Dying Well versus 'Having a Nice Death'

Before we can conscientiously make a decision on changing the law on euthanasia we need to consider: where it is all coming from/what spirit does it express; what difference might it make in our ways of being human and in our ways of treating each other; and what difficulties and inconsistencies it may get us into down the track. At least these, possibly others as well..

Where is it coming from/what spirit does it express?

Almost certainly, the spirit of late Capitalism, where (neo-) liberal attitudes which have dominated the substance of our lives since the neo-liberal consensus, with the demise of all the other traditions and the influence of the Internet, have now taken over almost the whole of the superstructure of our lives. We are being turned, more and more completely, into individualistic consumers of goods and services, the list of goods and services now taking up almost the whole of human life. This has extended even to death/dying: death/dying, rather than a natural part of life, to be done well or badly with the help of medicine to manage any pain, has become something like the ultimate consumer item. Our consumerist, throw away society, it seems, now gets to include life itself!

To put it another way: the good people of Wentworth or Warringah were said to be economically conservative and socially progressive. Perhaps they were just being consistent.

Or to put it yet a further way: talk of Left and Right on this issue may well be somewhat misleading. It might be more useful to revert to the old threesome, Conservative, Liberal, Socialist, plus nowadays Green. The spirit at work is actually Liberal rather than any of the others. Though nowadays more Neo-Liberal, with its fundamentalist, sometimes totalitarian tone.

This individualistic marketising consumerist spirit, the only Master Narrative left in advanced capitalist societies, melds only too easily with what is sometimes called the 'Technocratic Paradigm'.  This has been with us since the Agricultural Revolution when we ceased to be more or less creatively interacting parts of nature as in First Nations like societies and started to become its master.  It has usually been held within limits by other features of prevailing culture, but in late capitalist societies these limits have almost entirely disappeared.  Not content with being masters of nature we want to be masters of humanity and of all aspects of human life as well. If it were possible we would like to decide our own conception and birth.  The latest incarnation in Australian contemporary politics might be the mantra of "Can-Do Capitalism", which is supposed to save us from the environmental crises and climate change etc., in spite of this way of doing business being the very causes of the same! 

For more on this consult my website.

As for all this talk of autonomy: when I hear people talk of autonomy, I immediately think of PM John Howard after the Tampa incident: "We will decide who comes to this country, and the circumstances in which they come". Of course we will, that is in the Constitution. But the question, what is a good thing to decide, hasn't even been asked, let along answered. Autonomy, in the sense of full knowledge and full consent, is the condition for a human act, not for a good or a bad act.

The role of faith traditions in this context is exactly the same as that of other e.g. cultural or philosophical traditions of experience and interpretation. They stop us being just playthings of external forces. They at least give us a place to stand to enter into dialogue with the changing spirit of the times whatever it is. Without a place to stand, some kind of prior considered worldview commitment, statistically and overall there is nothing to stop us, including our politicians and journalists, from being such a plaything.

If something like this is the case: imposing it by law on all hospitals and doctors, looks like a species of totalitarianism, a government imposing by law a particular worldview, a particular way of being human. This is even more obvious if you parcel this with abortion law reform and some aspects of conversion therapy legislation. It is way beyond a matter of conscientious objection. Saying after it is passed it is the law doesn't say it is a good law or a law that has to be imposed on everyone.

What difference might it make?

The motivation on behalf of some of its proponents is a sometimes understandable individualistically focused compassion. But it is a compassion which is taking place against a whole new background, a compassion which doesn't see the wood for the trees, and which may not be as necessary as it thinks and is getting progressively less necessary.

This is the Paul Keating point I think. Changing the law and the changing attitude instilled by the changing of the law, in the present circumstances particularly, is, or will almost inevitably develop into, an attack on the full human dignity of us old people, the disabled, possibly our First Nations peoples particularly the elderly and infirm, indeed anyone considered by consumerist society at large to be suffering, or "a burden" or "living an unproductive life". I know of elderly people in my own family in the past who wouldn't go into a hospital for fear they would never get out alive. I am told this is an attitude common among our First Nations people. This is the case now: what will happen when protections of law are removed??

This links up with a point made long ago by Philip Adams of all people, when talking of Senator Brian Harradine. Our society right now, even back then, has it both ways. People who want medical assistance in their dying can already get it, and you don't have to look very hard. I know this also from what has happened in my own family. Whereas people who don't want to be put under pressure to have their lives ended, including whole classes of people, still have the protection of the law. This also makes it imperative that not all doctors and hospitals be forced into providing this so called service: it is imperative that people have places to go to where they can be assured they will not be put under pressure for their lives to be taken from them prematurely.

In this context it becomes important carefully to note the distinction between palliative care and euthanasia. They come from entirely different places. Palliative care is to provide medical, psychological and spiritual resources to enable people to die well. It is well in line with older ways of thinking of dying and classic ways of construing the role of the medical profession and health services. And it is getting better and better, in spite of woefully less than adequate resources. Euthanasia on the other side gives up on palliative care and turns the medical profession in the direction of providing death instead. Its wide introduction also changes the economics of dying: why put more money into palliative care when you can persuade people to allow themselves to be killed? This is much cheaper after all, whether the source of funds is public or private. People will protest strongly, this is not what they are about. But as every good Marxist knows (you don't even have to be a good Marxist), economics has a way of eventually changing the ideology.

Some difficulties and inconsistencies it might get us into

Most obviously to start with, it absolutely disturbs any message we may have about suicide. It seems now that some suicides are good and to be socially approved and resourced even with public money, and that other suicides are bad. Like in a public hospital you could conceivably have a Suicide Prevention Unit in one wing and a Voluntary Assisted Dying Unit right next door.

It also makes what we are doing during the present Pandemic a bit paradoxical, to say the least. Here we are, doing our very best to protect the old and vulnerable and to stop them from dying, and in the same breath doing something which inevitably will put them under pressure to get people to take away their lives.

Inbuilt safeguards very quickly turn into 'limitations of access', like seems to be happening in Victoria right now. The point to understand is that given the prevailing ideologies right now and what seems to be an almost infinite malleability in respect of changing social norms against the background of the demise of all the traditions, this is only to be expected. The slippery slope is written into the prevailing conditions.

Another point coming out of my own very recent experience of a VAD of one of our Belgian friends: it makes proper grieving almost impossible. The only way we could grieve for her was to regard her as a victim, someone to whom violence had been done, by the prevailing ideology in contemporary Belgian society and culture, by the complications of Belgian law, and with her inevitably confused family unable to render her much help. When it comes to grieving, the whole situation is unnatural, it is worse than suicide, a kind of suicide that you are supposed to approve of. This is just another illustration that this represents a wholly different way of being human.

Finally, it seems to me that an unnatural death, even if consented to, is always a form of violence. Your body usually doesn't want to die, except in the case of a natural death towards the end when it might actually want you to let it go. At very least it is a violence against your own body, even when it is not a violence to your whole set of relationships.

A little bit of dark humour to end up with, illustrating once again how paradoxical things have become. This has to do with the father of another of our Belgian friends. He decided to invite the Life Doctor (that is what they call them in Belgium) to come along and do his thing. He gathered his family around him and made all his preparations and then let the Life Doctor do his thing. He woke up next morning very angry, very angry that the Life Doctor hadn't killed him.

These are just the points I can think of right now, additional to points in the draft paper: there might be others as well.  Given the strength of the forces at work in our society and culture I doubt whether it will change anyone's mind, but you never know.

Notes:

The above was written, originally, to help my bishop prepare a paper in the context of the Queensland situation. It has been updated a bit, but coming from an old Labor Catholic perspective it may not be as relevant in NSW.  See Appendix below for paper prepared for NSW submission (max. 300 words).

The sentiments are sometimes very personal, but they also relate closely to philosophical analyses to be found elsewhere on my website. This is particularly the case with the unmasking exercise going on in the first section, Where is it all coming from?

Also, in my case (and in the case of my bishop), the attitude to euthanasia is to be taken not in isolation but as an intrinsic part of the Seamless Garment of Catholic social and ecological ethics and spirituality, as expressed previously in the website and alongside all the other positions put forward in the PowerPoint.

Finally it is also very much in line with emphases taken by Pope Francis, very much part of what he calls "integral ecology". To illustrate this and also the seamless garment idea, and by way of conclusion, let me quote at length an extraordinary passage from his December 2020 book, Let Us Dream:

"That's why I spoke in Laudato Si' of a distorted mindset known as the 'technocratic paradigm'. It is a mindset that despises the limit that another's value imposes. I made the case there that an ecological conversion is necessary to save humanity not only from destroying nature but from destroying itself. I called for an 'integral ecology', an ecology that is about much more than caring for nature; it's about caring for each other as fellow creatures of a loving God, and all that this implies.

"In other words, if you think abortion, euthanasia, and the death penalty are acceptable, your heart will [or should in all consistency - my insertion] find it hard to care about the contamination of rivers and the destruction of the rainforest. And the reverse is also true. So even while people will argue strenuously that these issues are different in moral terms, as long as they insist that abortion is justified but not desertification, or that euthanasia is wrong but polluted rivers are the price to pay for economic progress, we will remain stuck in the same lack of integrity that put us where we are now.

"I think Covid-19 is making this apparent, for those with eyes to see. This is a time for integrity, for opposing the selective morality of ideology [on both sides], and for embracing the full implications of what it means to be children of God... (Pope Francis, in conversation with Austen Ivereigh, Let us Dream: The Path to a Better Future (Simon & Schuster, London, 2020), pp. 34-3