The Right to Die: Sliding Down the Slippery Slope

Throughout the world, as medical technology has improved, an issue over the right to die has developed. Those in favor argue the individual’s autonomy and its variant, quality versus quantity, while opponents have argued matters of religion and morality, the health practitioner’s Hippocratic Oath, and where this right could lead us, using the slippery slope. Looking at both sides of the issue, I tended to agree more with opponents of the right to die, because evaluating the quality versus quantity arguments, questions arose around the standard set on how high or low qualities of life are acceptable, and morality of the right to die became a factor.

In the questions of the right to die, autonomy may be an important principle which calls our attention to the dignity of individuals and the justice and respect that are owed to them, but it is not the only germane principle in end of life choices. Death may be viewed as evil in many Judeo-Christian religions, where it is seen that all forms of life should be preserved, but on questioning end of life decisions, the most pressing question is “not how long we live, but how we live” (Wadell, 2007). This approach to the right to die is a variant of the individual’s autonomy, and is seen as the individual’s feeling they have led a happy life, and their own functionality and happiness is diminishing. Yet, even if the right to die is confined to these standards, opponents have pin-pointed the problem of determining how high or low a standard of an individual’s well-being is acceptable, and using the Nazi’s euthanasia program and comparisons to bolster their account (Macklin, 2001). Many advocates of pro-life have stated when the ethic regarding “sanctity of human life is proven indefensible at both the beginning and end of life, a new ethic will replace it. It will recognize […] the concept of a person is distinct from that of a member of the species of Homo sapiens, and that it is personhood, not species membership, that is most significant in determining when it is wrong to end a life” (Singer, 2005).

In response to this criticism, the advocates of the right to die have said “a coherent” quality of life position is “grounded in a theory of the value of humans as beings with a capacity for self-reflective deliberation and action. It explicates the meaning of ‘quality of life’ of human beings in terms of standards of individual well-being, rather than in terms of social worth,” unlike the Nazis (Macklin, 2001). But adding this to the argument did nothing to sway my opinion on the matter, and in fact, raised the question about those who did not have the capacity for self-reflection and deliberation. For example, those patients in a persistent vegetative state (PVS) or who are mentally handicapped cannot do so, and there is now a debate in whether or not a comatose person can feel pain. Overall, in this view, I found that this argument would tend to label whose life matters and whose does not.

Furthermore, I found the Catholic Church takes a similar stance on this issue. In the Catechism of the Catholic Church (1997), it states:
Whatever its motives and means, direct euthanasia consists in putting an end to the lives of handicapped, sick, or dying persons. It is morally unacceptable. Thus an act or omission which, of itself or by intention, causes death in order to eliminate suffering constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator.
In this argument, I found that our choices are not private, because we are accountable to God and that all of us are enmeshed in communities and relationships with others which create moral bonds and responsibilities that are easily blurred if we act on autonomy alone.
On the contrary, even though the Church is against euthanasia, it views death as an imminent part of life, and humans should resist “playing God.” The emphasis of patient autonomy in contemporary thinking has brought about another science-based medical defect, which James Bresnahan (1995) notes as “our near obsession with finding a medical ‘quick fix’ for all problems.” In Bresnahan’s (1995) article, he contends, “Our Catholic medical ethics urges a counter-cultural response to fears of both too little and too much medical intervention, [… called] ‘Catholic medical pacifism.’” Our cure-oriented medical interventions all too often prolong dying. The Church believes that discontinuing medical procedures that are “burdensome, dangerous, extraordinary, or disproportionate to the expected outcome are legitimate,” because it will not cause death; instead, it recognizes the individual’s inability to inhibit it (Catechism of the Catholic Church, 1997).

In end of life issues, individuals suffering can see their happiness and quality of life diminishing, and the overemphasis of autonomy can lead us into dangerous and worrisome ways. Judging whose life is worth living and whose is not can direct us to constrict life to those viewed as “the worthy.” In fact, this issue can go both ways, with those who try to deny our mortality. In Bresnahan’s (1995) article, he calls this “mortal vitalism,” where one does everything medically to ward off death, even if it needlessly afflicts a dying patient. Bresnahan (1995) attempts to solve this, answering, “We ponder our limits and seek to learn to accept and deal with them. We come to terms with living within the limits, the limits imposed by mortality and by the two-edged sword of high technology medical intervention.” Medicine, science, and technology may give us ways to prolong our lives, but they ought not be worshipped. Instead our overriding concern should not be how medical technology might one day enable us to conquer death, but ‘How should I want to live in order that I may die well’” (Wadell, 2007)?

References
-Bresnahan, J. F. (1995, November 4). The Catholic Art of Dying. America, 11, 12-16.

-Catechism of the Catholic Church (2nd ed.). (1997). New York, NY: Doubleday.

-Macklin, Ruth (2001). Which Way Down the Slippery Slope? Nazi Medical Killing and Euthanasia Today. In J. Harris (Ed.), Bioethics (pp. 109-130). New York: Oxford University Press.

-Singer, P. (2005). The Sanctity of Life. Foreign Policy, pp. 40-41.

-Wadell, P.J. (2007). Happiness and the Christian Moral Life. Lanham: Rowman & Littlefield Publishers, Inc.

--Jennifer W.

Conscience: Capacity, Process, and Judgment

“Conscience. It is probably the most well-worn word in our moral vocabulary” (167). So begins Paul Wadell’s explanation of conscience. Wadell begins by pointing out society’s contemporary stance on morality, with many thinking conscience is “rules and regulations” we all must follow in order to lead a moral life. But Wadell argues against this, pointing out a serious flaw, saying rules and laws can only be guidelines in our moral decision-making, but “they cannot always tell us precisely what needs to be done,” and they are “general, designed to apply to a wide variety of circumstances; however, our task is to do the good not in some general, abstract way, but in light of the particular, often complex, and frequently changing scenarios of our lives” (184). To help us understand our conscience, and ourselves, more deeply, Wadell divides conscience into three parts: capacity, process, and finally, judgment.

Wadell begins explaining conscience by suggesting it is first and foremost a capacity, saying conscience is a sacred possession, “‘the most secret core and sanctuary’ of a person, where he or she is ‘alone with God’” (167). This view is comparatively like Etty Hillesum’s “deep well” view of God, seeing God as the well she drinks from. With capacity of conscience, Wadell argues that like anything living, conscience may atrophy if it is not cared for, saying “Our conscience is a living thing, and like all living things it can grow and flourish, but it can also stagnate, weaken, and die. […] Everyone may be born with a capacity for conscience—a capacity for moral awareness, sensitivity, and responsibility—but that capacity has to be nurtured, honed, and developed into a habit or virtue of moral awareness, sensitivity, and responsibility,” which leads us into Wadell’s second aspect of conscience: process (171). With the previous quote, we can see we must continually grow and learn in order to maintain a healthy conscience, and a way Wadell suggests of doing this is through the counsel of others, stating, “Our experience, knowledge, insight, and awareness are too limited to always be trustworthy moral guides. Too, there are many things that blur our perception of reality. […] This is why being responsible for our conscience demands not only that we develop a love for and attraction to the good, but we also seek the counsel of others. [Which] requires ongoing input, guidance, and even correction of others” (177). The final aspect of Wadell’s form of conscience is judgment, which leads us to prudence. This part of conscience is viewed by Wadell to be freedom of conscience and the ability to be one’s own person, and Wadell quotes Richard Gula on this matter, stating, “It is not enough to follow what one has been told. The morally mature person must be able to perceive, choose, and identify oneself with what one does,” (180) and in turn, Wadell draws more support from another theologian, St. Thomas Aquinas, saying, “that we ought to die excommunicated rather than violate our conscience” (181). Wadell wraps up on conscience with prudence, saying, “Conscience is completed in action—its aim is to achieve excellence in goodness—but for this to occur we must become skilled in bringing goodness to life in the most fitting possible way, and this is the function of prudence” (183). With prudence, we are able to complete our conscience by making the most fitting decision, through practical wisdom, for the different particular scenarios in our lives.

In the course, we have also discussed these matters of conscience, and have come to the conclusion that none of the three facets—capacity, process, and judgment—can function without the other. With these, we looked at the “freeze frame” view of conscience, seeing how they all tie together. Like Wadell, we see capacity as the innermost and deepest sanctuary, where one is alone with God, and where a person’s responsibility isn’t to outside law, but to the call of God in one’s own life. But we have also placed our passions, our character, and our inclinations—protecting human life, sharing/nurturing/educating life, and seeking the common good together in society and coming to know the truth about God—in this component. In process, we gathered that the framework of conscience is the meeting place of the person with God, and where our conscience joins with the community for guidance in what is truly good. Process is seen as the ongoing process of reflection. And finally, in Wadell’s view on “courage to be one’s own person,” we garnered that the event of a moral judgment is the person coming back to themselves in making a judgment about what is right in a particular situation.

In summary, conscience is seen in both situations as capacity, process, and judgment. But still, contradictory to what we have been taught, many people would look on conscience as a device to be possessed. In this section of the course, we have been taught that conscience is something everyone has the capacity for, where one is alone with God, but in order for our conscience to grow we must continually learn and seek counsel in the many aspects of life, because our own knowledge wouldn’t be enough. Finally, in the last component, we are able to come back to ourselves to make good moral judgments on complex situations. With all these aspects, it is hard to argue conscience is only a mechanism we may possess, but as Wadell wrote much better, “We are our conscience” (168).

-Jennifer W.

"Deep Well" Realism

In this course, we have been challenged on our views of what ethics is and is not, and now, we are faced with the challenge of who human beings are. In this section, we are presented with two different philosophies: determinism and perfectionism. Determinism shows each person in a Darwinist light, saying that everyone is out to reproduce, fulfilling our own genetic dominance, and weeding out those who are not fit to inhabit this earth. Each of us has no free will, with only cause and effect explaining any natural phenomena, and there is no existing God. In perfectionism, God is the policeman, rewarding one if we are obedient, and punishing us for our missteps. Perfectionism is the view that human beings do have freedom, but that freedom can be taken away. Both of these philosophies are on polar sides of the spectrum, but they both leave us wanting in the full understanding of who humans are, with determinism unacknowledging a human being’s free will, leaving the diverse multitude of humans to be controlled by a set of equations and programs, while perfectionism is freedom we cannot see or claim, but we can lose it nonetheless. Reading the diaries of Etty Hillesum completely shatters both determinism and perfectionism, challenging both philosophies views of human happiness, God, freedom, community, and ethics, giving us a more complete view of who human beings are.

In the realistic view, the source of human happiness comes from within ourselves. To gain any sense of happiness, we must first find the inner peace that Hillesum gained and strove to maintain throughout her diaries. The realistic vision disbands all notions of human happiness depending on our internal instincts or external environment and living up to the moral rules given to us by society, with living a life of meaning and worth. But how do we measure that worth? According to Hillesum, that worth is measured by our own internal dignity and peace, despite a turbulent environment, with Hillesum writing, “It still comes down to the same thing: life is beautiful. And I believe in God. And I want to be there right in the thick of what people call ‘horror’ and still be able to say: life is beautiful” (226). Hillesum’s own internal happiness also comes from the continual growth of her inner self, with Hillesum writing, “I see no other solution, I really see no other solution than to turn inward and to root out all the rottenness there. I no longer believe that we can change anything in the world until we have first changed ourselves. And that seems to me the only lesson to be learned from this war. That we must look into ourselves and nowhere else” (84). Even though Hillesum is surrounded by a chaotic environment, she is able to turn inward to find inner peace with the help of God.

Unlike determinism and perfectionism, God is a being acting through us and who we see in ourselves and others. In the beginning of Hillesum’s diaries, she is struggling with her own faith, but as time goes on, she begins to have a clearer idea of who God is. To her, God is a companion who goes with her, He is her conscience, with Hillesum writing, “There is a really deep well inside me. And in it dwells God. Sometimes I am there, too. But more often stones and grit block the well, and God is buried beneath. Then He must be dug out again” (44). As seen in this quote, Hillesum struggles internally with God. She constantly loses her way, but she makes her way back to God to dig Him out. Unlike determinism and perfectionism, which either have a domineering God or one who is nonexistent, realism challenges both views with God as an internal being, not one who is heavenward. Hillesum’s own views of God are concurring with this view, with Hillesum writing, “I imagine that there are people who pray with their eyes turned heavenward. They seek God outside themselves. And there are those who bow their heads and bury it in their hands. I think that these seek God inside” (44). In the beginning of Hillesum’s diaries, her relationship with God is very intimate, with Hillesum writing, “The girl who could not kneel but learned to do so on the rough coconut matting in an untidy bathroom. Such things are often more intimate than sex. The story of the girl who gradually learned to kneel is something I would love to write about in the fullest possible way,” but as time goes on, her image of God becomes more communal, including those who surround her (61).

Unlike the determinism and perfectionism views of community, which exist for our education and keep us from harming others, but in which we don’t affect the community at all, realism contradicts this, because it allows us to affect the community of which we are in. For example, in the diaries of Etty Hillesum, she does things for other people, which really helps her, and in the end, it brings the community of Westerbork together. Upon Hillesum’s departure to the Auschwitz death camp, her friend, Jopie Vleeschhouwer writes, “After her departure I spoke to a little Russian woman and various other protégés of hers. And the way they felt about her leaving speaks volumes for the love and devotion she had given to them all” (364). In the beginning of Hillesum’s own diaries, one questions her attachment to reality, thinking that she is consumed only in herself. In her diaries, her observations are directed inward, aimed to solve her own problems, but as time goes on, she can begin to focus on her outside world, and when she is in Westerbork, her sense of community is full, with Hillesum seeing God through those around her. Hillesum writes on page 323:

“Many feel that their love of mankind languishes at Westerbork because it receives no nourishment—meaning that people here don’t give you much occasion to love them. ‘The mass is a hideous monster; individuals are pitiful,’ someone said. But I keep discovering that there is no causal connection between people’s behavior and the love you feel for them. Love for one’s fellow man is like an elemental glow that sustains you. […] It’s a little bit bare of love here, and I myself feel so inexpressibly rich; I cannot explain it.”

In this quote, Hillesum still finds meaning to life, still sees life as beautiful, even though her own physical freedom has been taken away.

Even though Hillesum’s own physical freedom could be taken away, her own spiritual freedom could not be hindered. In realism, human beings are free of material objects, and are more dependent on the internal freedom of thought and spirit, even though the external is confining. Hillesum says on page 287, “The realms of the soul and the spirit are so spacious and unending that this little bit if physical discomfort and suffering really doesn’t matter all that much. I do not feel I have been robbed of my freedom; essentially no one can do me any harm at all.” With this, we can see Hillesum is not tied down by her imprisonment, instead, she still feels a sense of freedom in Westerbork. But in the beginning of her diaries, her journey towards inner freedom is a struggle, with Hillesum writing, “It is a slow and painful process, this striving after true inner freedom” (55). Hillesum’s process of gaining inner freedom is not always easy and she is guided by S. (Spier) in these matters. She credits his teaching to helping her find her way to God, writing, “You were the mediator between God and me, and now you, the mediator, have gone, and my path leads straight to God” (200).

In determinism, ethics do not exist. Instead, it is seen as fate or destiny, while perfectionism sees morality as learning what is right, and then conforming your life to it. But in realism, morality is seen as an organic process of growing, where we evolve as people, growing to understand the human condition. Before we can become part of the community, we must evolve internally. As Hillesum states on page 84, “I really see no other solution than to turn inward and to root out all the rottenness there. I no longer believe that we can change anything in the world until we have first changed ourselves.” Like realism, Hillesum recognizes morality as an organic process, saying, “Everything is a growing process. And in between, emotions and sensations that strike you as lightning. But still the most important thing is the organic process of growing” (102). In this quote, Hillesum sees that the only way to grow is in continuing to better herself, and in addition, Hillesum can see that it is the only way to contribute to society, saying, “If one wants to exert a moral influence on others, one must start with one’s own morals” (216).

In the beginning of this section, we were told that Hillesum would be our guide to a new way of looking at who we are. I would have to agree with this. Hillesum’s own outlook on life can be so inspirational, that it pushes us to better ourselves, possibly only finding only one sliver of what she found. In the beginning of her diaries, we find Hillesum a complete wreck, but through her own mind and relationships, mainly S., she is able to further her mind, and develop a new understanding of the human condition. Some people have difficulties seeing Hillesum as any sort of mentor, claiming that we need someone like “The Terminator,” but Hillesum teaches us what “The Terminator” cannot. I believe that Hillesum can be seen as a universal mentor, because she possesses characteristics which we all have. Unlike an Arnold Schwarzenegger character, Hillesum is not impermeable; instead, she has her foibles and fortes, her doubts, her triumphs, and her failures. Hillesum is a mentor whom we can identify. Throughout her diaries, she is closed off to her surroundings, with her consciousness directed towards solving her own inner problems, but in her letters from Westerbork, she focuses on the environment surrounding her, giving a helping hand to those in need of it. Even though Etty is imprisoned, her outlook on life is a redefining experience, and she refuses to hate. Hillesum writes on page 11, “[…] indiscriminate hatred is the worst thing there is. It is the sickness of the soul,” and that “[…] every atom of hatred added to the world makes it an even more inhospitable place” (256). Etty’s own freedom of hatred is an inspirational test for us all.

In this section, we have learned about two different philosophies of who human beings are: determinism and perfectionism, whilst being presented with a third philosophy from Etty Hillesum. Determinism takes into account that all humans are left to be controlled by a set of programs and equations, removing all responsibility from our behavior, and saying that our main function is to reproduce, completing our gene pool. In perfectionism, all humans have freedom, a given ability to choose for oneself, but that freedom can be taken away. Thus, both attitudes leave us dissatisfied in their explanation of who we are. With Hillesum’s “deep well” realism, we can take into account that humans are much more complicated beings, with emotions, passions, and have free will. In realism, one’s physical freedom could be taken away, but one’s internal freedom of mind and spirit cannot. Hillesum’s realism is a more complete view of who humans are, with realism calling for our inner voices, saying that we all live a life a meaning and worth. “Deep well” realism gives our inner voice the name of God, seen as a companion that goes with us through our journey, but it can also be seen in others. Etty Hillesum’s process of “organic” growing is an inspirational journey, with Hillesum becoming our guide on our own roads.

-Jennifer W.