Changing The Law on Death with Dignity

by Jase, Executive Director-United Coalition of Reason

Here’s a hypothetical situation for you: “Explain why some people think the law on ‘Death with Dignity’ should be changed. Give reasons for your opinion, showing that you have considered another point of view. In your answer, you must also provide various points of view from at least one major world religion.”

Be honest with me…could you answer the question above? Could you exercise critical thinking, with impartiality, and show some understanding of an opposing point of view? (If you’d like an insight into this question, you can either continue reading, or skip to the end of the article to find a surprise…but it’s more fun to wait.) Having reported last month on the Death and Dying with Dignity symposium that was sponsored and organized by the Eastern Iowa Coalition of Reason and the Central Iowa Coalition of Reason, the topic of death and dying has been resurrected (no pun intended) in many local non-theistic communities.

A lot of the theistic-based arguments against the concept of “death with dignity” (known to some people in other parts of the world as euthanasia) is rooted in the theological tenet of the “sanctity of life,” meaning that some people believe that a deity created life, and therefore it is special and precious because only that God/god(s) has the right to take it away. We can see this concept represented in Biblical passages such as Genesis 1:27 or 2:7. Many (predominantly Christian) theological arguments are connected to the question of “When does life begin?” Perhaps it’s at the moment of conception, when the sperm fertilizes the egg. Perhaps it’s at the moment of the first heart beat, which, medically, is considered to be around 7-9 weeks after pregnancy. Perhaps it’s when a human baby is able to survive outside the mother’s womb, which is around the 24th week of pregnancy. Or, perhaps life begins when a baby is born, which is generally around 40 weeks after pregnancy. Trying to balance medical and scientific facts with a hermeneutic of a “revealed” religious text is already grounds for disagreement amongst many of our theistic friends.

The word “Euthanasia” has its origins in the Greek language, where “Eu” (ευ) can be translated to mean “good” and “Thanotos” (θænətɒs), meaning “death” can be translated completely to mean “a good death,” or the act of bringing about a dignified or easy and painless death. Most people—in general circumstances—consider euthanasia to mean a “release” for people who are suffering with an incurable disease, so that they are able to die with a sense of dignity and control over themselves. For some countries, like the UK, there are no laws that directly deal with, or prohibit, the act of active euthanasia, despite how some people could incorrectly misconstrue euthanasia with suicide. As an example, the Suicide Act of 1961 in the UK states that, “A person who aids, abets, counsels or procures the suicide of another is liable (not guaranteed…emphasis mine) to imprisonment for up to 14 years.” However, some countries such as Australia, The Netherlands, and even some parts of Switzerland, take a less punitive view, as they take into consideration things such as the quality of life, various acts of euthanasia (especially passive euthanasia) are often overlooked.

But what if we take into consideration some situations that are the “grey areas” such as voluntary euthanasia, which some consider painlessly ending a person’s life when someone in great pain requests death? Likewise, what about non-voluntary euthanasia, where a person’s life is ended painlessly, but in their best interest, when they are incapable of requesting death themselves? Of course, what do we do when a person writes a “living will,” stating that it is their express wishes not to be resuscitated or placed on some form of indefinite life support mechanism? In such circumstances, we can already hear the ethical arguments for and against coming from theistic and non-theistic quarters:

  • “People should be allowed to die with dignity.”
  • “There is nothing dignified with taking a person’s life.”
  • “God has given us the ability to think for ourselves, and we have free will; we should be able to choose what is best for us.”
  • “Life comes from God, and only God can give or take life.”
  • “People don’t want to be a burden.”
  • “There are alternatives, such as palliative care.”
  • “Keeping people alive with artificial means is actually going against God’s wishes for that person to die.”
  • “Allowing euthanasia is opening up for abuses such as murder, disguised as euthanasia.”

In the US, however, the attitudes and laws regarding death with dignity are a completely different situation, given barriers and opposition from various quarters. To help me better understand and illustrate these attitudes and obstacles, I went to local activists who are currently working with others to try to have “death with dignity” legislation passed in their home states. I was joined by Stan Greenberg, the Hartford Area Humanists’ representative to the Board of the Connecticut Coalition of Reason, who has been a driving force in the Connecticut CoR, leading the work for death with dignity legislation there.

Stan’s story and perspective is touching and filled with reason:

greenberg2This legislation is consistent with my values as a non-theist. It is rational and is based in reality. It posits that a person-not a government or religious institution-gets to make choices about her or his life and death. This legislation imposes nothing on anyone who does not believe in, or chooses not to use, aid in dying. Those who avail themselves of aid in dying typically do so in consideration of the effects on one’s family, friends, and society.

There are personal reasons that inspire me to work towards this legislation. A few months ago, I watched a friend suffer physically and psychologically as he approached a certain death, with no ability to end his life in a painless way and with some measure of autonomy and dignity. He wished he had that option, but aid in dying is not yet legal in Connecticut. It’s worth mentioning that he was receiving home hospice care, and he had access to as much morphine as he chose to take. But, since pain was not his main problem (it was breathing), the morphine was not very helpful. He didn’t want to take so much of it that he’d become unconscious and unable to communicate until he finally died in some sort of awful and dreaded state.

On an even more personal level, I have wondered how my remaining months would play out if I were facing a certain and potentially nasty death due to an incurable disease. I can easily imagine that the prospect of losing my autonomy and dignity and enduring an agonizing and protracted pre-death interval would be devastating to me and my family: a terrible way to end an otherwise contented life that I’ve enjoyed. I can also imagine that, with aid in dying as an option, I would be much calmer and better focused on taking effective measures to make my remaining time as comfortable and fulfilling as possible. This may explain why, contrary to expectations, passage of Oregon’s death with dignity law resulted in an increased use of hospice.

After extensively studying and analyzing the arguments for and against aid in dying, I’ve become increasingly invested in this cause and believe even more strongly that it is something worth working for. I’ve found that the arguments for it are based in fact, while the arguments against it usually describe hypothetical and fearsome consequences, some of which are not actually possible, given the provisions in the aid in dying bill.

Have I encountered any obstacles or barriers here in Connecticut that has impeded my work for Right to Die legislation? It’s important to note that the name of the Connecticut bill is “An Act Concerning Aid in Dying for Terminally Ill Patients”; it is more commonly referred to as the “aid in dying bill”. It’s failed to come to a vote in Connecticut’s General Assembly for three consecutive years.

This bill has two main opponents: the Roman Catholic Church and disabilities rights groups. These organizations have been its main opponents in nearly every state that has considered such legislation. I feel that there are two reasons why these opponents have been able to obstruct aid in dying bills in most states despite the fact that the majority of those states’ citizens favor it: 1) These institutions mount campaigns that are well funded; their budgets far exceed the spending of the proponents, most of which is provided by Compassion & Choices, and 2) The people who oppose aid in dying are better organized and more vocal than its advocates, who are, by comparison, a silent (and relatively passive) majority.

On a more personal matter, I’ve taken many steps to help my family when it’s my time to die. I’ve made sure my close family members know my preferences if I should face death as the result of a fatal illness or other cause and will try to honor them as best they can when the time comes. My healthcare directive also spells out my wishes regarding end of life treatments and care. I’ve given my family a detailed and comprehensive set of “when I die” information including end-of-life legal documents (will and incapacity documents), a detailed list of things to attend to, a comprehensive summary of our finances and other assets, and obituary and burial information.

Stan is not alone in his activism in New England. In the state east of Connecticut, Dr. Tony Houston—Coordinator for the Rhode Island CoR—is also making similar strides in his state:

As a human being, I don’t think people should suffer needlessly. That’s the heart of the matter. There are many theists who are on the same side. As a non-theist, however, I don’t have to reconcile my sense of fairness and compassion with any inherited tradition. In that regard, I’m like most secular people. According to The Nonreligious: Understanding Secular People and Societies (Zuckerman, Galen, & Pasquale, 2016) the nonreligious tend to “determine the relative morality of a given action based on its actual impact rather than on the belief that it is inherently good or bad.” (p. 172)

tony-houston2I was brought up as a Protestant before I became a non-theist. I don’t think anyone in my family would oppose this legislation. They have some backward ideas about sex and gender, but they trust sound medical advice. Rhode Island is a very Catholic State. It’s different here.

In Rhode Island, those of us who favor the legislation in principle agree that there should be safeguards to protect the chronically ill. We don’t support any legislation unconditionally. The opposition, however, is uncompromising. They boast about their successful obstruction of similar legislation in other states. There are no safeguards that would satisfy them.

Second Thoughts Massachusetts claims on their webpage that the Right to Die movement is “led by privileged secular white professionals.” Including “secular” in that series of adjectives betrays a fundamental misunderstanding of what it means to be secular. To renounce secularism, a secular person would have to choose a religion and then decide to believe it. Including secular people in that list is something you might expect of religious fundamentalists, not advocates for disabled people. Whether or not it’s intended as a “dog whistle,” it stokes the paranoia of religious zealots who think that religious freedom is the freedom to impose their values on everyone else. Whether it’s a cynical attempt to pander to religious fundamentalists or integral to the ideology behind the movement, it speaks volumes that they even mention secular people in this context.

The U.S. Constitution is secular, but that’s not the social reality. It’s absurd to characterize secular people as privileged in this country, much less in Massachusetts and Rhode Island. What draws secular people to this issue is that we value personal autonomy over religious authority and don’t allow inherited tradition to override our compassion and sense of justice. Many progressive religious people stand with us on this issue.

On a more personal level, my husband and I have living wills. We got them before marriage equality was the law of the land and we needed to secure our rights to advocate for each other. Everyone should have one, whatever their circumstances.

tony-houston

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Having taken into consideration the complexity of ethics, medical advances, financial implications and political lobbying, it’s no wonder why death with dignity legislation is such a hot topic these days in America. For people like Stan, Tony, and the two Iowa CoRs, they want to ensure that one sincerely-held belief doesn’t hold a monopoly on legislation. Likewise, their work is something that can be replicated in other states, should there be other people who want to help push for death with dignity legislation. If non-theistic people don’t make their opinions known, your right to choose about your life’s end might be happily taken away by others who might not be bothered with your opinions and final wishes.

As far as the question goes from the start of this article, it isn’t a trick question, but something that a 15-year old student would have to answer in their Religious Studies classes in the UK’s State-maintained schools. If a 15-year old student is educated in such a way that they can answer and address these kinds of theoretical, moral/ethical and legal questions-and understand how these have an impact on their lives’ experiences–shouldn’t we ensure that we’re equipped and ready to address similar questions in our current reality?