In my bioethics class we have been discussing death, terminating medical treatment, and physician assisted suicide. Most of my classmates have been soundly in support of a so-called "right to die", though they usually recognize some of the tensions present in the existence of such a right.
I'm still working through the issues - part of the reason for this post - I don't completely have my mind made up, but I'm leaning strongly against the idea that there could ever be a "right to die". For the purposes of this post, I am thinking mostly of physician assisted suicide, though perhaps the same questions and responses apply to termination of treatment.
First, I see an overriding importance of life. Life, quite simply, has value. Even if the human is in a persistent vegetative state their life must have value. We believe that nature - animals, plants, the Earth itself - has value, how much more so then the value of the human! There is value in the life, and that is important.
But more than the reasons against a "right to die", I have been considering the reasons in favor. Most people can see the appeal of these arguments, and they can be difficult to refute. I have been considering the roots beneath the arguments. I am becoming convinced that the "right to die" is premised on faulty assumptions, and that when pressed, these assumptions unravel quickly.
In my experience there are three basic reasons given to support a "right to die". The first is the idea that it allows a person to die with dignity. But this is incongruous. When we think of those who have died with dignity the first people who come to mind are usually those who have suffered boldly. I thought of John Paul II. Laura mentioned martyrs. I can see no connection between opting out of life via suicide (physician assisted or otherwise) and dignity. In fact, even if a person has the most noble reasons for opting out of life (i.e. to mitigate the suffering of others), it seems that they are de facto choosing a route that denies the dignity in persisting through suffering and overcoming hardship. If dignity is truly a concern then suicide is far from the obvious choice; and I would contend that most frequently suicide is fraught with tones of cowardice, an element diametrically opposed to dignity.
The second reason in support of a "right to die" is that allowing physician assisted suicide gives people a chance to alleviate pain and suffering. But are pain and suffering actually bad things in themselves? Aren't there times when it is good to feel pain? When it is good to suffer? Aren't these things actually neutral? Even if unpleasant, isn't it better for us to live through pain than to seek an artificial - and permanent - escape from it? What troubles us more - the pain we feel when a loved one dies, or not feeling sad when a loved one dies? I would certainly find the later more troubling. Can we say with any certainty then that dissolution of pain is good? No. But we can say that anyone seeking a life without pain has taken a troubling course.
Finally, the "right to die" is supported by an argument from autonomy. This says that we cannot know what it is like to be in the shoes of the person making the decision, and we must respect their choice because they are a rational being. Despite studies showing that 95% of suicidal persons suffer from depression, we'll assume that the individual making this choice is completely healthy. The argument is really a quality of life argument. It says that the individual making the choice knows best what their quality of life is, and if they deem it low enough, then they can terminate their life. Ultimately, the claim is that we cannot assess quality of life from the outside.
But if this is the case, couldn't a healthy, happy person simply decide that their quality of life was personally too low? Even if they were eminently comfortable, typically happy, with terrific friends and family, meaningful employment, etc. - they are in the best position to decide whether their life is worth living. How can we allow physician assisted suicide for the terminally ill and at the same time condemn suicide generally? The two are facially inconsistent. One says we cannot assess another's quality of life, while the other assess another's quality of life.
Moreover, the autonomy of the suicidee should not be the paramount value. Especially given that two people with exactly the same symptoms/quality of life may come to different determinations about the appropriateness of suicide. If we respect the autonomy of one, we respect the statement they make by their suicide - that life is not worth living at a particular level of quality. For all those who chose to live at that same quality, this statement is a condemnation of their autonomous decision. We cannot respect the autonomy of some while disrespecting it for others.
Finally, we must consider the fact that if physician assisted suicide is allowed and accepted, there will be greater external pressure for the terminally ill to choose this option. In fact, their autonomy will likely be coerced in this direction.
I certainly still have questions, and any comments on any of these issues is more than welcome (actually invited). As I see it now, the importance of life easily trumps the "right to die", especially when we consider the problems underlying the "right's" corresponding justifications. A "right to die" is a figment constructed on unfit assumptions.
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