Belgium: The Return of “Useless Eaters”

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English: Skull and crossbones

English: Skull and crossbones (Photo credit: Wikipedia)

At http://www.france24.com/en/20121218-belgium-looks-euthanasia-minors-alzheimers-sufferers is an article on a proposal that will most likely pass Belgium’s legislature that allows euthanasia for minors and for Alzheimer’s patients. Increasingly secular, godless Europe is finally passing laws that reflect the decline of the remnants of Christian ethics that held on for a while after the decline of religious belief. The phrase “useless eaters” was coined by a Nazi doctor who was discussing Nazi Germany’s euthanasia program. It had no problem killing minors and people with senility of whatever cause. With no clear cut behavioral diagnostic difference between Alzheimer’s Disease and senile dementia in general, the new law, when passed, could de facto be applied to some non-Alzheimer’s senile patients.

What are the limits on the age of minors? Apparently none–any minor deemed “too sick to live” by a doctor and by parents or guardians could be killed. The slippery slope that supporters of euthanasia claimed would not happen is already fact. Next door in The Netherlands, voluntary euthanasia quickly led to involuntary euthanasia, and there was, for a time, a proposal on the table to have a “quality of life threshold” below which a person would no longer have the right to live. It may just be a matter of time before the severely mentally retarded will join the list of “useless eaters” and euthanized. A godless society only gives life a utilitarian value. Although Kant tried to set up a secular system that allowed for intrinsic human dignity, his dream died, at least in some European countries, and the remnants of the Christianity that still influenced Kant died away. Now there is no bar to making decisions regarding euthanasia not based on alleged “mercy,” but on a person’s ability to “contribute” to society. The fittest survive; those considered unfit will be eliminated. The most frightening instances of murder are those murders that use mercy to justify them. The only “mercy” involved may be for the family to get a burden off their back and the state to save on medical bills due to fewer patients requiring long-term care.

The United States, for now, has enough residual Christian belief to avoid Europe’s direction for now. However, given the responses of most of my medical ethics students to questions regarding the moral rightness or wrongness of physician assisted suicide, it seems that those supporting PAS will win in the long run. If they do, it will be no surprise if PAS leads the way into voluntary active euthanasia and eventually to involuntary active euthanasia. Society will be at last be in part of a eugenics movement that will make the earlier movement in the first decades of the twentieth century seem like child’s play. God help us all if that happens–and it will happen in Western Europe (and probably in Canada) before it happens in the United States. But with 30% of young people in the U.S. classifying themselves as “irreligious,” the road toward Europe may be wider than one might think.

Atheists forget, when they catalog the crimes of religion, that the mass murderous regimes of the twentieth century were atheistic: Nazi Germany, the Stalinist Soviet Union, Maoist Communist China, North Korea, and Cambodia when it was under the rule of Pol Pot. The sanctity of human life does not make sense in an atheistic framework; the value of human life must be instrumental and not intrinsic in a consistent atheistic system. It is no surprise, then, that Belgium and the Netherlands are going the route toward allowing more and more classes of people to potentially be subject to euthanasia. The Nazi world of alleged “useless eaters,” a world Europe once claimed to eschew for good, is coming back to haunt a godless society. The price paid for such folly will be very high.

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Euthanasia: Love or Selfishness?

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I often listen to books on CD as I drive. Lately I have been listening to classics, the latest of which is D. H. Lawrence’s book, Sons and Lovers. It is a well-written book about two generations of the Morrell family, a mining family living near Nottingham. Near the end of the book, Paul Morrell is deeply disturbed by his mother’s suffering from cancer. He devoutly wishes that she would die. The agony becomes so great for him that he grinds up morphine-based pills and puts it in his mother’s evening milk. She drinks it, her breathing slows, and eventually she dies. Paul is relieved that his mother’s suffering is finally over.

Many readers will be sympathetic to Paul. After all, no one wants a beloved family member to suffer. Didn’t he do the most merciful thing? After all, we put animals down when they are suffering; why not allow human beings to have a similar merciful death?

I would argue that in many cases, including this fictional case, it is more likely that the giver of euthanasia was more concerned with his own pain watching a loved one suffer rather than concern for the loved one’s suffering. In the novel, Paul has put his life on hold during his mother’s illness. I would not deny that the story is meant to be read to show his love for his mother, but it also makes clear that the illness of Paul’s mother inconveniences Paul. There is an element of selfishness in his giving a deadly dose of morphine to his mother. If he had given it to her for the purpose of relieving her pain, knowing that death was a possibility, his actions could be defended under the principle of double effect. But his motive was to kill his mother, and this means that his actions were morally wrong–Paul is a murderer.

Family members who engage in euthanasia need to rationalize their actions, so they say that their action was wholly done out of love for the suffering family member. Perhaps that is true, but knowing human nature, it is easy for a person to rationalize selfish motivations as love to justify an intrinsically evil act. Sick people do inconvenience healthy family members. In American individualistic culture the prevailing ethic tells people to abandon the ill (or kill the ill person) so the survivors can fulfill their own life plans. This is pure selfishness and a grossly wicked attitude to have. We are not isolated individuals but are interconnected from our immediate family to our friends and then to others. Sickness is part of the human condition, and it is part of our duty as moral human beings to support our sick loved ones and not try to get them out of the way in the name of “mercy.” Too often the only “mercy” an euthanizer has is for himself–he gets rid of the source of his pain.

Hospice did not exist in Lawrence’s day; it does today and offers excellent care for the dying. Pain control methods are better, and doctors are now receiving training in pain control. Will this quiet the drive toward euthanasia? I fear that American society is too selfish to avoid the mistakes of the Netherlands in legalizing physician assisted suicide, which in turn has led to both voluntary and involuntary euthanasia. And in Lawrence’s book, Paul’s mother did not want to die; she desired to live as long as she could. Paul killed her against her will. Hopefully people who still believe in human community, the dignity of human beings, and mutual care for the most vulnerable among us will be able to stop any future moves to legalize euthanasia in the United States.

“Creating” Reality vs. Respecting Reality

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Women go against the natural impulse to care for their offspring and kill their children via abortion. Academics and the media deny that marriage and the family are natural institutions and believe that marriage and the family are whatever we make them. The tradition, dating back thousands of years, of marriage being between male and female is denied by academics and judges. Children no longer have a mother at home and are reared in day care centers, and academics and the majority of the media rejoice. Pundits talk about “designer babies” created through genetic engineering. Weapons of mass destruction are created out of thin air, and a Bush administration official says that “Reality is what we decide it to be.”

Most ancient and medieval philosophers believed in a natural order that human beings were required to respect. A violation of the set order of nature would lead either to societal chaos and the destruction of the proper natural order. That began to change in the modern era, with Rene Descartes (1596-1650) moving the direction of philosophy away from nature to the self. The idea that things had real natures was cast off by William of Occam’s nominalism in the fourteenth century, so it was easy to move from the emphasis on self to the notion that categories in the mind account for the general structure of the world we experience. This was Immanuel Kant’s (1724-1804) position. But Kant believed these categories were the same for all rational beings, so we all experience the same world. Once this assumption was abandoned, then reality was thought to be what man willed it to be. In this view, there is no natural order that exist prior to man; it is man who makes reality what he wants it to be.

I offer a long-term empirical test of the idea that we can manipulate reality to be what we wish it to be. America and Western Europe are trying to mold reality in a way that supports an overly-individualist, self-centered, and materialistic lifestyle. If a pregnancy gets in the way, kill the fetus–after all, life begins when we say it begins. If old people get in the way, kill them–after all, life is meaningful when we say it is meaningful. If politicians want to profit from war, they should go ahead–they will invent reality to justify starting a war. If the family gets in the way of our desires, there is divorce, and for those who prefer lovers of the same gender, they can adopt, too. Reality is what me make it.

My proposal for an experiment is this: Let society go the direction of trying to create reality in the image of its desires. If my belief that the actions resulting from that view violate the natural order is correct, society will inevitably descend to chaos and ruin. Either social order will disappear into crime and chaos, or a strongman will take power to restore order through dictatorial force. If I turn out to be wrong, I am willing to stand corrected. Deal?

Physician Assisted Suicide and the Ends of Medicine

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When I ask my medical ethics students whether they support physician assisted suicide (in the sense of the physician prescribing a deadly dose of a drug, usually barbituates, for the patient to take when he wishes), the vast majority raise their hands. Even most students in my classes who oppose abortion support physician assisted suicide (PAS). To me this is disturbing, especially since the strongest support for PAS has been in my class of future physician assistants.

What is so wrong, you may ask, about physician assisted suicide? After all, even with ideal pain control, some terminally ill patients either remain in a great deal of pain or have to be totally sedated. Why not allow such patients to “control the time and manner of their own deaths?” Surely PAS will encourage more dignified deaths among patients in intractable pain. And in referendums, Oregon and Washington have passed laws permitting PAS. Shouldn’t this practice spread to other states?

Although PAS sounds attractive, its practice would be a fundamental distortion of the proper goals of medical practice. The internal goods of medicine include restoring a patient to health, and when a patient cannot be restored to health, to make that patient as comfortable as possible. But supporting a patient’s suicide indirectly involves the physician in killing a patient. Physicians have a great deal of power over patients, power which, if misused, can lead to pain, suffering, and death–as the Nazi medical experiments and the Tuskegee Syphillis Experiment revealed. Now a physician can withhold or withdraw medical care that is only prolonging the dying process. The goal is not to hasten death per se, but to relieve the patient’s suffering. But prescribing a deadly dosage of a drug is designed to let the patient hasten his death. One may say that the motive is to relieve suffering, but there is a difference between allowing the disease process to take its course and giving a drug so a patient can actively commit suicide. This abuse of medical power has already spread in the Netherlands, where PAS is legal, to doctors actively killing patients without the patient’s permission or the patient’s family’s permission. Once the line forbidding a physician from assisting in a patient’s death is crossed, it will be difficult to turn back. Doctors participating in PAS will not be practicing medicine, but doing something else entirely–being accessories to suicide.

There is an assumption in the modern world that pain is the worst thing that a person can experience. That was not the view of the premodern world. Socrates was willing to suffer pain and death to keep his integrity. The early Christians suffered excruciating torture via persecution–they believed that they were sharing in the sufferings of Christ. And without modern pain control methods, people suffered far more from diseases than they do today, yet the drive for PAS is a modern movement (David Hume was among the first to defend suicide as an option in a person in great pain). This does not mean that we should not try to stop pain as much as possible short of actively killing the patient or giving the patients the means to suicide. Relieving suffering is a moral obligation of physicians as long as medical power does not cross over the line into aiding a patient in his active demise. Even in this post-Christian world, would secularists really want doctors to cross the line into PAS? Could PAS be controlled once the genie is out of the bottle? I do not believe so–but even if PAS is the only line that is crossed, it remains inimical to the ends of medicine and is wrong.