Supporting Assisted Death Doesn't Require Holding Contradictory Beliefs
A response to Yuan Yi Zhu
Yuan Yi Zhu recently wrote an article on the tragic case of Noelia Castillo, a Spanish woman who died by euthanasia. He states the following:
The truth is that to believe in euthanasia and assisted dying while not being a moral nihilist requires believing in three contradictory ideas before breakfast. Suicide prevention is good, unless the suicide gains the approval of doctors. The lives of the disabled have equal dignity to those of the non-disabled, but being in a wheelchair is grounds for the state to put you to sleep permanently. Our society’s treatment of the poor and the vulnerable is shameful, but we cannot consider these things when it comes to their decision to kill themselves.
Most supporters of assisted suicide and euthanasia cannot square the circle, which is why they either focus on autonomy or simply deny that this sort of case happens.
In response, those three ideas are not contradictory, and a little bit of clarity will show why.
First, it’s not true that suicide prevention is good, unless “the suicide gains the approval of doctors.” Rather, suicide prevention is good when we prevent people who don’t really want to die from dying. Suicide prevention is bad when we prevent people who really want to die from dying.
Doctors are needed to check whether the person has decision-making capacity and whether they meet the other qualifying criteria. They are not approving a suicide in the sense that they think it’s morally good. What we’re trying to avoid is people making such a decision when they don’t have the capacity to make such a decision.
Second, it’s true that people with disabilities have equal dignity, which is why I believe that people with disabilities and able-bodied people should have access to assisted death. Whether you’re in a wheelchair or not shouldn’t matter, morally speaking. It’s for the same reason why I think a person shouldn’t have to be terminal in order to qualify. No contradiction there.
And third, we can consider systemic inequalities when the vulnerable desire an assisted death; however, those inequalities, by themselves, shouldn’t prevent a person from having an assisted death, unless we’re also ready to stop honoring their refusals of care. Supporters of assisted death are not against addressing systemic inequalities, so if it turns out that a disproportionate number of people who die by assisted death are the poor and vulnerable, then that would give us a stronger reason to address said inequalities.
I’m not sure why the author says that, since supporters of assisted death can’t square the circle, we focus on autonomy. Autonomy indeed is one of the main reasons in favor of allowing assisted death, but it’s not a value that we resort to because there are these contradictions that we can’t resolve. Rather, it’s a value that we start with. I, along with many supporters of assisted death, believe that respecting autonomy is morally good. We’re not moral nihilists.
Autonomy is why there are doctors to assess the person’s decision-making capacity. Autonomy is why I believe the nonterminal should also have access to assisted death. Autonomy is also why we should address systemic inequalities and allow assisted death, just like we should address systemic inequalities and honor people’s refusals of care.
What would help me understand the author’s position is if he addressed the comparison between assisted death and the refusal of life-sustaining treatment. Does he think that Castillo should’ve had the right to the latter?
Further Reading
Here are a few other articles I’ve written on the subject:
