Over the summer the Canadian Senate was reluctant to pass the Liberal-majority government’s euthanasia bill. The senators did not think the bill went far enough in allowing euthanasia and wanted to remove the requirement that a person’s natural death be “reasonably foreseeable.” As Senator Andre Pratt put it, “I am convinced the government is making a serious and cruel mistake by taking away the right to medically assisted dying from a group of patients, those who are not terminally ill and yet suffering terribly.” Eventually conceding the ambiguous limit, the bill was passed by the Senate and received royal assent.
Last year, The Economist released a documentary about a woman who was, in Senator Pratt’s words, “not terminally ill and yet suffering terribly.” The film, “24 & ready to die,” is about a 24-year-old Belgian named Emily who was seeking a doctor-assisted suicide because of mental suffering. In it, she insists on her right to “choose” death.
The language of “choice” is often invoked in debates about euthanasia. For example, in a three-minute video, Dying with Dignity Canada CEO Shanaaz Gokool speaks about Canadians needing “real choice at the end of their lives” and calls opponents of euthanasia “strident anti-choice groups.” However, in On the Free Choice of the Will , Augustine argues that it is “absurd and inconsistent” for someone to say, “‘I would prefer not to be rather than to be unhappy.'” Yet, proponents of euthanasia seem to suppose it is reasonable to choose to die rather than suffer. Do Augustine’s reflections on the will have any insights to contribute to our contemporary debates about euthanasia?
Augustine thinks that people who want to die actually desire goods; they do not desire not to exist. In The Economist documentary, one of Emily’s friends asks her: “Is there ever a moment when you’ve thought, ‘I’m going to stop all this and go for life after all?'” and Emily answers, “No matter how you look at it, I’d prefer a bearable life over death.” Three of Augustine’s arguments that pertain to our contemporary debates about euthanasia include: 1) that a person who wants to die actually wants to be happy, 2) that choice always implies an object and liberty is for the sake of goods, and 3) that natural feeling can be a corrective for wrong opinions.
What does a person desire who says that he or she wants to die? Augustine, acknowledges “unbearable troubles” or, as Carter v. Canada puts it, “intolerable suffering” as an obvious motivation for desiring death. But Augustine thinks the opinion that a person can escape unbearable troubles through death is mistaken. He says that such a person is mistaken because what seems to be the desire to escape is actually a masquerade for the person’s natural desire for peace. If someone is suffering, then this person does not desire to die, but rather to be comfortable. Likewise, Augustine is confident that if someone is unhappy, then this person does not wish to cease to exist, but rather desires to be happy. “For if you were happy, surely you would prefer to be rather than not,” he says. To evaluate how this is borne out in experience, we can consider the account of Gloria Taylor, a person whose desire for euthanasia is discussed in Carter v. Canada:
Like Sue Rodriguez before her, Gloria Taylor did “not want to die slowly, piece by piece” or “wracked with pain.” She required home support for assistance with the daily tasks of living, something that she described as an assault on her privacy, dignity, and self-esteem…. “I intend to get every bit of happiness I can wring from what is left of my life so long as it remains a life of quality; but I do not want to live a life without quality…. I live in apprehension that my death will be slow, difficult, unpleasant, painful, undignified and inconsistent with the values and principles I have tried to live by… What I fear is a death that negates, as opposed to concludes, my life.”
Comfort, privacy, dignity, self-esteem, happiness, quality of life, values, principles, integrity—all of these human goods imply a fuller existence, not no existence. For this reason Augustine points out, “You are unwilling to die for no other reason than in order to exist. Thus, even though you do not want to be unhappy, you nevertheless want to be.” By admitting her fear of a “death that negates,” Gloria Taylor demonstrates the truthfulness of Augustine’s proposition: “It seems to me that nobody, whether he kills himself or wants to die somehow, has it in his mind that he is not going to be after death, even if to some extent he holds this as his opinion.” Non-existence is not an actual end that persons seek but it is the practical result of an assisted death. It does not serve the intended aims of the person and, worse, it precludes those purposes from any possibility of future realization because “once they have passed away, they will not be.”
We may wish for the dead to rest in peace, but we cannot know whether a person who does not exist in the world is at peace or not. As Socrates said, “Fear of death is indeed the pretense of wisdom.” So too, the desire for death is a conceit of knowledge, since nobody can know for sure what happens after death. Augustine argues that, “what is at peace is not nothing. Thus, the whole of his pursuit in the wish for death is not meant so that the person who dies is not, but rather so that he be at rest.” Furthermore he maintains, “We should not be bothered by the judgment of those who have been driven by their unhappiness to do away with themselves. Either they took refuge in a place where they thought they would be better off, and this is not contrary to our reasoning, whatever they may have been thinking; or, if they believed that they would be nothing at all, so much the less bothersome will be their false election of nothing.” This language of “taking refuge” corroborates Emily’s experience. Asked by the interviewer whether she thinks about death, she replied, “Often! I’ve thought about death a lot. I’m not religious, I don’t believe there’s something specific but I think it’s about where you personally find peace.” This is Emily’s thought, but we know Dante imagined a different one, particularly for those who committed suicide.
Augustine is adamant that choosing not to be is tantamount to choosing nothing: “For anyone who elects not to be is clearly shown to be electing nothing.” But is this really clear? To understand why Augustine thinks this way, it is helpful to note this argument of his: “[When] anyone attains what he rightly elects, he must become better. But whoever does not exist is not able to be better. Hence, nobody can rightly elect not to be.” Thus, right choices depend on personal improvement and self-realization, not on the mere fact of having made any choice. As G.K. Chesterton puts it: “[You] cannot praise an action because it shows will; for to say that is merely to say that it is an action. By this praise of will, you cannot really choose one course as better than another. And yet choosing one course as better than another is the very definition of the will you are praising.” But this is forgotten in such phrases as “free to choose” and “freedom of choice.”
The introductory paragraph of the judgment in Carter v. Canada says:
It is a crime in Canada to assist another person in ending her own life. As a result, people who are grievously and irremediably ill cannot seek a physician’s assistance in dying and may be condemned to a life of severe and intolerable suffering. A person facing this prospect has two options: she can take her own life prematurely, often by violent or dangerous means, or she can suffer until she dies from natural causes. The choice is cruel.
There is no admission that these may still include the least cruel of possibilities: it is cruel to suffer, and nobody wills it. But Socrates argued compellingly that it is better to suffer injustice than to commit it. Instead, we exalt the addition of more choices, even if they are worse. Our contemporary emphasis on consciousness, autonomy, freedom, and will clashes with the notion of a person becoming “grievously and irremediably ill.” Whereas, for Augustine, a person can never become incapable of becoming better, of improving in some way (morally if not physically, for example), as long as he or she lives.
Lastly, while the Supreme Court found that the prohibition against assisted suicide “trenches on their liberty,” John Stuart Mill, a key influence on our current understanding of liberty, said: “The principle of freedom cannot require that he should be free not to be free. It is not freedom, to be allowed to alienate his freedom.” Since liberty is the indispensable condition for realizing any of the aims of the will, it is never reasonable for a person to foreclose all possibilities of future action by an act of the will.
Having argued that persons who desire death actually desire peace and happiness rather than not to exist, Augustine makes some helpful distinctions between opinion, on the one hand, and feelings on the other. He says that opinions, whether true or false, belong to someone who reasons or believes while feelings are the fruit of nature or habituation. This is hopeful because “although [someone] believes in error that he is not going to be, he still desires by nature to be at peace, that is, to be to a greater extent.” Did this mean anything for Emily? During the interview she believed, “Without the option of euthanasia, it would have been a lonely and gruesome death because I would have killed myself.” Three doctors had approved her request for assisted suicide and had scheduled a date. But ultimately, Emily felt she could not go through with it. This perplexed her. Trying to account for the change, she said: “The past two weeks have been relatively bearable. Free from crises.” Free from crises sounds like tranquility of order, Augustine’s classic definition of peace. He also says that, “Peace … has the constancy in which we best understand what is called ‘being.'”
To love being more than hating unhappiness or, to put this more naturally, to love life more than hating suffering—is not easy. How then shall we live? Augustine’s encouragement is this: “If you will to escape from being unhappy [and suffering], then love in yourself the very fact that you will to be … you will to be more and more…. Give thanks that now you are! Although you are inferior to those who are happy, for all that you are superior to beings which do not have even the will for happiness.” For Augustine, as for the Greeks and consistent with the broad Western tradition, being harbors the good. For this reason, Augustine says that giving thanks and rejoicing in existence will draw us closer to God who supremely is and therefore is supremely good. “The more you love to be, the more you will desire eternal life,” says Augustine. And the less you will desire assisted death.