Life's Worth: The Case Against Assisted Suicide (Critical Issues in Bioethics Series)

Over the course of four interconnected, tightly reasoned arguments, Dyck takes readers from a basic concern for human suffering — the main focus of those who support assisted suicide — to the deeper truths of life's inherent worth. Dyck begins by examining the arguments of some physicians, moral philosophers, and theologians for making assisted suicide available. He also discusses the alternative practice of "comfort-only care," explaining why it differs morally from assisted suicide and euthanasia. Dyck then explores and defends the moral structure underlying the West's long tradition of homicide law as well as current law against assisted suicide and euthanasia — laws designed to protect both freedom and human life. Finally, Dyck shows that the moral structure undergirding our system of law is compatible with the views of Christianity, and he points to certain Christian beliefs that provide comfort and hope to those who are suffering, dying, or experiencing the death of loved ones.

Throughout the book, Dyck staunchly maintains that assisted suicide is unacceptable in any and all circumstances. The practice denies terminally ill patients the possibility of recovery and robs them of the chance to rethink the meaning of their lives or to achieve spiritual growth. Furthermore, because it undermines the shared moral structure that makes community possible, assisted suicide bodes ill for society as a whole. "Life's Worth" is a must-read for anyone grappling with this hotly debated issue.

In this book, Dyck, a Population Ethics professor at Harvard university, examines the various legal and philosophical arguments thrown up in favor of physician-assisted suicide (PAS), assesses different types of treatment available for the suffering and terminally ill, establishes the religious and moral framework which upholds the sanctity of life, and concludes with a look at Christian concerns over sickness and dying.

On the philosophical front, Dyck details recent defenses of PAC, and shows how major moral and philosophical shifts have taken place to allow such defenses to take root and flourish. A major shift in how we view human nature undergirds much of the euthanasia debate today. That is, we have shifted from an emphasis on the sacredness of human life to autonomy as the highest good.

For example, thinkers such as Hobbes, Locke and Kant understood human nature as including a strong sense of self-preservation, not just of the species, but of one's self. Mill, on the other hand, adopted an autonomous hedonism: self-happiness is the goal, regardless of how that is played out. Unfortunately, the thinking of Mill and others has tended to win out over the traditional view.

That, coupled with the rise of secularism and the collapse of religion, has led to a quality of life ethic replacing the sanctity of life ethic. These differing views of human nature and the social good underlie the differences found in the euthanasia debate today.

These differences take practical expression when we decide whether to utilise palliative care or simply administer a lethal injection. The two different actions reflect two different views of humanity. Dyck's second chapter examines the moral differences between comfort-only care and PAS. While there may be some overlap (pain relief can hasten death), the two are quite different in moral terms.

A major difference has to do with intent. What is the primary goal: to preserve life, or to end it? A lethal agent is introduced into the latter, making it ethically very different indeed.

Chapter three deals with moral rights and human right in the PAS debate. Traditionally it was held that we all have a moral responsibility to preserve life - others and our own. Suicide (and PAS) thus was seen as an abrogation of that central moral responsibility. Counter-arguments about autonomy and freedom of choice do not however curtail that responsibility, argues Dyck. The over-emphasis on choice and freedom may sound good, but it often leads to disastrous outcomes.

That is, what a society allows intellectually, and more importantly, legally, will impact on how individuals respond to those conditions. One study found, for example, that not one AIDS patients in England who wanted to end their life did so, while 30 % did in the Netherlands. The reason? PAS is illegal in England and hospice care widely available, while the exact reverse is true in Holland. So those who wish to legalise PAS will inevitably see a rise is such cases. Bad thinking leads to bad laws which leads to bad outcomes.

The better way is to show real compassion to the sick and dying, instead of wishing them a speedy exit. Dyke concludes this volume with a look at how Christian beliefs and practices are the best response to suffering and death.

The Christian world view has always had a high view of human life and its inherent dignity. This shows through in many ways, from missions of mercy to the establishment of hospice care. Indeed, both hospitals and palliative care largely spring from Christian roots.

Genuine compassion treats all life with respect and dignity, and does not judge life on the basis of functionality or usefulness. It is the harder, more difficult path to follow, but is the more loving and just path.

The transformation of our thinking on human worth is accelerating apace. So too are the corresponding calls for PAS and a host of other anti-life initiatives. Calls to legalise euthanasia will only become louder and more frequent. Those who seek to uphold the sanctity of life need to be ready for these challenges. Becoming informed about the euthanasia debate is part of the preparation. This important volume will help greatly in that task.