By Grace Hemmeke, Right to Life of Michigan Events & Outreach Coordinator
Thanks to Canada’s Medical Aid in Dying (MAiD) program, the topic of euthanasia is in the news again. Euthanasia is a controversial topic, leading some to defend it as a compassionate end to life, preserving human dignity, while others argue that it is inhumane and unnecessary. Because this controversy is over the nature of euthanasia itself, it is impossible to discuss the ethical and political decisions that our postmodern era faces without first looking over the history of what euthanasia is, and how it morphed into a Canadian government program.
The term “euthanasia” is derived from two Greek words: εὖ, (eu), meaning “well, good” and θάνατος, (thanatos), meaning “death.” The earliest use of the word euthanasia comes from Suetonius’s The Lives of the Twelves Caesars, where he writes of Emperor Augustus, saying that he was “blessed with an easy death and such a one as he had always longed for. For almost always on hearing that anyone had died swiftly and painlessly, he prayed that he and his might have a like euthanasia, for that was the term he was wont to use.” This usage does not call to mind a mercy killing or even categorize the death in a medical context. Augustus simply wished to have a painless and easy death, something which anyone in the twenty first century might also call a “good death” such as dying in your sleep, dying surrounded by loved ones, being at peace with death, unafraid, happy, etc.
One of the earliest references to what we today would consider “euthanasia” or doctor prescribed suicide came from Hippocrates, of the Hippocratic Oath, in which he vowed: “I will give no deadly medicine to any one if asked, nor suggest any such counsel.” This looks much like a modern physician assisted suicide. In ancient Greece there was some precedent for giving such deadly medicines to people which would cause Hippocrates to put such a line in his oath. Perhaps the most famous example of physician assisted suicide during that era was the execution/suicide of Socrates, who drank hemlock, despite the pleas of his friends and an avenue of escape from death being readily available to him.
Later, Francis Bacon made a differentiation of types of euthanasia, splitting euthanasia between the interior, or the preparation of the soul for a peaceful death, and the exterior, meant to make life easy and painless as a person died. This use of the term euthanasia marks a change from that of Suetonius. Where Suetonius used euthanasia to mean literally “a good death,” Bacon uses it to mark a preparation of some sort for death.
This is a small, but critical difference. By using the term euthanasia to encapsulate the mental and physical preparation for a good death, the path was open for the term to absorb other kinds of preparation. Physician assisted suicide, practiced for centuries, gradually melded itself into euthanasia. In the 19th century, morphine, a newly discovered painkiller, and chloroform were both used to put critically ill patients to sleep before death, easing their suffering. It was not hard then, for the term euthanasia to gradually expand, eventually encompassing the act of a physician giving not just painkilling, but lethal drugs to a terminally ill patient in pain. These developments were made possible by a series of philosophical schools which rapidly changed the way the world views a human being. The Enlightenment hyper-rationalized man, making Reason the greatest authority of the universe. The Romantics did the opposite and made Beauty or Aesthetic the greatest good. Jean Jacques Rousseau wrote that human beings are essentially good, and that they become evil when they are influenced by society. These schools of thought saw human beings as alone, without a universal “Special Thing” to set them apart. If Reason is the greatest good or Beauty is the greatest good, what does society do with the ugly, stupid person? Can they be considered a person at all?
The logic of these worldviews was carried to its end by Nietzsche, who wrote that God is dead, that the inner desires of humans are morals unto themselves (because without God, who else could create the concepts of “good” or “bad” but humans?), and that humans create humans, that is, we are products of our own making and we can forge ourselves into whatever we want. In fact, Nietzsche stated that the greatest thing any human can do is to do whatever they desire and to refuse to allow society to impose its will on his.
This is largely the worldview through which euthanasia and physician assisted suicide is seen today. One argument for euthanasia is that it gives the patient autonomy. Another is that it keeps the patient from being in excessive pain. A third is that is removes the burden of a terminally ill patient from their family, as prolonged life may cause emotional and financial stress on the family. This is how euthanasia proponents argue that euthanasia and physician assisted suicides are compassionate options for a person nearing the end of their life. If the dying person takes no joy from their life (Romanticism) then why should they have to keep living it? If the dying person cannot articulate themselves, cannot consent or refuse treatments (rationalism) then why should they have to keep living? If the dying person has expressly asked that their doctor end their life, then what authority does the doctor have to refuse that treatment (Nietzsche)? It would be inhumane by all these definitions to refuse physician assisted suicide or euthanasia. It would be grossly uncaring to neglect the wishes of a dying patient.
Now so far, this logic has only been applied to the terminally ill and dying. How if it were applied to someone who was not dying?
A healthy person without the faculty of reason, perhaps someone who is brain damaged or very autistic, has other mental illnesses, would by rationalist logic, be deprived of the very thing which makes them a human being. Their life would be worth substantially less than other lives. Same for romantic reasoning. If a person were unable to be happy, say if they were depressed, if they found no joy in the world, and nothing seemed beautiful or good to them, then they would be lacking the ability to live life to the fullest. The same logic that attempts to extend compassion to the dying has the unintended side effect of offering euthanasia to healthy people. This is why Canada sees homeless, depressed, low-income people applying for MAiD. Though physically healthy, they are experiencing problems that our society now sees as “dehumanizing.” While homelessness, depression, and an inability to pay one’s bills contributes to an injured sense of dignity, none of these things are core to a person’s humanity. A depressed person is still a human being. But from a romantic viewpoint, they are not. From a Nietzschean worldview, a person with the ability to exercise their autonomy, even at the expense of others’ autonomy, is more valuable than the person who holds themself back because they believe there is some higher authority than their own desires.
Such a worldview applied practically takes a dark form. Whole societies have at various times in human history, chosen to accept the view that autonomy is the greatest good. With this understanding, life serves autonomy; it exists to support it. Once the possibility of autonomy ceases, life is useless. A fairly powerful figure holding Nietzsche’s worldview could easily justify the decision to exert their autonomy over people with less power, even to the point of their deaths. An authority figure, such as a doctor, who has been influenced by this kind of thinking could see it as their patient’s right to demand death on their own terms.
Euthanasia is not humane. It comes from a utilitarian idea that life is not a good in and of itself. So euthanasia cannot lead to compassion—because what is there to take compassion on? The person? No, the person is inconsequential, for only their intellect, beauty, pain, or autonomy matters in the decision to die. Today euthanasia is not a “good death.” Euthanasia is not a preparation of the soul and body and mind for death. Euthanasia is a mathematical equation, stating that once the Valued Thing which makes us human is gone, we are without value and all that is left is death.