Sunday, November 27, 2011

Euthanasia: a slippery slope

Youth in Asia?
It was 1978.  The teaching assistant of my Russian Literature seminar entered the room. He sat down at the table and said, “Today we are going to talk about youth in Asia.”  My classmates and I looked at one another, puzzled. Sensing our confusion, he stood up and wrote ‘euthanasia’ on the chalkboard. “Mercy-killing,” he said. The debate was on. More than three decades later, the debate is heating up.

Last week, the Royal Society of Canada (RSC) released its report, “End-of-life decision making.” The Parliamentary Committee on Palliative and Compassionate Care also released its report. And, there is presently a legal challenge before the Supreme Court of British Columbia that seeks to decriminalize euthanasia.

Link to RSC report:
Link to Parliamentary Commiteee Report: 

Euthanasia, an act of compassion or moral confusion?
Euthanasia, which literally means “a good death,” has come to be defined as “the intentional killing by act or omission of a dependent human being for his or her alleged benefit.”

The proponents of euthanasia seem to value life, just as those opposed to it do. At the heart of the push for the decriminalization of euthanasia is the desire to ease suffering for the dying or the terminally ill and their family. Some would argue that euthanasia is a compassionate action because the elimination of suffering helps people experience a good death. 

But, enshrining euthanasia in law is a dangerous path for a society tread. It can lead to the slippery slope of moral confusion regarding the value of a particular individual’s life. Who decides when a person’s life no longer has value or meaning? Who judges the quality of that life, and on what criteria?

The RSC report recommends that Canada adopt a “permissive yet carefully regulated and monitored system with respect to assisted death.”  Based on evidence from other countries, the RSC dismisses the slippery slope argument. The report states that the decriminalization of euthanasia is not a threat to vulnerable people, nor does it lead to non-voluntary or involuntary euthanasia. 

The Netherlands
These two claims are debatable. The experience of the Netherlands, where voluntary euthanasia has been legal since 1984, suggests otherwise. In 1999, the “Journal of Medical Ethics” published a paper reflecting on the results of a 1995 survey of physicians. The survey found that in 20%, or 900 of 4,500 reported cases, patients did not request or consent to having their life ended. Some of these patients were mentally competent at the time of their death, while others were not. In two-thirds of these cases, the patient and physician had never even discussed euthanasia as a possibility.

The study also revealed that physicians withheld or withdrew life-prolonging treatment in 41 % of 1000 cases of infants under one year of age because they felt the baby’s life would be unbearable. In 20% of these cases, parents were not consulted.

The paper concluded that “the practice of voluntary euthanasia remained beyond effective control,” despite regulated guidelines and the duty to report enshrined in law. Although it was illegal, physicians were carrying out involuntary and non-voluntary euthanasia.

The physicians surveyed were not bad, evil people. They believed they were acting in the best interests of their patients. They were deciding which human life had value, meaning, and quality.

A study published in 2010 in the "Canadian Medical Journal" looked at physician-assisted deaths in Belgium, where voluntary euthanasia has been legal since 2002. That study also found that involuntary and non-voluntary euthanasia was occurring.

Dutch Physicians Association
The Dutch Physicians Association (KNMG) released a position paper on euthanasia this fall. The KNMG paper recommends that non-medical reasons, like loneliness or financial difficulties, should qualify a person for euthanasia. The rationale is that non-medical factors also cause unbearable suffering and affect an individual’s quality of life.

It's a slippery slope
All of this points to moral confusion; the slope seems slippery to me.

In the Christian worldview, life is sacred from conception to natural death. End-of-life decisions flow from this premise. Ordinary medical interventions and treatments must always be taken to preserve life.  Therapies that deliver compassionate and palliative care are essential to preserving the dignity of the dying person and contributing to a good death.

The RSC report acknowledges that Canadians are not preparing adequately for death, and that quality palliative care is not readily available.  The Parliamentary Committee Report makes recommendations for establishing a national system of compassionate and palliative care.  This is the direction in which we should be moving.

If we want to avoid the slippery slope, we need to choose a path based on the spiritual principle that life is sacred, from conception to natural death.

Saturday, November 12, 2011

Reflections for Remembrance Day

Tyne Cot Cemetery by Marc Aert

Since its original inception as Armistice Day in 1919, people in countries around the world gather on November 11 to commemorate the thousands of men and women who died in armed conflicts.

Over time, the international community has developed a set of traditions to mark the day, and to set it apart from other days. We wear poppies on our coats. We lay wreaths. We observe a period of silence. We listen to the roll call of those who died. We express our collective desire for peace. 

Peace - the absence of war or hostilities
Peace is defined as the absence of war or hostilities. The definition of peace suggests the reality that Remembrance Day draws to our attention; the world struggles with peace. The world defines peace by what it is not. Peace in this definition is a political reality; a nation or nations are not at war.

Growing up in Canada, I can relate quite easily to this definition of peace because my experiences of war are vicarious. I know about war not because I have lived through one fought on Canadian soil. I know about war because I have seen images of it on television, read about it, studied it, and listened to the wartime stories of others.

Family stories of growing up during World War II
My father has some fascinating stories about growing up on a farm in northern Italy during the Second World War. He and his family were no strangers to the insecurity that war creates. They lived with hunger, poverty, and a sense of an ever-present danger that accompanies living in a war zone.

Some of his stories are humorous, like the story of the bridge. The German soldiers repeatedly attempted to blow up a nearby bridge to cut off the transportation route. Instead, they repeatedly blew up ground around the bridge, always missing the bridge itself. This was a source of amusement to the villagers, and provided them with lighthearted moments of relief while living with the tension of war. After a time, the villagers began to suspect that the failure to destroy the bridge was a sort of mutiny. Everyone needed the bridge; it was a symbol of the common good.

One of my favorite stories speaks of the persuasive power of conviction. Towards the end of the war, as discipline in the German army broke down, my grandparents routinely assisted German soldiers who were deserting their posts. They did this although they were putting themselves in grave danger.

One day, members of the Black Shirts, a paramilitary Fascist group of armed thugs, descended on the farm. With guns pointed, they demanded that my grandmother hand over the two soldiers the family was hiding. My grandmother calmly told the men to leave. When they refused, looking the leader steadily in the eyes, she revealed the handgun under her apron, and repeated her request. Remarkably, the men backed away. They never returned.

They shared a common humanity
What was it about my grandmother that made such a profound impression on these thugs that they obeyed her? I think it was the strength of her conviction that she, the German soldiers, and the Black Shirts shared a common humanity. Her quiet but strong demeanor unearthed the goodness buried deep beneath the exterior cruelty of this particular group of men. She was the bridge of common decency that rehabilitated these men, at least temporarily.

My grandmother’s actions speak of an unshakeable belief in the inherent dignity of the human person. The German soldiers that she helped were not the enemy, the hated ‘other.’ They were simply young men, not much older than her sons. Like her sons, they too bore the image of a good God, and deserved respect. To hand them over would have been contrary to her belief.

The Universal Declaration of Human Rights
In 1948, as a direct result of the atrocities of World War II, the United Nations adopted the Universal Declaration of Human Rights. The members of the drafting committee came from a broad spectrum of political, cultural and religious beliefs. Despite their differences, Hernan Santa Cruz of Chile, a member of the committee, said they came to this consensus: the supreme value of the human person comes from the very fact of existing, not from belonging to a particular nation or group.
Read Santa Cruz's remarks:

Remembrance Day is a fitting moment to recall the preamble to the Universal Declaration of Human Rights.  The foundation of freedom, justice, and peace depends on recognizing and honoring the innate dignity, and the equal and inalienable rights of all members of the human family.
Read the Universal Declaration of Human Rights: