Philosophers take on the big, unanswerable questions in our lives. But they also tackle the sticky, nitty-gritty ethical questions that come up at patient’s bedsides. And everything in between. It has to do with what we know and how we know it. It has to do with ways of thinking our way through difficult issues. It has to do with how we organize ourselves in societies, and who gets to control how we do that. Mostly it has to do with what makes life — and by extension, death — meaningful.
Philosopher and Holocaust survivor, Elie Wiesel
A holocaust survivor, Elie Wiesel, wrote and spoke extensively about holding on to meaning in a situation designed to destroy it. Sadly, he reflects in an interview, “The world has not learned anything.”
Just glance at the titles and abstracts here to get a sense of the grand Nazi project of creating a perfect kind of human, and the errors in thinking that allowed doctors and nurses to design and participate in the torture and murder of people with disabilities; gays, lesbians and other non-binary people, as well as members of racial minorities, along with the entire Jewish population, in pursuit of their goal.
Hannah Arendt watched the Nuremberg trials of Nazi war criminals, and observed the technocratic, bureaucratic ways of thinking and behaving that allowed the horrors of the holocaust to unfold. She coined the term “the banality of evil” to counter the religious notion of evil as a devil with horns. Yes, it can come in frightening and terrifying guises, but the lack of humanity in systems — rule-making and enforcement that denies the lived reality of those held down and oppressed by the rules — is the root of all evil, in her view.
Then to bring it right up to the minute, Shelley Tremain, trailblazing Philosopher of Disability, in a guest appearance on the Disability Filibuster, March 10/21, presented a summary of her breakthrough article “Philosophy of Disability, Conceptual Engineering, and the Nursing Home-Industrial-Complex in Canada”, in which she analyses with searing precision, the predictable, preventable and disproportionate deaths of elders and younger disabled people in institutional (a.k.a. carceral) confinement in Canada. Her presentation makes clear the logic of disposable life that links Bill C7 to the atrocities of the past, as well as those of our modern “nursing home industrial complex”.
Today’s Canadian doctors, nurses and nurse-practitioners are quick to dismiss any connection to eugenic thinking and Nazi death-making practices. Likewise Canadian Parliamentarians and Senators. For them it’s all about “compassion” for those “suffering” from the pains and limitations of disabled, ill, broken or aging bodies that they themselves cannot imagine living in, would not want their loved ones living in. They insist that it’s all about autonomy and personal choice. And they do not want to hear from any of those bodies who speak with a positive and life-affirming voice.
Another branch of philosophy, namely epistemology, queries: How do we know what we know?
Parliamentarians and medical practitioners need to listen to the vast chorus of voices coming from bodies that are afraid in the face of the cultural shift occasioned by the legalization and normalization of euthanasia. Changing the name to MAiD may make it sound less threatening, but the result is the same.
According to Brittanica.com, ethics concerns itself with such questions as: “How should we live? Shall we aim at happiness or at knowledge, virtue, or the creation of beautiful objects? If we choose happiness, will it be our own or the happiness of all? And what of the more particular questions that face us: is it right to be dishonest in a good cause? Can we justify living in opulence while elsewhere in the world people are starving? Is going to war justified in cases where it is likely that innocent people will be killed? Is it wrong to clone a human being or to destroy human embryos in medical research? What are our obligations, if any, to the generations of humans who will come after us and to the nonhuman animals with whom we share the planet? Ethics deals with such questions at all levels. Its subject consists of the fundamental issues of practical decision making, and its major concerns include the nature of ultimate value and the standards by which human actions can be judged right or wrong.
The practice of state-sanctioned medically assisted suicide is a proper subject of ethical inquiry. Questions go well beyond individual liberty and autonomy, and query what kind of society we aspire to be. Do we really want to empower doctors and nurses to end lives on request? What is gained and what is lost when this practice becomes normalized in society?
The Journal of Ethics in Mental Health published a special online issue devoted to the subject of medical assistance in dying. It features articles on both sides of the issue.