person who is deathly ill and completely vulnerable. Everyone is subject to the Moral Law, which teaches that there is an objective truth outside of the individual. Therefore, willful murder is always wrong and a mortal sin, no matter the circumstances or excuses.

gordon friesen said...

Hi Mellie, thanks for responding. It is important to always keep repeating that. Our adversaries reject your interpretation out of hand, of course, but all the more reason to push back. thank-you. My own purpose is to engage them on a terrain which they cannot so easily ignore, which is to say, on the terrain of their own contradictions, within their own system, as they themselves have constructed it... wish me luck :)

Unknown said...

Anthropological background of Euthanasia is based on a lack of logical, scientific thinking. In ancient times, the lack of understanding of disease and infirmity led neolithic people to kill those who suffered: 1) as a means of ridding the tribe of those whose demise hindered its survival and taxed its resources; 2) to sacrifice the afflicted to placate the angry deities whose wrath was leveled on the tribe; 3) to rid the tribe of evil in its midst, embodied in the afflicted. The ancient practice of human sacrifice has this baseline. Euthanasia in our own times is, therefore, a legal form of human sacrifice. It sounds like a radical statement, but human nature is the same as it always has been since we first walked the Earth.
The logic used to justify euthanasia, generally follows one or all of those patterns even though the language is "adjusted" to reflect some kind of justification for what is essentially homicide. The same reasons are general also to the topic of capital punishment. The difference is that the patient "has the evil within" while the criminal "exudes the evil within into society." Euthanasia advocates will talk of a compassionate process, but they never get to the root of the issue, which is the unwillingness to accept affliction as inherent to life. Because they cannot honor human life in all its diversity and facets, and they can be any number of factors - diseased, poor, racial, aged, criminal, etc - the inducement of death is a huge and flagrant insult against the dignity of the individual. The encouragement to accept being killed is then to encourage abuse, and to devalue the abused to be discarded as if they are society's trash. Be it a Nazi, or a butcher-doctor, a "caring" relative, or an opportunistic heir, the rationale for euthanasia is always camouflaged by purposeful adjusting of words and attitudes that hide the moral reality. Killing is killing, regardless of intention or vocabulary.
The advocates will argue against this point by calling euthanasia a modern and compassionate answer to excessive pain and suffering. But in the bottom line, they cannot get past the prehistoric tendencies of tribal survival in a world seated in ignorance and rejection of value of human life.

Agi nurse said...

My mother was in hospital for 1 entire year after her surgery went terribly wrong. She was on life support with sepsis at least 4-5 times. I was often asked by medical staff if I wanted them to stop medical intervention. I was horrified each and every time they asked me such a question. I told them to do everything in their power to save her life! We have been blessed to still have her around and she still lives alone, thanks be to God!
She loves life and is so grateful to still be alive. The last time that she ended up in ICU with sepsis, she was alert and awake. The ICU physician asked her if she was tired of all this, and that if she is, he can make her comfortable. English is not my mother’s first language. So she had no idea what he was talking about, she thought he wS a lovely doctor and that he wanted to make her comfortable. I had to jump in and ask him to stop. I then told him that he needs to be more straight forward as people can misunderstand what he is offering. I looked at my mother and said “mom, the doctor is saying that if you do not want to fight for your life anymore, he can take away all your life saving medications etc. He can give you drugs to make you comfortable, while you die!”. My mother’s eyes bulged and she looked so shocked!!
She immediately screamed out “NO!!!!! I WANT TO LIVE!!!!”. Then I looked over at the doctor and said “Don’t you ever ask that question ever again!!!”. Can you imagine if I was not there? He could have had my mother sign a consent form to remove all life saving measures, and she wouldn’t have had a clue what she was signing!!!

gordon friesen said...

hi "unknown", I really like your analysis.

I would add one thing : This predates the human species, as other social animals turn on those in their midst who exhibit deficits. So I would say that not only are we, as moderns, rationalizing primitive behaviors, but those primitives were, themselves, rationalizing pre (sub) human behavior.

My own bias is that being human is a choice. That is : we can choose to be more than beasts, but there is nothing automatic about it. And euthanasia (killing off the weaker individuals among us) is one of those litmus tests of man (or beast) hood.

Thank you so much for taking the time to respond.

Gordon Friesen, Montreal

gordon friesen said...

Hi Agi,

Thank you very much for that amazing witness to the state of healthcare in Canada. And I am glad your mum is still doing well.

I have very similar experience with my mother-in-law, who is alive today only because of the unfailing protection of my brother-in-law who has refused the "make you comfortable" "let nature take its course" argument on more than one occasion (when his mother was admitted from long-term care for acute ailments like pneumonia).

Plainly, she has outlived the wishes of those public-budget minded doctors by at least ten years and is still going strong. This is a scandal. But a very dangerous scandal, because many think it perfectly rational and justified.

Our job is to push back. Thank you for contributing to that effort.