The Great Symbolic Euthanasia Compromise

Euthanasia is an ancient question.  You can read about it in ancient texts.  The Hippocratic Oath says that a doctor should not help a patient to die, even if they want to do it.  The Rabbi’s discuss whether it’s okay for people to allow other people to die on the battlefield in Jewish texts.  So it’s an old question, the question of how to die and whether to die or at any particular time.  

We went from one extreme to perhaps another. At least we have gone in one direction over the last 40 or 50 years.  In the 1970’s, this country, the United States was still having an argument that, by the way, is still going on in other countries over the issue of death and dying and what a doctor’s proper role is.  Back then the idea was to save people’s lives at all costs.  It doesn’t matter how much pain they’re in, it doesn’t matter what the quality of life is.  People may not remember this, but C. Everett Coop, who was Ronald Reagan’s Surgeon General, became famous in an argument, a debate, that he had, with a pediatrician at Yale, where his argument was that damaged neonates need to be kept alive at all costs and warehoused, which wasn’t his term, if necessary in large institutions because it is under no circumstances permissible to let a neonate die.  

We’ve come a long way from that.  And now we really believe that there are certain neonates that are so damaged, whose lives will be so miserable that the proper thing to do is not to intervene.  We believe that people have a right to say, “No more treatment.  I’ve had enough,” and to let natural death take its course, to disconnect themselves from life support systems.  

The question is, how much further should we go?  And what’s interesting in this culture in the United States is we’ve made that decision for now.  And how have we made that decision?  Well, the man that forced us to make that decision was Kevorkian, who is now dead.  And the way he made us make that decision was he began to help people to commit suicide.  And he was put on trial twice in Michigan for doing that, and both times he was acquitted. 

And then finally he got on “60 Minutes” and he said, “I’ve been helping people die.  I’ve helped over 100 people die.  But now I’m going to take the next step,” And there was a man named Mr. Yuke who had ALS, which is Lou Gehrig’s Disease, and he was getting to the point in his disease where he was very scared of choking to death or suffocating, which is a real possibility with ALS.  And he asked Kevorkian to help him die.  And instead of setting up a system whereby he could press a button, turn a switch, whatever it was, so at the very last minute it is actually the patient who commits suicide rather than Kevorkian doing it, even though Kevorkian has set up the whole thing, Kevorkian actually injected Mr. Yuke with a series of chemicals that caused his death.  And he said, “It’s silly to set up this kind of canard where I pretend they’re committing suicide when I’m really doing everything and they just have to press a button at the end.” 

He was put on trial for that act and he was convicted.  And what the American public in some sense was saying was an individual should have control over their own life and over their own death.  But as soon as someone else steps in and as soon as someone else acts on them, we don’t want to take that step.  So is that how everybody feels?  Of course not.   But so far that seems to be the line we’re drawing.  Oregon allows physician assisted suicide, but no state allows euthanasia.  

And so we walk that line carefully.  And we as a society have a conversation about it and sometimes we go in one direction and sometimes in the other.  And by the way, another interesting thing that happens that people often don’t recognize: we often want something to be illegal that we don’t actually want punished in a lot of circumstances. 

This happens over and over again.  So apparently in this country, we want smoking marijuana to be illegal, but we don’t want a college kid caught with a joint to be put in jail, not even arrested.  We want euthanasia to be illegal, but the elderly man seeing his wife in the throes of death from some terrible disease who can’t stand her pain anymore and finally helps her end it, we don’t want him punished.  

These are kind of symbolic laws.  That is, we want them on the books because we want to express our disapproval.  And by the way, that’s how, I think, we feel about embryo research too.  I can show you polls that show that say “I’m against the use of embryos in research” and “I’m against delaying cures for Parkinson’s and Multiple Sclerosis because of objections to using embryos.”  The same person will say both of those things even though they’re completely contradictory.  

I think this is a phenomenon, an unappreciated phenomenon, that we want certain things called illegal because we have great moral reserve about them, but in a practical sense, we’re a lot less worried as long as they’re done cautiously, as long as people are overseeing them and respect them.  

I think that’s where we are with euthanasia and physician assisted suicide.  The vast majority of people don’t want someone punished who engages in euthanasia in a way that we all think of as proper.  That is, someone dying in great pain, his quality of life is gone, who really wants it.  When people engage in that kind of euthanasia, the vast majority of people think they shouldn’t be punished.  But the vast majority of people think that euthanasia should be illegal.  

So that’s where we stand now in that kind of compromise, whereby we all understand all the difficulties of dying and the pain of dying and the agony of dying needs to be mitigated to the degree possible and sometimes stepping over the line of legality is the right thing to do, but it’s such a problematic area that we want that line to exist so that we can always appeal to it when people step over it improperly.  

In Their Own Words is recorded in Big Think’s studio.

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