Apprehending One’s Situation

I appreciate Patrick Lee’s participation in this conversation about life and death.

We are, however, unalterably at odds on the morality of death with dignity. I appreciate Lee’s ethical foundation. One’s life, he maintains, is always inherently valuable and worthwhile and should be respected. Therefore, one ought not to choose to destroy what is inherently valuable. One should not commit suicide, certainly not with the assistance of a doctor. Because life is worthwhile, medical science will do all it can to relieve your pain–even if this means indirectly causing your death (the “double effect”).

My moral bottom line is rooted in individual autonomy, the liberty of a competent adult to carefully apprehend his existence and to choose an action that he believes is in his best interest. I end with some lines from my first essay and a question:

“When I can’t tie my bow-tie, tell a funny story, walk my dog, kiss someone special,” said a man dying of ALS, “I’ll know that life is over. It’s time to be gone.” For this terminally ill person, PAD is how he will go.

Evidently, this dying person chose to die because, for him, his life was no longer inherently valuable. He has examined his existence and has concluded that very soon the life he has known will be “over” before ALS kills him.

Is it morally wrong for that dying ALS patient, with the assistance of a doctor, to end his life before the illness takes it away? I do not believe that it is morally wrong. If a terminally ill patient, after apprehending his situation, believes he longer has a valuable, worthwhile life, he can choose the “least worst” death.

Also from this issue

Lead Essay

  • Howard Ball reviews the recent history of physician-assisted death (PAD) in America. He argues that it is a fairly direct outgrowth of other trends in our society, including the medicalization of death, the movement toward palliative end-of-life care, and the longstanding concern for individual autonomy that has characterized American legal and political thinking. Social values evolve, and he argues that allowing physicians to assist patients in dying will eventually come to be an accepted value as well, as a matter of compassion for those who are suffering.

Response Essays

  • Philip Nitschke looks back at the Baby Boom generation. All through their lives, they have broken the mold, in women’s rights, contraception, divorce, and many other areas. Now, as they approach retirement and the end of life, they are again breaking the mold. Death isn’t what it used to be, and a long, drawn-out, medicalized death may not be to everyone’s liking. Yet the law has often lagged behind, and one might even question, with Nitschke: Why do we need law, or physicians, in deliberately ending our own lives?

  • Patrick Lee urges us to observe the difference between committing suicide and foregoing burdensome treatment. Committing or assisting a suicide both disrespect the intrinsic good of human life and are objectively morally wrong. We rightly abhor pain and suffering, but this sentiment should not lead us to attack the person who is experiencing the pain and suffering. If we do, the lives of the elderly and disabled throughout our society will be devalued, with grave consequences for all.