The Illusion of Personal Autonomy

in Assisted Suicide & Euthanasia

Advocates of assisted suicide & voluntary euthanasia present the illusion that their personal autonomy takes precedence over every other consideration. They demand the absolute right to choose this exit — no matter what harm to others. Autonomy is toxic when it damages the people left behind.

HUMANISM

Many supporters of assisted suicide & voluntary euthanasia are atheist or Humanist. Neither group believes in God, a Deity or supernatural beings. All Humanists are atheists — but not all atheists are Humanists! Humanists consider actions to be moral if performed for the welfare of humanity.

“Humanist ethics is also distinguished by placing the end of moral action in the welfare of humanity.”

— Oxford Companion to Philosophy

Not all Humanists support assisted suicide & voluntary euthanasia. One who strongly opposes AS/VE is Kevin Yuill, Associate Professor at the University of Sunderland. (You can follow Kevin on Twitter @historykev)

Below is information from the the Humanist UK website:

“Roughly speaking, the word humanist has come to mean someone who:

- trusts to the scientific method when it comes to understanding how the universe works and rejects the idea of the supernatural (and is therefore an atheist or agnostic)

- makes their ethical decisions based on reason, empathy, and a concern for human beings and other sentient animals

- believes that, in the absence of an afterlife and any discernible purpose to the universe, human beings can act to give their own lives meaning by seeking happiness in this life and helping others to do the same.”

AUTONOMY

“Autonomy, in Western ethics and political philosophy, the state or condition of self-governance, or leading one’s life according to reasons, values, or desires that are authentically one’s own.”

“In Medicine, autonomy means that a patient has the ultimate decision-making responsibility for their own treatment.”

LIMITS TO AUTONOMY

“Autonomy is limited when its exercise causes harm to someone else or may harm the patient. When harm to others is sufficiently grave, it overrides the principle of autonomy.”

“In some cases…autonomy may be overridden by sufficiently important matters of public interest.”

“Efficiency, fairness, and cost-effectiveness are good reasons to place limits on the extent to which clinicians accept patient requests.”

“Patients may choose among the options within the proffered range, but they cannot go beyond it. In this way, patient autonomy has boundaries and limits.”

LOSING AUTONOMY

The demands for personal autonomy in AS/VE seems linked to a loss of autonomy in developed countries. Western societies no longer honour and care for their seniors. Ol’ Folk get put into an Old Folks Home rather then cared for by family. This causes isolation and loneliness.

Statistics from Oregon’s Dignity in Dying shows that the vast majority of AS applicant are Caucasian with minor percentages of Asian & Hispanics. There were no African-American, American-Indian, Pacific-Islander, or other races (2021.)

Oregon’s statistics have repeatedly shown that “Losing Autonomy” is the prime reason for requesting AS. Indeed, the top 5 reasons are facets of this problem. (link to full 2021 report):

Losing Autonomy.
Less able to engage in activities making life enjoyable.
Loss of Dignity.
Burden on Family, friends/caregivers.
Losing control of bodily functions.

Curiously, loneliness is not listed — less than half of Oregonian applicants in 2021 had a partner or spouse which suggests that it is a significant factor.

AS/VE RESTRICTS AUTONOMY

When we look at AS/VE protocols carefully it becomes obvious that the protocols themselves limit the applicant’s personal autonomy. (Even if the doctor ‘rubber-stamps’ the application.)

“The entire process of PAS is critically dependent on the authority of powerful others who must approve (or veto) every decision along the way. Even more centrally, we have argued that genuine rational autonomy and authentic voluntarism are frequently undermined by subtle cognitive and emotional factors that are likely to be missed with standard, cognitively based evaluation tools. Patients who may not meet DSM-5 criteria for a mental disorder may nevertheless be experiencing hopelessness, demoralization, or despair—any of which can compromise rational autonomy and authentic voluntarism. In addition, current PAS statutes provide no mechanism for assessing external coercive influences that may drive the patient to suicide after having left the evaluation setting. In addition to the many ethical reasons to oppose PAS, psychiatrists should also be aware of the subtle cognitive and emotional issues that compromise rational autonomy in the context of terminal illness.”

Canadians rarely choose self-administered Assisted Suicide (>99% Euthanasia.) They abrogate their personal autonomy by requiring the doctor / Nurse Practitioner to do the final deed.

TOXIC AUTONOMY

Autonomy becomes toxic when a choice harms family, friends, community or society at large. Below is a non-exhaustive list which was discussed in a 2021 CA article: https://www.catholicarena.com/latest/assistesuicideuk170921

Family & Friends:

Young children may be traumatized when “abandoned” by a parent. Adults may suffer profound grief and some will suffer from an adjustment disorder or PTSD.

Regular, non-assisted Suicide:

There has been ~30% increase in regular, non-assisted suicide in the Netherlands since legalization of Euthanasia in 2001. Similarly, increases have been documented in those US States with Assisted Suicide.

Werther Syndrome: suicide contagion

More people are likely to seek AS/VE because recipients are celebrated in the media. I expect that children of current recipients will also use AS/VE/MAiD more often than their peers.

The disabled, the handicapped, the poor & the mentally challenged:

Human life is being devalued. This is leading to eugenics and the push for mass depopulation from Climate Change activists and the World Economic Forum. Later there will be involuntary euthanasia, capital punishment, torture, etc.

Palliative Care:

Palliative services have been reduced in many countries after introduction of AS/VE. Accountants realise there are cost savings with AS/VE. Underfunded programs push even more people to request AS/VE.

Demographic Death-Knell:

Already developed countries have birth rates below replacement levels. A terminally ill person receiving AS does not change demographics much. That will change when young people are euthanized for non-terminal conditions like gender dysphoria, anorexia, autism spectrum disorder, etc.

Health Care Workers:

Many will leave the professions if forced to participate in ethically abhorrent acts. Gradually employment requirements will include provision of MAiD/AS/VE and that will change the demographics of people entering the caring professions. More sociopaths will join up because they get their jollies by killing patients legally. Some are likely to graduate to Involuntary Euthanasia. [Killing a patient without consent.]

Medical Ethics:

AS/VE has damaged medical ethics and conscientious objection.

People were horrified at the 2011 ethics article “After-birth abortion: why should the baby live?” by Alberto Giubilini and Francesca Minerva, Journal of Medical Ethics, BMJ, which suggested that infanticide was ethical. This week the Democrats in the US just showed Infanticide is reality when they voted against the Born Alive Act.

Medical Education:

Medical students are being taught how to kill patients before they know how to heal. AS/VE has become a “therapeutic option.”

Human Rights:

The Supreme Court of Canada redefined the ‘Right to Life’ to mean that certain Canadians have the “Right to Die” at the hand of another citizen. As human beings, we have the free will to kill ourselves. There is no human right to kill ourselves and definitely no right to demand some other citizen to kill us.

POISONOUS AUTONOMY

In some jurisdictions where Assisted Suicide is legal, the poison may be supplied and ingested later without medical supervision. This provides a significant risk of accidental — or deliberate — ingestion by someone other than the approved person. This happened to a 35 year-old man in Colorado recently:

“The bystander states that the older man is a “death with dignity” patient who invited loved ones to be present while he consumed the MAID medication. After his first swallow, he remarked, “Man that burns!” The younger man said, “Let me see,” and then also took a swallow.”

This genius swallowed some of the poisonous mixture which included 100 mg digoxin; 1,000 mg diazepam; 15,000 mg morphine; 8,000 mg amitriptyline; 5,000 mg phenobarbital — enough to kill a herd of elephants! When EMS arrived the man was unconscious and had minimal respiratory effort. Luckily he made a full recovery after 2 days in ICU. A child might not be so lucky.

WEAPONIZED AUTONOMY

Assisted Suicide/Euthanasia can be used to deliberately harm family, friends or community members.

“Several publicly documented medically administered deaths in Canada, including my father’s, have deliberately occurred on dates or in circumstances that are significant to people other than the patient. Such choices in at least two of these deaths were motivated in part by malice toward a target person.”

“Deaths of ‘revenge’ or ‘resentment,’ falling on an important day to the target can be used to send a cruel message; to permanently link them with the death; to inflict guilt or responsibility for death; to imply culpability or neglect; or to saddle a celebratory occasion like a birthday with pain or regret. Trauma is prolonged through annual repetition, so the target is held hostage to negative anticipation.”

Altogether, assisted suicide / euthanasia is harmful to the welfare of humanity — so must be considered to be immoral, even in Humanist terms.

THE ANTIDOTE

Humanity is lost when we kill our fellow man or woman.

Humanity is adrift in the wilderness when we kill our fellow man or woman because of loneliness, poverty, illness or disability.

It will be nigh impossible to reverse course in Canada because the activist Supreme Court unanimously redefined the meaning of our Right to Life to include the Right to Die for some citizens. It would take a majority of the Justices — ruling on a specific case — to reverse their decision on euthanasia. That’s not happening.

The antidote for other countries is to NOT legalise assisted suicide / euthanasia in the first place, no matter how long and hard the supporters shout about “compassion” and “autonomy.” Good social support and universal access to expert palliative care is the true compassion.

Kevin Hay

(You can follow this Kevin on Twitter @kevinhay77)

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