Editor’s note: This article was adapted from a speech videotaped by Human Life of Washington for distribution to Seattle parishes.
In November, Washington state voters will decide whether to endorse a euthanasia bill, Initiative 119. I believe that this bill will be destructive of our culture, destructive of our political system, and destructive of you as individual human beings and citizens. While this destructiveness is not immediately evident, it does, upon further scrutiny, manifest itself.
We must ask ourselves four questions: first, does Initiative 119 actually enhance human rights, choices, and options or does it hinder them? Second, does it enhance the dignity of the human person or does it disenfranchise the human person? And finally, what is the actual experience of euthanasia in Holland?
First, does the proposal enhance rights? Does it enhance choices and options? At first glance it might seem so. It offers euthanasia, that is to say killing by a physician, only to those who want it. In that case, those who don’t want it shouldn’t complain. Why should we here be concerned with those who want to be euthanized? This seems to be a perfectly reasonable argument, but we must take a look at another level at which rights and choices manifest themselves. When we talk about rights, we always have to be careful that rights for one person do not interfere with the common good. And finally, we must be careful about both explicit and implicit violations of human rights.
Consider three hypothetical case studies. One is concerned with self-induced death requests; another, options that remove rights; and still another concerns others’ decisions that affect your rights. Before I go into the case studies themselves, let me say three things about the people— call them Mary, Suzanne, and Joe—in our case studies. All of these people should be concerned about three things. First of all will there be pain if they choose a prolonged process of dying? Secondly, what is the point of going through a prolonged process of dying if all we can do is lie in bed, seemingly functionless? And lastly, what would be the point of allowing our family or friends to see us dying in such a state?
First, the matter of pain. It would have been plausible even ten or 15 year ago to suggest that someone could have died an agonizing death with immense suffering. That is no longer the case. Such significant advances have been made in the last 2 or 3 years by pain control experts that now it can be said with assurance that you will almost certainly not die an agonizing death. It can be said with assurance that total pain control may be had in the vast majority of the diseases leading to death.
In short, then, pain is not really an issue. You might ask, “Does this control of pain inhibit my consciousness, or inhibit my appreciation of life? Or my appreciation of others around me?” The answer is, not really. The person who is under pain control such as morphine drips or skin patches can in fact enjoy a very good life. They are conscious. They are still able to appreciate their family members’ presence. For all of the people in our hypothetical case studies—Mary, Suzanne, and Joe—we will see that pain is not the problem, the diminishment of consciousness or of the appreciation of life is not the problem.
As for the second point: Why go through a prolonged state of dying? It seems as if we’re functionless, and if we’re functionless, perhaps we may as well be dead.
I speak to you not only as a Christian, not only as a Catholic priest. I speak to you also as an ethicist, a philosopher, an academic. I will attempt, at least in brief, to answer this question from the vantage point of all three.
When we talk about the reason for living, it can be said with great assurance that the only school of thought in the history of mankind that ever thought that the reason for life was exclusively to be functional was crass utilitarianism. I pray we are not that base. What, then, do we as Catholics, do we as Christians, do we as academics, do we as ethical people who may not have any religious conviction at all but at least have some sort of a sense of ethics in life—what do we think should be the function of life?
Virtually every philosopher has talked about it this way: in terms of love, in terms of self-knowledge, in terms of appreciation. Appreciation of what? Appreciation of the “other.” Appreciation of the goodness of the “other.” We are beings, then, that first and foremost are capable of recognizing the good in the “other.” We are beings that can see others, look into their eyes or just see them at work, and know that they are good, in fact be so amazed by their goodness—despite all appearances, despite their failings, despite anything which might inhibit this—that we delight in them.
This is a normal human bonding which leads to love. And so, also, we are loveable. When others see us, we are sensed to be good by them. We are delighted in by them. We are loved by them. And this bonding also has its effects, I believe, in the heavenly kingdom. It has this effect because God delights in us. God senses our goodness. God redeems us. God loves us. God wants the best for us.
And so it is that in this bonding, in this appreciation of the “other,” in this sense of goodness, in these acts of love, in this act of delighting, we are fully human. There lies our reason for living. There lies our reason for enduring the prolonged dying process.
You see, function is only minimal in such a life. For a moment we might think that we ought to produce, that by producing our lives have meaning. “Nay!” say the philosophers. By loving, by sensing the good, by being good as best we can, by trying to lead others to the good, trying to help others through the muck of life, and above all by sensing the good in the other and bonding them to ourselves—there we will find life’s meaning.
We mustn’t let go of that. For if we do, you and I will slip into a kind of crass utilitarianism and we will despair. We will despair of our genuine human value, our genuine human being. All delight in life will disappear. All human bonding will disappear. Nothing will be left.
Our three people—Mary, Suzanne and Joe—if they can in some way sense the good in another, affirm the goodness of another, do something by their words of love and their words of wisdom, by their virtue, by their heroic courage—if they can do something for the other to enhance love in the world, even flat on their back in a hospital bed, that contribution will be much more valuable than thousands of widgets produced today.
In short, then, the gift of our higher personhood, the gift of being able to give the good to the other is the reason for being and the reason for enduring prolonged dying. And more than that, all three of our hypothetical patients can also accept love in a deeper way than before. For love will now be given to them by their friends and their families, not because they can give something back that can be produced. Rather, their friends and their families will come to love them because they are loveable, because they sense the good in that “other.” And as Mary, Suzanne, and Joe lie there in that hospital bed unable to function, unable to produce, their loved ones will look upon them and see them in the purity of that goodness. For that’s all that is left—their lovability, their goodness, their capacity to love. It is in this bonding that there are no comparisons to take our mind off the beauty of the “other” as good and as loveable, and the beauty of ourselves as good and loving.
There is a reason for dying.
Death and the Unbeliever
Our third point concerns the dying process. The question arises, What about somebody who doesn’t have any faith at all? As Christians, we say that Jesus Christ will transform every act of love into love in the kingdom of God because love is eternal and never dissipates. Every act of love that we create upon this earth is destined for eternity, unlike anything else which perishes. But what about the person who does not believe that this love is eternal, 1 that this delight and this goodness are eternal, elevated indeed to a divine dignity. Is there anything there for them?
Elizabeth Kubler-Ross did a massive study of death and dying several years ago. In it she elucidated several stages of dying. The first part of it, of course, is shock at being told that one is about to die. Then there is anger and bargaining, even depression. But eventually, as one moves through various stages, Kubler-Ross discovered that that person reaches a point of acceptance.
When somebody accepts his or her dying, something marvelous occurs, something indeed almost resembling the miraculous: the depression dissipates. And when the depression dissipates, a new ecstasy, a new humanity, a new self-realization occurs both for believer and non-believer: the person no longer compares himself to anybody or to any future. The person says, “I’m going to die.” When he thinks about it, he says, “what’s the point of comparing myself to Joe anymore? I’m going to die! There’s no point in it. And furthermore,” he might add, “What’s the point of comparing myself to what I’m going to be in the future of this life? The future is brief.”
There’s an amazing revelation which occurs through this realization which all of a sudden rises up and makes the human spirit new. What is it? I look at my true self. I look at the self that is unimpeded in any way by these comparisons, by the jealousies, the contempts, the fears, and the anxieties that accompany these comparisons. Now I can see myself almost transparently just as a self, just as a good self, just as a loveable self, just as a self capable of loving—and others can see me likewise.
Wonder of wonders, everybody else who comes around me in these moments of dying can see me likewise, and so can my God. I let them in and I love them as if I let them in. Life becomes so poignant in that moment of self-acceptance, love becomes so strong in that moment of self-accep¬tance, that there is nothing comparable to it in the whole of our lives that preceded it. What’s remarkable about those last months is the utter poignancy, the utter power of love and self-acceptance, of the realization of good and goodness in its purity.
“Well, now, what’s the point?” asks Kubler-Ross. That’s the point! For believer or unbeliever, that is the point of enduring that prolonged dying. Some say, “Oh, I don’t want to die until I’ve seen Europe.” How about this: I don’t want to die until I’ve seen myself? My true self, the self that’s just a self in all its goodness and love. How about that as a gift of embarkation to what we as Christians believe to be the heavenly kingdom? Mary, Suzanne and Joe—all I believe can participate in these three presuppositions.
Furthermore, I believe that they don’t have to be utilitarians; they need not define their lives in terms of mere productivity of things and thingness but instead can live for goodness and sensing the goodness in the “other” and live for love and lovability. In that last moment the force and the power of love reach a poignancy that is appropriate to the kingdom of heaven, which Jesus wanted to bring by his own death.
Options That Kill
With this preparation, let us examine our hypothetical case studies. First, the problem of induced death requests. Let’s begin with Mary. Mary is an average 60-year-old woman. Let us suppose for a moment that Mary is not a religious person. Nevertheless, Mary does, in some ways, really want to live. Mary has been diagnosed with cancer. It is irreparable; Mary is going to die within six months. Her physician comes to her and says, “Mary, this new law has been passed. You have an option. You may now get lethal injection or some other form of administered death by a physician, or on the other hand, you may accept a pain protocol which will enable you to live throughout this six months with a great degree of comfort. The decision is yours.” The physician leaves.
Mary begins to think about this in her solitude: “Well, what should I do?” As she reflects, she thinks, “Well, my family will have to look at me slipping away. My family will have to look at me deteriorating. What about me? I won’t have anything to give them back. I won’t have a function. I won’t produce very much. I can’t do X, Y, and Z like I used to be able to do. Furthermore, I’m sort of taking up a hospital bed. That might be irresponsible. Somebody else might be able to use this hospital bed. In fact, my whole life might be irresponsible.”
Why is Mary thinking these things? She’s thinking these things for two reasons. First, naturally, she’s in a state of shock. She is probably depressed, because she has found out that she is going to die. Needless to say, in a morose moment during the depression, Mary is going to think of herself as having no value because she cannot function anymore. Furthermore, the physician has come with aid in hand and has told Mary that she has an option. But this physician whom she trusts, whom she believes will give her good advice, this physician has told her she should consider the option of having herself killed. What would you think? What do you think Mary will think?
Put yourself in Mary’s position. Would you feel that the physician is more or less telling you that your life really doesn’t have a value? After all, if I tell you that you have the option to kill yourself or to be killed by me, am I not suggesting, at least implicitly, that your life does not have value? The ethicists that I represent would say that suggestion is being made. Psychiatrists would say it is being made. Now add this suggestion to the depression that Mary is feeling. What is Mary likely to do? Mary is likely to ask to be legally killed. If you don’t believe me, look at the statistics from Holland that we will consider soon.
Mary’s rights have been implicitly violated because Mary should not be made to feel that her life is worthless if she doesn’t have a function. Mary should not be made to feel irresponsible if she should want to continue her life. Admittedly, Mary has not been told she must have herself killed, that she is irresponsible if she continues to live despite her functionlessness. No, Mary has only been presented with an option. But we must remember, options kill. It is the option that suggests to Mary that her life is valueless. It is the option that suggests to Mary that she is irresponsible. Options kill. And those options which kill violate the rights of Mary even though the violation may be implicit.
Let us proceed to the second hypothetical case. We are told that the new law presents an option to help our families, but consider Suzanne and her son Joe. Suzanne is another typical woman diagnosed with cancer, but let’s say Suzanne does have a religious belief this time. Because of this religious belief, Suzanne thinks to herself, “My value does not reside in my function. No, my value resides in my love. It resides in my goodness, which I believe in and which my children believe in. My value resides in my being able to love my children, even flat on my back, to sense their goodness but for a few moments. My value lies in being able to see my true self.” Suzanne, a convinced Christian, says, “No, I do not want to die.”
Joe, her son, is standing outside the hospital room with her physician. The physician, in very somber tones, is explaining to Joe the two options which face Suzanne. “First,” he says, “there is the way of lethal injection.” Then he explains there is a pain protocol that can also prolong Suzanne’s life. Joe, for a moment unreflective, goes into Suzanne’s room and says, “Mother, the physician tells me that you have two options. One would be to be legally killed by your physician or by someone else. The other option is for you to take a pain protocol which will prolong your life. What do you think you want to do? What kind of a decision should we make?
Suzanne and Joe discuss this for quite some time. Finally, Joe leaves the room, and Suzanne is left in solitude. She begins to think, “What has my son told me? My son has told me I have an option of being killed.” Now, I don’t care who you are; I don’t care how callous you are; I don’t care how much you say you really don’t care that much about the love of your children. You are going to be affected by the presentation of that option by a family member or friend. When you feel the sting of rejection that comes when your family member or friend has said this to you, what are you going to do?
If you were feeling depressed because you just heard about your imminent death, I assure you that you will feel all the more depressed when you reflect upon the fact that your own son or daughter has sort of escorted you into a decision that includes killing you. Examine what happens when Joe leaves his mother alone. Rather than feeling self- acceptance, rather than seeing her true self, what has the presentation of the option done? It has made Suzanne, his mother, feel rejection.
Irony of ironies, the so-called option which was said to enhance our choices and rights has instead led to rejection. This feeling of rejection then leads Suzanne to begin to contemplate her own death—despite the fact that she feels her life has value in light of her religious commitment. The pressure is on Suzanne now because she is depressed, seriously depressed. The sting of rejection may make her change her mind.
Because of this change, Suzanne is likely to act contrary to her former wishes and choose death rather than living with the acceptance of death. This presents another kind of violation of rights, namely, the pressure that is produced through this option because one is made to feel rejected. Suzanne need not have felt this pressure.
Scenario number three—Joe. Joe is lying in a hospital bed. He begins to think to himself, “I have no particular religious commitment, but I like living. I like seeing the sun shine in the morning. I like being able to look around me and see my family. I rather like life.” But Joe has a friend named Tom, who was euthanized six months ago. Tom has been eulogized as a hero for having taken the responsible way out. His family and his friends say to one another, “What a good man Tom was. He certainly took a brave path. He was certainly courageous in doing what he did.”
Joe feels the pressure of having to live up to Tom’s virtue. When Joe reflects in his solitude about the worthiness of his life, he feels that if he does not take Tom’s way out, he’s not a virtuous person; he’s not a real man. In this sense of degradation, in this feeling low or irresponsible when compared with Tom, Joe decides, “I ought to be a hero for my family, too. I ought to do what needs to be done. Despite the fact that I love my life and I love my family and do not want to die, I probably ought to take Tom’s way out. For after all, Tom is virtuous and Tom has been extolled as virtuous.”
Joe’s rights have been violated because Joe need not feel this pressure. Joe does not have to follow what Tom did. Joe should not have to endure the pressure that comes when he is compared with somebody else—his friend, or perhaps somebody who is a total stranger to him.
If you don’t think that these pressures are realistic, look at the statistics for euthanasia in Holland. They indicate very clearly that people not only feel these pressures to submit to active euthanasia, some of them never thought they had a choice even before they were sick. That’s sick. That’s a violation of rights.
We in these United States of America need not follow the path of Holland. We should protect the rights of our citizenry and protect our culture. We should protect the common good. We should protect the society which we hold dear whether we be believers or unbelievers.
There are two other crucial aspects to this euthanasia initiative. First of all, the proposed law for Washington state is written such that when a patient makes a request for euthanasia that patient’s request must be honored immediately, whether that patient be reversibly depressed or in an ignorant or distorted state of mind. Before they could have a chance to reconsider, before they would have moved through the stages that Kubler-Ross elucidates which indicate they may change their minds, before they have come to a point of accepting their dying—before they can do any of this, their request will be honored and they will be killed.
In addition, there’s absolutely no protection for your being put to death before your time. Suppose a physician or family member comes up to you and says, “Aha, you should be euthanized.” Are you protected against this inducement to having yourself killed? The answer, under this law, is no. Moreover, you are not protected if you are ignorant or if you are in a distorted state of mind. No provision is made whatsoever for the person who might be a little bit foggy, who might be a little bit depressed. No provision is made to protect those individuals. This is bad law. This is bad policy.
A few more points must be clarified. The first concerns the meaning of compassion. We are told that I. 119 is compassionate: it relives the misery of dying. The implication, of course, is that dying is miserable and compassion is relief of misery. But dying, as we have seen, is not miserable. Moreover, death is not useless. Death and dying lead the patient to a new love of self, to a new love of others, and to a new love of God. In fact, dying may be the most useful part of our lives, the most poignant part of our lives, and the part of our lives where we use the highest faculties that we have for the longest period.
Finally, compassion in the classic sense has never meant the relieving of misery. The classical authors defined compassion as suffering with, not with relieving someone of suffering. For the ancients, the privilege of friendship was to be able to engage one’s friend at the level of his or her pain. Both ancient poets and ancient philosophers thought it a privilege to be with one’s friend in pain, not a waste of time—anything but a waste of time. It was ennobling because the friend would know that he was loved, loved for himself and loved as a friend. And it was ennobling to the one who loved because he would know that he had exercised his highest power as a human being, the power to commit himself to another without expectation of return but only because he knew the goodness of the friend. That goodness and that love, they knew, had an eternal quality.
The ancients were not Christians, but they knew of the eternity of this. They called this “greatness of spirit” the meaning of life, and they thought it eternal—without the help of revelation.
This, then, is the meaning of compassion. We ought to be compassionate in the true sense of the word. But the proposed law militates against compassion in its true sense. Indeed, it drives it into oblivion. Friendship, love, goodness, eternity—what is all that if we put persons out of life when we are not putting them out of their misery?
Mysteries or Problems
Every culture has an interpretation of person. That interpretation of person is what gives birth to the law of the society. That law, in return, will affect all of our everyday lives by affecting the way we implement the law, the way we look at one another, and the way we bequeath rights to one another. If the understanding of person is changed, the laws—even if they are statutorily the same—will change.
There are two opposed notions of personhood. The per-son can be viewed as “mystery” or the person can be viewed fundamentally as a “problem.” If one views the person as mystery, we go back to the notion of the person as being capable of accepting love, the notion of the person as sensing the good in another.
What is it to be a person? It is to sense the goodness of another and to have another sense the goodness in you, to love another with great passion, with great sacrifice, and to have another love you with great passion and great sacrifice. What is it to be a person? It is to evolve into self-transcendence through God, if you believe in God, through a self-transcendent virtue if you do not.
What is it to be a person if you are a Christian? It is to be imbued with the love of Jesus Christ, to take Him as our guide to love everyone as He has loved us. That is what it is to be a person. A person is mystery. A person has an infinite depth because he sees goodness and love and because the divine love coming to him is infinite; it can never be exhausted. That is your nature, and that’s what it means to be a mystery.
But there is another, dangerous notion of person which is gradually becoming popular in this culture and which is gradually eradicating our mysterious, our infinitely loving and good natures. That is the notion of person as problem. When we treat the person as problem, we look at what the person can produce, we look at the person’s function. When a person ceases to produce things, when the person ceases to function as a thing, when the person ceases to produce more resources than the person consumes, then the person is treated as a problem.
What are we going to do with this non-productive element? Needless to say, once we admit in our culture and in our laws that a person is a problem, where will it stop? What function or functions must you have to be protected under the laws? Must you have an I.Q. of 130 or above? Must you have perfect physical health? Perhaps you shouldn’t be depressed for more than two months? Where do we stop when we begin within our society to define a person problematically, functionally?
If we fail to treat the person with regard for his or her intrinsic goodness, our laws will become administrative, and we will begin to take one another out of life, out of society, out of the protection of the law for no other reason than they are functionless.
This is dangerous. This, in fact, is the suicide of our culture.
Dutch Disease
Consider the example of euthanasia in Holland. First, physicians are encouraging lethal injection. Earlier I spoke of three possible scenarios where an option that was suggested to a patient encouraged him to take the route of lethal injection. In Holland, we now find that physicians actually encourage euthanasia. They walk up to their patients and say, “You should take a lethal injection.” With this kind of encouragement, of course, a patient would feel far more irresponsible for not having himself killed than in my hypothetical cases where there was a mere mention of the option.
Is this too far-fetched a scenario for the U.S. if similar laws pass? I would suggest not, because in Washington’s proposed law there is no protection against inducement by physicians. In other words, a physician could go into a room and say, “You should be euthanized. The patient in his depression could sign the required form and be euthanized on the spot. Right now, over one-third of the physicians in Holland actively encourage the practice of lethal injection or assisted suicide.
Secondly, Dutch physicians are performing two-and one-half times more involuntary euthanasia than voluntary euthanasia. “Involuntary euthanasia” means that a patient is given a lethal injection without having requested it. Now you may say, “Wait a minute, Initiative 119 does not allow for this. Why bring it up?” Well, in Holland, the Dutch law does not allow for it either. Yet Dutch physicians are actually performing involuntary euthanasia and are registering these incidences of involuntary euthanasia on death certificates as heart attacks or some other kind of ailment.
In short, then, there are no legal consequences for the physician for performing an act of murder—killing involuntarily. The evidence for this statement is a Dutch government study issued on September 10, 1991; the statistics came from physicians who volunteered the information to the survey-takers. The physicians actually admitted to pollsters that they have performed involuntary euthanasia on patients. None of them were prosecuted.
Indeed, there is presently a movement among physicians in Holland to make euthanasia mandatory in certain cases. This, of course, seems totally far-fetched with respect to the U.S. proposals, which are not asking for mandatory euthanasia. I bring it up because it is not such a farfetched scenario in the U.S.
Consider what happened in Holland. First, physicians in Holland encouraged lethal injections. In Washington there may soon be no prohibition against such inducement by physicians. Secondly, since physicians can hide involuntary lethal injections in Holland, it also follows that they can hide them in the U.S. Involuntary euthanasia in Holland is now being done illegally, yet it is being done. If this progression of events can occur in Holland, why couldn’t such a progression of events occur in the U.S.? Once physicians suddenly see there is this easy way out, once they see there is no necessity of moving through the unpleasantness of telling somebody that they have to die, then why shouldn’t they work to make euthanasia mandatory?
This last scenario represents the total decline of culture. It is the epitome of a culture that no longer recognizes love or goodness to be the value of life. It is a culture that values only one thing: convenience, function, some kind of production beyond consumption. That is a crass utilitarian culture. And that is the culture we are trying to prevent.
Dutch citizens presently carry in their pockets cards that read, “Please don’t euthanize me.” Think hard about what we are giving up if we allow euthanasia bills to pass. We are giving up the very value of our lives in love, the very self-transcendent value of our lives, and we are giving up the value of our death. We must oppose legal euthanasia before it eradicates us as persons and as a culture.