The problems of choosing death

I have been asked to share with my small international audience some thoughts about a public initiative in the Netherlands, which aims to give the elderly the right to choose their moment of death. In the proposal, this is a right to be given to everyone over the age of 70. In the Trouw newspaper, philosopher Paul van Tongeren goes over some of the objections against this proposal, in an article titled Self-chosen death is impossible.

Outright discussion of the affairs of society and politics is something which I have general avoided. Not because I consider it unimportant, but mainly because I fear my knowledge is lacking. Not that I have an extensive knowledge of Church and theology, but those topics are this blogs objective. Society is not, although the two obviously and rightly influence each other.

Euthanasia, like abortion and any other practice involving the murder of humans, is a grave sin. That much is clear. It is directly stated in the Fifth Commandment: You shall not kill. As far as historians can trace it, the wilful murder of people has always been considered intrinsically evil, although there have been societies which allowed it (and continue to do so) in certain circumstances. But what a society chooses to do has no effect on the objectivity morality of an action.

This as an introduction. Now let’s take some of Mr. van Tongeren’s arguments against the ‘free choice of death’ initiative.

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His first point, a relative argument, is the question how we can know what the death wish means. Is it a result of bad living conditions and can it therefore be remedied by improving those conditions?

He then questions the arbitrary age limit of 70. It is said that that age has been chosen because a death wish occurs more often in people over 70. But there is a risk in establishing that age as a boundary. Once implemented, we’ll see that the death wish occurs more often in people over 60. It is a boundary that demands adjustment downward. And there is another risk: people will have to explain themselves once they’re 70 and don’t want to die just yet.

Another point is if and how outsiders can decide if someone is ready to die. Would outsiders be so keen to decide in favour of death? Mr. van Tongeren says yes. One of the people behind the initiative, Hedy d’Ancona, said twice in an interview on Radio 1, that she know a few people of whom she thought that they were ready to die. There is then an outside pressure on the elderly to choose in favour of death.

The discussion that goes into more philosophical principles, most notably the principle of autonomy, related to the opinion that we are autonomous people who decide over our own life and death. Kant, one of the staunchest defenders of autonomy, said that when you do what you want because that seems attractive, you are not autonomous, because you don’t decide what you want, but are being led by your desires. Then you are heteronomous. You are only autonomous when you fully act according to reason. That means, among other things, that we have no automatic right to do whatever we please when, at the same time, we claim to act according to the principle of autonomy.

Self-determination does work ‘horizontally’. Someone who wants to order me about, has to justify himself, not the other way around.

In the history of philosophy we encounter a problematic but intriguing argument against self-chosen death: suicide is impossible. Of course, it happens and it that sense it is possible, but it can be countered logically, so it is a logical impossibility. Someone who wants to commit suicide chooses death, but that is not a choice between one thing and another (as when we normally want something). It is a choice between something (life) and nothing (death). And philosophy says: you can’t want nothing.

Van Tongeren explains to two forms of wanting: the object wanted, and wanting to be the wanter. We choose to want. Someone who wants to die, wants to stop being the wanter, which is a denial of wanting anything.

All that will not change the mind of someone who wants to die, but it indicates a problem. It’s not something we can want like we want other things. denying that problem is denying that there is any difference between wanting to die and wanting to go on a holiday. That is ultimately a denial of the very nature and identity of the death wish.

Van Tongeren closes with emphasising the importance of taboos in western civilisation. Taboos indicate boundaries that can’t be defended or defeated by logical arguments, but which society possible. Crossing them has destructive consequences.

Does it make sense to want to decide to die? We don’t decide we want to live. If we have no self-determination at the start, would it not be fitting to not have it at the end?

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It’s a difficult social  and ethical problem, this question of whether or not we should allow the free choice of death. I do think, like Mr. van Tongeren, that such a choice is the top of a downward slope. Not only is it a choice based in nothing more than gut-feeling, and as such it fails to acknowledge the differences between this choice and the choice of what you want for lunch today, it also tackles a taboo.

Taboos are not popular. Many people in our postmodern society consider them limits to our freedom. But are they? Are they not guidelines that lead to freedom? After all, any society without rules will quickly descend into chaos. Is that the freedom we want? Does that not limit us even more? I would say it does.

A life is sacred, in the religious and the social sense. We have neither the ability nor the right to give or take that life. There is not self-determination involved in the beginning and end of life. That does not make it easy. But do we measure our existence by the amount of pain we have? No. A person’s life is measured by his or her achievements, by the positive influence it has on us and on society.

We have a duty, an obligation to always choose life. The other choice is nothing but the easy solution and anyone knows of situations in their own lives where nothing is gained by the easy way out.

In a totally unrelated conversation, the following quote, from The Dark Knight of all things, came up: “It was always going to get worse before it got better.” The value of our goals can often be measured by the difficulties we have in achieving them. Difficulties are not inherently evil, although we rarely recognise them as such while we suffer them.

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6 thoughts on “The problems of choosing death”

  1. As for terminally ill people I have heard of them. In a sense we are all terminally ill, as we are all headed toward death. If knowing you are going to die is a reason to kill yourself, we should all do it immediately.

    Mark, I would add to the argument that the initiative would create a conflict of interest in health care providers, which would then have incentives to withhold or deny palliative care.

  2. No fighting here, please. I’ll (partially) delete personal attacks against me or other commenters. I welcome debate, not name-calling.

    Mike: I haven’t even considered the health care providers yet. In the Netherlands there is the advantage that the providers are, to a major extent, under government scrutiny. There is a minimum care they must provide, even though the market is free. But if the government would set an age boundary as proposed, the health care providers would possibly direct their clients towards the wrong choice.

  3. Hi incaelo,

    You wrote about euthanasia:
    “Not only is it a choice based in nothing more than gut-feeling, and as such it fails to acknowledge the differences between this choice and the choice of what you want for lunch today, it also tackles a taboo.
    Taboos are not popular.”

    Taboo’s are not popular for a good reason; imagine a world where depression, AIDS, homosexuality, child abuse cannot be discussed. You can go to those places, talk to ‘it’s victims’, read book, watch documentaries and see what the dark side of taboo’s can entail.
    You forget to highlight this, only to say limits and taboo’s encourage freedom. Sure that’s the bright side of the medal. Yes, rules about what’s good and bad, morality is needed, I totally agree. But morality is more then only this, read Kohlberg, read the New Testament, read Nietzsche.

    Ask yourself, how much of the opposition to euthanasia is due to the fear of death of due to the fear of taking responsibility, or fear because religion or society tells you it’s not right? I’ve seen it in myself and in others.
    Ask yourself, how much of the propositon to euthanasia is due to fear of death itself, fear of loosing direction in your life, I’ve also seen it in myself and others. A good friend told me she saw a man sitting up in defiance of death until he toppled over. Death itself was the taboo here.

    You suggest that the choice for euthanasia is nothing more then a gut-feeling, indistinguishable from the choice for lunch. As you know there are regulations in the Netherlands to avoid this. “I feel a little depressed today, well I’ve had a good lunch and a good life, lets end it…”, as if all people who go into this are like that! This is a skewed view, the choice is debated thoroughly with 2 experts in the field. No nothing is perfect, but we should do our best imo not push it into taboo land again. I can recommend the recent Dutch documentary’s (search for Euthanasia on uitzending gemist) on the topic, Wilber’s “Grace and Grit” final shattering chapter. There is lots of literature on the topic:
    http://www.carefordying.org/mainwebsite_html/books/bookDeath.html

    It’s possible to totally surrender and willing it at the same time for the right reasons. People have been there. This should not be a taboo, there should be room to discuss this possibility (which you seem to deny, correct me if I’m wrong) with mutual respect.

    On the other hand… I can wholeheartedly agree that individual choice is overrated these days, but for me this doesn’t automatically mean individual choice should be forbidden in the taboo cases.

    1. I didn’t go into the topic of what a taboo is and is not, that’s right. Nor did I really see a need in the context of this post.

      True, there are taboos and taboos. But taboos are, at least in this case, not so much taboos on speaking about topics, but on actually implementing them. We can discuss euthanasia and abortion without problem, but we shouldn’t perform them. The same goes for child abuse, homosexual acts and such.

      There’s an important difference there. If there was a taboo on euthanasia according to your definition, I would not have written this blog post.

      Euthanasia is definitely the result of fear, fear of losing control, fear of dying. That, in my opinion, is why people want to be as prepared for it as they can. It is the unknown that scares us, and people will do a lot to get rid of as many unknown factors as they can.

      I never suggested that choosing death will eb as simple as you suggest when you say: “I feel a little depressed today, well I’ve had a good lunch and a good life, lets end it…”, as if all people who go into this are like that!

      What I say is that once the option of voluntary death after the age of 70 becomes regulated in law, people will, perhaps involuntary, be influenced to choose that option.

      And since I firmly believe that we shall not kill… you see the dilemma.

      Total surrender is certainly possible. But that involves not controlling everything that happens to you, including death.

  4. Hi Mike, the topic was about voluntary euthanasia. Concerning involuntary euthanasia, I’m curious what the number are in countries where it isn’t regulated. The percentage of is going down over the years, a good thing, even though I am not sure the effect is really is due to regulation (it might have been studied by the statistics buro).

    I do agree with van Tongeren, individual choice regarding death is problematic (a dutch zembla documentary about a man choosing and forgetting his decision for euthanasia because of dementia is a good illustrative example) incaelo and I discussed this in a wider perspective regarding voluntary euthanasia in general in which I strongly disagreed with his assessment (which is not that of Mr. van Tongeren!) that voluntary euthanasia is always about the easy way out or a casual or impossible choice.

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