Sunday, August 26, 2007

The Case for Euthanasia

Interesting article much of which I agree with although I wouldn't have written it the way he did (it opens it up to attacks which would be irrelevant but which I predict would happen i.e. mostly on the grounds on emotions and "faith"). At the same time, I want to offer up some common arguments against euthanasia and why I feel most of them fall on balance or are mitigated if not derogated by other considerations.

The case for euthanasia

When thinking about our 'rights' to death, are there double standards? CHARLES TAN

DEATH is perhaps the only truly universal trait that we all share and thus, identify with — regardless of culture, status, or faith — and yet it is still taboo (if not impolite) to talk about it, much less debate it, in modern society.
Something I'm somewhat familiar with if not personally then by association with persons (or a person) who thinks hard about the issues and stills has problems communicating across those reasons to that person's parents.

If you've ever watched the Animal Planet channel, you've probably gawked in disbelief at how fortunate some pets are. Paris Hilton's pooch chows down on foie gras, while 3 billion people (that's half the world) live on less than $3 a day.

But if life is good for these pets, death might be even better — for when perceived to be in agony, at least they are put out of their misery.

Humans on the other hand, have no such option.
Strangely enough, this was something I was thinking about the other day and it is indeed a rather curious turn of events as to why this is the case. Especially so when one considers that the choice to be put down is not that of the pets but those of the pet owners and the veterinarian.

So, what is an aspiring economist doing questioning the legality of euthanasia? Aren't such matters best left in the hands of ethical philosophers and moral legislators?

The way I see it, the criminalisation of euthanasia is tantamount to a violation of the free market and individual property rights, and thus warrants a rational (read: economic) review.
Oh sigh... Geez. Violation of the free market? I don't see how this can constitute a violation of the free market except in a fairly roundabout way i.e. by denying the basic premise that individuals ought to be able to make decisions for themselves (which in itself is premised on the notion that only we know what's best for us). And of all ways to put it, "a rational (read: economic) review"?! I hope that this was a matter of editing and not the actual phrasing he used.

Now, it is patently obviously that this approach is not necessarily wrong and in fact arguably has much to recommend for it. But I submit that the basis for this is not economics (the science of scarcity as it were) but on the broader notion of rationality and "public reason" i.e. arguments that would be applicable to every member of society.

The most common justification for the flagrant infringement of a basic human right — the freedom of choice — is that the average person often makes "bad" decisions, thus the need to relieve him of certain options.

However, if a decision bears little to no adverse effects on anyone but oneself, why should the government intervene?

To be sure, I believe most would find the mohawk a "bad" haircut; but the hair on someone's head is his, not mine, and his garish haircut doesn't waft into my eyes like second-hand smoke does. How he decides to treat his hair should be no business of ours.

By the same token, what a man chooses to do with his life should be treated with equal respect, for it is the individual's prerogative, and not the communal right, to decide.
Well, that's the premise for paternalism to be sure and yes paternalism by definition infringes on certain of your basic liberties. But at the same time, there might be other reasons for the derogation of a right, up to and including, because it infringes on another's right or simply another right. It is this second part of the second aspect (another right) which I feel that this article does not quite deal with, although I say this for completeness sake rather than because I feel it is fundamentally detrimental to his case.

Choice presupposes ownership. Therefore, central to the euthanasia debate is religion, for your belief in the nature of cosmic truth will ultimately determine who owns, and therefore controls, your life.

Euthanasia finds its strongest opposition in the annals of religion — and this is perhaps the reason why supposedly secular legislation is skewed so — because modern law remains primarily based upon Biblical canon.

To deny one the right of choice over his own life, is to presume that he had no ownership over it to begin with.

Followers of monotheistic faiths believe that life was bestowed by some supreme Creator, and thus, can only be rightfully taken away by Him.
I think this is about right. Strip it to its core and I get the sense that this is what most of the opposition is about. While there are secular arguments against euthanasia as evidenced below, much of it is arguably excuses rather than real reasons why suicide should not be permitted as a principle (the arguments for euthanasia are arguably stronger).

Some might argue that our emasculation with regard to birth should follow into death, but such a fatalistic view is about as bright as saying that those born into poverty should not endeavour to enrich themselves.

Instead, Life, like an inheritance, is but an endowment, and has no bearing over what you may decide to do with it.

Let me concede that we have no say in our creation — our parents did.

Life is as much a given as Death is; but while (or perhaps, because) we have no control over the former, we strive to control the latter like we attempt of everything else around us.
Oh gosh, wouldn't it be much better to say it's a non-sequitur? Here's a reformulation of the argument based on secular human rights: the basis of human rights is that of life because one has those human rights as a result of one's life (and thereby accordingly the inherent dignity of life of which human rights are suppose to protect). Secondly, life and human rights presumes the capacity for choice whereas death is the ultimate negation of that choice. That ultimate negation is therefore the premise upon which the state may derogate your choice in order to prevent the ultimate derogation through death.

But while this argument may hold water in the case of say mental ailments e.g. anorexia that is causing the person to literary starve himself or herself to death, and that this is not a choice that is in any sense of the word rational or informed, therefore the state may legitimately abrogate that "choice" and perhaps institute a regiment of forced feeding and medication.

Where the analogy holds and falls apart in euthanasia is that we are talking really about end-of-life treatment. Euthanasia occurs with terminally ill patients and we're generally talking about patients with massively diminished quality of life due to pain or incapacitation from the illness. Thus while it is is a form of suicide BUT the premise of it is that this is simply hastening the process and avoiding the associated pain and/or the mental diminshment from the heavy palliative care that is needed (query: in the absence of our capacity to think and make choices, are we still human in any sense of the word? NB: we aren't talking about infants or even the severely mentally handicapped as that would be to use exceptions to make general policy).

Everything modern medicine has achieved might seem to be in contravention of a divine order.

Consider how — and this can be empirically proven — two identical people, with identical illnesses can experience vastly different life expectancies, when given, or deprived of, access to medical amenities.

To me, this is positive proof that we are either defying some heavenly instruction by our prolonged existence, or that perhaps such an order never existed to begin with.

If we assume, for the sake of argument, that such an order exists, it must then logically follow that if He does not find the extension of our mortal existence offensive, then why should the converse be so controversial?

If we try reasoning along an atheistic slant, then the argument becomes even more potent.
No arguments from me here. I could think of a couple of apologetics and even of theodicy but hey I didn't find them persuasive them, I doubt I find them persuasive now.

Many biologists argue that what differentiates humans from the rest of the animal kingdom is the capacity for emotion; and perhaps, what unites us, is the sensation of pain.

If pain truly is universal, then our double standard between animals and humans in this regard is not only hypocritical — it is downright perverse.
No it's actually worse. Every living organism feels "pain" insofar as we react to external stimuli. But when we talk about pain, what we're actually contemplating is the capacity to understand and to suffer. That's the huge difference between lobsters and "higher" organisms.

Consider this: An animal, with no means of communicating its true intent in a language intelligible by humans, except its display of perceived agony, is by default, put down if thought to be suffering; while a human, perfectly capable of communicating intent and/or visibly in pain, is by default refused any assistance for voluntary euthanasia.
Here here!

Lastly, a country that has the death penalty has no right opposing euthanasia, for one of the most popular arguments against euthanasia is that its legalisation constitutes a government sanction for suicide and therefore cheapens the inherent worth of human life.
Hmmmm, this requires quite a bit of elaboration but I think it basically fits. One counter argument is that the state is simply derogating your life in accordance with law and morality and rights when you abridge the life of another i.e. that the state is thus acting in a rightful manner and does not thus cheapen life. But by a similar token, this reasoning can be applied to a properly crafted euthanasia policy, see e.g. the Netherlands's policy or Oregon's Death with Dignity Act i.e. it ensures an informed decision and consent and that the state is simply giving effect to the intention of its citizens (or at least not interfering with them).

To digress a bit, there are other parallels to be drawn.

Some argue that the death penalty is justified in that it has a deterrent effect and that imprisoning a felon for "25 to life" is ridiculously expensive for the taxpayer to upkeep so heinous a criminal.
Actually it's 24 times more expensive to execute a person than to keep him in jail in the US. Much of that cost is due to the many levels and layers of appeals to ensure no wrongful conviction (which still doesn't keep innocent people off death row per the Innocence Project). But unless someone wants to make the argument that we wish to reduce the procedural safeguards to make it cheaper to kill someone, I can't see how this point is if nothing even more damning.

It should be obvious that the criminalisation of euthanasia has no deterrent effect on any individual, simply because it is not an act of frivolity, but one of desperation.

The able will still resort to messy alternatives or seek assistance in Holland, where euthanasia is legal. The unable must continue wallowing in pain. Even if the ban does preserve life, it most certainly robs it of dignity.
This to me is the heart of the entire issue. I think it helps to explain why euthanasia is and why it is (somewhat) different from plain suicide and I think it really helps to give some facts and figures as to existing problems to demonstrate that much of the concerns are not empirically derived.

Additionally, recall the point I made earlier. Human rights are "granted" simply by virtue of human life and the inherent dignity of human life. Thus once stripped of dignity (as is the idea behind cruel and ununsual punishments, inhumane and degrading punishment as well as torture and crimes against humanity and genocide), one is represented to be less than human, which is why we fight so hard against these violations of human rights and why even Singapore acknowledges them to be at the very core of human rights and non-derogable to boot.

Also, keeping an unwilling patient on life support ties up precious medical resources and attention, which could otherwise be used to save patients with a will to live. An outright ban is not only just cruel, it also runs in direct contradiction to the logic behind many of our existing laws and beliefs.
Cough cough...not really. As the author has already pointed out, quite a bit of our laws are indeed based on biblical notions by virtue of the fact we inherited them from the British (at least until we cut off our legal teat back in 1994 through the Applicability of English Law Act. Mind you though, we still cite English cases because that's how we were and still are trained).

But the more forceful point to be made is that we have quite a few laws that run powerfully counter to them. Abortion (public health grounds), HOTA (public health), Stem-cell (Science and public health), gambling (sad to say tourism although I like to believe that choice has a role to play in it), prostitution (public health and a sop to human fallibility of sorts. Yeah, it never ceases to amaze my foreign friends that prostitution has been legal here since the time of Raffles.)

The inconsistencies in our justification should compel us to question if our reasoning in support of the ban is valid, or if they are predicated upon traditional dogmas which are in serious need of intellectual review.
Snort. If only. Too much of religion is premised on faith and not reason (otherwise Hume's presumption of Atheism would stand).

As an atheist, I find that the absence of an afterlife in my ideology reinforces my love for life.

For only when we concede just how short life really is, do we begin to cherish what little time we have left.

Depriving us of our right to death does nothing to that effect.
Hey...atheist outing himself in the public press no less. Well given that we, the non-religious (by which I mean in Singapore as people who do not identify with any religion) make up a substantial minority in Singapore (possibly even more than the Abrahamic religions), I think it's a good idea for us to make our views heard.

The problem of course is that I don't think there is a consensus of non-religious views on almost any issue given the preponderance of axiomatic choices that one could make with regards to philosophy, epistemology (how we know things) and ethics (what is right and good and wrong and bad) that need not be premised on a divine being. So I know this other atheist (well a good number of others, including free-thinkers and agnostics and deists etc.) and we disagree on issues of the limits of freedom of speech and whether the death penalty ought to be abolished.

Nonetheless, I believe that it's generally still a good thing because given a debate between the non-religious, we simply cannot fall back on the position that God(s) said X and therefore X. Mind you, the religious don't always do so (see the point about public reason), but that's a fall back position that we don't have the luxury of. And further, in conjunction with the above proposition, without invoking God(s) said so, I can't imagine there to be a rational or moral viewpoint that cannot be adopted by one of us "godless". Instead there might be a more robust question of the sort of philosophical foundations as to what your views are founded on.

Tomorrow, I will go back on the issue of torture and explore how one can, without any religious justification (and I personally find that religion can justify almost any position that one can think of and history bears me out on this) come to differing viewpoints on the permissibility of torture and how one can still build bridges i.e. how a consequentialist can talk to an ontocologist.


Peace

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