Q&A with the Scholars: Physician-Assisted Suicide and Euthanasia
Richard Doerflinger, M.A., is a Public Policy Fellow with the University of Notre Dame’s Center for Ethics and Culture and an Adjunct Fellow in Bioethics and Public Policy at the National Catholic Bioethics Center in Philadelphia. He was formerly Associate Director of the Secretariat of Pro-Life Activities for the United States Conference of Catholic Bishops, where he worked for 36 years. He also serves on the Advisory Board to the Center for Bioethics & Human Dignity. Mr. Doerflinger is one of our nearly 40 associate scholars. In this interview, he discusses physician-assisted suicide and euthanasia.
What is physician-assisted suicide? Euthanasia? At what point, and where, did efforts to legalize these practices first gain prominence?
Doerflinger: Euthanasia is an act or omission that by its nature or by intention causes a person’s death, ostensibly to end suffering. In physician-assisted suicide one person provides the encouragement or the means for someone to kill himself or herself. The intention to help cause someone’s death is the same in both cases. These practices are very old, and the followers of Hippocrates, beginning in the fourth century B.C., differed from other pagan physicians in rejecting physician-assisted suicide. American promotion of euthanasia, prominent in the 1920s as part of the eugenics movement’s effort to eliminate the “unfit,” was discredited by the news of Nazi atrocities in the 1940s, but reemerged in the 1970s as part of a debate on “death with dignity.” Legalization was especially promoted after 1980 by the Hemlock Society, founded by British activist Derek Humphry, who had assisted the suicide of his first wife. Hemlock had its first legislative victory in 1994 in Oregon.
What is the most common argument in favor of legalizing physician-assisted suicide (PAS), and what are flaws in the argument?
Doerflinger: The argument is twofold, as suggested by the Hemlock Society’s more recent name “Compassion and Choices.” First, we have an obligation to relieve the suffering of terminally ill patients; second, these patients have a right to choose how to end their lives. But campaigning to end certain people’s lives doesn’t end suffering – it passes on the suffering to other similar people, who now have to fear they are the next people in line to be seen as having worthless lives. And people who have died from a drug overdose have no freedom of choice at all. Moreover, societies that authorize suicide as a “choice” for some people soon end up placing pressure on them to “do the right thing” and kill themselves. That is a development that Hemlock founder Derek Humphry predicted and favored for the elderly (whom he called “greedy geezers” eating up the resources of the young). Seeing suicide as a solution for some illnesses can only undermine the willingness of doctors and society to learn how to show real compassion and address patients’ pain and other problems. In states that have legalized assisted suicide, in fact, most patients request the lethal drugs not due to pain (or even fear of future pain), but due to concerns like “loss of dignity” and “becoming a burden on others” – attitudes that these laws encourage. The solution is to care for people in ways that assure them that they have dignity and it is a privilege, not a burden, to care for them as long as they live.
The movement to legalize PAS in the United States has witnessed several recent victories. What can we learn from the examples of other countries that have legalized PAS about the path that these decisions have set us on? Is it possible, in principle, to consistently advocate to legalize PAS but not euthanasia, or is there a logical slippery-slope linking the two?
Doerflinger: In the Netherlands, Belgium, and other countries with longer experience of this agenda, the killing has moved steadily from assisted suicide to euthanasia; from terminally ill patients to those with chronic illness, mental illness, or simple weariness of life; and from voluntary to nonvoluntary euthanasia. The Dutch have always held that it is inhumane to legalize only assisted suicide because some attempts fail or increase the patient’s suffering and so must be completed by the doctor. Once you have decided that your intent is to help cause some people’s deaths, it is easy to see the logic in that argument.
What do you think are the most effective messages for those who oppose PAS to employ in debating this issue in the public square? Proponents of legalization invoke “death with dignity” and other refrains that resonate with people emotionally—how can we most effectively counter that?
Doerflinger: We should meet the argument about “choice” head-on, by showing how allowing assisted suicide for one vulnerable class of people actually subjects them to the will of others – from greedy or uncaring relatives, to ethically challenged doctors, to society itself. When we exempt a whole class of people from the usual laws protecting life, that’s not about freedom – it’s about the government’s decision that some people are worth protecting, but other people are not, when they are tempted to make self-destructive choices. We should promote more compassionate choices, affirming people’s worth by giving them the support, pain management, and other care that they deserve.
Why are you pro-life? If you had 60 seconds to explain to someone why you have pursued the work that you have throughout your career, what do you tell them?
Doerflinger: At a time when I was not as serious about my Catholic faith as I am now, I studied the arguments for and against abortion and euthanasia, and it seemed obvious to me that the pro-life position makes more sense. As a science major in a pre-med program, I was never unclear about “when life begins.” And if we say we have an unalienable right to life, liberty, and the pursuit of happiness, those rights have to belong to everyone who belongs to the human species, at every stage. Otherwise we’re no longer talking about inherent rights, but about privileges bestowed on people because of various abilities – and those privileges can change or be taken away because they’re basically arbitrary. My family’s experience of caring for my older brother for 40 years after he was injured in a car accident and declared “hopeless” by doctors, gave me a much more personal conviction that if we care about people, we don’t give up on their lives. My realization that the Church was right about this issue helped bring me back to a fuller appreciation of its vision of life overall.
Mr. Doerflinger’s full biography can be found here.