Making Sense of Bioethics
Shouldn't death-dealing actions directed against ourselves be seen as a deep repudiation of our autonomy, insofar as suicide eliminates our personal freedom once and for all?
In an August 2015 column in The Washington Post, George F. Will argued in favor of physician-assisted suicide, summing up his perspective this way: "There is nobility in ...affirming at the end the distinctive human dignity of autonomous choice."
His conclusion, however, raises several important questions: Shouldn't death-dealing actions directed against ourselves be seen as a deep repudiation of our autonomy, insofar as suicide eliminates our personal freedom once and for all? If our ability to freely make choices is among the highest of our human faculties, isn't it a radical contradiction to mount an attack on that autonomy through suicidal acts? Isn't there a certain absurdity to marshaling our freedom to obliterate our freedom?
Autonomy is often described as being able to do what we want, being "self-governing" and "self-directing." Authentic freedom, though, doesn't actually mean the ability to do whatever we want; it means the ability to do what we ought, in accord with who we are. To grow in freedom and autonomy means acting in such a way that we attend to, and respect the designs written into our nature. Otherwise, autonomy collapses into a caricature of its real meaning, or worse, into raw violence and forcefulness against ourselves or others.
We can consider a simple example: exercising autonomy with respect to our car doesn't mean doing whatever we want with it, like pouring milk in the gas tank, and orange juice in the oil reservoir. If we intentionally sideswipe other vehicles as we drive along, and strike pedestrians on the sidewalk, these would be acts of violence, not acts of "autonomy" or "free choice." Authentic freedom with an automobile implies using it in an ordered way to get from A to B, driving safely and legally, and even doing the right maintenance and upkeep on it, maintaining respect for the way the vehicle was designed and intended to be used.
Freedom and autonomy regarding what we eat and drink, to consider another example, doesn't mean we can consume anything at all. We can legitimately choose between apples and oranges, but not between milk and drain cleaner. If, in the name of autonomy, we were to declare that we're free to do whatever we want with our bodies, and we ingested drain cleaner on purpose to make ourselves ill, we would actually undermine and surrender our personal autonomy. We would no longer be able to do what we might wish to do, as our body rebelled and constrained us to a stretcher on our way to the emergency room or poison control center.
Looking at a misguided choice of this kind reminds us how our autonomy is never absolute. This kind of choice would also raise doubts in the minds of those who cared about us regarding our mental and moral sanity. To deem self-inflicted sickness to be desirable would itself be a sickness, a kind of lie, spoken in the name of a perverted sense of being free to do whatever I want, even to the point of self-harm or self-annihilation.
The decision to intentionally end our own life by an act of suicide (whether alone or with the assistance of others) pivots our uniquely human power to make sound choices into a seditious power directed against our own good. To self-inflict death in collusion with a physician would constitute a profoundly disordered decision, and a radically corrosive attack on our autonomy. Rather than something dignified, this abuse of freedom is ethically indefensible.
If sane people can recognize that drinking poison to get ourselves sick is wrong, how can we feign that ingesting drugs or using other means to kill ourselves is somehow right and noble? Abusing our own freedom or autonomy isn't free or autonomous; instead, it enslaves and diminishes us. When medical professionals pivot in their role of healing and curing, and instead become accomplices in terminating the sick and vulnerable, they, too, undermine their own autonomy and corrupt their own professional freedom to genuinely care and "first do no harm."
True autonomy is not limitless or absolute, but is necessarily conditioned by the truth of who we are and the way we function. Properly exercised, our personal freedom manifests a genuine nobility, and a real dignity. We should never will that our final "autonomous choice" be directed against that noble dignity. Rather, we must flee the tyranny of false autonomy if our lives are to be authentically marked by human freedom in its full splendor.
Father Tadeusz Pacholczyk, Ph.D. earned his doctorate in neuroscience from Yale and did post-doctoral work at Harvard. He is a priest of the diocese of Fall River and serves as the Director of Education at The National Catholic Bioethics Center in Philadelphia (www.ncbcenter.org.)
Father Tadeusz Pacholczyk, Ph.D. earned his doctorate in neuroscience from Yale and did post-doctoral work at Harvard. He is a priest of the diocese of Fall River and serves as the Director of Education at The National Catholic Bioethics Center in Philadelphia,
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