Euphemising euthanasia (Part 3)
Bioethicist Margaret Somerville discusses how we talk about life, death and dignity.
Do we – or should we – have the right to choose when and how we die?
Margaret Somerville is originally from Australia but works in Canada as a bioethicist at McGill University. She’s sympathetic to those who see euthanasia as a way of easing suffering – but also strongly disagrees with them. Simon Smart talks to Professor Somerville about what’s happening with euthanasia around the world, why the language we use about it is so important, and why she feels that there’s more to us as humans than we can fully understand.
SIMON SMART: You seem to think that this is a very special issue for our society, why is that? Isn’t this just one of many issues and we can just let this one go because it’s just letting old people who are suffering die?
MARGARET SOMERVILLE: Simon, one reason it’s a special issue is because it’s universal, it applies to everyone. And it’s pretty hard to think of another issue that affects everyone. It’s a human rights issue, because we open up the possibility of abuse, and if we look at what we call the ‘slippery slopes’ in the Netherlands and in Belgium, we can see that once it’s legalised you cannot control either its expansion to other categories of people. For example, in the Netherlands you can now have euthanasia for a disabled newborn baby, if the parents want that, during the first 12 months; and there are people with Alzheimer’s Disease being euthanised, we’ve just had a new report from Belgium that 1 in 60 people who are euthanised don’t know that they’re being euthanised. And so there’s two kinds of slippery slopes: there’s the logical slippery slope, that once you say it’s ok for a person who’s competent, gives informed consent, is an adult, knows exactly what they’re doing, and has terrible suffering that you can’t relieve in any other way, and you go ahead with that, then you say, ‘Well, wait a minute, our reason for allowing this is the right of self-determination and autonomy, so why do you have to be suffering? Wouldn’t it be enough if the person says, “Well I’m tired of life, I’d like this”? Or, wouldn’t it be enough, if they can’t exercise their autonomy because they’re not competent, but they’re suffering? Isn’t it discrimination not to relieve their suffering with euthanasia, where we’d do it if they were a mentally competent person?’ So instead of requiring both justifications, you only require one or the other. And then it goes on, well, what about kids? They suffer too – maybe they need to be able to have euthanasia? And just last week, the Dutch Paediatric Medical Society has recommended that all children have access to euthanasia.
SIMON SMART: So it’s a slippery slope that has some realities that we’re seeing play out already, and so it’s not just your morbid thinking –
MARGARET SOMERVILLE: It’s not my imagination, no. But you raised there the issue of imagination, and what imagination is, is our connection to the future. And we have to be able to imagine as well: where will this lead if we legalise it now? I mean, I think the chances are that if we legalise it now, maybe not a lot of people will be given euthanasia. I don’t know – although currently in the Netherlands the official figure is that 4% of all deaths are by euthanasia, which is pretty high, and that’s definitely an underestimate. But the sort of imagination we also have to use is: how do you think your great, great grandchildren will die if you legalise this now? And I can almost guarantee to you that euthanasia will have been normalised.
The other important thing about euthanasia – we talked earlier on, and you picked up the point that language was important, and we talk about it in nice, soft, gentle, merciful terms. What we now know – and this is extraordinary new research – is that we’ve got experimental psychologists who are looking at how do we make ethical decisions. And what we now know – and I’ve been arguing this for a while, with no scientific evidence to back me up, which of course got me into lots of trouble – but I’ve long-argued that humans have got what I call multiple ways of knowing. And two of the important ones in ethics are imagination, especially moral imagination, and what I call examined emotions, when you have a response to something like you’re going to euthanise someone and take their organs for transplant, which is happening in Belgium, and you say ‘Yuck!’ You know, even we all said ‘yuck’, and we’re used to euthanasia. And that’s your emotions telling you, there’s something wrong. And there’s an old saying in ethics that you ignore your feelings at your ethical peril. What that language, that soft, gentle language does, it suppresses your moral intuitions and it suppresses your appropriate emotional reaction, and so you make wrong ethical decisions or you don’t see that you’re dealing with a very serious ethical issue. So it’s a complex reality we’re dealing with.