MAiD Makes an Idol of Autonomy

And a standard for dignity that no human being can attain

Photo by Danie Franco on Unsplash

Sometimes, changing your mind is a slow shift, where your hold on your former position is eroded, little by little, till there’s nowhere left to stand. If you’re lucky, you’ve gotten a sighting of at least seeming solid land to strike out for. You may not even know you’ve begun to drift till you’ve arrived.

There are only a few examples in my life where I can name the specific moment I definitively switched sides. One is when I became a Christian (the early hours of Palm Sunday, 2012). The other is when I turned against Euthanasia (reading the June 15, 2015 issue of The New Yorker).

As I explain at The Dispatch, euthanasia is premised on a false account of the human person, one which is dangerous to us at any stage of life.

Ultimately, euthanasia isn’t just about pain, but about what pain and need make us: more animal, less autonomous.

Nearly half (47 percent) were concerned with sparing others pain. They chose to die to avoid further burdening their loved ones. Dr. Ellen Wiebe, a Canadian doctor who specializes in euthanasia and abortion, said in an interview with the New York Times that of course she would and did sign off on MAiD requests that hinged on the fear of being a burden. She cited the example of a man who told her that he wished to die because “he had been a person who’d taken care of his family and now he could have people take care of him, and it was unbearable to him that he was in that state and wasn’t getting better.” In her judgment, he was “most definitely eligible.”

It is hard to reconcile the man’s pride in caring for others with his self-disgust at requiring care. Had he been degrading his family by supporting them during his many years of strength? Would they too have been eligible for MAiD if they’d interpreted his support as humiliation, not love? Dr. Wiebe was not interested in whether her patient was correct to interpret receiving care as a fate worse than death. It was enough that he hated it.

Once the state officially agrees that some lives are not worth living—that it might be unfair to others to continue to draw breath—there can be a contagious effect.

Some of the examples of how euthanasia regimes have transgressed taboos are shocking. A doctor smuggled into an assisted living facility to provide MAiD against the “no kill” policy of the home and the objections of resident Holocaust survivors. Bright, cheerful posters celebrating medically-blessed suicide plastered over a London tube station, offering a obscene rebuttal to the reminders to not throw yourself on the tracks.

I think the erosion of the sense that a life marked by dependence can be a life worth living (and one in which you are lovable) comes in many smaller ways before these big, horrible ruptures.

A major project of my forthcoming book, The Dignity of Dependence, is connecting the many ways we are unautonomous, so that each individual time of neediness feels less like an exile from a real, flourishing human life.

As I write near the end of the Dispatch piece:

Moving past the desire for “death with dignity” requires admitting that autonomy is not the ordering principle of a human life. Every person begins their life as a burden to someone else. It isn’t pejorative to say so—a baby simply must be carried, first by just one woman, in utero, and then after birth as a shared burden among more bearers.

Most of us (though not all of us) grow out of this severe, stark dependence, but our trajectory is an orbit, not an escape. For those with pronounced disabilities, chronic illness, or a severe accident, the orbit is tightly constrained. For others, the loops are a little more sprawling until illness, injury, or (for many women) childbearing, turns us inward to the space where our lives are more obviously defined by our weakness and need. But for almost all of us, dying is a return to our origin—a time of profound need, copious bodily effluvia, and reliance on another’s strength.

We are heavier in our old age, requiring more helpers to carry and clean us, but also freighted with shame.

Where have you found yourself trying to hide care from the recipient for fear of shaming them?

Where has someone caring for you tried to deflect thanks to avoid (possibly) humiliating you?

Where have you seen care given and recieved without obfuscation or shame?