Ethics Alarms master commenter Mrs. Q has the highest ratio of Comments of the Day to comments of any of the erudite participants here. If she would consider it, I’d love to feature her ethical musings in a regular column on the blog. This is the first of two Mrs. Q compositions you will see this weekend; it concerns the issues of euthanasia and consent, which were explored in twoposts this week, and a poll. Regarding that: here is the still live survey regarding the hypothetical I posed in this follow-up to the one about the Dutch doctor:
As you can see, those supporting the opposite position of Mrs. Q (and me) are in a distinct minority.
Here is Mrs. Q’s Comment of the Day, a reply to another commenter, on the post, “The Euthanasia Slippery Slope: A Case Study.”
My God fearing Catholic grandma had the opposite response to yours. She was 102 & 7mo. and after breaking her hip it was too late to even think of surgery. She continued to weaken & lose weight yet she fought by drinking milkshakes & trying to greet her many family/visitors.
Before she got to this point a few years prior, her care coordinator somehow changed her directive to DNR, which as a Catholic she wouldn’t have agreed to, yet this person tried to convince the family that my grandma said yes to the change. If my family hadn’t checked the paperwork, my grandma’s incorrect and unauthorized change would have remained; however our family changed it back. My understanding is such acts are not uncommon in these facilities.
Fast forward to her last days. She was increasingly given higher doses of morphine & we weren’t allowed to even give her sips of water, though she was clearly thirsty. Her last words ever spoken while she gripped onto me, and heard by everyone in the room were “I don’t want to die.” She didn’t want to go and the nursing home was killing her and she knew it.
I still feel complicit in her death, as I tried to “go along” with staff who I assumed knew best.
Yes, it’s sad to see our loved ones suffer but it’s also wrong to kill them off so we can avoid the suffering of watching them suffer. Such a concept seems like the ultimate in dehumanizing our vulnerable citizens because suffering is part of being human. Denying that makes our society increasing prone to relying on “happiness indexes” to determine whether someone lives or dies. And in the hands of those who desire technocratic medical control over the rest of us (take a gander at Google’s medical device patents for a frightening example) it will only become easier to kill us in the name of comfort and convenience.
When you have a society that deems it acceptable to abort a preborn because the child was a result of rape or may be potentially abused, then you have a society that believes their lives are inherently less valuable. When you have a society that believes it’s acceptable for an 8 year old to have the “right” to be permanently sterilized with hormones, & at 12 years old is ready to have a double mastectomy, then you have a society where bodily dismemberment is tolerated & even celebrated. When you have a society that is okay with snuffing out the sick and elderly because it sucks to watch them in pain, then you have a culture that is pro-death and anti-human.
A society of comfort nihilism is one that will eventually eat itself.
My grandmother’s end of life wasn’t marginal. And taking away anyone’s right to life isn’t either.
Ethics Alarms 
Glad to see this as a COTD
agreed
I’m speechless. Thank you Jack! And if you’re serious about the column, I’m game.
Mrs. Q,
It’s a well earned honor.
I am serious. Let’s figure it out.
Mrs. Q’s Cafe.
Hope it works out. Jack and Mrs. Q in tandem will be formidable.
Oops. “Hope”.
It’s a wonderful idea! Congratulations. Mrs. Q!
It is true that the old often suffer and it is true that it is very hard for the still-living to watch them suffer. But there is I think a great deal more to the question, and it hinges into both philosophical and religious notions and attitudes.
Though I am interested in Catholic doctrine, especially the ‘old school’ material that was stressed before Vatican ll, I also have another area of concern and interest. Anyone who reads what I write — the few who continue to from what I am told — will notice that I am captured in a sense by contradictions. One one side European Christianism and on the other European Paganism. I embody this by having a Jewish parent and a fully European father who converted to Judaism. I have become aware that my ‘essential conflict’ is somatic (having to do with the body) and that this is also expressed in the larger, surrounding European world. My view is that the sudden rise of what they call fascism — they always use the broadest and most general, and scary terms — has a great deal to do with European self-protection against invasive, controlling forms.
I am uncertain what name to give it though. It is hard to encapsulate. I might refer to it as The Religious Attitudes of the Indo-Europeans (which is a title of an interesting book by Professor Hans FK Günther). Or the Northern European rediscovery of their pagan roots which also is a rejection of the imposition of Southern European — Mediterranean and Roman — imperialistic religious modes. I do not have a very solid grasp on the Protestant Reformation, but on one level — a large level — it was a rebellion against imposed imperialistic modes of perception and understanding. Much as I might like to, it is not possible to simply reject the Protestant Reformation nor the uprising of a whole value-set which Nietzsche embodied. But it is a terribly conflicted territory.
How we view death has a great deal to do with this. How we confront our mortality has a great deal to do with this. Our attitude to death has a great deal to do with this.
I perceive that the ‘right to die’ and also the ‘right to suicide’ oneself has a connection to the reassertion of Indo-European modes of understanding and perception as-against those that come through imperialistic Christianity: Roman Catholicism in essence. I could visualize a ‘strong people’ — maybe someone like Gorky would have written about them? — who would embrace a metaphysics that would encourage a person not to cling *unneccesarily* to life. I put unnecessarily in quotes because I do not profess to know what the proper point to exit life is. But it does hinge on subjective issues, and issues of valorization. And personal strength . . . and also the level of one’s conviction to values.
There is an interesting quote I came across that (according to Günther) embodies a Indo-European mode. The more that I think about it the more influenced I am by it:
Death is in this sense the ultimate ‘rock’ and is our destiny. And everything that we are, and do, we do because the rock is there facing us. Everything depends on how we orient ourselves in regard to this destiny.
One could — as in the strong people that a writer like Gorky admired — imagine a society of people who would see it s an ethical duty not to become unnecessary burden, who would of their free will exit life ‘at the right moment’, and with a certain pride and conviction.
Nice comment Alizia. Thank you.
Hours ago I received a text from my mother in-law letting my wife & I know that my wife’s grandma doesn’t want to eat anymore. She’s in her late eighties and since her husband died, she has sort of floated along with life. The text read:
“I don’t want to lose her but I realize there is no quality to her life and that isn’t good for her so I have resigned myself to the reality that the day is drawing close ready or not so no choice, just brace for impact.”
I’m not sure in this case my wife’s grandma is exiting at the right moment because the idea of a “right moment” regarding death seems like a fantasy, much like the concept of “social justice.” Your point, if I understood it correctly, regarding one’s attitude towards death and mortality is quite apt and certainly colored my comment. Perhaps you even caught a whiff of my own fear of death, and my pain from losing loved ones recently.
Faith and philosophy indeed impact our views. The state and city I live in for example, has the fewest churches and most strip clubs per capita, as well a rise in something called “social justice Satanism.” Interestingly Oregon is a leader as a pro-death state (babies aborted up to breath for no reason, assisted suicide, healthcare providers can override a patient’s advanced directive – OR HB4135). I can’t help but wonder if the correlation between the two is worth exploring.
Quality of life vs. being a burden has no absolutes, which is why after thousands of years we’re still attempting to make sense out of what living and dying is. When a 16 year old in someplace like the Netherlands or Sweden is “allowed” a state sponsored suicide because of somatic or psychic discomfort (depression or being transgender for example) we are not dealing with the ending of a burden or valor. As for my wife’s grandma, though I do wish she’d try harder to cling to life, I accept that she is ready to exit this vale of tears.
When my wife died in September of 2017, I have to admit I almost lost it. I didn’t so much want to die as I didn’t much care about staying on. A very close friend sat me down and pointed out that I still had three sons, 7 grand-children and 4 great-grand-children. She told me I had a great deal to live for and that I had better get my ass in gear and start doing so. I’m still at loose ends a little bit, but I’ve got a LOT of friends who are looking out for me, It’s still tough, but I can understand your wife’s grandmother, as well.
I can’t say I blame you d_d. I think my grandma made it so long after my grandpa died because she had 14 grandkids, dozens of great grandkids, and was constantly surrounded by family. But I know she thought of grandpa daily & her grief was always in the background.
Thank you for your honesty.
The year my parents died was very stressful, as you can imagine. Their quality of life was poor, him with major cognitive and physical impairment from strokes and other problems and her with significant, chronic pain and a host of other medical problems.
My mother hung on — this is my and my siblings belief — through my Dad’s death. She was a very determined woman and we believe had decided to be there for her husband. After that, however, I believe she decided it was time to go and she died about 4 months later. I wasn’t ready for all this (who ever is, with their parents), but I knew they didn’t want any heroic measures, given their circumstances and I believe they died fairly peacefully.
I had years to brace myself and it was still very traumatic, but at least they lived full and productive lives.
Thanks for sharing that. I’m sorry for your loss.
One of the factors that interests me is that — relatively recently — it became possible to enjoy a life that was not a ‘vale of tears’. It is more or less standard material of course but the Protestant Reformation led to so many advances, and certainly as the narrative goes to medical advances, that as it has happened, and possibly for the first time, we in first world conditions can actually plan on having a really rather nice incarnation here. Isn’t this odd? Just a few short years ago parents, who could not control their pregnancies, had to live with the fact that many of their beloved children would, very shortly, no longer be with them. A whole new world has come into focus and it is one where a given person — an average person — can expect and plan to live many decades in circumstances of relative well-being.
My understanding is that this has opened up in a very unique and different way all the possibilities of life that were before-times restricted only to the fortunate and, as well, to those who had sufficient means to sustain themselves. And as Hobbes said especially of the unfortunate ones:
Some wonder why there is a decline in religion. But it must be recognized that in former times, when indeed life was miserable, poor, brutish and short, one in a sense had no option but to resign oneself to relative misery and hope as well for a time of relief.
But now we have upended this! And the way things are going — the advances of science and material manipulation — there looks to be developing those conditions in which men will be able to — I assume they will succeed — in reengineering themselves at a somatic-genetic level. Terrence McKenna wrote some essays on this topic of man becoming able to reengineer himself! What a notion.
Now, what religion has as a competitor is a long, fulfilled life filled with one achievement after another. A smart person if he or she has his wits about can very quickly get a grasp of things and advance into those undreamed of realms of wealth and physical well-being. And there of course — I say this simply because it is true — the entire sensual realm opens up in ways it had not been open before. And if we are to refer to this word ‘hedonism’ we must I think recognize that this is really how people — millions and millions of people, billions perhaps — actually begin to visualize their circumstances and its possibilities.
I recognize there are exceptions, and one might be ground to bits in a random (and also meaningless, i.e. non-Providential and merely statistical) car-crash or some similar event. But the general fact is that it is only later and toward the natural end that one has to face ‘the vale of tears’ (which I used to write ‘veil of tears’ as I imagined it like a sort of cloudiness or like teary eyes, not ‘vale’ as in valley).
My sense is that in this *world* of new possibilities — a new world that has opened up in the last 100-150 years quite substantially — that religious gravity has taken a blow or two. The fact of the matter is that one can live a long, sensuous, shallow, cluttered existence enjoying all terrestrial pleasures and a great deal of Satan’s pomps, with no noticeable ill-effect.
Where I am going with all this is simply to point out that at the end of the road, a road in which all and every pleasure had been tasted and known, and when it is no longer possible to enjoy as one had enjoyed, then it becomes nearly a logical choice to pull the switch.
Those with cosmic visions that seek escape from social constraints regarded as arbitrary, rather than inherent, tend to romanticize the unruliness of the underclass and the sense of being above the found among the elite.” -Thomas Sowell
At the end of the road, envy’s a bitch.
You don’t have to look to Northern European paganism to see arguments for and against suicide. Roman paganism espoused a noble suicide, generally as a means of taking final control of a life that you have no other control over, or atoning for an extremely shameful act. Augustine, in City of God, is the earliest Roman Catholic book I’ve read where suicide is explicitly condemned. His reasoning is basically that if you have committed some horrible deed, it is much better to atone for your son than to get out of it. And if it is because something has been done to you, then why would you kill yourself? You’ve done nothing wrong.
Really dodging the point there aren’t ya bud.
Of course the case Mrs Q references is unethical (and some of Jacks followup cases). Killing old sane people who dont want to die out of bureaucratic error or young babies who can’t possibly consent is obviously wrong. We’re not talking about that and that’s just one hell of a straw man. The original ethics question is about a sane person who wants to die and then goes insane and the insane version of themselves doesn’t want to die. Mrs Q’s and Jacks counter cases refute the reasonable and ethical course of action by substituting in some obviously wrong and/or emotional baited counter case. It’s so blatant.
The core principle:
If you’re sane and you want to die and you set the ball in motion to kill yourself then you go insane and not longer want to die, ethically, what is right to kill or not to kill?
Do people have the right to die? If so then, who has power over that choice the sane or the insane? Whether or not you personally would choose life, or you personally value life is irrelevant. It’s the sane individual’s choice and obviously so.
Our society rightly says that in matters of serious consent the insane do not get a choice. The order of shot callers is clear: the stated will of the person when they were sane, the opinion of those to whom the insane person has placed themselves in trust (i.e. lawyers of other legally empowered care takers), the immediate family, the government. Start from the top and work your way down. If at any point you find yourself defying the stated will of the sane individual and instead allow the insane person to call the shots in some self righteous nanny-esque “I know better, fuck what they actually want” kind of way you are in the wrong. I can come up with any number of off topic but close enough emotional heart string stories to prop that up, but I don’t need to. The ethics are clear and some people just don’t like the result.
The majority would let crazy people call the shots – “I choose life” they righteously shout! Congratulations. I guess that’d be the first time a bunch of self righteous were willing to throw ethics to the side and nanny away other peoples right to self-determination. Oh wait…
Not gonna lie, I’m super bothered by the esteemed commentariat reaction to this. I couldn’t stop thinking about it so I wrote one of those sappy emotional counter cases that illustrates the ethics at play.
Case: Your best friend, for various reasons ranging from early childhood abuse to general pessimism about the world, is vehemently opposed to having children. Her greatest fear is bringing a child into the world that might then be abused as she was. You think it’s kind of an overreaction but people are ultimately entitled to their hopes, dreams, and yes, their fears – this one isn’t even that irrational given her history. If your friend trusted doctors not to butcher the surgery she would go get sterilized in a heartbeat, her commitment to her principles is that strong.
To add to your friends misery, her family history pre-disposes her to a degenerative brain disease and she’s begun to show early onset symptoms. She knows that the end is near and begins to make plans. She doesn’t want to die, but she also doesn’t want to have children and is deeply concerned about possible sexual abuse at the home that she’s being taken to. Sexual abuse by either the staff or the other patients, while uncommon, is an unfortunate fact of the healthcare system and her life has not been a lucky one. She goes to her lawyer and has him make a statement of will for her future caregivers- “If I conceive while legally out of my mind and the pregnancy is caught in the early stages, I want and demand an abortion so that I will not put children into the world. If the pregnancy is caught in the late stages, deliver the baby and put it up for adoption.” Fair enough you think, early term abortion is not unethical and late term abortion is, so this is clearly a reasonable compromise. One that balances your friends deep and sincere conviction with the potential life of a baby.
Shortly after that she takes a sharp turn for the worse and is checked into a home. A few years later her streak of bad luck continues and her fears are realized. In a moment of lax supervision her and another patient who lack their full mental faculties copulate. They’re caught but not before the deed is done. In follow up doctor’s visits a week or two after the incident it becomes clear that she is in fact pregnant. Fortunately they caught it in the extremely early stages.
Only one problem, now your friend, in her almost child like mental state, simplemindedly betrays her life long conviction and decides she wants to keep the baby. She raves about it, screams about it, she demands to have the baby! The doctors have your friends statement of will but since she was overly trusting she doesn’t have a contract with the home to require it’s enforcement. They’re uncomfortable with the situation and decide to ask for outside opinions.
“I choose life!” Jack says sagely.
“It’s a second order mistake, if she recovers from her mental disease in time she can always elect to get the abortion later. I also choose life.” Chris says certainly.
“It’s inconvenient for this woman to have a baby, killing the early proto-fetus would reduce that inconvenience, and it’s wrong to end life out of convenience, I also choose life.” Mrs Q says focusing on only one interpretation of the issue.
With such sound ethical positions to point to the doctors decide to not provide the abortion. Your best friends unlucky streak has managed to continue long past the point where she’s lost her mind. Her biggest fear is forced on her and her strongest principle is being violated against her explicitly stated wishes because some people think the opinion of crazy people is as ethically valid as a sane person’s.
Change ‘opinion’ to ‘consent’ in that last sentence – my bad.
And for added emotional intensity in our hypothetical case let’s say the bad luck is on a roll and the kid goes into the system where they’re similarly abused. Her conviction was violated and allowed the exact thing that she feared most. It’s not necessary for the ethics in the story but damn does it sting.
Right!
We do not force mentally disabled women to have abortions or to be sterilized. Childlike friend is still a human being, and past adult friend, who no longer exits, should not have the ability to force her to do what she no longer wants to do from oblivion. And, I may add, what it to her, meaning the Spirit of Friend Past? She doesn’t exist any more.
Now we are edging to the realm of deathbed promises.