I intend to discuss the ethical implications of euthanasia throughout the course of this essay. Firstly I will be touching on the German philosopher Kant regarding his theories on personhood and consciousness in terms of people in vegetative states such as Terri Schiavo. I then will be moving on to broader issues of euthanasia such as the right to die and the legality of assisted suicide and refusal of treatment. The purpose of which is to determine whether or not euthanasia is an ethical approach to incurable illnesses or disabilities which affect quality of life.
Plato was quoted as saying “The brain was the seat of the soul” while Aristotle and Kant both agree that an intellectual consciousness is how define someone that is alive. With that in mind Terri Schiavo, to Kant would not constitute a person because she has been in a vegetative state for fifteen years. Hence she is not conscious and does not think. Kant would certainly not condone the extension of Terri Schiavo’s life because it’s not really a life, the only thing that is alive is the hope of her parents that she will eventually recover, which is a hope that is always alive if you believe in miracles but it’s just not reality.
Terri Schiavo, due to an ongoing bout of the eating disorder bulimia collapsed in a state of cardiac arrest in 1990. The twenty-six year old woman was without oxygen for approximately five to ten minutes, at the scene she was pronounced clinically dead. Michael Schiavo Her husband for the fifteen years has been in control of her wishes and her subsequent death.
While her parents The Schindler’s have been fighting against his decision to end her life from three years after her collapse. Her husband and her parents have waged legal battles over refusal of treatment, her rehabilitation and her life support. The case sparked a media frenzy, starting many a debate around the world.
Kant would first want to establish whether Terri was a rational being to justify the continuation of her life. "every rational being, exists as an end in himself and not merely as a means to be arbitrarily used by this or that willBeings whose existence depends not on our will but on nature have, nevertheless, if they are not rational beings, only a relative value as means and are therefore called things. On the other hand, rational beings are called persons inasmuch as their nature already marks them out as ends in themselves." (Kant, Foundations, 428)
With the use of CAT scans it was discovered that after her collapse there was no higher cortex function, which is what differentiates humans who think about their actions rationally and animals that act purely on instinct. Before 1990 Terri was a rational being and after she was no more than an animal.
Her brain simply regulated her basic functions such as her breathing and her heartbeat other than that she as completely without awareness, which Kant would determine as something that would constitute Terri as an animal. In Kant’s definition Terri as she has no rationality cannot be an end in herself so is almost classified as an inanimate object or an animal. Kant did not consider animals to be rational; he believed that rationality is what separated us from animals.
"A lower animal's attention is fixed on the world. Its perceptions are its beliefs and its desires are its will. It is engaged in conscious activities, but it is not conscious of them. That is, they are not the objects of its attention. But we human animals turn our attention on to our perceptions and desires themselves, on to our own mental activities, and we are conscious of them. That is why we can think about them And this sets us a problem that no other animal has. It is the problem of the normative *4 The reflective mind cannot settle for perception and desire, not just as such. It needs a reason" (Korsgaard, 93).
This basically means that because she is not aware of herself she essentially is an animal and when an animal is sick with no hope of getting better you put it down. Terri can no longer refer to herself as “I”. Being able to refer to oneself as “I” raises us above animals according to Kant, its self awareness that is the key factor regarding personhood.
"The fact that the human being can have the representation "I" raises him infinitely above all the other beings on earth. By this he is a personthat is, a being altogether different in rank and dignity from things, such as irrational animals, with which one may deal and dispose at one's discretion" (Kant, LA, 7, 127).
Kant would undoubtedly by his own findings that Terri was in fact an animal and sustaining her life in this fashion is almost like treating her like an animal because she has no worth in herself. She can never fulfil her potential anymore, she’s just living, she’s not actually alive. Kant would definitely object to keeping her alive because the only reason she’s living is to keep hope alive for her parents and that’s not fair to her or her husband because she’s basically trapped in her body.
"If a man shoots his dog because the animal is no longer capable of service, he does not fail in his duty to the dog, for the dog cannot judge, but his act is inhuman and damages in himself that humanity which it is his duty to show towards mankind. If he is not to stifle his human feelings, he must practice kindness towards animals, for he who is cruel to animals becomes hard also in his dealings with men" (Kant, LE, 240).
Tony Nicklinson has a disorder called ‘locked in’ syndrome which was brought on by a stroke, he is unable to communicate verbally or physically, and he is completely paralyzed from the neck down, he is literally a prisoner in his own body.
The fifty-eight year old was denied the right to die by the high court. Nicklinson states that all these things can be endured. What he finds impossible to live with is knowing that unlike most people he has no way out. His struggle is not one of empathy, he seeks purely justice. Every human is an individual one-size-fits-all solution, which opponents advocate, is not the answer.
“It is astonishing that in 1969 we could put a man on the Moon yet in 2012 we still cannot devise adequate rules governing assisted dying.”
Tony Nicklinson (2012)
Nicklinson said he was devastated by the courts decision to deny his right to die but that he would appeal.The case went further than previous challenges to the law in England and Wales on assisted suicide and murder.
"Although I didn't want to raise my hopes, it happened anyway because a fantastic amount of work went into my case and I thought that if the court saw me as I am, utterly miserable with my life, powerless to do anything about it because of my disability then the judges would accept my reasoning that I do not want to carry on and should be able to have a dignified death. It’s amazing that we have no decision when it comes to what happens in our own lives. If you want it to be over to avoid suffering that should be your choice, not someone else’s. I am saddened that the law wants to condemn me to a life of increasing indignity and misery." Tony Nicklinson (2012)
Lord Justice Toulson, said he was deeply moved but; "A decision to allow their claims would have consequences far beyond the present cases. To do as Tony wants, the court would be making a major change in the law. It is not for the court to decide whether the law about assisted dying should be changed and, if so, what safeguards should be put in placeUnder our system of government these are matters for Parliament to decide."
In religion, suffering has a purpose or some cleansing properties; you suffer and then are better for it, so you’re supposed to stick it out, because you deserve it. When we talk about quality of life philosophically we’re talking about measuring pleasure over suffering i.e. Am I experiencing more pleasure than pain in my life as a justification for staying alive. Through that you could determine whether life was worth living or not.
On the other hand religion sees suffering as part of quality of life, suffering in the religious community is supposed to make you a better person, it’s something to overcome but how can someone like Tony Nicklinson overcome effectively not having a body because someone believes that their god has done that to him for a reason?
How can others define your quality of life? How can you say ‘I want to die’ and someone else basically say ‘well you can’t because it’s a sin’? Logically speaking in religion you’d be transported from one hell to another but if you believe in a benevolent god that understands your suffering or you’re an atheist the pain will cease.
The law of necessity was quoted in the Nicklinson case, this is when there’s no other option left, Tony Nicklinson is never going to get better. The truth is no one wants to be the first one to make a ruling on it; judges ignored this case because it’s too hot an issue. They just want to pass the responsibility on to parliament.
Nicklinson also argued from a human rights perspective, that it is the right of every person to decide the time and manner of their death. He revealed that he would in fact just starve himself because his suffering was so great but he wanted euthanasia as a means to die without suffering. What he was trying to say was it was his right to die painlessly and with dignity.
Essentially, denying his right to die caused him more suffering as he starved himself and refused treatment for pneumonia which resulted in his death. Refusing treatment is seen as a valid way to stop life saving measures, as a form of passive euthanasia, if that treatment is simply keeping me alive as opposed to increasing my quality of life, I have the right to deny it.
On the other hand the Medical culture is one of trying, they never want to give up, they always want to save the patient and treatment even if it is futile and it won’t decrease that persons suffering. Doctors never take into account the measure of the individual person’s suffering it’s just a battle against death.
Allowing someone to die if they choose to is seen as ethically justified because death is inevitable and natural and standing in the way of the inevitable is unnatural. The right to self determination should also include a human right to die. Self determination is complacent comes to wearing a seat belt; I am unable decide that I don’t want to wear a seat belt as a form of euthanasia, as there are penalties attached to it and because it could cause harm to others.
The courts defend their position against assisted dying as a way of protecting vulnerable people from having unrequested assisted death. They’re throwing up this ridiculous reason for not having sanctions in place as it may be abused when here you have someone in writing telling you they want to die and there are countries all over the world who do this every day. Surrogate decision making is not relevant to this because it doesn’t happen and sometimes doctors give the option for people to decide beforehand whether they would life euthanasia if in a situation where they could not communicate that wish.
There is a strict criteria for what constitutes someone that has no option but death. When someone says they want to kill themselves they’re usually given medication and access to a psychiatric facility but when a disabled person states a wish to die, it can be justified as a reason for death because their quality of life has less chance of increasing. Disabled people should have access to mental health treatment as well as able people.
The right to die is selfish in a way that it affects the community because you have a right to die but it doesn’t just affect you, it affects your family and the nation and the law and possibly society as a whole. We don’t care anymore; modernity has impinged on our relationship with others. Religion and culture in theory should have no stance on this, life is the only freedom we truly have, and if someone wants to end it that’s their choice.
Religion wants us to just bear it because its founded on a work ethic, we suffer to make others money, we suffer in hope of a future reward that never comes, religion doesn’t care about suffering because it rationalises suffering, for example if you have a headache, a normal person just takes a painkiller a religious person might think god is punishing them for something. Isn’t keeping someone alive against their will to endure more suffer, torture? What is the benefit to society to force someone to prolong their life against their will?
Michele Causse ingested 15g of powdered Nembutal, dissolved in 60ml of normal tap water, ending her life. In Switzerland it’s legal to assist someone in ending their life if it is not done for egotistical reasons. Michele Causse loved life but didn’t want it to lose form; she’s basically saying that although she loves life it’s all downhill from here because of her health. Life is only going to get worse, so she wants to end on her terms instead of slowly deteriorating into a creature that can’t feed itself. She already can’t shop or cook or do a lot of the things she enjoyed in life, so what’s the point in living to lose more of things you loved to do? She has no control of her life anymore.
She’s killing herself because her life is losing it meaning. Death is easy, life is difficult. Everything is taken care of, even her death, there’s nothing to worry about, all your worries are gone because you’re going to die. She wonders why people say life is sacred, when we should be able to do with our own lives as we wish, you don’t need to tell people to cherish life, one person choosing death doesn’t equate to the whole world following suit.
Hordes of women didn’t all have abortions when abortions were legalized but they had the choice to do so. What she’s saying is her want for death doesn’t affect her or anyone else’s love for life, she loves life and people will still love life after she’s gone, death is inevitable, why shouldn’t we be able to control it?
Ludwig A. Minelli, Secretary General Dignitas. States; ‘Even a teenager has a right to die when his girlfriend leaves him’ On the other hand he wouldn’t help him until he explained that things can get better; there are plenty of fish in the sea but this is not the case for someone that is terminally ill.
Remy Salvat (1984-2008) was a French man who suffered from a degenerative nerve disease. He wrote a letter to the French president asking for assisted suicide, he didn’t want to go to Switzerland because he didn’t think it was right that it wasn’t legal in France. The French president, Nicolas Sarkozy, wrote back to Remy stating that on philosophical grounds, the government does not have the right to take life, but if they can’t do it and the person can’t do it and the parents can’t do it, should these people hire assassins?
Remy Salvat committed suicide alone in his room with a cocktail of pills and alcohol, his parents found him that way. He didn’t die peacefully in a bed he drowned in his own vomit on the floor of his bedroom. Eveline Widmer-Schlumpf – Minister of justice in Switzerland is against euthanasia because people come to Switzerland to die but are not seriously ill, it’s created a culture of ‘death tourism’, she doesn’t like the way in which it depicts Switzerland as a place to die.
Marc Englert from the Control commission on euthanasia in Belgium says there are three conditions for lawful assisted suicide; Incurable disease, intolerable suffering and a conscious un-coerced request. 85% of people that request euthanasia are cancer patients. A natural death is a nice thought but in reality, especially for cancer patient it’s long and it’s horrible. People should be able to avoid that if they want to.
Lynn Gilderdale a young woman who was very ill and who wanted to die, enlisted her mother in assisting her suicide, her mother now is on trial for murder. Lynn injected herself with an overdose of morphine and then when it appeared that it didn’t work her mother crushed up some pills and gave them to her to make sure she was dead. Which is where the controversy lies; although Lynn initiated her suicide her mother essentially ended it. Baroness Campbell of Surbiton states that sanctioning assisted suicide is too dangerous and could lead to opening the flood gates for disabled people to be killed, what they’re worried about is that someone can be coerced or feel bullied into it by the standards society sets people.
She thinks it’s as wrong to kill someone with their permission as it is to kill them without. Basically what she’s saying is by trying to prosecute Lynn’s mother Kay for murder they are setting an example as a deterrent to others that assisting in someone’s suicide is wrong but how can it be wrong in England and legitimate in Switzerland?
Obviously the idea that it is wrong is just an opinion, so how can you try someone for attempted murder on a difference of opinion? There have been regulations set in place in Britain around assisting suicide and one of them is that the person assisting cannot benefit from the death but in all likelihood it will be a family member enlisted to assist who will more than likely benefit financially so who else could you get to do it?
Doctors and strangers can’t do it for liability reasons and you’re family can’t do it for it financial gain, so who does that leave? Debbie Purdy (sufferer of advanced ms) has won a court case in which her husband will not be prosecuted if he takes her to another country to die if her ms worsens. She says that it’s a failure in the democratic process to ignore people’s rights to die. The law is saying it’s ok to take your own life but not ok for someone to assist you if you are not able. Lynn was acquitted and the crown prosecution was heavily criticised for seeking attempted murder.
In conclusion I do think assisted suicide is justified in a democratic society, as the idea of democracy is that you can decide what happens in your life, i.e. changing government and policy. The idea that this principal should not literally stretch to the nature of actually living and quality of life is absurd because democracy is supposed to be a fair system that allows everyone their own choice.
In terms of people in vegetative states like Terri Schiavo if her life has no meaning and by extension no hope of future meaning (because she would never get better, as her brain had literally shut down its higher functions and by association someone’s life can have no meaning without being in a vegetative state) it is the duty of the government and/or her family to put an end to her life.
Bibliography
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Gallagher, J. (2012) Tony Nicklinson loses High Court right-to-die case. Retrieved from
http://www.bbc.co.uk/news/health-19249680
Kant, Emmanuel. (1804) The metaphysics of ethics. Translated with an introd. and appendix by J.W. Semple (1836)
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