Australia’s popular radio and TV personality Andrew Denton has embarked upon a crusade to legalise euthanasia. He recently lashed out at a “subterranean Catholic force” of politicians and businessmen who are trying to frustrate popular demand for a peaceful death. “On the questions that are most fundamental to how we live, love and die, religious belief trumps everything,” he told the National Press Club in Canberra. “This is the theocracy hidden inside our democracy.”
This is an example of the “label as religious – in particular, Roman Catholic – and dismiss” strategy of pro-euthanasia advocates. It’s applied to both members of the public with religious beliefs and clergy. The strategy is founded on the argument that religious beliefs are unacceptable as an informing principle for values decisions other than purely personal ones, especially those decisions relevant to public and social policy, and, consequently, religious people’s voices should be excluded from the public square.
It’s a strategy used to avoid addressing the arguments or views of people with religious beliefs, whether or not their arguments and views are religiously based; they and their arguments are dismissed simply on the basis of having a religious affiliation. The assumption underlying this strategy and purportedly justifying it is that people who have religious beliefs are puppets of their Church, unthinking, uncritical automatons.
People who use this strategy, like Denton, overlook that everyone has a belief system. For example, secularism and atheism are belief systems, yet their adherents are not automatically dismissed for being such and should not be, because in a democratic society everyone has a right to a voice in the public square. To silence people because they are religious is anti-democratic and discrimination, just as silencing atheists and secularists would be.
If Denton has good arguments against his Catholic opponents’ positions he should present them and show why these Catholics’ arguments should not prevail, not try to suppress them. Indeed, his efforts to do the latter raises the issue of whether he believes his arguments will fail if they are competently challenged.
Because the euthanasia debate involves ethical decision-making, not only reason, but also other human ways of knowing, such as “examined emotions” and intuition, especially moral intuition, play an important role. A wise axiom in applied ethics is that “we ignore our feelings at our ethical peril.” That is not to say we should act just on the basis of our emotional reactions, but we must carefully examine these reactions and take them into account in ethical decision making.
We must react with compassion and care for people suffering from horrible illnesses, but our reaction should be to kill the pain and suffering, not the person with the pain and suffering.
Humans have an innate reluctance to killing another human being and rightly recoil from doing so. Indeed, in the past, soldiers have been psychologically deprogrammed in order to be able to kill an enemy soldier at close quarters. So might we need to be more concerned about the good conscience and ethics of doctors willing to inflict death, than those who refuse to do so for reasons of conscience or religious belief?
In that case, the situation in Canada, where euthanasia has just become legal, of pro-euthanasia advocates trying to force doctors with conscientious or religious objections to euthanasia to participate in it, is clearly unjustified and wrong. We should keep in mind that a doctor’s good conscience is a patient’s last protection.
Our choice of language is important and influential with regard to emotional and intuitive responses. For instance, Denton’s use of the word “subterranean” in describing “a Catholic force” brings to mind secret, dark, nefarious forces and conspiratorial activity.
And pro-euthanasia advocates such as Denton speak in the neutral terminology of “assisted death” (we all want medical assistance when we are dying) and they assiduously avoid the language of doctors inflicting death on their patients or, even more graphically, being allowed to kill them, as these latter descriptions rightly raise many people’s moral and ethical concerns about this practice.
Very recently, Denton announced the launch of a pro-euthanasia lobby group called “Go Gentle Australia”. It sounds like a catchline in an advertisement for Kleenex or toilet paper.
Denton had a traumatic experience with his father’s death and is seeking to have some good, or what he perceives to be good, come out of that. He wants to make sure that others will benefit from the suffering his father endured by trying to ensure that they do not experience the same suffering. In short, he wants to give his father’s suffering meaning. Seeking meaning, especially in suffering, is innate to being human.
But euthanasia will seriously harm our capacity to find meaning in the face of death, not promote it. It converts the mystery of death to the problem of death and offers a quick-fix technological solution to the problem, a lethal injection.
In contrast, making available fully adequate access to high quality palliative care for every Australian who needs it will help people to find meaning in the last days of life until death occurs naturally.
I note here that seeking good for others out of a traumatic medical event, such as Denton and his father experienced, is a very common reaction of people who either themselves or their child, spouse or parent have been the victim of medical malpractice. Failure to take all reasonable steps to relieve the pain and suffering, especially of terminally ill people, is medical malpractice and, as has been recognized relatively recently in the Declaration of Montreal, a breach of fundamental human rights.
The strongest case for legalizing doctor-assisted suicide and euthanasia is the one Denton makes, that is, the relief of the suffering of individual competent adults who want and consent to this. But in deciding as a society whether to legalize doctor-assisted suicide and euthanasia, we must look beyond what an individual might want and consider far wider issues.
Importantly, these include
- the impact of euthanasia on fragile or vulnerable people – those who are old or live with disabilities or even just perceive themselves as a burden on their families;
- the impact on suicide prevention of the normalization of suicide as an acceptable response to suffering; and
- what it means for society and our shared values to move from caring for those unable to care for themselves to killing them.
What would be the impact on important values, such as respect for human life, in general, in society? Respect for life must be upheld at both the individual and the general societal level.
If fully adequate palliative care is not available, what would it mean that we are saying we will not care for you but we will kill you? Religion used to carry the value of respect for life for society as a whole, but in a secular society, such as Australia, the institutions of law and medicine carry this value. How would their capacity to do this be affected by society changing the law to allow the infliction of death and permitting doctors to do that?
Finally, what would the practical reality be if euthanasia were legalized in Australia? Most advocates of euthanasia propose there’s no danger in legalizing it because it will be rarely used and only in extreme circumstances. Denton is reported as saying that “less than 4 percent of deaths in The Netherlands were as a result of assisted death”, seemingly, and quite astonishingly, as demonstrating this outcome. But if the same rate applied in Australia as in The Netherlands, using the lower more accurate figure of 3.6 percent, there would be around 5000 euthanasia deaths each year. Are we prepared to allow that? Can we live with it?
Margaret Somerville is Professor of Bioethics in the School of Medicine at The University of Notre Dame Australia and is affiliated with the Institute for Ethics and Society, also at Notre Dame. She was previously Professor of Law, Professor in the Faculty of Medicine, and Founding Director of the Centre for Medicine, Ethics and Law at McGill University, Montreal.