Mark Miller, C.Ss.R. Ph.D.
At a public forum on the euthanasia and assisted suicide issue, a rather assertive woman challenged me on my stand against the taking of any human life. “If my mother,” she said, “told me that she wanted her life ended, then it would be my loving duty to help her fulfill her wish. After all, it is her choice.”
To me this is the key issue in the debate on whether or not assisted suicide should be allowed. People argue that the ending of one’s life should be in one’s own hands, determined by one’s own criteria and values, and anybody who disagrees is being disrespectful of that person’s freedom.
I have great respect for people’s freedom. However, I have much less respect for their choices—not because people do not make good and wise choices, but because some choices are simply beyond my, or anybody’s, ability to assess. When people argue that assisting a suicide is merely respecting somebody’s free and autonomous choice, I have to point out that by respecting that choice the respecter is making a choice. Either the respecter is agreeing with the choice (“It is a good one”) or is agreeing with the fact that the person can choose (“I have no opinion about your choice, but I accept your right to make it”). In the first case, you are suggesting that you know the person well enough to know that the choice is in fact good. In the second case, you are attempting to avoid any moral responsibility for the choice (which may be perfectly legitimate in some circumstances).
However, let us return to the mother-daughter situation. For the daughter to agree with the mother, either the mother’s choice must be acknowledged as a good one or the daughter simply has to go along with the mother’s choice without question. But how would the daughter know it is a good choice? Obviously, she would question her mother. Perhaps her mother is dying, is having a rather difficult time of it, and has decided she wants to get it over with. A devoted daughter might try to convince her that there is still time, perhaps some better palliative care, that her family still loves her and wants to be with her and care for her. However, mother is adamant; she has made up her mind and she wants to die.
That she wants to die may seem obvious. But is it? Perhaps the mother senses that the daughter and other family members would like to get on with their lives. The mother’s dying is interfering; so good old Mom wants to make things easier for her children. She doesn’t say this because it would sound judgemental. Hence, the daughter thinks she is simply being true to her mother’s (expressed) wishes, while something entirely different is taking place.
Let us move to the second scenario. Suppose the daughter simply says, “Mom, it’s your choice; I don’t want to know about it. I’ll help you if you really want this.” What might the mother hear in these words? My daughter is ready for me to die; she doesn’t want to care for me any more; I was right- -it’s best for me to leave this world now.”
I hope that doesn’t sound cruel. But the fact is that we human beings often do not know our own motives for a particular choice, much less those of another, including someone very close to us. How often have any of us heard that even a spouse has never really listened on a particular issue, but instead projects his or her feelings or desires onto the other. The daughter may be able to guess that her mother is expressing her wish to die clearly. But she can never know with certainty.
I think that here we see the problem with the entire assisted suicide debate. The daughter would not attend to the mother’s wish if it came out of the blue and the mother were perfectly healthy. So it is not a matter of simply respecting a ‘free choice.’ No. Most people have certain categories of people whose lives appear not worth living. For some it may be relatively simple things like physical handicaps or Down’s Syndrome. For others it may be tragic conditions like Lou Gehrig’s disease or Alzheimer’s. For still others it would be the simple fact that one has a terminal disease like cancer. To the outsider there arises the almost natural question, “Why would anyone in that condition want to go on?”
That many in all of those conditions choose to go on should not be taken as a whimsical free choice that some people make and others do not. The basic choice is to live, even while dying. To intend death, especially one’s own, may be unstoppable (however regrettable) for a person who commits suicide. But as soon as another person, for example, an assisting physician, is involved, it is no longer a matter of a free, autonomous choice. The person who is assisting must also make his or her choice to do something to bring about this person’s death. And it is not good enough to say that “the person wanted it.” The assister, in some sense, must also have wanted the death. And no one can escape responsibility for his or her actions by saying that they were only fulfilling another person’s free request.
Just by agreeing to help, a doctor is giving approval to a patient. If society passes a law allowing assisted suicide, society is saying that it approves of individuals making such decisions. Not only might that kind of approval push people in the direction of such decisions (and would we then still speak of ‘free decisions’?), but such approval would state that we (doctors, society, any assistant) know either that the decision was a good one—which is impossible to prove—or that we can wash our hands of the decision because we are only ‘helping’ the person who made the decision alone.
In either case we are justifying our involvement on the basis of the victim’s ‘free choice.’ And that means that it is no longer an autonomous choice which others ‘must’ respect. It is a choice we choose to respect because we think it is good for people to kill themselves in some circumstances. And there is the vicious circle. Is the mother ready to end her life for her sake or her daughter’s? How would anybody ever know?