I’ve had it with my conservative fellows who insist on tightly linking abortion with right-to-die issues. Sure they are related. NO, they are not synonymous, nor must the decision to allow the right-to-die be instricately linked to abortion rights. Let us instead try to separately elucidate the principles that should govern our decisions at both ends of life, then look back and see where the overlaps are. Here’s my first take. You help me fill in the gaps ;). And yes, I am still a biblical Christian even if I don’t share your opinion ;)
Our general rule should be to err towards preserving life when a questionable case comes up. In all cases where we are considering refusing treatment or active termination, we must balance the value of life against the pain and suffering of the individual.
Beginning-of-Life Advanced Treatment Principles
In my post on Citizens for Reasonable Abortion Limits (CRAL), I outlined and discussed the possible principles for the beginning of life. Here are those principles (minus the discussion of each):
- In Any Pregnancy, Both Of The Parents And The Developing Child Have Limited Rights
- The Developing Fetus Has Human Rights After a Defined Point in a Pregnancy, The Point of Personhood
- Terminating a Pregnancy Based On Physical Attributes such as Gender, Race, Sexual Orientation, or Treatable Medical Conditions is Not Acceptable
- Terminating a Pregnancy for Severe, Untreatable Fetal Conditions Must Be Preserved as a Parental Right, but Not Required by Law
- Terminating a Pregnancy Based on the Means of Pregnancy (Rape, Incest, Artificial Insemination, Natural Insemination) is Not Acceptable
- Terminating a Pregnancy to Protect the Life of a Mother Must be Preserved
- Abortion as A Medical Procedure Should be Protected and Taught In Medical Schools, but Should Not Be Mandatory
End-of-Life Advanced Treatment Principles
Here are the analogs to the above principles. I am sure we could add lots of detail around this, as Oregon did around it’s Death With Dignity legislation.
- A lucid individual has the right to refuse medical treatment.
- A lucid individual has the right to assisted suicide if their condition is physically painful, untreatable, and terminal.
- If an incapacitated person has created an advanced directive regarding refusal of medical treatment or the use of euthanasia in certain types of incapacitation, this directive must be followed.
- If an incapacitated person has created an advanced directive giving authority to an agent in certain types of incapacitation, but does not specify what should be done in those cases, the agent has the right to refuse medical treatment or call for euthanasia in those cases only.
- If an incapacitated person has created an advanced directive giving authority to an agent, but the type of incapacitation in question is not specified in the directive, the agent may only authorize refusal of treatment or euthanasia if the condition is physically painful, untreatable, and terminal.
- If an incapacitated person has not created an advanced directive, their legal guardian may only authorize refusal of treatment or euthanasia if the condition is physically painful, untreatable, and terminal.
Overlap
The main overlap is in cases where the patient (unborn child or sick person) fits the following conditions: if the condition is physically painful, untreatable, and terminal, then assisted suicide (for the lucid) or euthanasia (for those unable to communicate) is permissable. So what do we do if we are missing one of the above? What if the condition is
- painful and untreatable, but not terminal? Palliative care.
- painful and terminal, but treatable? HIV comes to mind. I say treatment and palliative care.
- untreatable, terminal, but not painful? If there’s no pain, let them live and hope for a treatment!
I understand that many will agree with the above if I would just back off of the euthanasia/suicide thing and just stick with refusal of treatment. Despite the fact that one is active and the other passive, they are arguably both decisions to act, letting a person die. It is not always more noble to “let nature take its course” than to have the courage to act and eliminate suffering – to not act is not virtue, but often cowardice. It’s like when liberals say we should not interfere with another culture when it is involved in severe human rights abuses because we should have the virtue to “not interfere with their values.” That’s not virtue, that’s stupidity in not recognizing self-evident, objective principles of right and wrong, and cowardice in not being willing to confront another culture. I think I am covered, so fire away!