Social Policy in Ontario

Why my generation will be the one to enshrine the right to assisted suicide

Posted on October 16, 2014 in Health Debates

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NationalPost.com – Full Comment
October 16, 2014.   Jonathan Kay

In 2001, the Journal of Personality and Social Psychology published an ambitious article that analyzed the question of how human beings derive satisfaction from life. Hundreds of university students in the United States and South Korea were asked about what qualities characterized life’s “most satisfying events,” with their answers slotted into broad categories such as “pleasure-stimulation” and “money-luxury.”

American and South Korean students reported slightly different preferences. Among U.S. respondents, the promotion of “self-esteem” was a leading category. In South Korea, it was “relatedness,” defined as “a sense of contact with people who care for me, and [for] whom I care.” But in both countries, the students were alike in one respect: They both ranked “autonomy” — defined as the sensation “that my choices were based on my true interests and values” — at or near the top of their needs hierarchy.

As we grow older, our hunger for autonomy — “control,” to get at the same concept with half the number of syllables — seems to remain pronounced. In this post-religious age, few of us still embrace the calming notion that our fate is determined by a benevolent deity. Among even the most successful people I know (women, in particular) there is a widespread anxiety that our lives are spinning out of control — that we’re not making enough money, that our children are falling behind in school, that our homes are too messy. Imposing a sense of controlled order on this chaos has become the dominant obsession of Western consumer culture — from reality-TV home-makeover shows, to organic non-gluten peanut-free food-hygiene fixations, to luxury-car ads that seduce us with images of a graceful personal sanctuary that hovers our families serenely over all life’s hazards.

And yet, when it comes to one of the most important aspects of human existence — the way we die — even liberals, who demand autonomy in every other sphere of human activity, traditionally have submitted meekly to the reaper’s sadistic caprice.

Few of us will fulfill the dream of dying peacefully in our sleep, sound of body and mind, shortly after celebrating some three-digit birthday surrounded by loving friends and relatives. Some will die suddenly, clutching at their chests. Many more will die full of pills and tubes, swathed in diapers, our dementia-addled brains a swirl of pain and confusion after many months of bitter medical hardship. This is the status-quo that doctrinaire assisted-suicide opponents have sought to preserve in the name of safeguarding “the sanctity of life.” Why have the rest of us put up with it?

Part of the reason is intellectual squeamishness: None of us like to think about death. In fact, life is only bearable if we embrace the illusion of immortality in some abstract way as we go about our day-to-day lives. So we outsource the circumstances of our deaths to doctors, who usually will default to the option of keeping us (technically) alive till the last possible moment.

But the remnants of religious belief play a role, too. Deep down, many of the atheists who sneer openly at Christ and communion harbour an unspoken belief in something resembling a human soul. And in fact, a lot of the nominally secular arguments against assisted suicide rely on the verbal trick of using airy-fairy words as stand-ins for religious superstitions. (Conservative anti-assisted-suicide scholar Margaret Somerville, for instance, speaks of “a sense of the sacred” and “a space for the human spirit.”)

It is true that the taboo against arbitrarily taking human life exists in all human societies, and is embedded in our evolutionary psychology. In this sense, opponents of assisted suicide are correct that there is something “unnatural” about the concept of helping someone killing themselves. That is why the right to die in the manner of our choosing — the last great human right to be won in Western societies — has been so slow in arriving. In 1994, Oregon became the first North American jurisdiction to legally sanction physician-assisted suicide. In the 20 years since, only four other states have followed suit. Compare that to gay marriage, which went from one jurisdiction (Massachusetts in 2004) to 30 in the space of just a single decade.

But the tide is turning — most notably in Quebec, where a broad majority of provincial legislators voted in a law that will permit doctors to assist terminally ill patients who wish to accelerate their deaths. No surprise that Quebec is leading the nation in this area, as it is the province that, since the 1960s, has been most aggressive and forthright in shedding the once-dominant influence of Christian theology on social policy.

In the rest of Canada, things have moved more slowly — in part because our federal government (in both its Liberal and Conservative incarnations) has been petrified of legislating on divisive social issues. Abortion, gay marriage, prostitution, medicinal marijuana — all of these were punted to the courts over the last quarter century. The same is true with the right to assisted suicide, which is supported by a solid majority of Canadians, and which likely will attain force of law when the Supreme Court issues its judgment in the case of Carter v. Canada, on which oral arguments were heard this week.

When the right to assisted suicide does become the law in Canada, it will be my generation — men and women now in middle age — who will claim credit. As the first generation of Canadians to grow up in a post-religious Canada, we are now beginning to watch our parents enter their final decade or two of life. Unencumbered by a belief that the extinguishing of a human soul is a divine prerogative, we are horrified at the thought that they might not have the freedom — the control — that we would want for ourselves.

Old enough to bury our parents, we are also young enough to be on Facebook. A decade ago, my social-media feed was a steady diet of baby pictures. Now, there is sadder stuff mixed in with the soccer and thanksgiving montages. In this confessional culture, the details of death are not swept under the carpet, as they were in my grandparents’ time. Three friends of mine lost fathers over the last month — and in all cases, we candidly discussed what went right and what went wrong with the medical process as it played out in the finals days. There are too many cautionary tales out there of “bad deaths” — and every one of them argues for more end-of-life options for those of us still walking the earth, and a shedding of old taboos that do nothing but incubate needless suffering.

Even when the right to assisted suicide is firmly established, relatively few people will avail themselves of it. (In Oregon, Belgium and the Netherlands, the number of accelerated deaths is small — though you wouldn’t know it from the way that scare stories are promoted by assisted-suicide opponents.) The baseline desire to see another day is encoded in every animal’s DNA. But even for the majority of us who never will avail themselves of the right to assisted suicide, there still will be enormous psychic comfort in knowing that, if things get truly unbearable, the option is there — that our precious sense of control won’t be denied us at the moment in life when it matters most.

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Tags: disabilities, Health, ideology, mental Health, rights, standard of living

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