To Die or Not to Die

Abstract

Madam: John Hardwig's provocative essay ("Is There a Duty to Die?" HCR, March-April 1997) begins in a personal vein but steers into the hazardous zone of health and social policy. He says, for example, "I am first of all concerned with my own duty," being careful to say that he will use "duty," "obligation," and "responsibility" interchangeably, and (as he explains in the footnote) avoiding contractual legal obligations and eschewing any right that others may exercise to have such a duty fulfilled. Yet trouble ensues when he addresses who has a duty to die. While claiming agnosticism, Hardwig goes on to list conditions that would make this duty "more likely." Yet if the reasons for thinking one has such a duty really are "particular and contextual," as he claims, then Hardwig is mistaken to suggest circumstances that would make this duty more compelling. This listing of circumstances sounds ominously like the rudiments of social policymaking, rather than the clarification of a personal virtue. Also, the voice of the essay changes here from a self-descriptive one to an impersonal one, offering general formulations about age, degrees of burden, and past contributions. If Hardwig had said simply, "This is my personal code," I could have viewed him as a paradigm of late Stoicism (which I admire), rather than another effort to turn personal convictions into social policy (which I consider dangerous). I share Hardwig's views almost completely, but I doubt that many others do, and I doubt that any good social policy considerations can come from efforts to apply the teaching of Epictetus and Seneca to late 20th century Americans. Finally, Hardwig cited me inaccurately. I do not believe that "Christian ethics takes us far beyond" Hardwig's position. When I claimed in Rationing Health Care in America that "Christian doctrines of stewardship prohibit the extension of one's own life at a great cost to the neighbor ... And such a gesture should not appear to us as a sacrifice, but the ordinary virtue entailed by a just, social conscience," I was speaking about efforts to extend life by expensive medical interventions, not about a duty to take one's own life. I, like Hardwig, believe that there are situations in which it would be virtuous and noble to kill oneself, but I know of no Christian doctrine that endorses a duty to kill one's self in order to unburden neighbors or families. Christian theologies I am acquainted with endorse a duty to be proportionate in striving to stay alive when one is terminally ill because death-as much as life-can be thought of as a gift and our finitude seen as a benefit.