Dying for autonomy

By Jennie McLaurin  |  ChristianWeek Columnist

Efforts to legalize euthanasia continue in Quebec. Doctors say they don't necessarily support euthanasia, but they do want guidelines to protect their potential complicity with ending a patient's life. Proponents of euthanasia appeal to the right to avoid a gruesome death, unending pain and drawn-out suffering. They criticize opposition as unfeeling and dismiss all arguments against euthanasia as forcing a faith-based idea on the general public.

The arguments are a bit stale. What about the reality? Quebec might learn something from Washington State, which enacted a physician-assisted suicide bill one year ago. This measure is more conservative than Quebec's proposition; Washington's law requires patients to self-administer their own lethal dose of medication. The measure was passed based on the same assumptions voiced by the Quebec euthanasia advocates.

Washington records data on "death with dignity" patients as part of the public record. A total of 63 prescriptions were written in response to the legalization of lethal dosing, and of these prescriptions, 36 have been used to induce death. Some who received prescriptions died from their diseases rather than from a lethal dose.

What drove these people to choose a scheduled death over a death by natural causes? It wasn't to avoid pain or physical suffering. The Seattle Post-Intelligencer's headline states: "Autonomy, not Pain, was Concern for Washington's First Assisted Suicides"(March 6, 2010). "All were concerned about loss of autonomy, 82 per cent about loss of dignity, and 91 per cent about losing the ability to participate in activities that made life enjoyable. Only 25 per cent mentioned inadequate pain control, although 79 per cent had cancer; 23 per cent feared being a burden," the article reported. Clearly, even the secular pundits were surprised at this news.

Autonomy and dignity. Evidently dependence, even interdependence, is to be feared more than death. Life somehow loses its dignity and possibility for expression when we are not in control. For euthanasia advocates, it seems that what makes us most human is our capacity to live apart from other humans. How odd to hold a core value that ultimately demands our self-destruction.

Is autonomy even possible? It is hard to imagine anyone who is really autonomous. We start out as infants, dependent and even burdensome. That dependence continues throughout our childhoods. We see enjoyment and dignity in all stages of family life, which so necessarily subdues autonomy in favour of interdependence and self-giving.

Euthanasia proponents argue that potential for adult autonomy is the distinctive issue. In fact, those with poor potential for self-rule are in peril. Abortions are often considered appropriate for those who might not grow into independence. And no matter how autonomous one has been, losing autonomy erases a lifetime of worth. Calculations based on autonomy rarely come out in our favour.

Our secular stance supporting autonomy is unusual in world cultures. Community over the individual, family over self and sacrificial care of weak elders by strong youth are more normative. What we might scorn as passive fatalism is seen by other cultures as dignified patient acceptance of life's sorrows. The criticism of an unfeeling stance toward those who suffer can be directed right back to the autonomists.

God does not call autonomy good. We give rule of ourselves over to Christ. We are made for relationship. We receive dignity and joy as we love God and love our neighbour. The body of Christ mysteriously connects us all with each other. Even our God is Trinity.

We don't believe in autonomy. We believe in contingency, dependence and interrelatedness. We believe in frailty and finitude. We believe in paradox, where the little ones are welcomed to the table of the grand, the last shall be first and the master is servant. That is dignity that can't be lost.

Jennie McLaurin is associate professor of bioethics at Regent College and a physician with 25 years of experience serving poor migrant communities.

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