Some
Aspects of the Euthanasia Debate
IAIN BENSON
Iain Benson responds to the arguments of the pro-euthanasia
lobby. He begins with a discussion of how we now speak (and
think) about “right” and “wrong”, the problem of “values
language”.
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INTRODUCTION:
In this talk I am not going to discuss in any detail the main
arguments of the pro-euthanasia lobby. I will just briefly list them
now: 1) Dying in pain; (91% of pain can be 100% controlled; the other 9%
can be controlled within patient comfort) 2) Quality of Life; (the
importance of the last 6 months of life for personal growth of patient,
family, loved ones); 3) It's just an option (an additional right) “you
don't have to avail yourself of it” (rights for some become duties for
others — the vulnerable are then pressured to go along with the new
“option”); 4) Cost (due to the use of extraordinary medical
interventions that are frequently unnecessary). It is important to
understand how to deal with these arguments and I know of no better
presentation on these points than a video of Fr. Robert Spitzer recorded
at Westminster Abbey, Mission B.C. in the fall of 1994 on the topic of
Euthanasia. This brilliant tour de force by Fr. Spitzer has impressed
many who have seen the video.
I would like to make some comments to you that are of general
importance and that I believe to be very important in the Euthanasia
debate. I would like to spend a bit of time at the beginning by
discussing a problem that is relevant to all moral debates in society
and that has to do with how we speak (and think) about “right” and
“wrong”. Obviously, on a particular issue such as euthanasia and the
law, if there is an issue that deeply affects the way in which we think
about “right” and wrong then that should be considered. I refer to this
problem as the problem of “values language”. A large part of my talk
will be in fleshing out this important point. Once that is done, I would
like then to touch on some key points in the euthanasia debate.
PART A. BACKGROUND: VALUES LANGAUGE
After this I would like to touch on some other aspects of the debate
surrounding euthanasia and assisted suicide.
PART B. MISCELLANEOUS KEY POINTS
IN THE DEBATE.
- Who Bears the Onus for a Change in the Law? (c.f.#4 below)
- *The Nature of Medical care and the Compassionate Society
- The fact of “Botched Suicide” does not Provide a Justification
for Allowing Euthanasia:
- *Threats to the Most Vulnerable: The Inability to Control
Euthanasia if it is Legalized:
- *Ethics and the Position of Sue Rodriguez: Should the Wishes of
The Autonomous Self Drive Law Reform?:
- The Need to Distinguish Between Withdrawing Fruitless or
Burdensome Treatment on the One Hand and Intending to kill a person
with Euthanasia or Assisted Suicide:
- The Concern That Legalizing Euthanasia Would Conflict With the
Good Of Palliative Care: The Netherlands Experience:
- The Manipulation of Language and Improper Questioning in Polls:
__________________________
PART A. BACKGROUND: VALUES LANGAUGE
1)
The Rise of a “values” approach to ethics
Judging by what is available in bookstores, there seems to be
significant interest in “healing” and “self-help” in today's society. In
philosophy, too, many writers speak of a need to restore wholeness or to
deepen “authenticity” as a means of overcoming aspects that are seen as
problematic. Many books have commented on the nature of the individual
in North American society in terms that speak of “alienation”,
“atomism”, “loneliness”, “narcissism” and “individualism”. And in the
midst of all this, in all the western countries, we seem to be suddenly
fascinated with death and talk of the right to die when and how we want.
And this quest for death is discussed, as abortion used to be, in the
language of autonomy, choice, and dignity and in “rights” themselves.
This essay attempts to link, in a general way, this desire for wholeness
and meaning with an aspect of current language which, it is argued,
points to a loss of learning which deeply affects our ability to speak
of goodness with conviction. The rise of insecurity about what is “good”
and “bad” affects all aspects of society including law itself.
The courts determine what the law is and how it applies to specific
disputes. The role of the courts has always been important in affirming
the symbolic role of law as well as its practical outworking. People
will never stop murdering one another, but it is important to maintain
our collective revulsion for murder by keeping the law against it on the
books, the penalties severe and the enforcement as effective as
possible.
The current philosophical discussions referred to above are not
discussed in legal judgments which necessarily focus only on the matter
at hand. However where “fundamental rights and freedoms” are being
discussed by the courts, as they must be in evaluating the Canadian
Charter of Rights and Freedoms that Canada adopted in 1982, the judges
must occasionally venture out upon deeper philosophical waters. The
courts are, however, wary about discussing the nature of human
flourishing and human happiness. This is perhaps understandable given
the nature of legal (and general) education which has not, for many
years, dealt with philosophical concepts with any rigour. In fact, a
rigorous examination of philosophy is not required in most Canadian law
schools and it is courses in the technique of law, not the purpose of
law, that dominate.
This separation of technique from purpose is visible in every area of
human endeavour and reflects the separation of articulated philosophy
from education. Many have suggested that it is education that is the
wide-spread cause; or, rather, what education does not do. Some have
said, that education is not occurring and has been replaced by
“schooling”. Education would require a grounding in these deeper areas.
In the former idea of education, the liberal arts were the artes
liberales, from the Latin root for freedom: learning about the truth
enabled us to be free from the shackles of being chained to what was
only of our particular time (truth being eternal). The basis of all
philosophy is the belief that there are better and worse things. The
study and the work are in identifying on what basis we say some things
are better or worse than others. The first principle of all moral
philosophy has been said to be: We ought to desire whatever is really
good for us and nothing else. [1]
Would many endorse this statement today? I suspect that many would
not because they have been taught that “goods”, like “values” are
necessarily relative, one person's not being the same as the others. Yet
is this quick dismissal satisfactory? Do we actually occupy a world of
consistent relativism? I do not believe that we do and have come to the
conclusion that our discussion has become obscured by language which is
increasingly ambiguous and that masks the fact that we have, in fact,
many beliefs which we share in common because they are “good”. In
holding such views, moreover, we intend to assert that such concepts are
“good” not because we think they are but because they are, in the nature
of things — in reality. That others may disagree with us is not due to
truth being relative but to something else. To take an admittedly
extravagant example, few would agree with a person who said that they
believed it was a good thing to rob banks at gunpoint. Most would say it
was a bad thing and they would not accept another person's arguments to
the contrary even if it was a part of that person's “values system” to
assert such a thing. We recognize that “values” can differ but we do not
allow “values” to act as a cover for actions we consider corrupt.
Let us take a look at the term “values”. When we speak of our values
do we actually mean that they are purely individual and that we do not,
in some sense, have an obligation to respect these “values”? While we
may take it as a foundational principle that “my values” and “your
values” are necessarily personal, do we actually mean by this that this
state of affairs is a good thing? Do we think about “values” that we
mean to be or hope to be shared? I believe that we do in fact use
“values” in this way as well.
At a conference on medical ethics which I recently attended (and I
know this kind of language is everywhere in educational materials — such
as the Year 2000), speaker after speaker address such notions as
“community values”, “shared values” and “fundamental values”. These
speakers apparently addressed notions which they thought important
because they had some validity beyond merely their valuing them as
individuals. How is a “fundamental value” fundamental if it can or
cannot be accepted by any particular person? Recall Mortimer Adler's
point (footnote #1 to this paper) about “human
rights” having some meaning because we recognize a validity to such
rights for all people and all countries. We would not for a moment
accept as valid the statement by a national leader who said something
like this: “those human rights are your values, they are not the values
of my country”. Would we not counter such a suggestion by saying that
such “values” ought to be recognized by all countries? But once we
insert the term “ought” into the argument, we have stepped beyond the
language of “values”, or, at the very least, highlighted a problem with
using such an ambiguous language.
In fact, it is interesting to look into the history of the use of the
term “values”. When we do so, we see that it is a usage that is very
recent. The philosophers who have considered the term have pointed out
that it came into Western usage from the German philosopher Nietzsche.
He was the philosopher of the will who advocated the triumph and
domination of the will. He spoke of the need to have a “transvaluation
of all values” in which goodness would be only what we willed it to be
and not what was given to us in the nature of things.
The person generally considered to have been Canada's leading
political philosopher, was the late George Grant. Grant's several books
raise profound questions for our time. He was one of the clearest
writers on the phenomenon of “values language” which, as he once noted
in a Canadian Broadcasting interview is “... an obscuring language for
morality, once the idea of purpose has been destroyed. And that's why it
is so widespread in North America”. [2]
“Everybody uses the word “values” to describe our making of the
world”, says Grant:
... capitalists and socialists, atheists and avowed believers,
scientists and politicians. The word comes to us so platitudinously
that we take it to belong to the way things are. It is forgotten
that before Nietzsche and his immediate predecessors, men did not
think about their actions in that language. They did not think they
made the world valuable, but that they participated in its goodness.
[3]
Grant then comments how use of “values language” by those who do not
accept what it leads to, actually leads to a contradiction of many
peoples' more deeply held notions.
What is comic about the present use of “values”, and the distinction
of them from 'facts', is not that it is employed by modern men who
know what is entailed in so doing; but that it is also used by
'religious' believers who are unaware that in its employment they
are contradicting the very possibility of the reverence they believe
they are espousing in its use. [4]
The use by both religious and non-religious people of “the language
of values” is ubiquitous. The term “values”, like others (such as
“pluralism”) is often used in areas of moral debate to bridge the gap I
have been trying to describe between a personal language of meaning and
a sense that there must be shared goods. The need for a “bridge” is
obvious once one thinks about it, for the reasons I have tried to
describe above. However, what I want to stress here is that these
language bridges obscure rather than facilitate meaningful dialogue
about goodness. This is an important point because language is central
to our defense of goodness itself. Once corrupt a people's ability to
speak about goodness and truth and you soon hamper their ability to
think about goodness and truth. Language is related to thought and
thought precedes action.
Garbled language about truth eventually disables the ability to act
and virtuous action was once seen and understood to be a key to human
happiness itself. The Biblical account of the Tower of Babel and
Orwell's accounts of language manipulation in his novel 1984 both
speak to the relationship between language, meaning and human purposes.
In identifying this chain of thought, we are now closer perhaps to
identifying why books on “self-help” and “healing” are so prevalent at
the very time when our language about virtue and goodness has become so
confused. There is a deep poignancy in this two-fold phenomenon because
it points both to our longing for communal goods which we wish to assent
to and search for together and to our cooption by a language which
undercuts this very effort. How ironic that our very search for meaning
is undercut by a language which in its relativistic ambiguity precludes
the very meaning we seek in its use: — our compasses have damaged
needles.
What has occurred, in part, is that the belief in intrinsic
worth (which is the Oxford English Dictionary definition of the
word “value”) has been replaced with the idea that the individual him or
herself determines (or “creates”) worth, there being nothing “out there”
to discover. Such usage of the term “value” may have plausibility when
one is discussing aesthetic choices such as cut of clothes. Such use,
however, becomes erroneous when such things as “the value of human life”
are being discussed. Yet the modern use does not make a distinction and
renders all “value” ultimately personal.
In Canada one frequently hears people suggest that it is improper for
people to attempt to force their personal values on others by way of
law. This presupposes that there is such a thing as a “value-free” law.
However law is about norms, and normative statements, no matter how one
may attempt to dress them up, are not “value-neutral”.
But note how far from any sense of “intrinsic” worth such a notion of
“value” has come. There is no basis upon which one may assume that what
“consensus” achieves will bear any relationship to an objective truth at
all. [5] In fact, the notion of objective truth
has been lost sight of altogether. If applied to governmental policy
formation, this approach amounts to the ship of state being steered in
the direction in which the bow happens to be pointed at the moment.
Grant sees the modern creation of values approach as a sharp contrast
to earlier ways of viewing the world. In this modern view of life:
Man makes the world, and there is no overall system which determines
what he makes. To act is to choose what kind of a world we want to
make. In our acts we show what things we regard as valuable. We
create value, we do not participate in a value already given. We
make what order there is; we are not made by it. In this sense we
are our own; we are independent. We are not hound by any dependence
on anything more powerful than ourselves. We are authentically free
because what happens in the world depends on us, not on some
providence beyond our control. The fate of man is in his own hands.
We and not God are the creators of history. [6]
Joseph Power comments that:
those who lived through the shift of meaning were largely unaware of
it because they assumed that the terms were equivalent. And now as
long as we assume that “values” is just a contemporary way of
speaking of the good, or conversely that the language of the good
and of the excellence of man as man is “just a crude way of talking
about values, pretending that they have some status in the nature of
things beyond our choosing,” we hardly notice the linguistic
substitution. Grant is saying, however, as forcefully as he can,
that “values” is not the equivalent of what has been meant by “the
good.” [7]
The ubiquitous use of “values language” ought to make us aware of the
extent to which the moral universe many of us think we inhabit has been
ignored (or usurped) by modern relativistic notions which if we
recognized them many of us would reject. We can see examples of
value relativism everywhere. It is particularly prevalent where issues
relating to ethics are being debated. Sue Rodriguez, who so narrowly
failed to get the Supreme Court of Canada to find a constitutional right
to physician assisted suicide, expressed the modern view succinctly as
follows:
Why on earth would anyone want to impose their own value system on
me? I've got mine, they've got theirs. [8]
In fact, the international euthanasia debate provides many good
examples of the indeterminacy of "values" language. Ethicist Eike Kluge
from Victoria, in his presentation before the Senate Special Committee
on Euthanasia and Assisted Suicide, made the following statements about
values that serve to illuminate aspects of the problem of values
language:
Everyone is embedded in a social context, and that context shapes
our expectations but also our values. There are two points that are
important here, namely: the values are the primary determinate of
how individuals will exercise a particular right, and second, that
members of society usually come to accept the values of the society
in which they are embedded.
...[Where a proxy must make the decision in a person's place]
making a decision involves the application of a value to the options
that obtain. Consequently, if a proxy decision-maker has been given
no values to use, the proxy cannot make a decision, in which case
the proxy decision-maker is faced with the obligation of making a
decision but not having the tools with which to make it.
Proxy decision-makers, therefore, have two options. They may use
their own values, or they may use the values of the social context
in which the incompetent person is embedded. For reasons that I have
outlined elsewhere, the first is ethically unacceptable. The second
is correct. It is the only way in which it is possible to exercise
the right of choice for the now incompetent individual.
Therefore, I submit that people whose values differ from the
societal context have an obligation to inform others that this
is the case, lest for want of such notice they should be treated
according to prevailing societal values and receive treatment which
their values would label anathema. Correlatively, society has the
right to assume that people who have not given indication of such
difference share the prevailing societal values.
[This brings me to the exception. If previously competent persons
have made no disposition, if a decision must be made, and if,
finally, the prevailing societal values would be in favour of
deliberate death under the circumstances, then the duly empowered
proxy decision-maker must request deliberate death. In fact, for the
proxy not to act in this fashion or for society to refuse to honour
such a proxy request would be for society to discriminate against
the incompetent person on the basis of handicap.]
[9]
We might ask, however, if values are merely personal, the
product of autonomous will, where do we go to find “societal values”?
How do we know that "societal values" bear any relation to what is, by
any standard, "good"? History, even contemporary history, is full of
situations in which societies are doing things most would consider wrong
or unjust. Do we actually believe that results of polls, or the desires
of the majority are satisfactory ways of determining over time what is
"right" and "wrong" in society? The Royal Commission on New Reproductive
Technologies thought not, in some of its recent analysis, and for this
reason decided to disregard the views of the majority of Canadians who
did not believe that lesbians should have access to donor insemination.
The Commission said that
As we made clear in Part One of this report, the Commission believes
that society's approach to new reproductive technologies should be
governed by the social values of Canadians. We are also aware,
however, of the difference between social values and individual
opinions. We believe that social values held by Canadians are
reflected in the Canadian Charter of Rights and Freedoms, and the
prohibitions on discrimination it contains must be our guide in this
matter. [10]
In "The Poison of Subjectivism", an essay published in 1943, C.S.
Lewis comments on the different way in which moderns view "judgements of
value". He states:
Until modern times no thinker of the first rank ever doubted that
our judgements of value were rational judgements or that what they
discovered was objective... The modern view is very different. It
does not believe that value judgements are really judgements at all.
They are sentiments, or complexes, or attitudes, produced in a
community by the pressure of its environment and its traditions, and
differing from one community to another. To say that a thing is good
is merely to express our feeling about it and our feeling about it
is the feeling we have been socially conditioned to have.
[11]
Lewis views the modern enterprise as a rejection of what he termed
"traditional values" and states that:
This whole attempt to jettison traditional values as something
subjective and to substitute a new scheme of values for them is
wrong. It is like trying to lift yourself by your own coat collar.
Let us get two propositions written into our minds with indelible
ink.
- The human mind has no more power of inventing a new value than
of planting a new sun in the sky or a new primary colour in the
spectrum
- Every attempt to do so consists in arbitrarily selecting some
one maxim of traditional morality, isolating it from the rest, and
erecting it into an unum necessarium.
[12]
This impossibility of creating values means that one must, in a
sense, take certain things as one finds them:
Either the maxims of traditional morality must he accepted as axioms
of practical reason which neither admit nor require argument to
support them and not to 'see' which is to have lost human status; or
else there are no values at all, what we mistook for values being
'projections' of irrational emotions. [13]
As Lewis says by way of summation, "...a philosophy which does not
accept value as eternal and objective can lead us only to ruin" and:
If 'good' means only the local ideology, how can those who invent
the local ideology he guided by any idea of good themselves? The
very idea of freedom presupposes some objective moral law which
overarches rulers and ruled alike. Subjectivism about values is
eternally incompatible with democracy. We and our rulers are of one
kind only so long as we are subject to one law. But if there is no
Law of Nature, the ethos of any society is the creation of
its rulers, educators and conditioners; and every creator stands
above and outside his own creation. Unless we return to the crude
and nursery-like belief in objective values, we perish.
[14]
Again Lewis asserts that "a dogmatic belief in objective value is
necessary to the very idea of a rule which is not tyranny or an
obedience which is not slavery". [15] [Here
one might refer to the German jurist Gustav Radbruch, who, just after
the second world war, indicated that law must be rooted in norms that
transcend the state and made an impassioned plea for the necessity of
natural law as a recognized grounding for civil law]. Again, Lewis,
commented on the shift he saw occurring, and, just a couple of years
before Radbruch, wrote:
For the wise men of old the cardinal problem had been how to conform
the soul to reality, and the solution had been knowledge,
self-discipline, and virtue. For magic and applied science alike the
problem is how to subdue reality to the wishes of men: the solution
is a technique; and both. in the practice of this technique, are
ready to do things hitherto regarded as disgusting and impious...
[16]
Throughout the centuries many of the greatest thinkers have discussed
the importance of learning and preserving the central truths which
define the society. These truths are not relative or subjective but
transcendent. Michael Polanyi has written that:
...the adherents of a great tradition are largely unaware of their
own premises, which lie deeply embedded in the unconscious
foundations of practice... if the citizens are dedicated to certain
transcendent obligations and particularly to such general ideals as
truth, justice, charity, and these are embodied in the tradition of
the community to which allegiance is maintained, a great many issues
between citizens, and all to some extent, can he left — and are
necessarily left — for the individual consciences to decide. The
moment, however a community ceases to be dedicated through its
members to transcendent ideals, it can continue to exist undisrupted
only by submission to a single centre of unlimited secular power.
[17]
That many people in our society “are largely unaware of their own
[moral and ethical] premises” is a fact. The purpose of raising these
concerns here is to point to a body of academic opinion that ought not
to be ignored. This body of academic opinion states categorically both
that it is necessary to know transcendent ideals (such as the "sanctity
of human life" or the “inherent dignity of the human person" or "the
essential wrongness of actively taking innocent life") and also that the
modern age is rife with a language which obscures purpose and leads to a
rampant and lonely individualism that threatens community. As was said
in the influential book Habits of the Heart:
....we have never before faced a situation that called our deepest
assumptions so radically into question. Our problems today are not
just political. They are moral and have to do with the meaning of
life. We have assumed that as long as economic growth continued, we
could leave all else to the private sphere. Now that economic growth
is faltering and moral ecology on which we have tacitly depended is
in disarray, we are beginning to understand that our common life
requires more than an exclusive concern for material consumption.
[18]
Certain contemporary writers have written about the effect of a
failure to teach the precepts of traditional morality and the difficulty
that modern ethical theories pose to our understanding of ourselves in
the modern age. These writers are invaluable for understanding what has
happened and is happening to us on the moral level.
[19]
In various ways, these contemporary writers comment on different
aspects of the emotivism that passes for moral discussion in the present
day. "Emotivism", which dovetails with "values language" is defined by
one commentator as:
....the doctrine that all evaluative judgments and more specifically
all moral judgments are nothing but expressions of
preference, expressions of attitude or feeling, insofar as they are
moral or evaluative in character...moral judgments, being
expressions of attitude or feeling, are neither true nor false; and
agreement in moral judgment is not to be secured by any rational
method, for there are none. It is to be secured, if at all, by
producing certain non-rational effects on the emotions or attitudes
of those who disagree with one. We use moral judgments not only to
express our own feelings and attitudes, but also precisely to
produce such effects in others. [20]
Such a development, the writer continues, has led to a situation in
which “...morality has to some large degree disappeared — and this marks
a degeneration, a grave cultural loss.” [21]
These writers point Out the fact that such a diminution of the moral
framework in theory has not, in all circumstances been represented in
practice. They note, for example, how many people will accept
uncritically the notion that "values" are merely personal, one person's
being on par with the next and then will use analysis or make comments
indicating that they believe in or are using concepts of objective good.
Thus, some people may enunciate, in one breath, a view that morals are
purely subjective then, in the next, condemn apartheid, environmental
polluters or Colombian drug barons, oblivious to the fact that they
have, at the root of their views, a massive contradiction. We are
becoming incapable of speaking about things that we consider must still
be objectively true [22].
CANADIAN JUDGES:
The situation as far as judges are concerned is more dire because of
the practical consequences of their impoverishment. They are vested,
amongst other things, with the duty to interpret the Canadian Charter
of Rights and Freedoms: in doing so they are forced, in the midst of
this vacuum of education, to give meaning to such general (and deeply
philosophical) concepts as "freedom of association", "freedom of
religion", "security of the person" etc.. At a conference held a few
years ago at the University of British Columbia, Mr. Justice Willard
Estey, who should be admired for his candour, stated that the judges are
not trained in the very area for which we are looking to them for
guidance.
There are many examples of the difficulty the courts are having
articulating a coherent approach to fundamental issues in society. Some
might say the Rodriguez case itself (on the question of
physician-assisted suicide) was such an example. I would like to examine
another case, one in which the nine judges of the court were unanimous
as to the approach to take. The judges were unanimous, but, as shown
below, incoherent.
The case of R. V. Butler [1992] 2 W.W.R. 577 involved the question of
the definition of obscenity in the Criminal Code. In upholding
the Criminal Code definition against a Charter challenge
on the basis of the "freedom of expression", the court was at pains to
attempt to base the restriction on pornography on the "harm" it does
even though it could not establish a clear causal connection between the
existence of pornography and harm arising from it. The court could not
avoid the fact that such a restriction depends upon a moral basis yet it
undercuts determining a valid ground for moral evaluation by saying that
it must be found in the Charter itself. This is a nonsensical
approach because the Charter is an open ended document that
states its rights in outline and in the broadest of terms. The court, in
dealing with a Charter case, once it has found a breach of a
particular guaranteed right, must determine ultimately whether the
breach or limitation is demonstrably justified in a free and democratic
society; and this is an external analysis, involving matters not to be
found in the Charter itself.
It can be observed in the passages which follow, therefore, that the
court, by seeking to avoid a particular moral framework, cannot erect
any moral framework and ultimately ends up creating an entirely circular
approach that makes moral articulation impossible. Mr. Justice Sopinka,
in giving the majority judgment of the court [23]
stated, at p.p. 606-607, that it is no longer an appropriate objective
of law "...to advance a particular conception of morality" and that:
....this particular objective is no longer defensible in view of the
Charter. To impose a certain standard of public and sexual
morality, solely because it reflects the conventions of a given
community, is inimical to the exercise and enjoyment of
individual freedoms, which form the basis of our social contract. D.
Dyzenhaus, "Obscenity and the Charter: Autonomy and Equality"
(1991), 1 C.R. (4th) 367 at p.270, refers to this as "legal
moralism," of a majority deciding what values should inform
individual lives and then coercively imposing those values on
minorities. The prevention of "dirt for dirt's sake" is not a
legitimate objective which would justify the violation of one of the
most fundamental freedoms enshrined in the Charter.
On the other hand, I cannot agree with the suggestion of the
appellant that Parliament does not have the right to legislate on
the basis of some fundamental conception of morality for the
purposes of safeguarding the values which are integral to a free and
democratic society. As Dyzenhaus writes (at n. 376), "Moral
disapprobation is recognized as an appropriate response when it has
its basis in Charter values".
As the respondent and many of the intervenors have pointed out,
much of the criminal law is based on moral conceptions of right and
wrong and the mere fact that a law is grounded in morality does not
automatically render it illegitimate. [emphasis added]
Justice Sopinka then recognized that moral corruption and harm to
society are inextricably linked and “it is moral corruption of a certain
kind which leads to the detrimental effect on society” (p.608). But if
it is "moral corruption of a certain kind" that leads to the detrimental
effect on society, and Parliament has the right to legislate "on the
basis of some fundamental conception of morality" then it is simply not
possible to avoid "a particular conception of morality". Even at
its most basic level, if Parliament legislates it would necessarily
adopt a particular conception of morality (of whatever sort). Yet
this was the very thing that Justice Sopinka said at the outset was "no
longer appropriate". This is just another example of what might be
termed the epistemological insecurity (or incoherence) of modern
justice. The process of justice, due to the questions that come before
it, must deal with matters which raise moral issues and competing
philosophical approaches that could tax (and have taxed) the most
learned of philosophers.
With this sort of analysis from Canada's highest court, one wonders
how much longer Canada can afford to continue forms of schooling that
avoid an articulation of philosophy and a concomitant analysis of
purposes as well as techniques.
The fact that we speak of "rights" and "wrongs" in a language of
"values" that is at best ambiguous is a clue to a deeper impoverishment
on the level of moral learning. It is true that "the heart has its
reasons which reason cannot comprehend" but it is also true that reason
can offer a justification for action that can convince and inform those
who "feel" it is a good thing to do good but do not know how to argue
that we should.
When we think about it, is it not a part of a full life to talk and
to debate about the nature of life and love and goodness itself? In so
doing we are in a world that is much richer than that recent and now
almost dominant world of ambiguous "values" language. This new world, in
its implicit but uneasy relativism cuts us off from encountering the
truths we may or may not share but about which it is essential for us to
discuss. Even in our disagreements about what is true and good we share
more than we do when speaking to ourselves in the mirror of our personal
"values".
In discussing the approach which Socrates (5th century B.C.) took to
knowledge, it is useful to reflect upon what Sir R.W. Livingstone wrote
at p.xix of his Portrait of Socrates (Oxford: Clarendon, 1938):
“The true approach to knowledge was not through books or lectures, but
through conversation, discussion, question and answer, two or more
persons beating a subject up and down, till the chaff is winnowed from
the wheat...”
If we care about goodness and the community that is an aspect of
goodness, we must challenge the meaninglessness of "values": until we do
we shall not be able to speak meaningfully (or with authenticity) about
goodness and community or how to pursue them.
PART B: AN EXAMINATION OF
MISCELLANEOUS KEY POINTS:
1) Who Bears the Onus for a Change
in the Law?
Where what is being proposed is a radical revision of our traditional
understanding of the concept of the "sanctity" or "dignity" or "respect"
for human life, such a revision must be clearly grounded. We stand at an
uncertain pass: so uncertain that the status quo is to be
preferred on these matters. It is in circumstances such as these where
presumptions may be used. The Law Reform Commission of Canada has said
that:
The Commission believes that any reform having to do with human
life must begin by admitting a firm presumption in favour of
life [24]
In fact, the entire idea of law itself would crumble if we were to
accept the notions of law- making that underlie the arguments based on
autonomy. We cannot, in fact, cut off serious issues from all moral
evaluations. The phrase "the issue is choice" is just silly and cannot
form the basis of any workable moral system. It is a sleight of hand
that succeeded (in abortion) and is becoming more and more prevalent in
the euthanasia debates. The necessary (but not always easy) relationship
between law and morality has been commented on many times in Canada.
Note what the Law Reform Commission of Canada said about the role of the
criminal law in their Report Our Criminal Law, Ottawa: 1976:
In truth, the criminal law is fundamentally a moral system.
In may be crude, it may have faults, it may be rough and ready, but
basically it is a system of applied morality and justice. It
serves to underline those values necessary, or else important, to
society. When acts occur that seriously transgress essential values,
like the sanctity of life, society must speak out and
reaffirm those values. This is the true role of criminal law (at 16,
emphasis added). [25]
Mr. Justice Sopinka, speaking for the majority in Rodriguez, said
there is:
....a generally held and deeply rooted belief in our society that
human life is sacred or inviolable (which terms I use in the
non-religious sense described by Ronald Dworkin, Life's Dominion:
An Argument About Abortion. Euthanasia, and Individual Freedom
(New York: Knopf, 1993), to mean that human life is seen to have a
deep intrinsic value of its own). As members of a society based upon
respect for the intrinsic value of human life and on the inherent
dignity of every human being, can we incorporate within the
Constitution, which embodies our most fundamental values, a right to
terminate one's own life in any circumstances?
[26]
The majority of the Supreme Court of Canada answered this with a
resounding “no” and by articulating the respect for "the deep intrinsic
value" of human life, recognized that there are valid and necessary
limits to personal autonomy. We support that decision and go further to
say that no possible proposed legislation can show that the respect for
human life would be adequately protected so that it would be impaired
"as little as possible" [27] so as to satisfy
a constitutional challenge.
2) The Nature of Medical care and
the Compassionate Society
It is fundamental to the nature of medicine that there be trust
between the doctor and patient and that the doctor be trustworthy. It
has been said of this that:
The core minimal content for trustworthiness is that doctors can be
relied upon never to kill patients on the grounds that the patients
are thought not to have worthwhile lives.
For undergirding a coherent concept of justice in society and ethics
in medicine is:
the assumption that every human being simply in virtue of his or her
humanity has a fundamental worth and dignity and, consequently,
basic rights which are to be respected... In so far as doctors have
shifted from a position of fundamental respect for all human beings
to one in which they discriminate between human beings in terms of
acquired abilities and quality of life, they have not merely
abandoned what is required for just dealing with other human beings
in general, but they have also abandoned the core requirement of the
ethic which is internal to the practice of medicine.
[28]
The Canadian Medical Association Annual General Meeting in 1994
passed a motion that doctors should not be involved in intentional
killing or in assisting in suicide. Similar positions have been taken by
doctors groups in many other countries who recognize and maintain the
Hippocratic tradition which forbade intentional killing.
The word "compassion" means, to "suffer with". This is the role of
doctors and all those who have compassion for those who suffer. As
Vancouver doctor Margaret Cottle put it in her testimony before the
Senate Committee, "if we are walking along a bridge and we see someone
about to jump off do we say, 'here, let me give you a push'?".
3) The fact of “Botched Suicide”
does not Provide a Justification for Allowing Euthanasia:
A wrong does not create a right. It is interesting how many of those
who wish euthanasia or assisted suicide played a large part in the
horrific scenes they describe by insisting on killing themselves at
home. They never give good reasons for avoiding palliative programmes
but simply focus that it was not their choice to use them. They then
experience some horrible experiences in dying (the drugs didn't work
fast enough, the bag slipped off, the person vomitted up the pills etc.,
etc.). But such unpleasant scenes can provide no basis whatsoever for a
moral claim that the position of the law should change.
4) The Inability to Control
Euthanasia if it is Legalized:
Many people and groups would agree with the Report of the Select
Committee on Medical Ethics of the House of Lords
[29] when they found that "...we do not think
it possible to Set secure limits on voluntary euthanasia". The members
of this committee, who toured the Netherlands and rigorously examined
the system currently operating there, found that "it would be next to
impossible to ensure that all acts of euthanasia were truly voluntary,
and that any liberalization of the law was not abused"; moreover,
“...vulnerable people — the elderly, lonely sick or distressed — would
feel pressure, whether real or imagined, to request early death".
This Report is comprehensive both in terms of the groups and
people who appeared before it, and in terms of its analysis of many of
the same arguments you have before you. We hope that you will consider
it in detail while making your deliberations. In their Opinion, the
Committee concluded that:
Ultimately, however, we do not believe that these arguments are
sufficient reason to weaken society's prohibition of intentional
killing. That prohibition is the cornerstone of law and of social
relationships. It protects each one 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. We acknowledge that there are
individual cases in which euthanasia may be seen by some to be
appropriate. But individual cases cannot reasonably establish the
foundation of a policy which would have such serious and widespread
repercussions. Moreover dying is not only a personal or individual
affair. 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.
[30]
This fear that the legalization of euthanasia would "chill" the most
vulnerable amongst us has frequently been expressed by those appearing
before the Senate Committee and it was on this issue that the Washington
and California attempts to gain acceptance for euthanasia floundered.
The Oregon "Death With Dignity" legislation, on the other hand (which
allows physicians to prescribe lethal dosages for patients knowing the
patients intend to kill themselves) was full of measures that were put
forward as "safeguards" but would not have worked as such. Proponents of
euthanasia are learning just how much they can succeed with and, having
failed several times, are precisely crafting their legislation for
maximum public acceptability — in the full hope of then expanding it
more broadly, in other words, beyond the so-called "safeguards" [Glasgow
Conference in 1993]. Concerns for the vulnerable were a key factor
before the Lords Committee as well. [31]
A central weakness in basing a notion of a "right to euthanasia" on
personal choice or autonomy is that once one has a "right "to
euthanasia (in whatever form) on the basis of autonomy, there is no good
reason to limit it to the terminally ill or those in the last stages of
illness. Serious depression can be just as agonizing in its way as
physical suffering and is subjectively defined; a focus on autonomy must
require access to personal choice in both instances. To argue otherwise
is to ignore the nature of arguments based on autonomy or to erect a
sentimental barrier in the first instance that cannot withstand other
arguments over time. This was the German experience and is also the
Netherlands experience. Recall that in the Netherlands, a young woman
with anorexia was able to have euthanasia long before she was at a
terminal stage of illness. [32]
5. Ethics and the Position of Sue
Rodriguez: Should the Wishes of The Autonomous Self Drive Law Reform?:
The idea that the law consistently does (or can) require us to accept
the untrammelled choices of the autonomous self is an error. Yet, in the
euthanasia debate now, as with the abortion debate of a few years ago,
some approaches amount to this. For example, Prof. Kiuge, in his
testimony before the Senate Committee, referred to the Supreme Court of
Canada's general acceptance in Morgentaler of the importance of
personal conscience and beliefs, aspirations and values. If the idea is
that such a recognition somehow creates a right to the working
out of these beliefs then, with respect, this would be nonsensical.
[33] It may well be that "Sue Rodriguez's
conscience, beliefs, aspirations and values” were treated unequally. But
this is no basis to overturn the law; it is an invitation to look more
closely at the nature of the beliefs that are in conflict.
Quite apart from whether such actions are moral or not, the means of
taking ones' life are there for everyone (as Senator Keon, himself a
noted surgeon, pointed out during the Senate Hearings) refusing to eat
is a choice for death (to say nothing of its moral character). It is
simply dishonest to say that terminal patients do not have the means to
kill themselves. There is something else going on in their wish to have
others involved in their self-controlled deaths.
[34] In addition, it is key to recognize that being "pro-life" is
not the same as failing to recognize when death is the next natural
stop. It is important to recognize the importance of not prolonging the
process of dying when treatment has become excessive or burdensome.
There is a time at which it is perfectly valid to refrain from further
treatment. On these matters, the wishes of the patient must be
respected.
6. The Need to Distinguish Between
Withdrawing Treatment on the One Hand and Euthanasia and Assisted
Suicide on the Other:
Various writers now suggest, that the distinction between an allowing
a person to die and killing them, "while psychologically comforting" is
"ethically of no import". [35] The key to the
distinction is the reasons for a withdrawal of treatment and whether it
is being done with the intent of killing a person. If the intention is
to kill, then there is no difference between an act and the "inaction"
of withdrawing treatment. But this is not what is usually meant by those
who say there is no difference between an active role and a so-called
passive one. Again, and with respect to those who hold this view, they
are incorrect. Various examples they may give to illustrate the
similarity do not adequately recognize that only certain physician
non-actions are morally acceptable but in the case of "burdensome" or
"unnecessary" or "extraordinary" treatment at the end of life, such
inactions do not intend the end, they simply do not interfere
with an end that will happen naturally. The line is sometimes difficult
to draw but it is a crucial distinction for, without it, much of the law
relating to human acts would be weakened.
What could Prof. Kiuge mean, for example, when he states that the
palliative physician includes the death of the patient as part of his
intention to palliate. [36] The death of
the patient is an inevitability (given the nature of the illness) that
makes palliation an option.
The palliative physician no more intends the death than she or he
intended the illness that leads to it. Intent, far from being
irrelevant, or erroneous, as Prof. Kiuge suggests, is the essence
of the distinction. This was recognized by Mr. Justice Sopinka's
majority judgement in Rodriguez in the following terms:
....in the case of withdrawal of treatment, the death is "natural
-the artificial forces of medical technology which have kept the
patient alive are removed and nature takes its course. In the case
of assisted suicide or euthanasia, however, the course of nature is
interrupted, and death results directly from the human action
taken....
The administration of drugs designed for pain control in dosages
which the physician knows will hasten death constitutes active
contribution to death by any standard. However, the distinction
drawn here is one based on intention — in the case of palliative
care the intention is to ease pain, which has the effect of
hastening death, while in the case of assisted suicide, the
intention is undeniably to cause death. The Law Reform Commission,
although it recommended the continued criminal prohibition of both
euthanasia and assisted suicide, stated, at p.70 of the Working
Paper, that a doctor should never refuse palliative care to a
terminally ill person only because it may hasten death. In my
view, distinctions based upon intent are important, and in fact form
the basis of our criminal law. While factually the distinction
may, at times, be difficult to draw, legally it is clear. The fact
that in some cases, the third party will, under the guise of
palliative care, commit euthanasia or assist in suicide and go
unsanctioned due to the difficulty of proof, cannot be said to
render the existence of the prohibition fundamentally unjust.
[37]
The distinction has a long historical tradition, is rooted in notions
that are the basis of the criminal law (and all criminal law), and has
commanded a wide philosophical following. It is, therefore ethically
important, not "of no import" as Prof. Kiuge suggests.
[38] The key philosophically is that there is
no necessary moral difference between killing and letting die. But, as
an editorial writer in the influential British Journal of medical
ethics, noted:
....from the conclusion that there is no necessary moral difference
between killing and letting die it simply does not follow that they
are necessarily morally equivalent; all that follows is that there
are cases where letting die is morally equivalent to killing (and of
course vice versa)...
....The Dutch have instituted a social experiment which in the
coming years should give some indication of how justified or how
exaggerated such [slippery slope] worries are. Meanwhile spurious
philosophical claims or suggestions that when doctors forego
life-prolonging treatment their omissions are necessarily morally
equivalent to killing their patients must be rejected: in particular
such ideas should not be allowed to bolster nonsensical notions that
somehow doctors fall into the same moral camp as murderers unless
they do all they possibly can to prolong their patients' lives,
regardless of their patients' wishes, regardless of the burdens on
the patients, regardless of the costs and opportunity costs to
others, regardless of the quality of life prolonged and regardless
of the probabilities of achieving such prolongation.
[39]
7) The Concern That Legalizing
Euthanasia Would Conflict With the Good Of Palliative Care: The
Netherlands Experience:
Many people believe that palliative care is a good that should he
encouraged in society. Many of those involved in palliative care have
spoken of the fact that many people request euthanasia early in their
illnesses, out of fear and prior to the important stage at which
reconciliations etc. occur. The literature contains numerous
accounts, we all know of examples personally. The Senate Committee
hearings contained numerous accounts of people who were initially
insistent on their wish to he finished off, subsequently changed their
minds and expressed gladness that they did. Those learned in Palliative
medicine report how all requests for suicide disappear once fear of pain
is alleviated. In fact, the ability to treat pain has led Pieter
Admiraal, the Dutch euthanasia expert to say that it is unethical to
give euthanasia for pain because pain can be treated.
A fact that needs to be emphasized, however, is that physicians are
not yet routinely trained in palliative medicine or the most current
methods of pain management. Before the Senate, many groups of Palliative
care-givers complained of the poor training of physicians and urged the
Senators to recommend additional training rather than euthanasia. Easy
recourse to euthanasia would work against such goods.
Moreover, experience elsewhere tells us that once the ethic of death
is embraced, the ethic of care withers. It is well known that the
Netherlands has almost no palliative care, and in the opinion of one of
the experts who appeared before you and has studied the situation:
....it is noteworthy that one of the great laggards tin instituting
palliative care in Europe] is the Netherlands.
The evidence for this is that an examination of the use of
pain-relieving drugs is relatively so small in the Netherlands,
compared with countries where palliative care is good, that they
could not possibly be getting even basic symptom relief as a basis
for which care can be given... [40]
Its ethic of "easy death" has not led to the establishment of the
ethic of care that is the proud hallmark of palliative care
professionals. Some of these have told you they fear that palliative
care, which needs to he encouraged by Canadian society, would suffer a
set-back or not be introduced at all if euthanasia were to he legalized
in Canada.
The Senate Committee heard that 95% of people surveyed in nursing
homes in the Netherlands opposed euthanasia and that 60 % of the general
population are afraid of involuntary euthanasia.
[41]
These are extraordinary statistics! No less extraordinary was the
testimony of the Dutch Physicians League before the House of Lords
Committee to the effect that:
What public support there was for euthanasia [came from] clever
campaigning by the media and by the Dutch Voluntary Euthanasia
Society. Many who supported euthanasia did so after witnessing the
painful dying of relatives or friends, but this could be avoided
by concentration on improving treatment.
[42]
8. The Media, The Manipulation of
Language and Improper Questioning in Polls:
Anyone who read the press coverage of the Rodriguez case will
be familiar with what is meant by "clever campaigning by the media". In
the light of the portrayal of Ms. Rodriguez in the media, it is, to say
the least, sobering to read the Hobbs Birnie book about her tragic life
and death. Recently Phil Marchand, Senior Books columnist at the Toronto
Star has published some Reflections on the Media in which he has noted
that the primary purpose of the media today is to titillate and
generally entertain. Yet the media's ability to influence what
"evidence" people are aware of has a lot to do with how a story is
perceived. It was for this reason that the media images of Sue
Rodriguez, when compared with the stark commentary of Hobbs Bimie's
book, was so shocking. What was not discovered or disclosed was
absolutely relevant to the issue of assisted suicide.
In addition, some commentators have noted that the form of
questioning on polls can lead to sway poll results (referred to in Dr.
Margaret Sommerville's testimony before the Senate Committee). One ought
to be more than a little skeptical about embracing euthanasia in these
circumstances without being extremely careful about ones sources for
information. [43]
PART C. CONCLUSION: THE PERSON IN
COMMUNITY IN CANADIAN SOCIETY
Sue Rodriguez's anguished question as to who owned her life, could
have been answered much better than it was by a society that recognized
that her tragic loneliness and anger were the very key to her personal
isolation. Palliative care could have helped her but, in the end, in the
poignant words of someone who knew her:
She had an aching soul, and never had internal peace. She wouldn't
let love in. and when you are starved for love, you sabotage any
attempts people make to give it to you. There's a sort of attitude:
love me, leave me alone. If you love, you can forgive and let go of
the anger. I can say goodbye without a terrible resentment. But
anger was Sue's foundation. Her identity was based on it.
[44]
It is the task of all of us who are concerned with alienation,
loneliness and despair in society to do what we can to encourage those
practices which assist support, care, nurture, hope and the progress of
love. No close reading of Hobbs Birnie's account of Sue Rodriguez's
death and life can fail to move us by the tragic circumstances of that
life and her inability to reconcile with those who were closest to her.
In testimony before the Canadian Senate Committee on Euthanasia and
Assisted suicide, a highly experienced palliative care physician quoted
an AIDS patient as having found the following theory in the suicide
literature as he lay dying: "Many suicides want the fullness of
control of their death because they could not control their lives.
It is a tragic indictment, but it does explain the control".
[45] This powerful conclusion should he read
along-side Sue Rodriguez's life, it should be kept in mind for every
life where suicide is being sought rather than palliative care.
Euthanasia enters humbly and speaks the language of "dying with dignity"
and "freedom of choice" within an age befuddled by ambiguous "values"
language. In the experience of those who live near it, however, the
spirit that the practice generates ends up further fracturing the moral
code, and increasing what is already too present: isolation, evasion,
hypocrisy and fear.
ENDNOTES
- Mortimer J. Adler, Ten Philosophical Mistakes (MacMillan:
New York, 1985) p.125. In Chapter 5, "Moral Values", Adler points
out the history of the mistakes that end up reducing moral judgments
to mere opinion. He notes that unless there is a similarity of human
needs for all human beings everywhere "... we would have no basis
for a global doctrine that calls for the protection of human rights
by all the nations of the earth" (p.127). Back to
text.
- “The Moving Image of Eternity", written and produced by David
Cayley, C.B.C. "Ideas", January 27, February 3, 10, 1986
(rebroadcast since then) transcript p. 17 Back to
text.
- Time as History (Toronto: C.B.C.,1969) p.p. 44-45.
Back to text.
- ibid. p.45. Those further interested in this point should
consult a perceptive and pivotal essay by Joseph F. Power, "Grant's
Critique of Values Language” in Larry Schmidt ed. George Grant in
Process (Toronto: Anansi, 1978) p.p. 90 — 98. Back
to text.
- "Consensus" is another word which can rightly join the list of
those such as "values" and "pluralism" which, if not properly
understood, may be used in a manner which vitiates attempts to deal
meaningfully with moral truth. Back to text.
- Philosophy in the Mass Age (Toronto: Copp Clark 1966)
p.40. Back to text.
- Power, above, note #4, p.94. Back to text.
- Quoted in Lisa Hobbs Birnie, Uncommon Will: The Death and
Life of Sue Rodriguez (Toronto: Macmillan, 1994) p.116.
Back to text.
- Eike-Henner W. Kiuge, Proceedings of the Senate Special
Committee on Euthanasia and Assisted Suicide, (Thursday, March,
17, 1994) Issue No.2, at p.p. 2:20-2:21. Back to
text.
- Proceed With Care, Report of The Royal Commission on New
Reproductive Technologies (Ottawa: Canadian Communications Group,
1993) at p.456, emphasis added. Back to text.
- "The Poison of Subjectivism" in Walter Hooper ed., Christian
Reflections (London: Bles, 1967) p.p. 72 — 81 at 73.
Back to text.
- ibid. p.p.74 — 75. Back to text.
- ibid. p.75. Back to text.
- ibid. p.81 Back to text.
- ibid. p.46 Back to text.
- ibid. p.48 Back to text.
- Science, Faith and Society (Chicago: Chicago Univ. Press,
1966) p.76 Back to text.
- Robert N. Bellah et al. Habits of the Heart (New York:
Harper & Row, 1986) p.295. Back to text.
- See, for example, the books by George Grant referred to in the
text, and: Mortimer J. Adler, Reforming Education (New York:
Macmillan, 1988); Robert Bellah et al. Habits of the Heart
(New York: Harper & Row, 1986); Allan Bloom, The Closing of the
American Mind (New York: Simon and Schuster, 1987); Robert
George, Making Men Moral: Civil Liberties and Public Morality
(Oxford: Clarendon, 1993); Christopher Lasch, The Culture of
Narcissism (New York: Warner, 1979); Alasdair MacIntyre's,
After Virtue (Notre Dame: Univ. of Notre Dame, 2nd ed. 1984) and
Whose Justice? Which Rationality? (Notre Dame: Univ. of Notre
Dame,1988); Charles Taylor, Sources of the Self (Cambridge:
Harvard Univ. Press, 1989) and The Malaise of Modernity
(Toronto: Anansi, 1991). Back to text.
- Alasdair Maclntyre, After Virtue (Notre Dame: Univ. of
Notre Dame, 2nd ed., 1984) pp.11-12. Back to text.
- ibid. p.22. Back to text.
- Yet, in being critical of subjectivism, there is an important
point that has been aptly put by Charles Taylor: ....we have to
avoid the error of declaring those goods invalid whose exclusive
pursuit leads to contemptible or disastrous consequences The search
for pure subjective expressive fulfilment may make life thin and
insubstantial, may ultimately undercut itself....but that by itself
does nothing to show that subjective fulfilment is not a good. It
shows only that it needs to he part of a 'package', to be sought
within a life which is also aimed at other goods...a dilemma doesn't
invalidate the rival goods. On the contrary, it presupposes them.
Sources of the Self (Cambridge: Harvard Univ. Press, 1989) at
p.511. Back to text.
- Mr. Justice Sopinka spoke for himself and six other judges. The
minority reasons of Gonthier J. agreed with those parts of Sopinka's
judgment here referred to. On the analysis being discussed,
therefore, the nine judges of the Supreme Court of Canada were
unanimous. Back to text.
- The Law Reform Commission of Canada, Working Paper No.28
Euthanasia, Aiding Suicide and Cessation of Treatment, 1982,
p.36 emphasis added. Back to text.
- Recall the first section of this brief for a moment, it is
interesting to note that this Report, which contains many excellent
passages about the criminal law and morality, also contains "values"
usage which confuses its weightier claims. The heading of Chapter
III, for example, is entitled "Criminal Law and Values" yet, only a
few lines of text below this, the statement is made that "Crimes are
not just forbidden, they are also wrong" (p.5,emphasis added). Yet
"wrongs" mean more than that a particular person does not personally
have them as part of his or her values. The difficulty the learned
authors of the Report have in articulating the difference is a mark
of how confused discourse has become; a confusion reflected in part
by an obscuring language of values. Why societies adopted that
language, like the question of why we are now seriously considering
euthanasia, are questions that are not resolved in this brief but
are touched upon throughout it. Back to text.
- Rodriguez v. B.C. (A. — G.) (1993)107 D.L.R. (4th) 342 at
p.389. Back to text.
- ibid. p. 411 Back to text.
- Luke Gormally “The Practice of Medicine and the Need for Moral
Consensus” in J. Glasa ed., Contemporary Problems of Medical
Ethics in Central Europe (Bratislava: Institute of Medical
Ethics and Bioethics, 1992) p.15 at p.p. 17 – 18, p.24.
Back to text.
- House of Lords, Report of the Select Committee on Medical
Ethics,(London:HMSO,1994) (hereinafter "Lords' Committee
Report"). Back to text.
- ibid., p.48 para.237, emphasis added
Back to text.
- Proceedings, p.p. 5:10; 6:49 and the Lords Committee
Report, p.49, para. 239. Back to text.
- This has been called “a major weakness of arguments for
euthanasia...”in the “Statement on Euthanasia and Physician-Assisted
Suicide” issued by some of Canada's leading palliative care experts:
see, Journal of Palliative Care (Sumrner: 1994) 10:2, 80-81. A
useful review of “the slippery slope” in these areas is to he found
in Nat Hentoff's series of articles in New York's Village Voice in
1987. The entire series is collected and republished in The Human
Life Review Vol.15, No.2 (Spring, 1988) p.p. 52-88. Hentoff has
collected interesting first hand accounts of the situation in
Germany in the early decades of the century, from, amongst other, a
medical expert at the Nuremburg trials (Dr. Leo Alexander). The
accounts are required reading for any who assert that "what happened
in Germany could not happen here". Further research in the same
area, this time by a noted American novelist, Walker Percy (who was
also a physician), can be found in his novel The Thanatos
Syndrome (New York: Farrer, Straus, Giroux, 1987).
Back to text.
- Prof. Kiuge, Proceedings, p.2:15. Back
to text.
- The nature of suicidal choices have been the subject of some
study. A recent paper raising important questions is that by
Francois Sirois "Psychosis as a Mode of Exitus in a Cancer Patient"
Journal of Palliative Care ,9(4): 16-18. Emile Durkheim's classic
study Suicide (New York: Free Press, 1951), first published at the
end of the nineteenth century, raised many interesting questions
relating to the social life history of individuals. The most
wide-spread form of suicide according to Durkheim, is egoistic
suicide. This he characterized as: A state of depression and apathy
produced by exaggerated individuation. The individual no longer
cares to live because he no longer cares enough for the only medium
which attaches him to reality, that is to say, for society. Having
too keen a feeling for himself and his own value, he wishes to be
his own only goal, and as such an objective cannot satisfy him,
drags out languidly and indifferently an existence which henceforth
seems meaningless to him (p.356). [He also states that] there is a
certain parallelism between the development of homicide and that of
suicide (p.358). Finally, he says that “. ..we are only preserved
from egotistic suicide in so far as we are socialized”(p.376). All
of these ideas resonate with suggestions in our brief and ought to
prompt one to think a little harder about what might be prompting
the urge for legalized suicide at this time when our culture is
experiencing, in the words of Charles Taylor's recent Massey
Lectures, "The Malaise of Modernity" Back to text.
- Kiuge, Proceedings, p.2:21. Back to
text.
- ibid. p.2:23 Back to text.
- Rodriguez, above, at p.p. 405 — 406, emphasis added.
Back to text.
- See for example, the Lord's Committee Report, note #41, above
p.20, para.75 where the Crown Prosecution Service, in testifying
before the Committee, endorsed the doctrine of "double-effect",
stated that the intention of the doctor was key to culpability as
well as whether the doctor's actions caused the patient's death. On
all three points, therefore, they were in sharp disagreement with
Prof. Kiuge. Back to text.
- Raanan Gillon, “Euthanasia, Withholding life-prolonging
treatment, and moral differences between killing and letting die"
Journal of medical ethics, 1988, 14, 115 -117 at p.115 and
p.117. Back to text.
- Dr. Paul Henteleff, Proceedings, (Wednesday, May 11,
1994) p.5:18. Back to text.
- Dr. Margaret Scott, Canadian Cancer Society, Proceedings
(Wednesday, May 18, 1994) p.6:50. Back to text.
- Lords Committee Report, note #39, above, p.66, emphasis
added. Back to text.
- Dr. Margaret Sommerville, Proceedings (Wednesday, May 18,
1994) p.6:6 f.f. On the question of the manipulation of language,
this Committee should read an invaluable essay by George and Sheila
Grant entitled "The Language of Euthanasia". It is to be found in
Technologv and Justice (Toronto: Anansi, 1986) at p.p. 103-115.
Back to text.
- Dr. Sandra Elder, quoted in Lisa Hobbs Birnie, Uncommon Will:
The Death and Life of Sue Rodriguez (Toronto: Macmillan, 1994)
p.p. 137-138. Dr. Elder was, according to Hobbs Birnie “better able
to understand Sue's emotional state than anyone else”. Dr Elder is a
registered grief counsellor and counselling psychologist who met and
counselled Sue Rodriguez. It was Sue Rodriguez's wish for Dr. Elder
to speak with Hobbs Birnie and for the latter to write the book on
her life. Back to text.
- Dr. Margaret Scott, above, Proceedings p.6:52.
Back to text.
ACKNOWLEDGEMENT
Benson, Iain. “Some Aspects of the Euthanasia Debate.” presented at
the Catholic Educators Conference, 1995, Holy Cross Regional High
School, Surrey, B.C., February 17, 1995.
THE AUTHOR
Iain T. Benson lectures internationally on philosophical,
theological, and legal issues related to strategic cultural renewal. A
senior research fellow for the Centre for Renewal in Public Policy in
Ottawa, Canada, Benson studies the connections between public policy,
culture, moral discourse, and religious conviction. He has published
articles on abortion and education, and is an authority on the thought
and works of C.S. Lewis and G.K. Chesterton. Iain Benson is a member of
the Advisory Board of the Catholic Educator's Resource Center.
Copyright © 1995 Iain Benson
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