Can we return death to disease

Can We Return Death to Disease? Why does the interest in active euthanasia and assisted suicide seem to have taken on a renewed vitality of late?(1) The question is worth pondering; the answer is not all that obvious. It is hardly a new topic, going back to Greek and Roman classical culture. More recently, it has had some zealous supporters in Great Britain, since the mid-to-late 19th century, and in this country since early in the 20th. As far back as the 1930s the topic was debated in a few state legislatures, and bills introduced to legalize it. But until the past few years it was never a powerful or widespread movement. It is quite possible, indeed, that it is still not as potent as it may appear on the surface (as the recent defeat of the California initiative suggests). Still, there does seem evidence of new stirrings in this country, and the situation in Holland represents a prominent and visible case of change in a country with values much like ours. What is going on? The darkest interpretation is that it is simply one more manifestation of a growing disrespect for life. This view sees it as part of the falling series of dominoes that stretches back through the Babies Doe and Jane Doe cases in the early 1980s, the Claire Conroy and other nutrition-hydration cases of the mid-1980s, and the desire to cut costly medical care, particularly in the last days of life, that has come to dominate the end of the '80s. Yet this is a view with little or no empirical support. Despite the talk of a "new eugenics" and a cheapening of life, the simple fact is that mortality in the United States continues to decline for every group. Lives are not being shortened. They are steadily being lengthened, and particularly for those who are the most powerless: sick children and the very old, the mentally ill and mentally retarded, the disabled and the demented. That reality points most obviously, I believe, to the main reason for the increased support of active euthanasia. The power of medicine to extend life under poor circumstances is now widely and increasingly feared. The combined power of a quasi-religious tradition of respect for individual life and a secular tradition of relentless medical progress, creates a bias toward aggressive, often unremitting treatment that appears unstoppable. How is control to be regained? For many the answer seems obvious and unavoidable: active euthanasia and assited suicide. If those (like myself) who strongly oppose this answer are to prevail in the years ahead, much will depend upon the success of physicians in addressing the kind of fear of dying in the company of modern medicine, ever growing, that lies behind the impulse to legalize euthanasia. That is where the most important struggle will be carried out. We will need a dampening of the push for medical progress, a return to older traditions of caring as an alternative to curing, and a willingness to accept decline and death as part of the human condition (not a notable feature of American medicine). Yet that is probably not the whole story. Two arguments in particular have gained ground in recent years, and they have lent an air of reasonableness to the drive for active euthanasia that has cracked what has otherwise been a stale, and more or less stalemated, intellectual debate. One of them is a revitalized argument for self-determination, pushing the idea of autonomy and patient rights as far as they can go, to the right to be killed on request. The other is the claim that the traditional distinction between killing and allowing to die, commission and omission, is simply wrong. Self-Determination: Until Death Do Us Part What is the status of the self-determination argument? That question is best answered by looking briefly at the two main traditions that have opposed euthanasia. One of them is clearly religious. It is that God alone is the author of life and that, whatever other rights we may have, the right to take or destroy our own life is not among them. …