The Face of the Good Death: Euthanasia and Levinas

Abstract

SOMETHING IS AMISSThe philosopher and medical ethicist Margaret P. Battin has published, adopting the term used in a well-known New York Times Magazine article about her life and work, 'wheelbarrows full' of book and articles championing the cause of euthanasia and physician-assisted suicide since entering the debate in the early 1980s.1 It might be somewhat surprising, then, that she began her article on the topic for the 2003 Oxford Handbook of Practical Ethics with the statement: 'Something is amiss with the debate over euthanasia and physician-assisted suicide'.2What makes this claim stand out is that those who support the legalisation of euthanasia, simply using this word from now on, tend to sound quite satisfied with a debate that they seem convinced they are winning or have effectively already won. Organisations in the UK such as the Campaign for Dignity in Dying champion statistics such as 82 per cent of the British population supporting a change in the law on assisted dying for terminally ill adults, rising to 86 per cent among the disabled and only falling to 79 per cent among those who identify as religious.3 The former chairwoman of that of that group, Margaret Branthwaite, expressed a common sentiment among campaigners when she stated that 'it's only a matter of time before it's legalised'.4 While rival organisations such as Care Not Killing marshal rather different statistics and the UK parliament recently rejected a proposed 'right to die' in England and Wales by a significant enough majority that the issue is unlikely to return for some time, the tone of campaigning in the legalisation movement remains that the march of history is on their side and inexorable. If it is only a matter of time, what, then, is amiss?According to Battin, the primary problem with the ongoing debate relates to established patterns of discourse in which the issue is posed in for-andagainst terms. While adversarial debate is vital for social and ethical issues that are 'just breaking open' - a situation where for-and-against analysis isolates, identifies, catalogues and critiques relevant elements - 'once a debate begins to mature, it becomes time to pursue attempts at resolution'.5 Rather than an interminable back and forth over already well-churned ground that promises at best to unearth only an occasional new subtlety, the call for the debate to move from infancy to maturity is a push for not only theoretical but practical consensus. The obvious obstruction to such a development is that the euthanasia debate barely merits its definite article, being highly stratified between a public debate where the strong majority support change and specialised debates in legal, political and medical circles where such consensus is lacking. For example, while the British Medical Association shifted its position on assisted dying to neutrality in 2005, it returned to opposition in 2006 and since then the proposal for adopting a neutral stance has been put to the vote and rejected a further five times.In such a situation, it is not uncommon to hear philosophers promoting their own block of the debate as the keystone around which harmony might be established. As Thomas Nagel wrote in his review of L.W. Sumner's Assisted Death: A Study in Ethics and Law, such a book:provides a superb example of the relevance of philosophy of public policy. The reason is that public policy governing treatment at the end of life is to a great extent shaped by philosophical confusions. It may not be too much to hope that a book such as this will help to rectify the situation.6Indeed, such a hope does not seem entirely unrealistic when sources ranging from the public-facing website NHS Choices to Medical Ethics Today: The BMA's Handbook of Ethics and Law do indeed engage with the issues and a vocabulary that was developed in the adversarial debates of philosophers. However, without giving too much credence to traditional divisions between analytic and continental philosophy, it is notable that both public and specialised discussions engage with a relatively limited spectrum of thought in terms of its provenance, style and range of references. …