Last month, the New York state Court of Appeals dismissed a case filed by three terminally ill plaintiffs asking the court to declare a constitutional right to “aid in dying,” better known as assisted suicide. The judges wrote, “this Legislature … has concluded that an absolute ban on assisted suicide is the most reliable, effective, and administrative means of protecting against its dangers.”
What could those dangers be? More than three decades ago, the three-term governor of Colorado, Richard Lamm, told a group of health care lawyers that the terminally ill elderly have “a duty to die and get out of the way” instead of trying to prolong their lives. Lamm compared the fulfillment of this “duty” to “leaves falling off a tree and forming humus for the other plants to grow up.”
Fast-forward to the present, when six states and Washington, D.C., have legalized physician-assisted suicide, permitting physicians to order a lethal dose of medication that a terminally ill individual can take to end his or her life. Another 30 states are considering such legislation.
Legalizing physician-assisted suicide has a lot to do with autonomy, a stance that would make a claim like “it’s my life, and I want control over how to end it.” A recent Gallup poll found almost three-quarters of Americans agree.
They maintain: “I should have a right to die.”
The 14th amendment of the Constitution provides us with a right to life, but we have no constitutional right to die.
The philosopher John Hardwig writes “The only way to prevent the ‘right to die’ from becoming a ‘duty to die’ is to reject the ‘right to die’ from the start. Anything else places the most vulnerable, the elderly and especially the disabled, on an already well-greased slippery slope.”
Just think this through. When we fight for a right to be legislated, we’re not just advocating for our own personal situation. Once passed, it becomes society’s responsibility to execute.
With every right comes a corresponding obligation. If we demand a right to die, does that then become a duty to die? A right to life obligates society to protect one’s life. Would a right to die obligate a whole society to help end one’s life?
Western culture values autonomy and productivity. The danger is that this culture could not only marginalize the vulnerable, but it also could require dying in order to make space for the young, vigorous and productive.
Charles Camosy, an associate professor of Christian ethics at Fordham University, speculates: “Suppose that Hardwig’s view was adopted by a patient nearing the end of her life — could we say that her ‘choice’ to die would be truly autonomous and free? Or would her choice in fact be coerced by a number of underlying social factors, including a perceived duty to die and get out of the way of her family and the broader society?”
Hardwig adds that it “would be foolish to think that the ‘right to die’ won’t, much less can’t, one day become the ‘duty to die,’ especially in an aging society where health care costs as a percentage of the GDP are projected to double over the next 25 years.”
They both caution, “That trend, as long as autonomy and consumerism dominate in the West, can do nothing other than continue.” In light of this social situation, it is understandable why so many bioethicists believe that a “right to die implies a duty to die.”
Physician-assisted suicide legislation takes us from a discussion of personal rights to the potential for a corresponding societal duty. Do we really want to go there? I applaud the court’s decision. We need more judges who can see the dangers … and not just the expediency.