This is an interesting and rhetorically powerful argument, but I disagree with it for multiple reasons.
First, the author objects to a "government-run death apparatus" without seeing how one might say the same of his argument, namely, the status quo is a "government-run pain-permitting apparatus". That's pretty barbaric if you ask me. But we can leave that aside for now because the author will likely not agree on this point.
Second, having an extra option available to you does not make it impossible to take those other options (palliative care or a painful (more 'human' death?). I understand the thrust of the author's worry though. They think having this option available will lead to a coarsening of our moral senses, lead to a general indifference toward human life and perhaps lead some people to be pressured into assisted suicide so that they are no longer burdensome. These are valid concerns, but they are not unique objections to assisted suicide -- they are worries about badly designed policy without adequate safeguard. Perhaps the author thinks no amount of safeguards could prevent these bad things from happening, but that is an empirical question and no amount of rhetoric will change that. Absent a good reason to believe that having an extra option will NECESSARILY tip the scales toward all the bad thing the author points out, it's hard to see why we should agree with them.
Third, the author should consider the deeply paternalistic nature of what they're saying. The idea that grievous suffering is something worth bearing, individually or on a societal-level, is something reasonable people can disagree about. In the face of that disagreement, we can ask how ought we to accommodate reasonably disagreeing others? Clearly, banning assisted suicide imposes a set of values on others that they could reasonably reject. They are being FORCED to do something here. But there's a crucial asymmetry. Simply having the option does not impose values on others at all because no one is FORCED to take this option. The author’s real problem should be with being FORCED into this option rather than having it all together.
Beautifully said! It is, and should remain, the choice of the individual. The point of course is that whereas previously you had to have poison or a gun at home, now you can get some assistance when you've had enough. It's time for those who are so vehemently against it to meet people who wish to use it and go through the experience with them. Maybe then they'll understand better. Walk a mile in their shoes before you spout about how "terrible" and "immoral" it is.
The language about being forced overlooks the power of offering a choice.
Most people do not wake up making that supposedly primal philosophical choice of not killing themselves. Instead, most people, even seriously ill people, wake up living by default.
The philosopher David Velleman, who was (and maybe is, I'm not sure) in favor of euthanasia in principle but against it in practice, describes this problem by analogy. He's having a dinner party and you're not invited. You're just not going by default. If he invites you, though, you can choose to go or not to go, but the one thing you can no longer do is not go by default:
"Offering someone an alternative to the status quo makes two outcomes possible for him, but neither of them is the outcome that was possible before. He can now choose the status quo or choose the alternative, but he can no longer have the status quo without choosing it. And having the status quo by default may have been what was best for him, even though choosing the status quo is now worst. If I invite you to a dinner party, I leave you the possibilities of choosing to come or choosing to stay away; but I deprive you of something that you otherwise would have had - namely, the possibility of being absent from my table by default, as you are on all other evenings. Surely, preferring to accept an invitation is consistent with wishing you had never received it. These attitudes are consistent because refusing to attend a party is a different outcome from not attending without having to refuse; and even if the former of these outcomes is worse than attending, the latter may still have been better. Having choices can thus deprive one of desirable outcomes whose desirability depends on their being unchosen."
The offer of death works similarly. You can choose to live or choose to die, but the one thing the mere offer takes from you is the possibility of living by default:
"Once a person is given the choice between life and death, he will rightly be perceived as the agent of his own survival. Whereas his existence is ordinarily viewed as a given for him - as a fixed condition with which he must cope - formally offering him the option of euthanasia will cause his existence thereafter to be viewed as his doing.
The problem with this perception is that if others regard you as choosing a state of affairs, they will hold you responsible for it; and if they hold you responsible for a state of affairs, they can ask you to justify it. Hence if people ever come to regard you as existing by choice, they may expect you to justify your continued existence. If your daily arrival in the office is interpreted as meaning that you have once again declined to kill yourself, you may feel obliged to arrive with an answer to the question 'Why not?'."
I think it is unlikely for the near future that people will need to justify their existence to others, but the offer will at least force people to justify their ongoing existence if only to themselves. "I've not thought about that before. Why do I want to live?"
Some might say this forced reappraisal of one's life is existentially healthy, but I say it puts the most vulnerable among us in a precarious position where they are only equipped to use the utilitarian tools available them to weigh the worthiness of their lives.
Once the power to kill people is granted to the medical machine, and to the government without due process, it will swiftly become mandatory. Insurance will not cover extended palliative and hospice care and families will be compelled to kill their grandparents and parents to avoid financial ruin.
The idea that this process will remain entirely voluntary, especially where most people approaching death are not lucid and capable of making decisions, is obviously wrong. We will all be on a conveyer belt to the lethal injection or other murder weapon with no options and no exit, based on bureaucratic rules driven by finances.
Killing people because they are inconvenient is the ultimate barbarism. And we are likely to be seeing lots of barbarism in the years ahead, because it will mean lots of money to the people who run the machine.
Prediction: Within fifteen years it will be unlawful to keep anyone alive if they have certain defined medical conditions, killing them will be mandatory because of the risk that they will impose undue financial costs on the machine.
There's a risk that this will become eugenics without even the moral responsibility of a Nazi caste--as some form of consent will be "given" beforehand, the practitioner can eliminate the petitioner with a clean conscience.
Classes of people whose lives are deemed of low value by those with power and influence will be killed off.
Imagine emergency rooms where care is denied because the cost of trying to revive and rehabilitate a "low value" person is deemed unjustified by government and insurance company guidelines. Can there be ANY doubt that will happen? The whole push for euthanasia is cash driven, with a veneer of personal autonomy as the motivator.
That doesn't even have to happen for euthanasia to have chilling effects on healthcare access-- rumors that the "doctor will kill you" could be enough to discourage someone from treatment. And there have been cases where physically healthy enough people have applied because they can't access or are losing benefits. They're not dying of terminal cancer, if they were able to access a safe indoor living space they'd prefer to live, but...
I think we can only hope you’re wrong, truly, but stranger things have happened.
This is a tough one for me to reconcile because it comes down to a simple fact that I have seen people die slow and painfully and begged for death but couldn’t have it. I’m a big proponent of having this for the bonafide terminally ill who consent. These other issues… poverty, mental health… they feel very circumstantial and I’m shocked they can even stand as qualifiers even under the current maid model. Of course addressing them involves resources and that’s where your argument really takes root.
Edge cases are always a problem. But the rule that no one can kill anyone else intentionally except with due process and as a criminal penalty is a firewall we should not breach. People dying and in pain can be given pain killers. I do not say this is an easy question. I do say that the people promoting this do not have good intentions and their agenda is not what they claim it is. That is speculation on my part. I do not have secret recordings. But watching how actual laws and regulations are made, and how a public face is put on self-serving government action in virtually all cases gives me full confidence that I am right about this. We have an incoming wave of elderly and dying people and we have government and private insurance programs that don't want to pay for it. Solution: Kill them. That's what this is about.
Why is there so much angst about giving humans full control over their life? Don't like euthanasia, don't use it. Just like abortion. Against it? Don't, but none of your business if I want to. Same with Euthanasia. Sure, it can be abused, like everything, but why deny people who want a peaceful exit, for whatever reason? My body, is not your business
I think the issue is less about allowing individual humans to make decisions, and more about the (inevitable) moral logic of having it become a "treatment" option with industrial suppliers and regulators.
At some point, when it no longer carries special moral weight and is considered "normal" you are going to get your medical provider or insurer refusing life preserving or comfort preserving care because euthanasia is cheaper.
And *that* is barbaric.
So while I maintain that a personalized, bespoke, and highly restricted MAID option is a moral good, I also agree there's a vast chasm beyond of horror.
There is was a vast chasm of horror beyond the descovery of nuclear power, there is a vast chasm of horror beyond AI. Humans are like that. I still believe the rights of an individual over his or her body is paramount. We manage killing eachother just fine, while denying a peaceful death to those who wish it.
I, and my brother and our wives, said goodbye to my mother a month ago. She had for years been consistent that when a good life was no longer possible and the end was near, she wanted to skip the pain and confusion and look to whatever came next with clear eyes.
And so she said that morning, with clear mind and voice, that it was time. And of course she had been though the appropriate doctor and psych reviews and none of this was a surprise.
I helped prepare the drugs, and held her hand as she took them, and as she left us. This was hard, profoundly hard. But as I said when she gave me the option to skip it... I have held every pet that we ever euthanized as they died, how could I do less?
I agree with many of the author's sentiments, I think MAID is in some regimes applied far too broadly and I am very skeptical of using it in situations where the person is not clearly terminal or has not had a long term expressed desire for this end. It's a very slippery slope. And commercialized industrial machinery of death is morally repugnant to me.
But, forcing someone who is of clear mind, and of consistent will, when the outcome of their death is clear and imminent, to wait until their lungs fill with fluid and they can only be kept "comfortable" with painkillers that rob them of their mind, is also barbaric.
Having been by the bedside of suffering loved one suffering from painful cancer, begging for the end, we were grateful to live in a State that allows the individual to choose when to let go. It is NOT ASSISTED! The person must be able to drink the medicine themselves, without help. And that is after several conversations sustains with their doctor and social worker and counselor. When a patient is SCREAMING for relief, you may think differently.
This was my thought. Confronting death so directly seems more human, not less. We live in a culture that ignores and distracts itself from death, and death with dignity allows one who is at the end of their life to look death directly in the face.
I admit it isn't an easy choice for anyone to make. I'm sorry your loved one went through so much pain.
It makes some intuitive sense, but are there any known instances of assisted suicide policy 'actually' deadening a society's moral sense? If so, then it would be dreadful policy. Applying a large part of the national wealth to creating weapons for killing people... an army, is also insane and likely to deaden moral senses. Until one considers the probable human cost of not doing so. There lies the rub... and the obstacle to simple answers.
Really powerfully argued, Matthew. No surprise that this is eliciting some impassioned responses on all sides.
Oddly enough, I wrote an essay last spring which made a similar argument about exactly the opposite issue: transhumanists’ attempt to defeat death altogether:
The concluding statement tells us all we need to know. Earlier the author stated, “assisted suicide encourages spiritual suicide,” which should have been the clue to his conclusion––it’s about a belief in the “spiritual,” not in individual human rights. In fact, he also claimed that it “de-individualizes us.” Therein, lies the core argument he should have pursued: Individual rights. Instead, the debate here is not about individual human rights, it’s about the same old religious argument versus “technocratic capitalism”––a false premise that contends there is some amorphous, universal, spiritual power (e.g., God, Allah, Zeus, et al), whose ubiquitous control over each and every individual is more important than our individual right to control the one and only human life we possess in our journey to get through a period of existence that is common to all of us. As Schopenhauer might say, it is our singular existence, no one else’s (not even the “spirit’s”), and we have the right to decide how we live it––and end it. The author has conjured up an erroneous debate, it’s not about “liberal-mindedness" and "technology" and "anti-human will," it’s about individual human rights––try again!
If you’ve ever watched an old person suffer for years in a care facility, you would look for a way to allow humane and legal suicide at the end. And you would see that there’s already a perverse financial incentive: hospitals love keeping you alive, because they can continue charging for your care. I’ve seen it up close, and it’s ghoulish at the end.
Our species wasn’t meant for “care” like this. Few would choose it. But once you’re inside the hospital walls, what choice do you have?
The first thought I have, reading this, is why is the government involved at all? Governments have institutionalized our entire lives.
It has been possible for many years to keep a brain-dead body alive indefinitely. Decisions must be made about 'pulling the plug'. The less government has to do with it, the more I like it.
Yes, we all die. And with modern healthcare, we often don't die until our bodies are essentially dysfunctional. And sometimes in great pain. Assisted death has to be an option. But there is no reason to add it to the long list of cradle to grave nanny state interventions into our lives.
I have held off from forming a strong view about assisted suicide until today, but this piece has crystallised for me the sense of unease I have had about it.
'Choice' is the language of the rapacious capitalist system we inhabit, and it is an illusion. The only important choice we have now is between holding on to our humanity, or allowing machine intelligence to take over. Outsourcing decision-making to AI is absolutely what is happening on multiple levels, and if you do it you are ceding control to a psychopathic entity that is anti-human.
'Choice' is the word that persuades humans they have some sort of control over their messy, painful vulnerability. It's repugnant to the Silicon valley people, who despise their own humanity and see no value in things that cannot be measured or monetised. For this reason alone would I reject assisted suicide.
I am not religious but it is plain to me that the attacks on the sanctity of human life dovetail very easily with the rise of the machine.
"One does not have to defer to the slippery slope fallacy to organize an argument against assisted suicide. Assisted suicide is dangerous not because it implies an immediate cascade of consequence, but because it represents a changed premise in the social code which inevitably produces gradual coarsening of human bonds."
Assisted suicide is a symptom before it is a cause of the coarsening of those human bonds. When we stopped asking what about medicine and health were for, and instead deferred everything to the autonomous individual, the limits and boundaries began to fall away: https://familymeetingnotes.substack.com/p/autonomous-patients-isolated-people
I say that to say this: You say that the process is "barbaric". I would counter that making people live in pain, knowing that they are at the end of their life, is worse than barbaric. It is torture & having the option to end your life peacefully & surrounded by loved ones is a more civilized pathway for an enlightened community. Furthermore, at the end of the day, if I get into a situation like the ones in law, this should be my call. No government or church should have the ability to say no should I make the decision for my own life. Again, that is barbarism, not enlightened social policy.
I have a lot of problems with this essay, but in order to try and have a more productive engagement I’ll let slide the string of slippery slope fallacies, appeals to emotion, and paranoia and critique from a position of good faith with respect to the authors’ valorisation of fully encountering death as part of the human experience.
We seem to agree that in some cases euthanasia seems the most humane. (To rely on a fallacy of my own, the ability to keep many individuals suffering the most horrifying conditions alive is itself an “unnatural” recent innovation.)
So let’s take for granted that there is a moral and/ or spiritual victory in confronting death, and not anaesthetising ourselves to it (with some exceptions). Even on these terms, the arguments of the essay fail.
Starting from the authors’ own worldview, the correct conclusion is that we should encourage people to *choose* to face their own death stoically, not to do the underhanded thing and ban it outright (so much for conservatives being for “individual responsibility, eh? It’s only government overreach when it’s something I don’t like).
The author fails to realise that for many, choosing death in this way is precisely the stoic, moral, honourable way of accepting and confronting our mortality that he seems so enamoured of.
My grandfather died drugged to the gills without having known who anyone was for months. He didn’t choose to accept his fate; he had no agency to begin with. Choosing to die a short while earlier would have given him the chance to actually face his death head-on.
Either the author fetishises the suffering of watching the human form cling to the bitter end (an end that gets more and more bitter the better we are at preventing complete metabolic collapse), or the author has had so few experiences with death that he can’t realise that the humanness of death comes from more than just the fact that at the literal moment your life is extinguished, nobody helped you to do it.
EDITED to reduce (somewhat) the unnecessary snark.
Honestly, I found this an unserious and reactionary essay of the worst sort. Perhaps I misunderstood aspects of it (I am somewhat exhausted), or maybe I am being uncharitable as I am in a bit of a bad mood. But I found that the author produces a cartoon vision of assisted suicide. Creating a vision of a technocratic death-march dystopia for those unproductive to the world and those simply old, with roaming death units and pods, reminds me of a weird inverse of Huxley's Brave New World. It is simply not serious or reflective of the earnest debates currently taking place on assisted suicide.
I am not sure if assisted suicide makes us barbaric. As the author themselves notes, there are plenty of worthy examples of assisted suicide, the one which most comes to mind is that of Socrates. The example of Socrates tells us that assisted suicide is not inherently a choice which requires the collective deadening of our moral senses. A more recent example is that of Marc Anthony in the TV show Rome, when Lucius Vorenus nobly performs the act.
Assisted suicide also does not mean we don't eradicate the humanity out of death. Of course, a particular form can, just as drinking the cheapest form of diet cola will take us far away from classic Coke, so does dying alone in a pod (which, btw, to my knowledge, has not been legalised) away from anyone. But this is a false choice the author presents to us. We should be maintaining human dignity and relationships while allowing people who are of sound mind the option of considering if the immense pain they are in is worth continuing when no treatment exists to alleviate it.
I am also not sure who is 'incentivising' death, as the author proclaims. To my knowledge, no euthanasia programme gives someone or a family a cash payment to shuffle off their mortal coil. I am happy to be corrected if I am wrong. Neither am I sure how assisted suicide necessarily coincides with a spiritual suicide. If anything, being more open, honest, and serious about death provides us with the opportunity to rediscover these important roots of human connection at both the micro and macro levels. It enables us to discuss what dignity means and how best to honour it both for those who resist the notion of assisted suicide and those who believe in its ethical essence.
Of course, if we put assisted suicide into an unserious society which is dominated by utility, technology, and an increasingly empty liberalism, then assisted suicide will follow said trend. But the author gets it precisely the wrong way around. It is not assisted suicide which drives these trends, but the trends which reform what assisted suicide could mean. Given the seriousness of the outcomes, I wouldn't want to introduce the notion of assisted suicide in an attempt to turn the ethical tide of societies. Still, the debates I have watched in the UK are a world away from what the author describes.
the notion of assisted suicide and those who believe in its ethical essence.
Of course, if we put assisted suicide into an unserious society which is dominated by utility, technology, and an increasingly empty liberalism, then assisted suicide will follow said trend. But the author gets it precisely the wrong way around. It is not assisted suicide which drives these trends, but the trends which reform what assisted suicide could mean. Given the seriousness of the outcomes, I wouldn't want to introduce the notion of assisted suicide in an attempt to turn the ethical tide of societies. Still, the debates I have watched in the UK are a world away from what the author describes.
(for some reason the last bit of my comment was hidden)
This is an interesting and rhetorically powerful argument, but I disagree with it for multiple reasons.
First, the author objects to a "government-run death apparatus" without seeing how one might say the same of his argument, namely, the status quo is a "government-run pain-permitting apparatus". That's pretty barbaric if you ask me. But we can leave that aside for now because the author will likely not agree on this point.
Second, having an extra option available to you does not make it impossible to take those other options (palliative care or a painful (more 'human' death?). I understand the thrust of the author's worry though. They think having this option available will lead to a coarsening of our moral senses, lead to a general indifference toward human life and perhaps lead some people to be pressured into assisted suicide so that they are no longer burdensome. These are valid concerns, but they are not unique objections to assisted suicide -- they are worries about badly designed policy without adequate safeguard. Perhaps the author thinks no amount of safeguards could prevent these bad things from happening, but that is an empirical question and no amount of rhetoric will change that. Absent a good reason to believe that having an extra option will NECESSARILY tip the scales toward all the bad thing the author points out, it's hard to see why we should agree with them.
Third, the author should consider the deeply paternalistic nature of what they're saying. The idea that grievous suffering is something worth bearing, individually or on a societal-level, is something reasonable people can disagree about. In the face of that disagreement, we can ask how ought we to accommodate reasonably disagreeing others? Clearly, banning assisted suicide imposes a set of values on others that they could reasonably reject. They are being FORCED to do something here. But there's a crucial asymmetry. Simply having the option does not impose values on others at all because no one is FORCED to take this option. The author’s real problem should be with being FORCED into this option rather than having it all together.
Beautifully said! It is, and should remain, the choice of the individual. The point of course is that whereas previously you had to have poison or a gun at home, now you can get some assistance when you've had enough. It's time for those who are so vehemently against it to meet people who wish to use it and go through the experience with them. Maybe then they'll understand better. Walk a mile in their shoes before you spout about how "terrible" and "immoral" it is.
The language about being forced overlooks the power of offering a choice.
Most people do not wake up making that supposedly primal philosophical choice of not killing themselves. Instead, most people, even seriously ill people, wake up living by default.
The philosopher David Velleman, who was (and maybe is, I'm not sure) in favor of euthanasia in principle but against it in practice, describes this problem by analogy. He's having a dinner party and you're not invited. You're just not going by default. If he invites you, though, you can choose to go or not to go, but the one thing you can no longer do is not go by default:
"Offering someone an alternative to the status quo makes two outcomes possible for him, but neither of them is the outcome that was possible before. He can now choose the status quo or choose the alternative, but he can no longer have the status quo without choosing it. And having the status quo by default may have been what was best for him, even though choosing the status quo is now worst. If I invite you to a dinner party, I leave you the possibilities of choosing to come or choosing to stay away; but I deprive you of something that you otherwise would have had - namely, the possibility of being absent from my table by default, as you are on all other evenings. Surely, preferring to accept an invitation is consistent with wishing you had never received it. These attitudes are consistent because refusing to attend a party is a different outcome from not attending without having to refuse; and even if the former of these outcomes is worse than attending, the latter may still have been better. Having choices can thus deprive one of desirable outcomes whose desirability depends on their being unchosen."
The offer of death works similarly. You can choose to live or choose to die, but the one thing the mere offer takes from you is the possibility of living by default:
"Once a person is given the choice between life and death, he will rightly be perceived as the agent of his own survival. Whereas his existence is ordinarily viewed as a given for him - as a fixed condition with which he must cope - formally offering him the option of euthanasia will cause his existence thereafter to be viewed as his doing.
The problem with this perception is that if others regard you as choosing a state of affairs, they will hold you responsible for it; and if they hold you responsible for a state of affairs, they can ask you to justify it. Hence if people ever come to regard you as existing by choice, they may expect you to justify your continued existence. If your daily arrival in the office is interpreted as meaning that you have once again declined to kill yourself, you may feel obliged to arrive with an answer to the question 'Why not?'."
I think it is unlikely for the near future that people will need to justify their existence to others, but the offer will at least force people to justify their ongoing existence if only to themselves. "I've not thought about that before. Why do I want to live?"
Some might say this forced reappraisal of one's life is existentially healthy, but I say it puts the most vulnerable among us in a precarious position where they are only equipped to use the utilitarian tools available them to weigh the worthiness of their lives.
Once the power to kill people is granted to the medical machine, and to the government without due process, it will swiftly become mandatory. Insurance will not cover extended palliative and hospice care and families will be compelled to kill their grandparents and parents to avoid financial ruin.
The idea that this process will remain entirely voluntary, especially where most people approaching death are not lucid and capable of making decisions, is obviously wrong. We will all be on a conveyer belt to the lethal injection or other murder weapon with no options and no exit, based on bureaucratic rules driven by finances.
Killing people because they are inconvenient is the ultimate barbarism. And we are likely to be seeing lots of barbarism in the years ahead, because it will mean lots of money to the people who run the machine.
Prediction: Within fifteen years it will be unlawful to keep anyone alive if they have certain defined medical conditions, killing them will be mandatory because of the risk that they will impose undue financial costs on the machine.
There's a risk that this will become eugenics without even the moral responsibility of a Nazi caste--as some form of consent will be "given" beforehand, the practitioner can eliminate the petitioner with a clean conscience.
Classes of people whose lives are deemed of low value by those with power and influence will be killed off.
Imagine emergency rooms where care is denied because the cost of trying to revive and rehabilitate a "low value" person is deemed unjustified by government and insurance company guidelines. Can there be ANY doubt that will happen? The whole push for euthanasia is cash driven, with a veneer of personal autonomy as the motivator.
That doesn't even have to happen for euthanasia to have chilling effects on healthcare access-- rumors that the "doctor will kill you" could be enough to discourage someone from treatment. And there have been cases where physically healthy enough people have applied because they can't access or are losing benefits. They're not dying of terminal cancer, if they were able to access a safe indoor living space they'd prefer to live, but...
Agreed. And not just a rumor, the reality. People are justifiably afraid of being at the mercy of a system that can legally kill them.
Also, people who are having a hard time may feel social and family pressure to be euthanized rather than be a source of trouble and expense.
Nothing good will come of this. Palliative care for the dying is already a specialty. Nothing can entirely eliminate pain while dying.
The last generation of people permitted to die a natural death and not be killed the government and insurance companies are the ones dying right now.
I think we can only hope you’re wrong, truly, but stranger things have happened.
This is a tough one for me to reconcile because it comes down to a simple fact that I have seen people die slow and painfully and begged for death but couldn’t have it. I’m a big proponent of having this for the bonafide terminally ill who consent. These other issues… poverty, mental health… they feel very circumstantial and I’m shocked they can even stand as qualifiers even under the current maid model. Of course addressing them involves resources and that’s where your argument really takes root.
Edge cases are always a problem. But the rule that no one can kill anyone else intentionally except with due process and as a criminal penalty is a firewall we should not breach. People dying and in pain can be given pain killers. I do not say this is an easy question. I do say that the people promoting this do not have good intentions and their agenda is not what they claim it is. That is speculation on my part. I do not have secret recordings. But watching how actual laws and regulations are made, and how a public face is put on self-serving government action in virtually all cases gives me full confidence that I am right about this. We have an incoming wave of elderly and dying people and we have government and private insurance programs that don't want to pay for it. Solution: Kill them. That's what this is about.
There are some things we ought not to have control over in order that the ego can die
Why is there so much angst about giving humans full control over their life? Don't like euthanasia, don't use it. Just like abortion. Against it? Don't, but none of your business if I want to. Same with Euthanasia. Sure, it can be abused, like everything, but why deny people who want a peaceful exit, for whatever reason? My body, is not your business
did you read the essay
I think the issue is less about allowing individual humans to make decisions, and more about the (inevitable) moral logic of having it become a "treatment" option with industrial suppliers and regulators.
At some point, when it no longer carries special moral weight and is considered "normal" you are going to get your medical provider or insurer refusing life preserving or comfort preserving care because euthanasia is cheaper.
And *that* is barbaric.
So while I maintain that a personalized, bespoke, and highly restricted MAID option is a moral good, I also agree there's a vast chasm beyond of horror.
There is was a vast chasm of horror beyond the descovery of nuclear power, there is a vast chasm of horror beyond AI. Humans are like that. I still believe the rights of an individual over his or her body is paramount. We manage killing eachother just fine, while denying a peaceful death to those who wish it.
I, and my brother and our wives, said goodbye to my mother a month ago. She had for years been consistent that when a good life was no longer possible and the end was near, she wanted to skip the pain and confusion and look to whatever came next with clear eyes.
And so she said that morning, with clear mind and voice, that it was time. And of course she had been though the appropriate doctor and psych reviews and none of this was a surprise.
I helped prepare the drugs, and held her hand as she took them, and as she left us. This was hard, profoundly hard. But as I said when she gave me the option to skip it... I have held every pet that we ever euthanized as they died, how could I do less?
I agree with many of the author's sentiments, I think MAID is in some regimes applied far too broadly and I am very skeptical of using it in situations where the person is not clearly terminal or has not had a long term expressed desire for this end. It's a very slippery slope. And commercialized industrial machinery of death is morally repugnant to me.
But, forcing someone who is of clear mind, and of consistent will, when the outcome of their death is clear and imminent, to wait until their lungs fill with fluid and they can only be kept "comfortable" with painkillers that rob them of their mind, is also barbaric.
Having been by the bedside of suffering loved one suffering from painful cancer, begging for the end, we were grateful to live in a State that allows the individual to choose when to let go. It is NOT ASSISTED! The person must be able to drink the medicine themselves, without help. And that is after several conversations sustains with their doctor and social worker and counselor. When a patient is SCREAMING for relief, you may think differently.
This was my thought. Confronting death so directly seems more human, not less. We live in a culture that ignores and distracts itself from death, and death with dignity allows one who is at the end of their life to look death directly in the face.
I admit it isn't an easy choice for anyone to make. I'm sorry your loved one went through so much pain.
This dude ever see some die “naturally”? Often real painful and sucks real bad. Pray for legalized euthanasia the alternative is often horrid.
It makes some intuitive sense, but are there any known instances of assisted suicide policy 'actually' deadening a society's moral sense? If so, then it would be dreadful policy. Applying a large part of the national wealth to creating weapons for killing people... an army, is also insane and likely to deaden moral senses. Until one considers the probable human cost of not doing so. There lies the rub... and the obstacle to simple answers.
Really powerfully argued, Matthew. No surprise that this is eliciting some impassioned responses on all sides.
Oddly enough, I wrote an essay last spring which made a similar argument about exactly the opposite issue: transhumanists’ attempt to defeat death altogether:
https://evernotquite.substack.com/p/and-death-shall-have-no-dominion
The concluding statement tells us all we need to know. Earlier the author stated, “assisted suicide encourages spiritual suicide,” which should have been the clue to his conclusion––it’s about a belief in the “spiritual,” not in individual human rights. In fact, he also claimed that it “de-individualizes us.” Therein, lies the core argument he should have pursued: Individual rights. Instead, the debate here is not about individual human rights, it’s about the same old religious argument versus “technocratic capitalism”––a false premise that contends there is some amorphous, universal, spiritual power (e.g., God, Allah, Zeus, et al), whose ubiquitous control over each and every individual is more important than our individual right to control the one and only human life we possess in our journey to get through a period of existence that is common to all of us. As Schopenhauer might say, it is our singular existence, no one else’s (not even the “spirit’s”), and we have the right to decide how we live it––and end it. The author has conjured up an erroneous debate, it’s not about “liberal-mindedness" and "technology" and "anti-human will," it’s about individual human rights––try again!
If you’ve ever watched an old person suffer for years in a care facility, you would look for a way to allow humane and legal suicide at the end. And you would see that there’s already a perverse financial incentive: hospitals love keeping you alive, because they can continue charging for your care. I’ve seen it up close, and it’s ghoulish at the end.
Our species wasn’t meant for “care” like this. Few would choose it. But once you’re inside the hospital walls, what choice do you have?
I guess I agree and disagree.
The first thought I have, reading this, is why is the government involved at all? Governments have institutionalized our entire lives.
It has been possible for many years to keep a brain-dead body alive indefinitely. Decisions must be made about 'pulling the plug'. The less government has to do with it, the more I like it.
Yes, we all die. And with modern healthcare, we often don't die until our bodies are essentially dysfunctional. And sometimes in great pain. Assisted death has to be an option. But there is no reason to add it to the long list of cradle to grave nanny state interventions into our lives.
I have held off from forming a strong view about assisted suicide until today, but this piece has crystallised for me the sense of unease I have had about it.
'Choice' is the language of the rapacious capitalist system we inhabit, and it is an illusion. The only important choice we have now is between holding on to our humanity, or allowing machine intelligence to take over. Outsourcing decision-making to AI is absolutely what is happening on multiple levels, and if you do it you are ceding control to a psychopathic entity that is anti-human.
'Choice' is the word that persuades humans they have some sort of control over their messy, painful vulnerability. It's repugnant to the Silicon valley people, who despise their own humanity and see no value in things that cannot be measured or monetised. For this reason alone would I reject assisted suicide.
I am not religious but it is plain to me that the attacks on the sanctity of human life dovetail very easily with the rise of the machine.
"One does not have to defer to the slippery slope fallacy to organize an argument against assisted suicide. Assisted suicide is dangerous not because it implies an immediate cascade of consequence, but because it represents a changed premise in the social code which inevitably produces gradual coarsening of human bonds."
Assisted suicide is a symptom before it is a cause of the coarsening of those human bonds. When we stopped asking what about medicine and health were for, and instead deferred everything to the autonomous individual, the limits and boundaries began to fall away: https://familymeetingnotes.substack.com/p/autonomous-patients-isolated-people
Before I go on, I was a NM State Rep who carried the bill allowing Medical Aid In Dying in our state. I was passionately for it then & remain a strong supporter. You can read about the process, my own story, and the stories of other involved, here. https://nmpoliticalreport.com/2017/02/03/aid-in-dying-bill-advances-after-emotional-hearing/
I say that to say this: You say that the process is "barbaric". I would counter that making people live in pain, knowing that they are at the end of their life, is worse than barbaric. It is torture & having the option to end your life peacefully & surrounded by loved ones is a more civilized pathway for an enlightened community. Furthermore, at the end of the day, if I get into a situation like the ones in law, this should be my call. No government or church should have the ability to say no should I make the decision for my own life. Again, that is barbarism, not enlightened social policy.
I have a lot of problems with this essay, but in order to try and have a more productive engagement I’ll let slide the string of slippery slope fallacies, appeals to emotion, and paranoia and critique from a position of good faith with respect to the authors’ valorisation of fully encountering death as part of the human experience.
We seem to agree that in some cases euthanasia seems the most humane. (To rely on a fallacy of my own, the ability to keep many individuals suffering the most horrifying conditions alive is itself an “unnatural” recent innovation.)
So let’s take for granted that there is a moral and/ or spiritual victory in confronting death, and not anaesthetising ourselves to it (with some exceptions). Even on these terms, the arguments of the essay fail.
Starting from the authors’ own worldview, the correct conclusion is that we should encourage people to *choose* to face their own death stoically, not to do the underhanded thing and ban it outright (so much for conservatives being for “individual responsibility, eh? It’s only government overreach when it’s something I don’t like).
The author fails to realise that for many, choosing death in this way is precisely the stoic, moral, honourable way of accepting and confronting our mortality that he seems so enamoured of.
My grandfather died drugged to the gills without having known who anyone was for months. He didn’t choose to accept his fate; he had no agency to begin with. Choosing to die a short while earlier would have given him the chance to actually face his death head-on.
Either the author fetishises the suffering of watching the human form cling to the bitter end (an end that gets more and more bitter the better we are at preventing complete metabolic collapse), or the author has had so few experiences with death that he can’t realise that the humanness of death comes from more than just the fact that at the literal moment your life is extinguished, nobody helped you to do it.
EDITED to reduce (somewhat) the unnecessary snark.
Honestly, I found this an unserious and reactionary essay of the worst sort. Perhaps I misunderstood aspects of it (I am somewhat exhausted), or maybe I am being uncharitable as I am in a bit of a bad mood. But I found that the author produces a cartoon vision of assisted suicide. Creating a vision of a technocratic death-march dystopia for those unproductive to the world and those simply old, with roaming death units and pods, reminds me of a weird inverse of Huxley's Brave New World. It is simply not serious or reflective of the earnest debates currently taking place on assisted suicide.
I am not sure if assisted suicide makes us barbaric. As the author themselves notes, there are plenty of worthy examples of assisted suicide, the one which most comes to mind is that of Socrates. The example of Socrates tells us that assisted suicide is not inherently a choice which requires the collective deadening of our moral senses. A more recent example is that of Marc Anthony in the TV show Rome, when Lucius Vorenus nobly performs the act.
Assisted suicide also does not mean we don't eradicate the humanity out of death. Of course, a particular form can, just as drinking the cheapest form of diet cola will take us far away from classic Coke, so does dying alone in a pod (which, btw, to my knowledge, has not been legalised) away from anyone. But this is a false choice the author presents to us. We should be maintaining human dignity and relationships while allowing people who are of sound mind the option of considering if the immense pain they are in is worth continuing when no treatment exists to alleviate it.
I am also not sure who is 'incentivising' death, as the author proclaims. To my knowledge, no euthanasia programme gives someone or a family a cash payment to shuffle off their mortal coil. I am happy to be corrected if I am wrong. Neither am I sure how assisted suicide necessarily coincides with a spiritual suicide. If anything, being more open, honest, and serious about death provides us with the opportunity to rediscover these important roots of human connection at both the micro and macro levels. It enables us to discuss what dignity means and how best to honour it both for those who resist the notion of assisted suicide and those who believe in its ethical essence.
Of course, if we put assisted suicide into an unserious society which is dominated by utility, technology, and an increasingly empty liberalism, then assisted suicide will follow said trend. But the author gets it precisely the wrong way around. It is not assisted suicide which drives these trends, but the trends which reform what assisted suicide could mean. Given the seriousness of the outcomes, I wouldn't want to introduce the notion of assisted suicide in an attempt to turn the ethical tide of societies. Still, the debates I have watched in the UK are a world away from what the author describes.
the notion of assisted suicide and those who believe in its ethical essence.
Of course, if we put assisted suicide into an unserious society which is dominated by utility, technology, and an increasingly empty liberalism, then assisted suicide will follow said trend. But the author gets it precisely the wrong way around. It is not assisted suicide which drives these trends, but the trends which reform what assisted suicide could mean. Given the seriousness of the outcomes, I wouldn't want to introduce the notion of assisted suicide in an attempt to turn the ethical tide of societies. Still, the debates I have watched in the UK are a world away from what the author describes.
(for some reason the last bit of my comment was hidden)