Euthanasia, Part 2 (Finally)

Note: new picture up at FMPhoto.

Sorry it took so long to post this follow-up to my previous discussion of the subject. My thoughts are still somewhat all over the place on euthanasia. But here I go anyway.

Assisted Suicide

Implementation of legalized euthanasia is no easy task. What grounds for euthanasia are permissible? Who is capable of making the decision?

The easiest area to deal with (aside from passive euthanasia) is when a person decides for himself or herself to end his or her own life. But I think we all agree that suicide is more often than not a bad choice. There should be safeguards to prevent using legalized euthanasia to act out the suicidal choice of someone who is mentally unstable. Here is one process that I envision for ensuring responsible assisted suicide:
1. The person must file a petition with a court of law.
2. Interested parties must be given notice. These would include:
a. Close relatives, named in the will or otherwise, if any
b. Dependents, if any
c. Spouse, if any
d. Anyone else who would have standing to challenge the will
3. The court would appoint a psychiatrist
4. An informal trial would be held on the issue of mental capacity to choose euthanasia, as well as whether the grounds for choosing euthanasia are acceptable.

Another advantage of this system is that any challenges to the will could be litigated with the testator present to give evidence. The most important issue is often the intent of the testator, and who would be better to give evidence on that issue?

But should any grounds be acceptable? Depression by itself I think would not be enough. I think anyone amenable to legalized euthanasia would agree that painful terminal illness would be sufficient grounds. Should we otherwise limit it?

Nursing homes can cost a lot of money—about $70,000 a year. Many people, when forced into nursing homes, will first convey most or all of their property to relatives so the nursing home can’t seize all of their assets to pay for care. This makes them wards of the state. It’s quite natural, I think, for people to want to pass on their assets to their loved ones, and to keep it out of the grubby hands of the care providers. Should you be able to end your life simply to avoid these massive expenses?

What about the early onset of Alzheimer’s or some other disease? Personally, if I was diagnosed with a disease that will destroy my mental capacity, I think I would want to end it all. Paralysis is a similar situation. Many people go on from paralysis to lead very fulfilling lives, but many others simply sink into a deep depression from which they never recover. I think assisted suicide should be available in these circumstances, although if I was a legislator I may require a waiting period after onset of paralysis or some other diseases.

But these questions are relatively easy to answer. What about involuntary euthanasia?

Involuntary Euthanasia

I limit this part of the discussion to “active” euthanasia, the administering of lethal treatment rather than the denial of life-saving measures.

Should active, involuntary euthanasia ever be permissible? I established in the previous discussion on this subject that the impossibility of leading a happy life is the basic premise behind the support for euthanasia. But many people that are incapable of leading a happy life are also incapable of choosing to end that life. Examples include people in the later stages of Alzheimer’s disease. They are very expensive (and mentally taxing) to care for, and are certainly unhappy and confused a majority of the time. Perhaps the severely retarded would also qualify, as well as possibly some others.

But the question here is, who gets to decide? We naturally loathe letting some people decide. A very rich man with Alzheimer’s may be at the mercy of the people named in his will or who would receive property through intestacy statutes. At the same time, however, those who stand to gain nothing also likely don’t know what the wishes of the person would be. And we certainly don’t want the government to decide, especially when the person’s life at issue is a life supported by the government’s treasury. Most people could handle these issues in a living will, and I think that’s probably the best option. But then there are still countless others who can’t decide for themselves. Can we trust the parents of a severely retarded child to make the right choice? Most such parents love their children without regard to any mental or physical defect. But what about the others? And when you get into this area, I think you are getting dangerously close to the issue of abortion.

Conclusion?

This is why it took me so long to post. Note all the question marks in the post. I think it’s very difficult to answer most of these questions, and I personally don’t know how. I’m not immediately opposed to involuntary, active euthanasia, but once these questions start to pop up then sometimes my gut squirms a bit. Maybe some of you will be able to help the discussion along.

On Euthanasia, and Where I Disagree with Organized Religion

(Those atheists/agnostics who know me might enjoy my divergence from what I’ve been taught.)

Euthanasia, like capital punishment, war, and abortion, is a divisive moral issue. I haven’t heard a lot of non-Christians weighing in on the issue, but even within Christian circles different conclusions have been reached. And I know that many people (including some federal judges) don’t agree with Oregon’s statute on the issue (which allows doctors to perform assisted suicide).

We do it for our pets. Why not our parents?

We love our pets. I, for one, think that dogs are better than people. But when they get old, and can’t hold their bladders, and are in pain from cancer or can’t enjoy life anymore, then we do the merciful thing. We put them down. The day we put my first dog, Bernie, down was the saddest day of my life, but even my young mind (I was around 10 at the time) could understand that it was the humane thing to do. (I even found a web site once with a discussion on the most humane way to euthanize a goldfish—freezing or alcohol?) Now, on to Raider.

(Photo by Laura Hoffart)
Raider has been with my family for the better portion of my life (quantity and quality). He’s one of my best friends. He’s quite the character too. And at over 13 years of age (that’s 91 in dog years—98 in May) he’s still quite the happy old dog. He doesn’t have cancer to our knowledge, and he can still hold his bladder for over 12-14 hours on the odd occasion that’s necessary, despite having food and water always available. And he goes for a walk every day that the air outside is above 0 degrees Fahrenheit. But he does have some heart trouble. So when the air outside is cold, he wants a shorter walk.

I’m not looking forward to it, but when he doesn’t feel like walking anymore then it will be time. Why, when we put them down, do we do it?

1. Our dog is no longer capable of leading a happy life
2. Life is not worth living if you can’t be happy
3. THEREFORE, the humane thing to do is to euthanize him

Why is it, then, that we don’t apply the second premise to people? Is there some other premise that applies to human life than to animal life? Do we love our dogs more that we permit them to die when they can’t be happy (thereby being selfish in keeping our family members alive)? Or is it selfish euthanasia, that we don’t want our dogs around anymore when they’re not any fun? I certainly don’t think it’s the last one.

Until very recently I hadn’t come to this conclusion. Is it flawed? I don’t think so.

Do humans have an even stronger case?

Humans may have an even stronger case for euthanasia as applied to them. A mind that is more conscious of suffering, that can anticipate future suffering, is a mind that suffers more. Also, in many cases, the object of euthanasia can choose for him or herself whether to be “put down.” Whether we should ever actively euthanize a person who can’t decide (or refuse it for a person who ostensibly can) is a subject for next week.

What does religion have to say?

I put a lot of stock in what the Bible and the church have to say about moral issues. Whether you do or not it’s still useful to look to a group that’s been arguing about morality for much longer than you or I have. And when two denominations that don’t bullshit (tiptoe through the tulips/blow smoke up your butt/beat around the bush) about the issues are in disagreement, something can be learned from their division. And if there’s anything that applies differently to people than to animals, then it must have something to do with the soul, right?

Take the case of Terri Schiavo. The Catholics raised an outcry over this. Their position is that it’s immoral to commit any kind of euthanasia because it’s God who should decide when someone dies.

I was raised in the Lutheran Church, Missouri Synod (which is pretty big in this area). The only newspaper article I read that quoted an LCMS pastor must have found the wrong guy, because he tiptoed through the tulips. The official position of the LCMS (if I recall confirmation class correctly) on euthanasia raises a distinction between active euthanasia and passive euthanasia. Active euthanasia is what got Dr. Jack Kevorkian into the news—administering lethal treatment. The LCMS says this is wrong for the same reason the Catholics say all euthanasia is wrong, because it usurps God’s role in deciding when people should die. Passive euthanasia, on the other hand, is what happened to Terri (or rather her brain-dead body). It’s allowing a person to die of natural causes by removing or failing to administer life support. The LCMS says this is not immoral, because it’s not usurping God’s role. In fact, you might find some LCMS pastors who would say that giving “extreme” life-saving measures is usurping God’s role in life and death.

I have come to the conclusion that both churches are wrong on this issue. Why? Perhaps this has something to do with the reason many people think that God is cruel, or that there can’t be a god because he would have to be a cruel god. God doesn’t kill people! If you believe that he does, you seriously need to rethink your theology and your relationship with God, because Christianity doesn’t make any sense at all if you think God is going around killing people. (By rethinking it, I don’t mean abandoning your faith, of course, but rather seriously considering my view.) Death is a natural result of sin, in Christian theology, and God has nothing to do with sin—ergo, God has nothing to do with death.

(I’m going to e-mail this link to my pastor and see what he has to say about it. I’d hate to take a position when no one is around to champion the other side. It offends my lawerly view of the world.)

Next week: Euthanasia, part 2—I might quote you, link to you, maybe even change my position, and talk about pragmatic concerns.

And now, my usual command: Discuss!