Euthanasia, Rights, and Metaphysics

Think carefully about how you justify some moral actions because it could turn on you in another moral situation.

I got a hold of the Sunday Oregonian and right on the front page is an article that starts out like this: "Dutch Researcher Warns of Lingering Deaths." The significance of this being a Dutch researcher is with regards to Measure 16, Oregon's new measure that goes into effect in a couple of weeks, physician assisted suicide. The Dutch have been practicing this de facto, though not technically legally for the last twenty years. I think they are a good case example, by the way, to find out where this kind of thing leads, and I'll tell you about that in just a moment. But here you have a Dutch researcher who is a leading authority on physician assisted suicide, and he makes an observation, which is basically, I don't know if you folks realize what you are in for here with this because the fact is that one in four people that we try to euthanize using barbituates don't die quickly [which apparently is the restrictive element in this particular measure; in other words, lethal injection is not an option]. Sometimes the death can be prolonged over two days. He says, I hope you guys are ready for some nasty scenes here because the families are not going to appreciate this when they watch their loved one gasping during a comatose period of up to two days before they finally gasp their last.

Now you might think that that's just kind of an aesthetic thing. It doesn't really deal with the moral issue of physician assisted suicide, and you are right. But there is something else coming out of this article that I think is worthy of observation, and it points to a serious problem with these kinds of things.

I mentioned yesterday on a related issue that President Clinton has banned funding for embryo creation; but he has approved funding for doing experiments on embryos. In other words, you can't make or create embryos for the purpose of doing experiments on these living human embryos, but you can use living embryos that you happen to find here and there. There are some leftover embryos from in vitro fertilization in which the mother had a successful fertilization from one of the eggs that was implanted. They've got to do something with the others instead of flushing them down the toilet, so they can sell them for research. The President thinks that's okay, but creating embryos for that purpose is somehow morally offensive to him.

My response on this issue was that it seems curious that he would approve the one and object to the other because they seem to be the same kind of thing. It showed me that this is a man who was dealing on a national level with legislation that deals with a vital life and death ethical issue who has not carefully thought through the issue, so he has no rationale from which to work to either approve or disapprove these things. If he did, he'd either approve them both or disapprove them both, it seems to me. What it shows is the liabilities and confusion that results when people are making ad hoc decisions about things. In other words, he is kind of shooting from the hip. He is not making a reasoned policy about a particular thing and then applying that policy to an ethical issue.

I think you see a parallel in the paper today, and there is an interesting comment made by the Dutch researcher. He said that in predicting agonizing dilemmas for those who are witnessing such a scene, especially family members, he says that some might be tempted to suffocate loved ones by putting plastic bags over their heads. Now you see the picture? Under the patient's request, the doctor gives a lethal dose of barbituates which may take sixty tablets, according to this one report. Sometimes they can't swallow that many, and sometimes they vomit up the capsules so they get a sub-lethal dose. Or they get a dose that kills them slowly and the loved ones watch this person labor on the brink of death for two days, and they simply can't take it anymore so they say, We're going to end it, and they want to put a plastic bag over their head.

Now listen to the remark of the Dutch researcher. This guy is a specialist in euthanasia. He's assisted in hundreds of these kinds of things, that's why he knows so much about it. He says, "Is that acceptable in a civilized world?" Is what? Killing them? No, not killing them, but putting a bag over their head to kill them. Is that acceptable in a civilized world? "In my opinion, no," he says.

What is wrong with this picture? What this Dutch specialist is saying is that the act of killing itself is not immoral, only certain types of killing are uncivilized. If you want to give them tablets and let them die, that's civilized. Or maybe a lethal injection, which isn't allowed under the present measure, but that's what the Dutch do when they have problems with barbituates. They just shoot them up and they're dead in five minutes. But what about putting a plastic bag over someone's head, which can do the job in about ten minutes as well? Well that's barbaric, uncivilized.

My point is, I don't get it. I don't get how lethal injection or tablets that may require a person to labor on the brink of death for two days are considered civilized, but putting a plastic bag over their head, or maybe strangling them, or lopping their head off is uncivilized. If the idea is mercy killing, shouldn't we kill the person as quickly as possible? If that is the case, then the guillotine is the best solution.

I guess what I am saying here is what has happened as people have made in passing this measure just by a slim margin an ad hoc, emotional kind of response on a deep and substantial ethical issue. They have said, basically, you know I kind of like this idea about mercy killing so let's allow it. And when they do, this decision has ramifications for a whole bunch of areas that they didn't anticipate. And so they run into circumstances like this and they say ridiculous things like putting a plastic bag over someone's head is an uncivilized way of killing them but it is civilized to allow them to linger on the brink of death for two days before they finally gasp their last.

Here's something I want you to latch onto. And I feel frustrated talking about this now, because it's somewhat like closing the gate after the horse is out. But this issue isn't over. Even though it's been passed a couple of weeks ago, measure 16. It isn't over yet because if this goes anything like the Dutch practice has gone, you are going to see the dominoes begin falling and so your voice is going to be very valuable in doing damage control here. The thing that I think people don't realize is that these kinds of laws make metaphysical statements. When I say metaphysical statement, I am not trying to blind you with science here. What I am saying is that this kind of law makes a statement about, in this case, human life that goes beyond mere physical things. It has to do with more ultimate issues. What does it mean to be a human person? Where is the value of being human? And I'm not talking about just a physical body, here. Because I think being a human entails much more than that.

By the way, the arguments for these kinds of propositions assume such. They assume, for example that a human being is the kind of being that one ought to allow to live freely. And so if a person wants to decide to commit suicide and take their own life, they ought to be allowed to do so. Now that is a metaphysical statement. It is a metaphysical argument that says that human beings are not mere animals but they are beings that have a substantial self that has value and ought to be respected. Most of us don't see that same kind of thing in other animals. Because we hold other animals to be metaphysically different than human beings. Now, radical animal rights people see animals and human beings as all just animals and so consequently they have equal rights. It's not an elevation of animals to human rights status, it is a demotion of human rights to animal rights status.

But the arguments in here for something like measure 16 is that a human being has a right to make a choice for himself and that's a metaphysical statement. Because rights for choices don't proceed from mere physical bodies. We can't look at a mere physical body like a mere human being or a mere cow or a mere dog and say that this physical body has a right to anything. We are acknowledging that there is something elevated about a human being. He is a personal being with value of some sort, such that the value ought to be respected by letting him do what he chooses to do. And this is our argument for freedom. Human beings have arguments about freedom and liberty, animals don't and it's a mistake to apply that kind of argumentation to animals. So the point I am making is, when you argue for Measure 16 you are making a metaphysical argument based on something that is uniquely human. A liberty that one ought to respect to choose when one wants to live or die.

What happens though when you pass something like this you make more metaphysical statements than just that. And here's that statement that is made. The statement is that a human life is not valuable in itself. This sounds contradictory. I thought you just said it is valuable that's why we allow freedom and now you are saying that it isn't valuable in itself. My point is, that is exactly true. There is a conflict here. People don't see it. When we pass a law that says that human life is not valuable in itself, but it only has value in that it can product something good, like health or well being or making a contribution to society. It has instrumental value to produce this. Then when the life isn't able to produce this other thing that is valuable, the life is then forfeit. Then we can take the life. You see, once we do that though we make the statement that there is a human life that is not worthy to be lived. Say a human life that is in pain, or one that is a burden on society financially or that can't get better, or any of a number of things that are related that this kind of question. Then you've made a definitive statement, a metaphysical statement about human beings. And you know something? That statement stays and it begins to eat away at other things as well, so that pretty soon, remember this other metaphysical argument, that people ought to be free to choose what they want? Pretty soon, that argument, which is at odds with this one, gets eaten up. And that's exactly what happened in Holland.

Now in Holland, twenty years later, twenty years of de facto, legalized euthanasia, where doctors administer it, nearly twenty per cent of the deaths of that country every single year, 19.4% specifically, are a result of euthanasia. One in five people in Holland are euthanized. But here's the terrifying statistic. That's pretty sad. The one that is terrifying is that 11.3%, more than one in ten, of the total number of deaths in that country, every single year (14,691 according to the Dutch government's own report on euthanasia) are cases of involuntary euthanasia. What's involuntary euthanasia? That's when the patient says, "I don't want to die", and the doctor says, "You're dead", zap.

What happened to this metaphysical right, freedom to choose? That right that you argued for in Measure 16 got eaten up by another statement that is more powerful that the Measure actually makes. Because the measure says this, that your life isn't worth anything in itself. And if your life really isn't intrinsically valuable in itself, why ought we care what you think about when your life should be ended? Your life is valuable if it makes a contribution. It is not making a contribution, so you are out of here. That's not just a slippery slope fallacy. That's not the old domino scare tactic. It's already happening in Holland and it started just this way. That's why when you make this kind of decision you better do your metaphysical thinking first. Instead of having your metaphysical conclusions that you made unwittingly gobble you up in the end.

Greg Koukl

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