Euthanasia and Assisted Suicide: Seven Reasons Why They Should Not Be
[A law permitting euthanasia, which was passed by the Legislative Assembly of
the Northern Territory of Australia in 1995 (and which came into force in July
last year) was overturned last month by a law passed by the Australian Federal
Parliament. The 'Andrews Bill' had been passed by a large majority in the House
of Representatives, but the result in the Senate remained uncertain up to the
day of voting. In the event it was passed by 38 to 33 votes. The Linacre Centre
was gratified to learn that several Senators said they had been influenced to
change their minds and oppose the legalization of euthanasia by a talk given in
1995 by Luke Gormally at the John Plunkett Centre in Sydney, which the Centre
subsequently published and distributed widely. The article below is an edited
version of a Submission made last year by Luke Gormally to the Senate
Legal and Constitutional Legislation Committee, which reported on the issue of
legalization prior to the Senate vote.]
1. The 'justification' of voluntary euthanasia
involves rejection of a tenet fundamental to a just framework of laws in
Voluntary euthanasia is the killing of a patient at his or her request
in the belief that death would be a benefit to the patient and that the
killing is for that reason justified. The mere fact that someone says, in
an uncoerced fashion, that he or she wants to be killed does not in itself
provide a doctor with a reason for thinking death would be a benefit to
that patient. No doctor would accede to an apparently naked request to be
killed, however seemingly uncoerced, if he thought the patient had prospects
of a worthwhile life. A request to be killed appears to be a ground for
euthanasiast killing only if the doctor believes that the patient does not
have a worthwhile life.
Now, to say that the ongoing life of a person lacks value amounts to denying
value or worth to that person, since the reality of a person is not something
distinct from his or her ongoing life. What underpins euthanasiast killing
are judgements on the overall worth of certain human lives.
It would be contrary to any legal system which purports to protect and enforce
a just social order to legalize killing which rests for its justification
on the belief that certain lives lack worth. Why? Because justice in society
itself requires a non-arbitrary and non-discriminatory way of identifying
who are the subjects of justice. But the only way of avoiding arbitrariness
in identifying the subjects of justice is to assume that all human beings,
simply in virtue of being human, are entitled to be treated justly and are
the subjects of certain basic human rights. In other words the basic human
dignity and worth which are recognised in respecting human rights must be
seen as attaching to our humanity. Basic dignity and worth would not, however,
be a title to just treatment if human beings were thought capable of losing
them. They are, so to speak, ineliminable features of our humanity.
Euthanasiast killing, even when it is voluntary, involves denial of the
ongoing worth of the lives of those reckoned to be candidates for euthanasia.
It is a type of killing, therefore, which cannot be accommodated in a legal
system for which belief in the worth and dignity of every human being is
It is of critical importance to every state to maintain a body of laws consistent
with respect for the dignity and worth of every human being. In particular,
it is important not to legalize killing of the innocent. For it is the fundamental
task of civil authority to protect the innocent. But if the claim that a
person lacks a worthwhile life is held to make killing lawful, then the
state has ceased to recognise the innocent as having binding claims to protection.
If the state treats these claims as null, then what claim has it to that
authority which derives precisely from the need of citizens for protection
from unjust attack?
2. To legalize assistance in suicide is also inconsistent
with the same fundamental tenet of a just legal system
The decriminalization of suicide (and attempted suicide, therefore) makes
sense if we contemplate the plight of people having to face criminal proceedings
after failed suicide attempts. Decriminalization motivated by the desire
to ease the plight of such people does not, however, imply that the law
takes a neutral view of the choice to carry out suicide. Those who attempt
suicide are clearly moved by the (at least transient) belief that their
lives are no longer worthwhile. Since just legal arrangements rest on a
belief in the ineliminable worth of every human life, the law must reject
the reasonableness of a choice which is so motivated.
Hence the law must also refuse to accommodate the behaviour of those who
effectively endorse the choice of the suicide: for they too are acting on
the view that the person they are helping no longer has a worthwhile life.
Their behaviour would not be sufficiently explained if one were to say that
they were acting 'out of friendship' or 'out of compassion'. For how could
the motives of the person assisting in suicide be described as 'friendship'
or 'compassion' if they were not informed by the thought that the person
intending to kill himself would be better off dead? If one thought this
person could continue to have a worthwhile life it would hardly be an act
of friendship, for example, to help him kill himself.
So there is reason to resist the legalization of assisted suicide as fundamental
as the first reason given for resisting the legalization of euthanasia.
3. If voluntary euthanasia is legalized then the
most compelling reason for opposing the legalization of non-voluntary euthanasia
has been abandoned
Many of those who support the legalization of voluntary euthanasia are
opposed to the legalization of non-voluntary euthanasia. But if we cannot
make sense of the claim that euthanasia is a benefit to the person to be
killed without relying on the thought that that person no longer has a worthwhile
life, then supporters of voluntary euthanasia are buying into a larger package-deal
than they perhaps realise. For if one can be benefited by being killed,
is it reasonable to deprive people of that benefit simply because they are
incapable of asking to be killed? And if we are puzzled (rightly) by the
claim that someone might be benefited by having his life ended, we might
nonetheless accept the claim that a person cannot be harmed by having his
worthless life ended.
In fact the most active and clear-sighted advocates of the legalization
of voluntary euthanasia are also advocates of the legalization of non-voluntary
euthanasia. They promote the view that many human beings lack the 'moral
standing' (what is here called 'basic dignity') in virtue of which they
enjoy basic human rights; so they cannot be wronged even if the motive for
killing them is merely the convenience of those human beings who do have
'moral standing'. The whole exercise of drawing a line between human beings
who do and those who do not possess 'moral standing' is utterly arbitrary.
Advocates of the legalization of euthanasia, such as the philosophers Peter
Singer and Helga Kuhse, who embrace such arbitrariness, do so without any
evident concern for the subversion of the foundations of justice which the
4. Legalization of voluntary euthanasia would
also encourage the practice of non-voluntary euthanasia without benefit
This would happen in two ways:
firstly, it has proved to be the case that those who begin by saying
they wish to confine the practice of euthanasia to voluntary euthanasia
come to think that, if that is allowed, no good reason remains for
disallowing non-voluntary euthanasia, so they begin to plan for the systematic
practice of non-voluntary euthanasia. This phenomenon can be seen, for example,
in the behaviour of The Royal Dutch Medical Association over the past fifteen
years. Having worked for the acceptance of what purported to be the 'strictly
controlled' practice of voluntary euthanasia only, they are now working
for the acceptance of the practice of non-voluntary euthanasia.
secondly, because the criteria for delimiting the practice of euthanasia
to killing at the request of the patient prove to be irremediably imprecise.
The Dutch experience has demonstrated the truth of what critics said about
any legal accommodation of voluntary euthanasia (whether by statute law
or by judicial decision), namely, that it would lead to the extensive practice
of non-voluntary euthanasia. The available data show, on a conservative
estimate, that about 1 in 12 deaths in Holland in 1990 were euthanasia deaths
(10,558 cases) and more than half of these were without explicit request.
5. Euthanasia undermines the dispositions we require
in doctors and is therefore destructive of the practice of medicine
The practice of medicine cannot flourish unless doctors are so disposed
that they inspire trust in patients many of whom are extremely vulnerable.
Doctors will not inspire trust unless patients are confident that doctors
are for no reasons disposed to kill them;
have no inclination to ask whether a patient is worth caring for or
treating, rather than asking what care or treatment might benefit the patient.
But the practice of euthanasia systematically undermines both of the required
dispositions. For it disposes doctors to kill certain of their patients,
and it inculcates a disposition to think of some patients as not having
worthwhile lives. Since there are no non-arbitrary criteria for determining
who has and who has not a worthwhile life, the temptation to categorise
the difficult and the unappealing as not having worthwhile lives is very
strong for the person who has failed to eschew such discriminatory thinking
as a matter of principle.
It is an important part of the duty of the state to maintain a framework
of law which is conducive to an essential profession such as medicine functioning
well in the interests of citizens. The state would fail in that duty were
the law to permit behaviour on the part of doctors which was corrosive of
the doctor-patient relationship.
6. The legalization of euthanasia undermines the
impetus to develop truly compassionate approaches to the care of the suffering
and the dying
The proper expression of compassion is care motivated by a more or less
strong sense of sympathy with the affliction of the person suffering. But
one cannot care for people by killing them.
It is very important to bear in mind that a key element in the context of
contemporary debates about legalizing euthanasia is the drive to reduce
health care costs. One of the conspicuous dangers of legalization is that,
before long, euthanasia would be seen as a convenient 'solution' to the
heavy demands on care made by certain types of patient. Medicine would thereby
be robbed of the incentive to find genuinely compassionate solutions to
the difficulties presented by such patients. The kind of humane impulses
which have sustained the development of hospice medicine and care would
be undermined because too many would think euthanasia a cheaper and less
personally demanding solution.
7. Three Committees established by English-speaking
legislatures to consider proposals to legalize euthanasia have recommended
that it not be legalized
1994-95 saw the publication of Reports of Committees established by the
House of Lords of the UK Parliament, by the New York State Task Force on
Life and the Law, and by the Senate of the Canadian Parliament. All these
Committees were composed of people with different views on the intrinsic
morality of euthanasia, yet they were clear in opposing its legalization.
For example, the House of Lords' Select Committee had among its members
many who were on record as advocates of euthanasia. And yet after a year
of hearing and reading an extensive body of evidence and debating the issues
among themselves, they decided unanimously to recommend that euthanasia
should not be legalized.
There is much in all three Reports that is worthy of the attention of the
Legal and Constitutional Legislation Committee of the Senate of the Australian
Federal Parliament. Let the following quotation from the House of Lords'
Select Committee Report stand as the epitome of the collective wisdom of
'[S]ociety's prohibition of intentional killing ...is the cornerstone of
law and social relationships. It protects each of us impartially, embodying
the belief that all are equal. We do not wish that protection to be diminished
and we therefore recommend that there should be no change in the law to
permit euthanasia ...The death of a person affects the lives of others,
often in ways and to an extent which cannot be foreseen. We believe that
the issue of euthanasia is one in which the interest of the individual cannot
be separated from the interest of society as a whole.'
It is the hope of the present writer that the members of the Legal and Constitutional
Legislation Committee will, after due consideration, associate themselves
with the moral and political wisdom exhibited in this statement.