On March 30, 2011, a team of doctors euthanized a Belgian couple at their request. The 83-year-old man suffered from terminal prostate cancer. His 78-year-old wife, although suffering from severe rheumatism, was not terminally ill. But she did not want to live with-out her husband. This became the first official, public instance of co-euthanasia in Western Europe. The death announcement in the newspaper stated that they “choose to end it together.”
Euthanasia is legal in the Low Countries under two conditions: The request must be made by an adult of sound mind, and the patient must have an incurable disease that causes unbearable suffering. Although there is no cure for rheumatism, the Belgian woman did not meet these conditions. However, she would have had to move to a nursing home after her husband was gone. So horrified was she by this prospect that, combined with her age-related ailments, it was deemed by doctors to constitute “unbearable suffering.”
One can empathize with her. Apart from the wish not to be alone in one’s later years, credible stories abound of elderly people left unwashed in bed, as nursing homes fail to provide proper care. But, empathy notwith-standing, this de facto legalization of “euthanasia for love” shows us that another taboo has bit-ten the dust. A mere nine years after euthanasia was legalized, the strict conditions for its use are already showing major cracks.
Other taboos vanished earlier—some even before legalization. In a 1994 decision of the Dutch high court, “mental suffering” was accepted as a reason for allowing euthanasia. This followed a case in which a doctor gave a lethal over-dose to a 50-year-old woman who had been chronically depressed after a difficult divorce and the death of her two sons. In 1998, a retired Dutch socialist senator claimed to be tired of life and, therefore, to have the right to die. His doc-tor agreed. Although the doctor was convicted of culpable assisted suicide, the Dutch high court took the view that clinical depression can be a sufficient justification for euthanasia. Finally, the Dutch medical association stated last year that decline caused by age ought to be considered sufficient reason for euthanasia.
The Financial Times recently (and correctly) referred to the Nether-lands as the “California of Europe”: where Holland goes, the rest of the Continent will follow.
A 2008 study of the Swiss death clinics Exit and Dignitas claimed that many of those who committed suicide there suffered from weariness of life rather than a terminal medical condition. Since its founding by a human-rights lawyer in 1998, Dignitas has become an important European centre for suicide tourism.
Across Europe, pressure groups are pushing for legalization of euthanasia and assisted suicide. In Spain, support for legalization was strengthened by an Academy Award-winning film about the assisted death of Ramon Sampedro, who was paralyzed from the neck down after diving into shallow water. In Britain last June, the BBC aired a documentary about Dignitas narrated by Sir Terry Pratchett, one of the world’s most successful fantasy writers. Diagnosed with Alzheimer’s, Pratchett has since announced his plan to complete the necessary forms for Britain’s assist-ed suicide waiting list. The BBC was criticized for airing what amounted to its fourth pro-euthanasia documentary. Yet in February 2011, the British director of public prosecutors said his office would be less likely to prosecute cases of assisted suicide in which the motive was compassion and not a desire for personal gain.
A slippery-slope argument is a fallacy—except when it is not. The gradual shedding of taboos is precisely what opponents of legal euthanasia have warned about. From first being recognized as a regrettable practice that should be allowed only in the most exceptional cases and under strict regulations, euthanasia is increasingly being presented as a human right.
Note that we are not talking merely about the right to die. Euthanasia involves others doctors, perhaps family, friends, or strangers—who must help you die. Of course, if you have a right to be killed, someone else may be given the duty to do the deed. And if you grant the right to the terminally ill, can you deny it to anyone else—given that rights are, by definition, universal?
In the Netherlands, this change of perception is giving rise to misgivings even among those who have been in the vanguard of the legalization movement. Els Borst, the minister originally responsible for introducing the 2002 law legalizing euthanasia now has some regrets. She believes her country should have focused instead on palliative care: “We first listened to the political and societal demand in favour of euthanasia. Obviously, this was not the proper order.” A recent book by Dutch anthropologist Anne-Mei The concluded that many patients ask to die “out of fear,” because of an absence of effective pain relief.
Many Dutch doctors are also changing their approach. Instead of informing patients about euthanasia, they first tell them about other forms of care. They have found that very ill patients will agree to whatever they suggest—whether death or treatment. But not all patients. As one doctor recently said: “Patients no longer request euthanasia, they demand it as a right. It’s as if we doctors are being pushed to cross borders.”
Last year, doctors in the Netherlands granted euthanasia requests to only 25 people suffering from dementia—a mere fraction of those requesting it for that reason. The reluctance of some medical professionals is prompting demands for a new clinic for assisted suicide, where patients can go if their doctors re-fuse to cooperate. But an opposite trend toward full legalization also exists and it involves not the sick but the healthy. A group of prominent people over age 70—including writers, artists, and politicians—are urging that the law allow anyone over 70 to be legally euthanized if he or she so chooses. Their demand is that euthanasia no longer be considered a medical decision and they want the right to die to be included in the Dutch Constitution. The idea is: I am the captain of my own ship. Why can’t I sink it?
It is a theological truth that life is a gift and receiving it is a task. Ownership is not a correct metaphor for our lives. But even if it were, this would not free one from responsibility. If I own a Rembrandt, that doesn’t give me the right to use it to light my cigar. Permitting euthanasia or assisted suicide is a world away from making it a constitutionally guaranteed right. At the moment, the question arises mostly with the elderly and the severely ill. But is there really any reason to draw the line there? If 70, why not 50? If 50, why not 35? Creating a new constitutional right to die would render these questions illegitimate in public discourse.
The recognition of an inalienable right to die undermines the foundation of a true community defined by mutual rights and duties. As citizenship is increasingly seen as a matter of rights without duties, the state becomes a slave to the wishes of the radically free individual who can turn in his passport—or, in this case, demand death—at will. Thus, the most basic duty to others—to remain alive—is rejected.
There are also curious practical consequences. If there is, in fact, a right to be killed, may the rapist avoid his term by requesting death? Or imagine a friend comes to you and says that she is thinking of committing suicide. If that death is a right guaranteed by the state, what is then the appropriate response? As with abortion, the convention may become to treat suicide as a private matter—removed it from the realm of public morality and discourse.
The Hindu custom of suttee, in which the wife of a deceased husband immolates herself on his funeral pyre, was famously banned by the British in 1829. In the West, the Vikings had similar customs. Now, in the California of Europe, an ap-peal to human rights is being used as an argument to allow doctors to kill wives who want to join their husbands in death.
It’s difficult to say whether Indian or Viking widows freely chose to die, but it’s quite possible that many of them did. Envisioning a culture in which couple-euthanasia becomes a social expectation rather than a purely individual choice takes some imagination. But it doesn’t take a whole lot.
A millennium after Christians converted the Vikings and banned the practice, it may be worth asking whether Western suttee is sneaking in through the back door.