The Jewish Humanist, August 1990
The right to die.
An eccentric doctor, a desperate woman and a bizarre contraption have dramatized that issue. Ever since Dr. Kevorkian assisted Alzheimer victim Jane Adkins to kill herself, the question of justifiable suicide has received undue public attention.
Traditional religion forbids suicide, even the suicide of terminally ill patients. Since God has given us life, only God has the right to take it away. And since God is just, there must be a good purpose for the suffering and humiliation endured by the hopelessly sick. Because the limited human mind sees suffering as evil does not mean that it is evil. God works in mysterious ways.
For traditional religion there is no right to die. Only the threat of sexual violation or religious apostasy can justify the choice of death. And even then, not by one’s own hand.
In recent years the right to die issue has become important because we live in an aging society. Medicine and medical technology are now able to prolong life to the point where the quality of life hardly justifies its continuance. Thousands of -old people are attached, as helpless victims, to mechanical life-support systems. Millions of old people suffer chronic and terminal illnesses -which deprive them of any reasonable control over their fate. They are deprived of dignity and happiness and are condemned to endure a living death.
This medical “advance” has been accompanied by a quantum jump in human expectations. At one time people – expected no more out of life than suffering. Today they expect far more. They want -pleasure, fulfillment and dignity. They are – no longer prepared to settle for resignation and degradation.
The right to die derives from the even more fundamental right to happiness. Life is not sacred when it is all pain, misery and fear. It is not meaningful when all it provides, is the prospect of endless suffering. To view human existence as an irreversible prison sentence is to deprive it of all significance.
People with terminal illnesses, with unendurable pain and humiliation, have the right to die. They have the right to choose death. And they have the right to be assisted by the medical profession to achieve their goal with the minimum of pain.
Many doctors acknowledge the right to die. But they vehemently deny the right to medical assistance. If the patient wants to kill himself, he should not be prevented from doing so. But he should expect no help from his physician. After all, the doctor is under oath to save lives.
But, without medical assistance, the patient is deprived of the expertise he needs to execute the deed efficiently and painlessly. To deny the patient the help of a physician or a medical technician is an act of cruelty. The patient must suffer because the physician is emotionally unable to terminate the suffering or morally unable because of the promise he has made.
However, when morality sponsors cruelty, maybe it is not morality. Perhaps the doctors’ oath ought not to be one to preserve life. Perhaps a more ethical oath would be a promise to heal the sick and to alleviate suffering. The moral and compassionate thing to do is to enable the patient to die.
What are the implications of this morality? Should any individual have the right to recruit any physician to assist him in an act of suicide when he determines that he is suffering from an incurable and unbearable illness?
The answer is no. There is no absolute right to suicide. If there were, we would have to allow depressed teenagers, who cannot endure the pain of hopelessness, to kill themselves. We would have no right to intrude. To leave the decision of what is terminal and unendurable to the victim alone would be to surrender to the distortions of reality which many depressed people suffer from.
The decision of the patient needs to be supported by the concurrence of experts who determine that the perception of the victim is indeed accurate. (There is a terminal unendurable illness.) And these experts cannot be self-appointed (as in the case of Kevorkian). They have to be appointed by the community and be responsible to the community.
Jane Adkins had the right to die. She had the right to be supported in her decision by the medical profession. In a moral world that recognizes her right she would have been assisted by members of her own community – doctors, lawyers, psychologists and clergy. She would have died at home or in any setting of dignity that she would have chosen.
She deserved more than death in a car van. Perhaps her courage will force our society to find a more compassionate way to deal with the rational despair of needy people.