Right to Die

Braun, Will. Competent adults to get right-to-die. Canadian Mennonite, Volume 19 Number 5, March 2, 2015, p. 18

Enns, Ruth. Court turns medicine into 'death dealing. Canadian Mennonite, Volume 19 Number 5, March 2, 2015, p. 19

As in many of our most challenging moral issues, it's really difficult to decide which is the all-important platform from which a case can legitimately be argued. In Will Braun's article in the Canadian Mennonite, two competing platforms emerge from the deliberations of the Supreme Court of Canada resulting in their decision regarding the current ban on Physician Assisted Death: one is the “autonomy and dignity of a competent adult who seeks death as a response to a grievous and irremediable medical condition;” the other is “the sanctity of life and the need to protect the vulnerable.”

      And as is so often the case seemingly-logical, persuasive arguments can be made that are in total disagreement with each other, depending which platform the debater has chosen to stand on to mount a particular defense.

      In logic, there's a flaw that's called 'begging the question.' In essence, it means that an argument that may appear to come to a perfectly satisfying conclusion fails because one or more of the premises on which it rests has not been proven. Take this example: “Adolescents have not yet developed the maturity to make quick decisions in dangerous situations, therefore no drivers' license should be granted to anyone under the age of 16.” The truth of the conclusion depends on the reliability of the supporting premise. We know that reaction times, judgement under stress and so on do not develop equally quickly in all adolescents, so although we have as a society accepted arbitrarily that it's true enough to make a rule, the assertion that “ no drivers' license should be granted to anyone under the age of 16” is rendered weak based on the shakiness of its supporting premise.

      So how valid are the premises on which supporters and opponents of the Supreme Court's ruling base their respective conclusions? If I'm allowed to rephrase the opponents of PAD's argument to say that PAD should not be allowed because life is sacred, then I need to consider whether life sanctity is an assumed value among the population falling under the Canadian Charter of Rights and Freedoms. In logic, the conclusion begs the question because a) we have never established what sanctity and sacredness mean as regards life, and b) there is no direct connection between assumed life sanctity and the certainty that it must be prolonged at all costs. 

     All kinds of activity in our culture could argue for and against our understanding of life sanctity including our slaughter and ingestion of animals to our decriminalizing of abortion, to medical experimentation on animals and (sometimes humans), our production and use of weapons designed solely for ending human life, etc. And on the other side, our monumental efforts to save beached whales, our struggles against inhumane and careless killing seem to support the sanctity premise. But the record on our values in this area are really, really mixed.

      In the logician's catalogue, the sanctity of life is a red herring when it comes to debating PAD; it can't stand the test of the incorruptible syllogism.

      For those who choose the other platform—basically the right to choose one's time of death argument—the main supporting premise derives from the Charter of Rights and Freedoms and however one words that and whichever equality/fairness clause of the Charter one chooses to quote, the gist is that if an able-bodied person is able to choose his/her time of death, a suffering, disabled person ought not to be deprived of that same right. Again, the conclusion begs several questions: a) the assumption that our common values include autonomy of the individual and b) that we are entitled to dignity, in this case, dignified passage from life to death. According to Braun, the court assumed these premises as supports for its conclusion that banning PDA encroaches on basic human rights.

The questions being begged here, then, are: a) is it my right to make an end-of-life choice autonomously? and b) are we clear in law about what constitutes death-bed dignity?

      I have a great deal of confidence in the Supreme Court's ability to separate the wheat from the chaff on legal matters and to plough through the emotions and anxieties that might seek to force decisions seeming right to certain ethical worldviews although not to others. If a law is necessary (like the one which until now made it a criminal offense for a physician to assist in hastening a death), then that law has to be one that best fits a multicultural, multi-faith, multi-ethnic Canada; it can't be a law that satisfies philosophical liberals while offending conservatives or v.v. It's why we have a Supreme Court to test issues like the one at hand and whose decisions invariably have one group cheering and the other complaining.

      Obviously, a court ruling in a matter like PAD is never the final arbiter on what will actually happen in practice. Through the use of heavy doses of pain killers and other drugs, doctors have always helped smooth the way to dignified death when death was determined to be inevitable; whether or not the hastening effect of these actions constitute PAD or euthanasia is a question that might someday be legally tested. In other words, the area is grey, not black on white. The Supreme Court's decision will ensure that doctors can assist in a peaceful conclusion to a life without fear of being charged with a criminal offense for what constitutes a merciful, professional action . . . always assuming legitimate consent, of course. The Court has—to its credit—defined what constitutes legitimate consent.

      Also to be considered, of course, are the slippery slope questions. I'm generally skeptical of such arguments; they appear to be last-ditch attempts at a lost cause. I'm confident that the Court has done its best to prevent abuses that would, for instance, result in a PAD administered in a moment of weakness, as a “remedy” for a condition for which other, life-enhancing treatments are available, “getting rid of grandma so we can get at her will” attempts, etc., etc.

      I empathize with doctors for whom any hastening of a death represents a crisis of conscience. I leave it to others to determine if a doctor choosing not to administer a PAD procedure could be subjected to a penalty for withholding treatment. It's my understanding that no doctor is now compelled to perform an abortion where conscience is at stake, no minister is obliged in law to marry persons whose union he/she cannot support in good conscience. Freedom of conscience, too, is one of our deeply held values and I would hope that it would always inform us when difficult choices place professionals, demanding and/or needful persons and the law into the same ring at the same time.