ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Saturday, March 30, 1996 TAG: 9604010004
SECTION: EDITORIAL PAGE: A7 EDITION: METRO
SOURCE: DANIEL C. KOLB
IN YOUR March 8 editorial (``A right to die with dignity''), you jumped on the assisted-suicide bandwagon. While spouting the cliches du jour - "agonizing choices," "death with dignity," "that very private decision" - you come down squarely on the side of a policy that's wrong in principle and dangerous in practice.
The institutionalization of assisted suicide says that we as a society think such deaths are a good thing, that a doctor may rightly intend to cause the death of an innocent person and take steps to bring it about. In the case of assisted suicide, the doctor takes active steps to make it possible and assure its successful completion.
Of course, one might retort that no one is saying that the suicide itself is an intrinsically good thing. What's good is that we respect patient autonomy and the patient's right to choose. But ``choice'' here, as in the abortion debate, is a smoke screen. Unless we think the choice is of something good, or at least something morally permissible, we ought not to respect it.
The distinction between assisted suicide and euthanasia is morally insignificant. If I give my friend my rifle believing that he'll hunt with it, I've done nothing wrong. If I give him my rifle believing he'll use it to kill his wife, I've aided him in murder. I understood his intention, and helped him to his goal. In helping him, I had to think his action was good or at least morally permissible. Of course, I might try to evade responsibility by hiding behind the language of ``choice,'' arguing that I didn't want him to kill his wife, but I didn't think I should impose my values on him. After all, my belief in the sanctity of life is notoriously associated with Christian belief, and is therefore subjective and private.
Or I may hide behind the rhetoric of ``tragic, agonizing options,'' arguing that I acted to minimize suffering. The other alternatives that my friend mentioned for killing his wife - bludgeoning, knife wounds, strangulation - involved a greater degree of trauma and pain. In giving him my rifle, I acted to minimize suffering.
These lines of reasoning are absurd. Murder is wrong, regardless of the rationalization. We shouldn't aid murderers, even when we see some relative good that might come from violating the absolute prohibition against murder. Likewise, assisted suicide.
Anyone who doesn't think assisted suicide is a Trojan Horse for euthanasia ought to think again. The connection isn't a hysterical slippery-slope argument. It's a clear, logical one. Once it's decided that the value of innocent lives can be weighed and measured against relative values such as pain and suffering, the moral threshold has been crossed. The question of who does the final act of killing is relatively minor.
Of equally dubious value is the line between terminal and nonterminal cases. If subjective evaluation of suffering renders as respectable the terminal patient's choice of death as preferable to life, from what perspective do we gain the moral authority to tell severely depressed, handicapped or injured individuals who aren't terminally ill that this choice isn't for them? Their suffering may be greater, more relentless and more unrelieved than terminal cases. Who are we to tell them to soldier on?
And if death can be chosen as a good, how can we not consider it as an option in cases where substituted judgment is required? We must make judgments for children, the mentally handicapped, the seriously disabled. If it's accepted that death cannot only be a good but that it's permissible to take direct action to bring it about, we would be irresponsible not to consider ``exit options'' among possible ``treatments.'' The courts already recognize this in many cases, allowing caretakers to deny basic medical care and even, in some cases, food and water to otherwise nonterminal patients based on ``quality of life'' considerations. Handicapped infants are often chosen to receive this blessing.
The force of the argument in favor of assisted suicide rests on a faulty dichotomy: death or life made meaningless by relentless suffering. If we accept this dichotomy, we discourage medical practices and innovations that can ease the suffering of the terminally ill; we discourage institutional and social-support systems, such as hospice, that help the terminally ill and their families to accept their condition and find value in what life remains; and we create emotional and financial pressures for patients to choose death.
The natural process of death is unpleasant and disquieting to all involved. Being in the presence of dying people, even (or, perhaps, especially) those who are close to us, is fearful and stressful. The institutional practice of assisted suicide would in itself bring pressure on patients to accept this option rather than to ``selfishly'' cling to life. Medical providers will necessarily consider suicide among the ``exit options'' that must be presented to patients.
Terminal cases always frustrate doctors whose primary goal is to cure the patient. Why waste emotional and financial resources on these hopeless cases? It will necessarily become harder and harder to find a response. To respect patients' right to choose life becomes less plausible when we offer equal respect for their right to choose death. Why don't they just do it and get it over with? We'd all be better off.
Daniel C. Kolb of Riner is an associate professor of philosophy at Radford University.
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