Monday, August 04, 2008

A Moral Defense of the Right to Die

I am a firm believer in the right to die -- and that the government has no business legislating how I choose to end my life. But many people disagree, and most of them site moral grounds for their objection (which constitutes a violation of the separation clause if you ask me).

Akansha Bhargava, writing at The Institute for Ethics and Emerging Technologies, offers a moral defense of the right to die. I agree with her stance that individual rights trump any other considerations (this, of course, excludes suicide, although many would also debate this).
A Moral Defense of the Right to Die

Akansha Bhargava

Akansha Bhargava

Posted: Jul 28, 2008

In the realm of moral and legal debates, the right to life holds a highly esteemed position. However, the overwhelming support for an individual’s right to live appears to be one sided. The antithesis: the right to die is often neglected. In both the medical and scholarly communities alike the idea of a right to death is often scorned or brushed aside. There seems to be an underlying assumption in favor of life and an implicit belief that those that wish to end their lives are misinformed or mentally incompetent. This paper will defend the position that there are legitimate reasons and justifications for a person to request the right to die and that under certain circumstances it is morally obligatory that these rights be upheld.

Imagine a hypothetical situation where a man name Jack slips on a tennis ball and becomes completely paralyzed. He is now only able to communicate through eye blinks and has repeatedly expressed his wish to die. Furthermore, let us suppose that prior to his accident he arranged an advance directive, which appoints his wife as his health care agent in the event that he cannot make decisions for himself. His wife, Ima Loire says that Jack had a very active lifestyle prior to his accident and that she is sure that he would rather die than continue to live paralyzed. His doctor, I. M. Hopeful, on the other hand has treated many patients who are quadriplegic and assures the couple that most of his patients regain the will to live after six months of undergoing treatment. He consequently recommends that Jack undergo rehabilitation and approaches the hospital ethics committee for advice on the matter. In this situation the main factors to evaluate include: patient autonomy, informed consent, and limited medical resources. This paper contends that these three reasons support the patient’s decision to refuse treatment on a ventilator and additionally outweigh any opposing claims made by the doctor, namely: mental incompetence of the patient, statistical evidence, and sanctity of human life.

The most fundamental issue in this controversy is the matter of patient autonomy. In the United States, the ideal of freedom, particularly personal freedom to do as we wish, is highly regarded, provided that in the process of pursuing our freedom we do not cause harm or injury to others. This idea comes from respect for individuals and the choices they make and implies that there is an implicit bias towards individual liberty and personal autonomy with regards to decision making. Jack expressed a wish to refuse treatment and to consequently be allowed to die. Although his physician may feel his goal is to provide medical care to improve the quality of his patient’s life, his first goal is to respect his patient, which in this instance requires that he respect Jack’s desire to forgo treatment. The idea of patients refusing treatment is a relatively new concept in Western medicine. It was previously understood that doctors are knowledgeable of their patient’s best interests and are the most qualified to make decisions concerning those matters. With the advent of hospital ethics committees, the Nuremberg code, and increased patient liberty in decision making, this view is no longer popular. In fact the medical practice has increasingly begun to move away from this paternalistic stance on patient treatment. In acknowledging Jack’s right to make decisions about how he should be treated we are respecting his autonomy and inherent right as an adult human being to make personal decisions that he regards as in his best interest. This right to autonomy does however assume that Jack is mentally competent to make decisions for himself.

Read the whole article.


3 comments:

greenfrog said...

I like the point of this article. Thanks for linking to it.

An aside:

But many people disagree, and most of them site moral grounds for their objection (which constitutes a violation of the separation clause if you ask me).

You've alluded to this concept before -- that enacting specific moral beliefs associated with a religious viewpoint violates the separation clause of the First Amendment -- but so far as I've seen, you've not elaborated it.

I'm frankly puzzled by it -- the vast majority of our criminal laws (and much of our civil legislation as well) depends entirely on notions of morality, almost all of which are valued to one degree or another by some religious group. If we were to prohibit morally-based laws (which, itself, would be an implementation of a particular morality), we'd be short of a lot of relatively uncontroversial criminal statutes.

Our notions of morality give rise to religious rules, surely, but the same notions of morality give rise to societal rules, as well. The adoption of a notion of morality by a religious group should not(and does not, under current Supreme Court Separation Clause jurisprudence) prevent a society from adopting the same notion of morality in its legislation.

william harryman said...

Hey Greenfrog,

You raise a good objection. In general, I see nearly all morality based in religion, so I agree with you on that point.

Where I object is when one religious viewpoint places limits on individual rights, especially those that have ZERO impact on another human being (such as the right to die, gay rights, etc).

So maybe I need another argument. The Separation Clause is violated, as you suggest, by the majority of our laws, since most of them are base in a Judeo-Christian worldview.

I should probably stop using that argument, even though I would like to see ALL laws based in religious beliefs re-evaluated within a secular, humanistic framework.

Peace,
Bill

greenfrog said...

Where I object is when one religious viewpoint places limits on individual rights, especially those that have ZERO impact on another human being (such as the right to die, gay rights, etc).

I agree wholeheartedly with this, and I think it's the clearest way to demonstrate (and argue, I hope) why such efforts are, themselves, immoral. From my very limited perspective, most of the opponents of gay marriage are still looking for some way to argue that gay marriage poses some threat to heterosexual marriage. I think they're still looking because they realize, even if they don't admit, that if they can't show such a linkage, they're completely on the wrong side of the issue. For a similar reason, I think that the longer the Massachusetts and California rights remain in place, the more clear it will become that the "weakening family values" line is just wrong, and the less political support the opponents will have.

But your main point -- not that gay marriage in particular should be permitted, but rather that gay marriage is in an entire class of behavior that should be outside of legislative limitation -- would require people to step back from their particular worldview enough to see that they should respect others' right to self-determination, even if they reach different substantive conclusions about what path to follow. That kind of meta-thinking was evident when the Bill of Rights was drafted. It is stunning to me that centuries later, the general populace still doesn't seem to have gotten the point.

So maybe I need another argument. The Separation Clause is violated, as you suggest, by the majority of our laws, since most of them are base in a Judeo-Christian worldview.

I should probably stop using that argument, even though I would like to see ALL laws based in religious beliefs re-evaluated within a secular, humanistic framework.


On a personal and introspective level (or "quadrant," I suppose), perhaps there's an opportunity to examine the source(s) of our own subjective moral preferences, then to compare them with a more objective view of those same moral preferences in ourselves. With that, we then have a basis for thinking about others' moral sensibilities, which we typically only perceive from the outside.

On a societal level, especially with right to die issues, I think there is actually already a pretty strong degree of support for individual choice, and while the cause is side-tracked a few years at a time by personalities (Kevorkian, for instance), the general direction remains unchanged, and is moving toward self-determination.
* * *

Anyway, I enjoy your blogging.

Thanks for it.

be well,

s