The Slippery-Slopists Were Right About Euthanasia
Globally, assisted dying is suffering from mission creep.
I read in i that the ‘darkly entertaining’ euthanasia drama Truelove ‘could not be more timely’. The story deals, apparently, with some friends who agree to bump each other off rather than wait for the inevitable. The way the show depicts this, and the supposedly ‘timely’ questions it raises, have put mercy-killing back in the news and so back in the public mind. Esther Rantzen has also played her part, having said the other day she would think about assisted dying if her cancer treatment failed to cure her.
Perhaps the legalisation of euthanasia is unavoidable. But the arguments made for it are often appeals to emotion. Of course, you would need to have a heart of stone not to be moved by someone’s story of watching a loved one die in pain, unable to choose when to meet his maker. But there are still some of us who are not sold by this, or by any of the other cases made in defence of assisted dying. I mean, I have doubts.
The argument put forward most often against euthanasia is the slippery-slope argument — you know, the claim that once we start to let people kill themselves even if only in special cases, it is inevitable that whatever boundaries are in place will be relaxed. Euthanasia might start with the terminally ill, runs the thinking, but soon it will come to include the ill, the less ill, the sad, the hopeless, etc. Such ‘where will it lead?’ arguments, applied to matters like weed legalisation, tend to be a bit weak, since taking a small step does not guarantee that more and more, or bigger and bigger steps will be taken afterwards. But mercy-killing is different, I think, because death is intrinsically serious. No first step towards assisted dying could be small, and any steps taken afterwards would have to be bigger and bigger.
The argument most often put forward against euthanasia is the slippery-slope argument.
There is also mounting evidence that the slippery-slopists, (as I like to call them) were bang on. Wherever assisted dying has been legalised, the rules in place to prevent ‘mission creep’ have been relaxed. In Canada, for instance, there was a rather alarming case in which a woman chose to die because the government refused her a flat that would not inflame her allergies. ‘The government sees me as expendable trash, a complainer, useless and a pain in the ass,’ said ‘Sophia’ in a video she filmed eight days before her death. And also in Canada, a man with a neurodegenerative disease said that nurses and a medical ethicist tried to persuade him to kill himself, first by threatening to ruin him with extra costs, then by saying they would boot him out of hospital, and then by withholding water from him for 20 days. Surely these are not the kinds of situation the government had in mind when it passed its euthanasia law.
The first version of that law made provision for medically assisted death in any case in which suffering was deemed ‘unbearable’, a term so vague that it is no wonder nearly every disability rights group in the country stood against the proposed legislation. They said disabled people would be coerced into accepting euthanasia or made to feel like it was their only option because of their lack of societal support. Moreover, if someone to chose to die because they had been disabled, that would suggest that the life of a disabled person was not worth living, or at least was worth less than the life of an able-bodied person Now, there is talk in Canada of widening the law to include those requesting deaths on mental-health grounds. The Collège des Médécins du Quebec has proposed that babies with severe disabilities be made eligible for euthanasia.
It is not just Canada getting carried away. Belgium also blazed a trail (if that is the phrase), in the area of dying-on-demand. In 2014, it made an amendment to the existing law, permitting assisted dying for minors who ‘repeatedly and voluntarily’ requested it. Shanti De Corte, a survivor of the ISIS attack on Brussels airport in 2016, showed how grey the grey area could get when she chose to take her own life through assisted dying. She had seen her classmates die and was in ‘such a state of mental suffering’ that a panel of doctors said her trauma and depression was incurable. They are professionals, of course, and their expertise in this area should be respected; I am not a doctor. But you cannot help but wonder whether all treatments had been tried. And what about in future? Might it not be possible that a new drug or treatment method might emerge? Is it not the nature of depression to think there is no hope?
Shanti De Corte, a survivor of the ISIS attack on Brussels in 2016, showed how grey the grey area could get when she chose to take her life through assisted dying.
The Dutch government, in the meantime, having introduced quite a spacious assisted dying law back in 2002, also relaxed its rules after just a few years, extending euthanasia to terminally ill children between the ages of one and 12 if the parents wanted it. It also made people with psychiatric problems, such as 29-year-old Aurelia Brouwers — killed by choice in 2018 because of her chronic depression — eligible. Dr. Bert Keizer, who worked for what used to be called the End of Life clinic (and is a fan of assisted dying, by the way), wrote of the euthanasia law that ‘every time a line was drawn, it was also pushed back.’ His quote is worth reproducing in full: ‘We started with the terminally ill, but also among the chronically ill it turned out to be hopeless and unbearable suffering. Subsequently, people with incipient dementia, psychiatric patients, people with advanced dementia, (high) elderly who struggled with an accumulation of old-age complaints and finally (high) elderly who, although not suffering from a disabling or limiting disease, still find that their life no longer has content. Looking ahead, there is no reason to believe that this process will stop in case of incapacitated dementia.’ Which means what, exactly? That anyone who wants to die will be able to easily and painlessly?
Now, I do realise all this is a bit gloomy. I also realise that you may well say that a small number of unhappy euthanasia cases does not discredit the whole idea. Sceptical types are often accused of generalising from too small a sample. It is a reasonable complaint in some cases — but not this one. As with capital punishment, one accidental (or deliberate) state killing of an innocent person seems to me to be one too many. And the temptation for the rulers of the day to encourage assisted dying will be strong in the coming years. An ageing population, a welfare state groaning under the weight of its dependents (worsened by the ageing population, of course: the welfare state is, in effect, a Ponzi scheme that constantly needs new blood) … Ten years ago, Taro Aso, then Japan’s finance minister, said, in defence of euthanasia, that the elderly should be allowed to ‘hurry up and die’ because of how they stretched the national budget. From the state’s point of view, euthanasia is good value for money, and one can clothe oneself in a mantle of kindness while endorsing it.
Whatever your view, the whole conversation around assisted dying raises some fairly important questions. For example, is the exercise of personal freedom our highest good? Because if it is, there is no real argument to make against euthanasia; it not does violate ‘the harm principal’ that libertarians are so fond of invoking. But what if it is not our highest good? Louise Perry has said that in the context of sex, exalting personal freedom — that is, choice — has turned life into a marketplace and everything (and to some extent, everyone) into a product. Marxist thinkers like Terry Eagleton, meanwhile, say that a vision of the future summed up as ‘like now, but with more options’ is a bleak one indeed. (No surprise, you may say, that there is a crisis of meaning.) And others still suggest that your life is not just yours, and that those around you should have a say as well.
