Autonomy Über Alles

As with a number of evil ideas, physician assisted suicide can be defended without great difficulty. The magic word for making the case is “autonomy”—the right of individuals to make choices about their future (or, here, lack of one).

That is precisely the argument that was made in Oregon, Washington and Montana, states that have legalized assisted suicide (or, as it has been renamed in Newspeak, “death with dignity”).

The same argument was made (and the phrase enshrined) of late in Massachusetts, where voters, by a slim margin rejected the “Death With Dignity Act,” permitting doctors to help patients kill themselves if they are “terminally ill.”

Every life, however, has a terminus. Mortality happens; in fact it’s currently the rule. And so, “terminal illness,” at least philosophically speaking, is a meaningless term. (Halacha recognizes a state of “in the actual process of dying”—goses—but that concept is of no pertinence here; it is forbidden to kill a goses.) One is either alive or one is not. And suicide is either an autonomy-based human right or it isn’t.

It pays to consider some questions here. Why do civilized societies consider a healthy person who wishes to end his life to be terribly misguided? Why do law enforcement and social service agents do their best to intervene when people stand on bridges or window ledges with intent to carry out their autonomous wishes? The justification for doing our best to prevent suicides is based, first and foremost, on the fact that most would-be suicides are the product of psychological depression, a state that is not necessarily permanent, as is (at least until techyas hameisim) death. Depression can pass, and it can be amenable to medical treatment.

That is why animals never willingly kill themselves. (The popular notion that lemmings do is a mistaken one.) Only humans can suffer deep angst.

Another question: Why do we care about someone, depressed or not, who chooses to end his life? Answer: Because the end of a life means the undermining of whatever relationships, accomplishments, and good deeds potentially lie in the death wisher’s future. By cutting off that future, he deprives himself, and his relatives and friends and society, of unknown and untold meaningful benefits. He, quite literally, wastes a life.

Which leads to the next question: In the case of a person deemed “terminally ill” who wishes to be helped to kill himself, are the facts above any less true or pertinent? The answer is no.

Despite assumptions to the contrary, the impetus for suicide in such cases is usually, if not always, likewise motivated by psychological depression, just as in cases of suicidal people who are physically healthy. Doctors who assisted “dignified” suicides in Oregon between 1998 and 2009 reported that a mere 22% of those patients were in physical pain or fearful of its onset. The vast majority simply felt anguish over their physically compromised lives or over the toll their lives were taking on their loved ones. Food for thought for anyone who considers a physically healthy person’s suicide a terrible tragedy but an ill person’s a mere matter of autonomy.

And in 100% of the Oregon assisted suicides, of course, as in 100% of all suicides, those who perished were rendered unable to accomplish anything meaningful after their wishes were carried out.

What meaningful accomplishment could a bedridden, sooner-rather-than-later-to-die person possibly accomplish? To ask that question is to demonstrate a severely limited understanding of human life’s import. It doesn’t lie in running or jumping or being entertained; nor in traveling or reading or surfing waves or webs. The most meaningful matters any of us ever can access are things like forgiveness, repentance, prayer, commitment, love, and fulfilling what we believe is G-d’s will.

If meaningful life is defined as dependent on mobility and physical gratification, then the notion of “autonomy über alles” may make moral sense. But if we recognize that life’s true meaning transcends physical activity and sensations, then there is no difference whatsoever between assisting a healthy would-be suicide and one who happens to be sick.

Human life is human life. Whether at its earliest stages or its final ones, it is invaluable.


The above essay may be reproduced or republished, with permission and the above copyright appended.

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