Dying with Dignity?

Americans have always been a very practical people.  Proof of this can be seen by examining the number of how-to books that make their way onto the bestseller lists.  One how-to book that is particularly noteworthy, entitled Final Exit, climbed to the top of the New York in September of 1991.  Derek Humphry’s bestseller was unique in that it was a practical guide on “self-deliverance and assisted suicide for the dying.”  Given the book’s popularity, it is not surprising that the demand for assisted suicide has been on the rise in our country.  Physician Assisted Suicide is considered one of the most effective remedies for restraining death.  There are a number of arguments that have been brought forth to defend this practice.  The reasoning ranges over a number of fields including: legal, philosophical, medical, practical, and economic arguments.  With the possibility of the State of California joining Oregon and Washington as states where assisted suicide is legal, it is important that the Church come to the defense of truth.

To begin it is necessary to define what one means when they speak of assisted suicide.  Dr. Timothy Quill, one of the champions of the cause of assisted suicide defines it as “the act of making a means of suicide available to a patient who is otherwise physically incapable of suicide, and who subsequently acts on his or her own.”  Although Dr. Quill and many proponents of assisted suicide differentiate it from euthanasia, the Church for her part views both though the same lens.  Each is an act of the intentional killing of an innocent human person for reasons of mercy.

At the heart of each of the arguments is the notion of the principle of autonomy.  Simply put this principle says that if a person gives free and informed consent then they ought to be in control of their own life and manner of death.

The legal arguments are founded upon this principle of autonomy.  Current American jurisprudence seems to recognize assisted suicide as a liberty interest.  To date, the Supreme Court refused to recognize assisted suicide as a fundamental right.  However in Vacco v. Quill (1997) and Washington v. Glucksberg (1997), the Court ruled that because it was a liberty interest it ought to be left it up to the states to decide.  Currently there are three US states (Oregon, Washington and Montana) in which assisted suicide is legal.

These arguments clearly confuse freedom with license.  In man, his freedom is the most “exceptional sign of his being made in the image of God” (Gaudium et Spes, 17).  However, this freedom does not extend to control over life and death.  That is not freedom but license.  “We are stewards, not owners, of the life God has entrusted to us. It is not ours to dispose of” (CCC2280).

Assisted-Suicide sign

Although the legal argument sits upon the philosophical principle of personal autonomy, there is another philosophical reason that is often put forth.  This viewpoint involves a functional definition of personhood in which a person has value only insofar as they can be useful to society.  This represents a reduced view of human dignity that is finds its basis in the writings of Thomas Hobbes, who defined dignity as “the public worth of a man, which is a value set on him by the commonwealth.”

The Church for her part places human dignity upon a threefold foundation with a permanent character that cannot be taken away.  Regardless of the extent to which a person suffers diminished spiritual and physical capacities, or even if he commits the most heinous sin, he still retains his human dignity.  This dignity is “manifested in all its radiance when the person’s origin and destiny are considered: created by God in his image and likeness as well as redeemed by the most precious blood of Christ, the person is called to be a ‘child in the Son’ and a living temple of the Spirit, destined for the eternal life of blessed communion with God” (Christifidelis Laici, 37).

In reflecting upon this threefold foundation we find an additional characteristic other than its permanence.  Human dignity is also something which is to be achieved and realized in “communion with God.”  This notion of dignity shows that even when ‘quality of life’ diminishes or perhaps hasn’t been ‘achieved,’ ­dignity can actually increase because of the response of the sick to their suffering.

The economic arguments are perhaps the most straightforward.  Supporters of assisted suicide argue that the economic resources that are spent treating a seriously ill person could be put to better use by the family or society as a whole.  This viewpoint is flawed in that it puts economic resources ahead of the life of a person.  We ought to recognize this and be willing to accept any economic burden that would accompany allowing a person to die in a manner that is commensurate with their inherent dignity.  Mercy consists not in aiding to kill a person, but in shouldering the burden of journeying to death with them.  This often includes not only an emotional burden, but an economic one as well.

The medical arguments usually involve an argument that appeals to the just principle of “treating like patients alike.”  If terminally ill patients with free and informed consent are able to refuse medical treatment that will prolong their deaths, then those who are suffering but are not dependent upon medical treatment to live, ought to be able to hasten death through assisted suicide.

This argument fails to distinguish between refusing an extraordinary measure and being allowed to die and acting with the direct intent of causing death in the patient.  The decision to refuse treatment may be based upon the excessive burden that the treatment places upon the person and not represent a direct choice to die.

From 1990 through 1998, Dr. Jack Kevorkian assisted in the deaths of over 130 people.  While he had in mind the goal of reliving the suffering of the afflicted, his motivation was of a more practical nature.  He argued that “if the patient opts for euthanasia…he or she can save anywhere from five to ten lives.  Now the death becomes definitely positive.”  His argument was that by donating their bodily organs, their death contributed to the good of society as a whole.  He is not alone in arguing for assisted suicide for “practical” reasons.

This is a misapplication of the principle of totality.  In its simplest form, the principle of totality holds that that under certain circumstances it is morally permissible to sacrifice the good of a part for the sake of the whole.  However there is an “essential difference between a physical organism and a moral organism.”  The organs of the body exist solely for the sake of the body while each human person does not exist for the sake of the whole of humanity.  Instead each human person has intrinsic worth and thus cannot be coercively sacrificed for the sake of the whole (Pope Pius XII, “Speech to Leaders and Members of the Italian Association of Cornea Donors and Italian Association for the Blind”).

We see then just how important the distinction between a physical organism and a moral organism is in determining the application of this principle.  A physical organism is one in which there is a unity on the level of essence.  Thus the relationship of part to whole exists if the part by its very nature has no finality outside the whole.  A moral organism however is a group of individuals that are bound together in some unity of action.  Each member of the group has a value that is intrinsically bound up with what (or more accurately who) they are rather than what they contribute to the community.  To kill another person for the sake of harvesting their organs is always morally wrong, regardless of the good that may come from it.

In conclusion, although many argue in favor of assisted suicide using legal, philosophical, medical, practical and economic reasoning, these arguments ultimately are flawed.  It is always contrary to the dignity of the person to directly intend their death by either an act of commission or omission.  Furthermore, we find that in allowing this to occur it only further promotes a culture of death, not just in the killing of the person, but in what it does to those who willingly participate.  As Archbishop Charles Chaput said, “in helping the terminally ill kill themselves we’re colluding not only in their dehumanization but our own.”


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