In Part I of this post I wrote about a philosophical error we ought to avoid when thinking about the value of human life: namely, the idea that human life is the highest good possible.
Here, in Part II, I would like to discuss two more common errors we make when thinking about the value of life: first, that the goodness of life is entirely subjective (that’s the fancy word for “up to us”); second, that freedom can somehow be a good even when it destroys life. Both of these errors are exemplified in the tragic suicide of Brittany Maynard. More importantly, however, these are errors that are “in the air.” That is to say, they are by no means specific to the thought of the late Ms. Maynard: they are everywhere, pervading most discussions of the issues of physician-assisted suicide and euthanasia. Most importantly, these errors will surely influence the ongoing debate about the “Aid in Dying” Bill (SB 128) that has recently been introduced in the California legislature, and they will factor in the debates about future legislative initiatives in other states.
The Value of Life Exceeds Our Perception
The most common problem I find in both philosophical and popular discussions of bioethical issues such as physician-assisted suicide is the idea that the value or goodness of one’s life is relative to one’s perception of that value–that one’s life is as valuable as one thinks it is, end of story.
For a sophisticated example of this, consider Catherine Constable’s 2012 article “Withdrawal of Artificial Nutrition and Hydration for Patients in a Permanent Vegetative State: Changing Tack” (Bioethics 26, no. 3). In the article, Constable notes that it is sometimes said that life has intrinsic value, the sort of value that can never be lost. For this reason, some people (or institutions, like the Roman Catholic Church) think that patients in seemingly irreversible comas should continue to receive food and water–sustaining their valuable lives. Constable disagrees, and her response to this point exemplifies the error in question: “Without consciousness, continued life cannot benefit [the patients].” In other words, Constable assumes that the goodness of human life is in the eye of the beholder. For someone lacking consciousness, the ability to perceive the goodness of one’s existence, life loses all its value.
Brittany Maynard never explicitly says that her life would have lost all value had she seen her illness through to its end–however, the idea is there implicitly in her open letter. After discussing the awful side effects her proposed course of treatment would have had, Maynard states: “My quality of life, as I knew it, would be gone.” To be sure, that little phrase “as I knew it” leaves open the possibility that there could be some remaining quality of life–but not for someone like Maynard. Her judgment about the value of her life is assumed to be paramount. This same attitude–that I am the judge of the quality and goodness of my life–reemerges in her powerful final question: “Who has the right to tell me I don’t deserve this choice?”
But as we wish we could have asked Maynard, what gives you such confidence that all value is subjective, that life has no quality or goodness beyond what you know? Why should you assume that your perception fully determines reality? As Thomas Aquinas reminds us, only God’s knowledge is causal in that way. Human knowledge, by contrast, is “caused by the things known.”
The dependency of human knowledge upon reality is important because it means that life might still surprise you. Despite all your “knowledge,” reality escapes the net of your expectations. Even a person with a terminal disease might find still more moments of happiness. And more importantly, someone enduring a terminal disease might give others an example of courage in the face of unrelenting suffering. That sort of courage is something one’s fellow humans ought to see; they need to see it, as they struggle with their own pains. That, it seems to me, is the surprising answer we would have to give to Maynard’s rhetorical question. Who has the right to tell you that some choices are not legitimate? We do. We all do.
No Freedom Without Life
The final error I wish to discuss is assumption that the exercise of freedom (in the sense of self-determination, at least) is a much higher good than life, so much higher that freedom may even be used to destroy life. We see this in Maynard’s statement “I want to die on my own terms.” Only that sort of death is, presumably, a “death with dignity.” Christy O’Donnell, a 46-year-old mother with lung cancer, makes the point even more forcefully in her recent interview in People magazine: “It’s an injustice that I can’t die the way I want to.” Dignity is thus understood to be inextricably found up with freedom. Freedom is more important than life. Freedom is so important that whatever thwarts freedom is unjust. Even life may be brushed aside in the name of freedom.
First of all, if it is true that dignity always requires freedom of choice–and that’s a big if, because that would seem to mean that marriage is undignified, school is undignified, and anything else that restricts our freedom–then it is even more true that dignity requires life. Why? This isn’t a hard one to figure out: you can’t exercise freedom if you don’t exist.
In his article “Death-suicide-euthanasia,” the philosopher Robert Spaemann tries to bring home this point in a discussion of euthanasia, and it seems to me that the same principles would also apply to cases of suicide like Maynard’s. In a reductio ad absurdum, Spaemann asks why everyone supposes that euthanasia should only be allowed in cases of terminal illness. If self-determination, the right to “die on my own terms,” is truly the important thing, then “Why should the suicide that follows from weighing up all the plus and minus columns be placed at a disadvantage? Why not suicide out of unrequited love?” As Spaemann says, no rational answer to those questions is possible, as long as one continues to make the fundamental mistake of thinking that one’s freedom can validly be exercised to destroy one’s life. In fact, life is the precondition of freedom.
Freedom and life can be distinguished in speech, but they are existentially united in the human person. The freedom that allows us to determine the course of so much of our lives is the direct result of our having a rational nature, a rational form of life. Freedom arises out of life. Practically speaking, this means that life provides the context for all of the exercise of our rationality. It is an unspoken premise in all the justifications one gives. It can only be good to play soccer while one is alive. It can only be good to get married while one is alive. It can only be good to end one’s life while one is alive–oh wait, did you see the problem there? In ending one’s life, one ends any possible goodness, any reason the action might be justified.
Freedom and life are not meant to stand in an adversarial relationship. Rather, freedom exists for the protection of life. As the philosopher John Locke puts it, freedom is meant to act as a sort of “fence” around life, and “that ill deserves the name of confinement which hedges us in only from bogs and precipices.” In other words, we are free so that we might attempt to save our lives–not destroy them.