Forced Exit

Assisted Suicide: The Liberal, Humanist Case Against Legalization?
by kevin yuill
?palgrave macmillan, 208 pages, $85

I have always believed that liberals should be the euthanasia movement’s natural enemies. The liberalism to which I committed myself in my youth was concerned with expanding the moral community by ending ­racism and protecting weak and vulnerable people against exploitation and abuse. Today’s liberalism is ­increasingly concerned with ­advancing personal desires at the expense of societal norms. It favors narrative and appeals to emotion more than principle.

Perhaps that is why movement liberalism increasingly embraces the cause of legalizing assisted suicide. Gone are the days when social outlaws and unhinged advocates like Jack Kevorkian and Derek Humphry represented the “movement.” Its leaders are now mostly well-tailored (and well-paid) professional advocates who consciously seek to tie assisted suicide to more popular liberal causes such as feminism, gay rights, and abortion. They focus intensely on personal stories of suffering and avoid discussing the impact that legalized killing as an answer to human suffering would have on society and its most vulnerable populations.

Enter Kevin Yuill, an historian at the University of Sunderland in the United Kingdom, a self-described atheist and adamant secularist who disdains conservative opinion and freely spouts canards about the opponents of assisted suicide. He insists, for example, that the primary arguments against legalization are religious, when in fact even the most religious opponents mostly use rational arguments in the public square.

He also falsely accuses conservative opponents of vitalism, that is, of wanting to force all to undergo intensive life support to the bitter end. He is apparently unaware that even Catholic moral teaching clearly permits dying patients to refuse such care when the suffering it causes is “disproportionate to the expected outcome.” In fact, Pope John Paul II did just that.

Having proved his bona fides to the target audience for Assisted Suicide: The Liberal, Humanist Case Against Legalization ”atheists, political progressives, adamant secular humanists”Yuill offers an often compelling humanistic argument supporting the prohibition of doctor-prescribed death. He accepts the narrative of those who want to help suffering loved ones out of the world, while still seeking to protect the vulnerable. Thus, he argues that “spontaneous compassion” is acceptable, which he defines as intimates and physicians helping a suffering patient commit suicide on an ad hoc basis in truly compelling cases.

At the same time, he recognizes that structurally legalizing assistance creates invidious categories that will lead to discrimination based on health, ability, and age. “The division between ‘the dying’”whether they have six or twelve months to live”and the rest of us is false. Who is not dying one day at a time? We are all ‘terminal,’ and the worth of our lives should not be crudely measured by the time we have left.”

He also worries that legalizing assisted suicide would further an ongoing medicalization of social ills. Our culture increasingly understands “moral, political or social issues as medical problems,” he writes, noting a pronounced tendency “to expand the definition of disease” to include a wide range of cultural phenomena and the vicissitudes of life. Many addictions are now spoken of in the language of ­disease, as is obesity and the functional “infertility” of gay and lesbian couples.

Yuill stands against this trend as it relates to death. Dying is “not a medical act,” he exclaims. Indeed, bringing doctor-assisted suicide into the process dehumanizes the deathbed when our mortality should be approached as a “spiritual, existential or philosophical issue.”

Not that he thinks that suicide, per se, is always wrong. Some suicides are “noble,” but he asserts”much to my surprise”that suicide should remain “an individual decision in order to assign responsibility” and that each act needs to “be judged in moral terms.” Legalization, however, “renders the lives of those within the circumstances where suicide is allowed less worthy.”

In other words, when the law dictates suicide prevention for some suicidal people, but facilitation for others, it creates explicit inequality among different categories of despairing people. “The emphasis on autonomy upon which many of the pro-assisted suicide philosophers and ethicists base their arguments,” he writes, produces

an unrestricted freedom of conscience that “spell[s] [the] doom of every organized community.”If suicide for any purpose at all is allowed, the inherent goodness of the existence of other human beings is removed. There is no shared sense of good or bad, no right or wrong.

Advocates of assisted suicide insist that all who support abortion rights must also agree with legalized assisted suicide, as both”they claim”involve personal freedom and “choice.” Yuill disagrees, arguing that the proper liberal position is “for abortion, against assisted suicide.” His most important task”if he is to convince his target audience of his position”is successfully distinguishing the two issues.

First, he criticizes the pro-life position, assuring readers that he is an enthusiastic supporter of abortion rights as necessary to guarantee that women “play an equal role to men in society.” Then he pivots, claiming that “there is no composite societal interest in providing assisted suicides; nor are they necessary.”

Indeed, he makes the astonishing claim that “the anti-abortion movement and the pro-assisted suicide movement” have “more in common than the pro-abortion and pro-­assisted suicide movements.” Both seek to “redefine existing norms” (never mind that when abortion was first legalized, it redefined the then-existing norm) and distort the definitions of protectable human life.

“The pro-life movement wants to extend the parameters of personhood back to the creation of an embryo,” he sniffs, while “the assisted suicide movement wishes to roll back personhood from those with a terminal illness.” Thus, “both suggest radical redefinitions of human life.”

Further, Yuill calls abortion a “political issue,” while he claims assisted suicide is an “individual issue.” “Women as a class need abortion rights in order to be equal.” They are “less free when and where they are denied abortion rights.” In contrast, “no one is less free because we prevent doctors (or others) from ­assisting suicides.”

More cogently, he worries that assisted suicide opens the door to “state intrusion” into the deathbed”a novel argument that I think effectively bridges the liberal“conservative divide. Legalization threatens privacy, he warns, because allowing some”but not other”patients to have their overdose deaths facilitated requires “transparency,” that is, legally enforceable “safeguards” against abuse.

Funerals, he writes evocatively, “may be public events, but the approach to death is a time for intimacy, of close friends and family, for emotions, personal goodbyes, forgiveness, humility, reflection and sadness.” He worries that

if assisted suicide ever became institutionalized, the situation would become more formal, all those making up the deathbed would have to justify their relationships with the dying person so that ulterior motives might be crossed off, and the deathbed scene would need to be recorded. Dying in short would become a public event.

I confess that I have never heard this argument before, and after twenty years of anti-assisted-suicide advocacy, that’s saying something. But it is a powerful claim that I will use in my own work going forward.

In actual fact, liberals and conservatives, religionists and secularists, theists and atheists oppose legalizing assisted suicide. But that is not the popular perception. In a time of political tribalism, it is important to liberate liberals to oppose assisted suicide without feeling like cultural traitors. It can be done: In 2012, Ted Kennedy’s widow Victoria published a letter urging a “no” vote in a Massachusetts legalization initiative, an action that is widely credited with sinking the referendum.

Yuill’s sometimes stridently liberal and distinctly humanist case against legalization does the job, freeing progressives to oppose assisted suicide without feeling they have become sullied by conservative attitudes. As an added bonus, he also provides arguments that can be openly adopted by those who do not share his worldview.

Dying is a profoundly challenging experience. Those facing it are among society’s most vulnerable people. Despite my misgivings about Yuill’s sometimes too simple thinking about conservative advocacy, I was greatly heartened to see a proud liberal’s attempt to reconnect his grand tradition to those at life’s end.

Wesley J. Smith is a senior fellow at the Discovery Institute’s Center on Human Exceptionalism. He also consults with the Patients Rights Council and the Center for Bioethics and Culture.