Euthanasia for All - or None

The word 'dignity' is a staple of contemporary medical ethics, where it often follows the words 'death with'. People unfamiliar with this usage might expect it to reflect one's manner of dying, for example, a stately exit involving ceremonial farewells. Instead, conventional usage generally holds that "death with dignity" ends or prevents life without dignity, by which is meant life marked by illness and disability. Popular examples of dignity-depleters include dementia, incontinence, and being "dependent on machines".

In Sir Thomas Malory's Le Morte DíArthur, published in 1485, Blamor, overcome in battle, asks his adversary, Tristram, to slay him, saying, "I had lever [would rather] die here with worship [honor] than live here with shame." Guenever tells Meliagaunt, who is abducting her, "I had lever cut mine own throat in twain rather than thou should dishonor me!" My students often find it barbaric to prefer death to the shame of defeat in battle. They find it hopelessly sexist to suppose death is preferable to the "dishonor" of being raped, or even to suppose rape dishonors the victim (as opposed to the perpetrator) at all. Will future generations consider "I would rather die than live with the degradation and indignity of incontinence and dependence" barbaric? Will they consider it hopelessly "ableist" (to use a current unaesthetic neologism that would make Malory turn over in his grave) to suppose that using a respirator undermines oneís human dignity? Should future generations feel this way? Whether they will is obviously a speculative empirical question where evidence is unattainable. But some of my current research bears on the philosophical question of whether they should. This question is important both for theoreti...

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...eans of high-tech life-supports. Since "hospice philosophy" does explicitly preclude this, however, its claim to provide the most effective route to a dignified death shows bias against the ill and disabled by denigrating the dignity of those who live by means of such supports.

To return to the issue of physician-assisted suicide, dignity is obviously not the only consideration advocates advance in favor of legalizing physician-assisted suicide only for the terminally ill, or only for the terminally ill and the severely and permanently disabled. I lack space to discuss the other considerations here. I have argued that physician-assisted suicide should either be kept illegal for everyone or, as a true fulfillment of the rhetoric of privacy and autonomy, legalized for all competent adults, including the young and healthy - the very people our society values most.