Human Dignity: End of Life

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  Euphemising euthanasia (Part 1)

  Bioethicist Margaret Somerville discusses how we talk about life, death and dignity.

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  SIMON SMART: 21st-century medical advances have in some cases outstripped our ability to process the complex ethical questions that go with them. But not to worry, help is at hand: Professor Margaret Somerville is an internationally renowned ethicist from McGill University in Montreal. She’s thought about these questions for decades. She’s the author of several books including The Ethical Canary and the upcoming Bird on an Ethical Wire: Battles about Values in the Culture Wars. She was in town to deliver a lecture at Notre Dame University called ‘Death Talk: The Case Against Euthanasia’.

  Margaret Somerville, welcome to CPX.

  MARGARET SOMERVILLE: Thank you.

  SIMON SMART: Now we’ve all known people who’ve suffered at the end of life – it’s not hard to see why people are attracted to the idea of euthanasia, is it?

  MARGARET SOMERVILLE: No, and the suffering individual who’s competent and believes that there’s nothing ethically or morally wrong with euthanasia is the strongest case for legalising it. That’s the case that I think we have to deal with, as people who are against euthanasia – as I am – and it’s often put in terms of right to autonomy, right to self-determination, right to control, suffering is equated to a loss of dignity – and they think you can’t do anything to give them back a feeling of dignity. And so the way that the pro-euthanasia case is argued is that their dignity is restored by putting them out of their suffering with a lethal injection.

  And I just want to make it very clear what euthanasia is. Euthanasia is when a doctor has a lethal injection, gives it to the patient, intending to kill the patient. And in Canada euthanasia has been brought in as legal by never using the word ‘euthanasia’, never using the term ‘assisted suicide’. And what it’s called in Quebec is ‘medically assisted death’ and in the rest of Canada they call it ‘physician assisted death’. In one big survey of about 2000 people, 60% of the Quebecers who voted for this didn’t understand that ‘medically assisted death’ was a lethal injection. They were shocked!

  SIMON SMART: Well this is where you say the language we use on this topic is critical in understanding it?

  MARGARET SOMERVILLE: It’s absolutely critical. So first of all, what we do is, I call it ‘euphemising euthanasia’. We put nice, soft, cuddly words on it – we put a white coat on it, because we are used to thinking doctors don’t do bad and unethical things, we think that doctors heal and cure you. So there’s a big project of promoting euthanasia as just ordinary medical treatment, just a little step along the way from what we already accept, such as rights to refuse treatment, turning off respirators when that is an unwarranted invasion, giving fully adequate pain management even if it could shorten life but if it’s done properly that is extremely rare.

  But it’s not a tiny little step from that. A physician intervening with an intention to kill is a radical change in the law; it’s a radical change in medicine having physicians doing that; and it’s a radical change – this is the biggest change of all – in the most fundamental of society’s values, namely, respect for life.

  SIMON SMART: Yes, and so this question around freedom to choose which seems to be an ultimate good now in our society – do you think that’s what’s lying beneath most of this discussion?

  MARGARET SOMERVILLE: Yes, but I think it’s an expression of something else. I think what it is, is that we naturally and understandably all have a fear of death. We always have a fear of the unknown. And we used to deal with that fear in a given place, at a certain time, once a week. We went to synagogue, mosque, prayer house, church, whatever it was, you know? And people haven’t got that place to engage in what I call ‘death talk’, that is, we have to discuss death around some situation and with other people to be able to live reasonably comfortably with the knowledge that we will die.

  SIMON SMART: So what’s lost then when we’ve moved away from that weekly engagement with a community and a story that’s bigger than ourselves?

  MARGARET SOMERVILLE: Well, we’ve got no way to control that fear, and we haven’t got any way to convert it into something that we feel that for the next week we can live with until we talk about it again. And I think death has leaked out, it’s like it’s everywhere – even if you look at the movies and violence on television, things like that. And in a way that’s a way of trying to control death – what the social psychologist called a ‘terror management’ device, and they don’t mean ‘terror’ in the sense of ‘terrorists’ that we talk about now, what they meant it as was that we’ve got this intense fear, it creates a free-floating anxiety, and somehow control of fear makes us feel better. So euthanasia can be seen as a control mechanism for the fear of death, because we’ve lost our other control mechanisms of it.

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