A feminist case against self-determined dying in assisted suicide and euthanasia.Familiar clarion calls for choice, autonomy, and the moral right to control one's own body ring forth in current movements to legalize le·gal·ize
tr.v. le·gal·ized, le·gal·iz·ing, le·gal·iz·es
To make legal or lawful; authorize or sanction by law.
le physician-assisted suicide Noun 1. physician-assisted suicide - assisted suicide where the assistant is a physician
assisted suicide - suicide of a terminally ill person that involves an assistant who serves to make dying as painless and dignified as possible and euthanasia. In the United States United States, officially United States of America, republic (2005 est. pop. 295,734,000), 3,539,227 sq mi (9,166,598 sq km), North America. The United States is the world's third largest country in population and the fourth largest country in area. dedicated activists, some physicians and certain respected ethicists make a moral case for the right to assisted suicide assisted suicide: see euthanasia. and euthanasia in order to control how and when one dies. (1) Feminists and other members of society must now confront the dilemma of whether this new liberty would contribute to human flourishing and well-being. More specifically, would women in particular benefit from more choices at the end of life?
Women have for so long been denied full autonomy and respect in our society that it might be tempting for feminists to immediately endorse a social measure purporting to increase women's freedom of choice. But at the same time feminists have learned to exercise a "hermeneutics hermeneutics, the theory and practice of interpretation. During the Reformation hermeneutics came into being as a special discipline concerned with biblical criticism. of suspicion" and be cautious when new social or medical interventions are on offer. Proposals for increasing personal choices which initially look positive can result in unforeseen drawbacks and dangerous side effects--especially when medical technologies are involved. One only has to think of recent intra-feminist debates surrounding reproductive technologies, hormonal therapies, abortion, surrogate motherhood surrogate motherhood
Practice in which a woman (the surrogate mother) bears a child for a couple unable to produce children, usually because the wife is infertile or unable to carry a pregnancy to term. , no-fault divorce No-fault divorce is divorce in which the dissolution of a marriage does not require fault of either party to be shown, or, indeed, any evidentiary proceedings at all. It occurs on petition to the court, typically a family court by either party, without the requirement that the , pornography, prostitution, alimony alimony, in law, allowance for support that an individual pays to his or her former spouse, usually as part of a divorce settlement. It is based on the common law right of a wife to be supported by her husband, but in the United States, the Supreme Court in 1979 , child custody The care, control, and maintenance of a child, which a court may award to one of the parents following a Divorce or separation proceeding.
Under most circumstances, state laws provide that biological parents make all decisions that are involved in rearing their and employment practices, to name but a few. (2) In the face of so much controversy the valid question arises as to whether there is any consensus to be found among feminists, and if so what would characterize a feminist critique of assisted suicide and euthana sia?
Pluralism and Consensus in Feminism
While there has as not yet been a feminist debate over euthanasia, it is easy to point out an ever increasing pluralism in the feminist movement over many other issues, including the nature of feminism. Turning to collections of feminist writings in many disciplines one finds diversity on display. In a comprehensive compilation of essays devoted to feminism and philosophy, for instance, there are sections devoted to perspectives on feminism described as liberal, Marxist, radical, psychoanalytic, socialist, ecological, phenomenological and postmodern. (3) In religious and theologically oriented feminism one finds another wide-ranging variety of feminist approaches growing out of different theological and faith traditions. A recent review of Christian theological literature even includes a sampling of post-Christian feminism work. (4) Different ethnic and geographical groups of women, such as Hispanic or Asian women, also have developed their own specific approaches to feminism. (5)
Can any consensus or commonality in all of these diverse manifestations of feminism be found? Yes, I think it can be said that while a thousand flowers bloom, feminism is not self-destructing through fragmentation, but enjoying a dynamic pluralism. All forms of feminism are constituted by a critique of a status quo [Latin, The existing state of things at any given date.] Status quo ante bellum means the state of things before the war. The status quo to be preserved by a preliminary injunction is the last actual, peaceable, uncontested status which preceded the pending controversy. in which power is abused by unjust gender discriminations against women. (6) A critical feminist analysis will recognize, protest and demand an end to gender subordination and exclusion; women should no longer be excluded from discourse defining themselves or their roles, or have their voices suppressed in the decision-making of male-dominated societies. Feminism is always and everywhere a call for justice and social change on behalf of women's well-being and human flourishing.
But when it comes to a more detailed analysis of what has contributed to women's oppression, or to ideals of human flourishing, or to recommendations for strategic policies to effect social change, then pluralism and disagreements emerge. A general critique held in common and an agreed-upon global goal can be supported by a variety of fundamental principles, analyses and assumptions, especially when it comes to proposals for reform. After all, feminist thinkers come to feminism historically formed by a plethora of subcultures, ideologies and belief systems, as well as from different intellectual disciplines. Those affirming psychoanalytic thought, for instance, will focus on different variables and recommend different social strategies for change than feminists employing a neo-Marxist class analysis. Obviously, different feminists will appropriate different dimensions of several sets of complex traditions and create different intellectual configurations of argument when confronting any new challenge. My own a rguments here against assisted suicide and euthanasia will represent a personal synthesis of my experiences as an aging, white, middle-class, married, American woman and mother, educated as a social psychologist.
In my reading of feminism, it appropriates and affirms the importance of concrete contexts and the different perspectives or standpoints of embodied participants in any encounter. Feminists have rightly attempted to make explicit what has too often been ignored-- i.e., the social and dynamic developmental realities of actual human lives. Human beings must be born, nurtured, reared, domestically maintained and cared for when they are ill, old or dying. A unique individual self can only be formed within social matrixes of interpersonal relationships; the self is partly created by ongoing self-other dialogues. Each adult person continues to live within embodied, embedded and interpersonal relationships. Inevitably, the private and the personal interact with public and political actions because no one can live or work without receiving domestic and emotional support. These hidden tasks of nurturing and maintenance have usually been assigned to women, then denigrated and accorded little recognition or reward. (7)
Most feminists have tried to affirm the value of the traditional contributions of women, including care of the ill and dying, while simultaneously working to open up expanded roles and new opportunities for women in society. Women's traditional power and powerlessness must both be recognized. In many creative feminist proposals for revising gender roles, men's potential contributions to cooperative caretaking in the family are also reappraised and welcomed. To emphasize only women's victimization victimization Social medicine The abuse of the disenfranchised–eg, those underage, elderly, ♀, mentally retarded, illegal aliens, or other, by coercing them into illegal activities–eg, drug trade, pornography, prostitution. by men gives too unbalanced a picture. In old age and at the end of life, for instance, gender roles in families and societies tend to become more flexible, overlapping and shaped by the unique characteristics of individual personalities and strengths.
Yet it must also be recognized that women are going to be more affected by the euthanasia debate than men, simply by virtue of the fact that women live longer than men, and in their old age command fewer financial and social resources. In a sexist society that also suffers from ageism ageism Geriatrics A bias or belief that may be held by a health care provider that depression, forgetfulness, and other disorders are a normal part of aging and that older individuals will not benefit from treatment of mental disorders. Cf elderly. or prejudice and discrimination against the old, more women will end up living alone as fragile persons in need of care. As families become smaller and more dispersed, many women, particularly single childless women, will not have nearby kin who can care for them or serve as their advocates within increasingly complex health-care systems.
By and large, women still have been socialized so·cial·ize
v. so·cial·ized, so·cial·iz·ing, so·cial·iz·es
1. To place under government or group ownership or control.
2. To make fit for companionship with others; make sociable. to be less assertive than men, and have less of a sense of entitlement when dealing with mostly male authority systems. And in their turn, authority systems are more likely to discount women's voices. According to according to
1. As stated or indicated by; on the authority of: according to historians.
2. In keeping with: according to instructions.
3. some disturbing studies of gender disparities in the legal and medical system, women's medical treatment preferences were more often ignored because the courts "treated prior evidence of women's values and choices as immature, emotional, or uninformed, but considered men's prior statements and lifestyle decisions to be mature and rational." (8) In other words Adv. 1. in other words - otherwise stated; "in other words, we are broke"
put differently , old women will bear the brunt of any inadequacies in the system our society devises for the fragile old at the end of life. Feminists have long recognized the double standard of aging and are open to the worry that there may be a double standard of dying.
Another valuable contribution of feminist thought has been its questioning of rigid methods of inquiry and narrow forms of abstract logic which limit discourse and restrict reasonable argumentation. (9) Feminism has been an interdisciplinary undertaking. By making explicit a social system's implicit private power arrangements, feminism challenges the methodologies, conventions and acceptable limits of the analysis adopted by the status quo. The idea, for instance, that one's own arguments are completely value-free, neutral, impersonal and rationally objective, is always an illusion. More realistically, feminists have championed a wholistic interconnected analysis of phenomena which recognizes personal commitments and denies the split of affect from cognition or emotion from reason.
When concrete human embodiment is taken seriously, affect and emotions, whether positive or negative, will be seen to play as large a role in life and decision-making as supposedly detached instrumental rationality Two views of instrumental rationality can be discerned in modern philosophy: one view comes from social philosophy and critical theory, another comes from natural philosophy. . Feminists have also done well to point out the power of symbolic rationality. Symbols, imagery and language work to shape individual and collective consciousness. Words are never mere words. (10) Thus feminists have been alert to the way a male-oriented language functions to ensure women s conformity to the system; subtle forms of communication and euphemisms implicitly shore up the power of dominant elites.
As feminists emphasize symbolic reasoning and the ecological interconnectedness of events, their ethical analysis of a social problem can become subtle and penetrating. As noted feminist philosopher Alison Jagger jag 1
1. A sharp projection; a barb.
a. A hanging flap along the edge of a garment.
b. A slash or slit in a garment exposing material of a different color.
tr.v. has noted in a comment on reproductive debates:
Feminist approaches to ethics must understand individual actions in the context of broader social practices, evaluating the symbolic and cumulative implications of any action as well as its immediately observable consequences. They must be equipped to recognize covert as well as overt manifestations of domination, subtle as well as blatant forms of control and they must develop sophisticated accounts of coercion and consent. (11)
Subtle sophisticated accounts of the symbolic and cumulative implications of instituting assisted suicide and euthanasia are desperately needed. In reaction to abuses of power and overt and covert coercion by elites, feminists have endorsed nonhierarchical modes of collaborative problem-solving. While some feminists would see these cooperative methods as arising mostly from innate biologically based differences in nurturance between men and women, others like myself would more credit women's traditional socialization socialization /so·cial·iza·tion/ (so?shal-i-za´shun) the process by which society integrates the individual and the individual learns to behave in socially acceptable ways.
n. into a female subculture of familial caretaking. In the practices of "maternal thinking" needed to nurture children and dependents, women have learned a great deal about encouraging potential and creating effective communities that work through dialogue and persuasion. (12) A different form of power can be discerned and affirmed. Power need not, and should not, be exercised by the "logic of domination" employing violence and coercion of the weak by the strong. Many feminists have affirmed the imp ortance of "actualizing power" or creative enabling power which eschews the violence of the jungle and seeks to solve problems in a more fundamental dialogical collaborative way. (13)
From the nineteenth century on, many feminists have led or been allied with peaceful, nonviolent approaches to civic reform. The growth of the modern ecology movement The global ecology movement is one of several new social movements that emerged at the end of the sixties; as a values-driven social movement, it should be distinguished from the pre-existing science of ecology. has also engaged feminist energies and aspirations. But since the core of the feminist critique is a demand for justice, feminists have espoused an approach to caring which stresses justice as the fundamental basis and starting point Noun 1. starting point - earliest limiting point
terminus a quo
commencement, get-go, offset, outset, showtime, starting time, beginning, start, kickoff, first - the time at which something is supposed to begin; "they got an early start"; "she knew from the of caring, or an ideal of "just care." (14) In a commitment to justice, feminists embark on struggles of nonviolent resistance nonviolent resistance: see passive resistence. to evil and endure conflict. The working goal is that both justice and care should inform the lives of interdependent individuals living in mutually nourishing communities of opportunity. Dedicated to inclusive justice for themselves, many feminists have taken up the cause of other vulnerable members of society, particularly children, the handicapped and minorities who have also been excluded from power. The argument between pro-life and pro-choice feminists, for instance, has been over whet her the unborn should be another vulnerable group to be protected. Are not these developing human lives, like their mothers, most in need of advocacy and nurture?
Today, even in affluent democratic America, women have not achieved full equality or overcome obstacles of overt and subtle gender discriminations. Old women end up with a poorer economic status and are more psychosocially depressed than men, because earlier in their lives they have enjoyed fewer opportunities and less structural supports in pursuing education and work, or in combining motherhood and careers. Unfortunately women also still can confront domination and physical harm from male aggression, sexual abuse, rape and domestic violence. Pro-life feminists would add the prevalence of permissive legalized abortion, even to the point of sex selection for males, to the list of harmful conditions. While women's oppression can be more dire and extreme in other male-dominated repressive societies around the world, the stress upon women in America, particularly upon young adolescent women, needs to be addressed. At every point in the life cycle, from conception and reproduction to death and dying, fundamental moral questions arise and become debated. I argue here that instituting self-determined dying by approving either assisted suicide or euthanasia would be a wrong and harmful step for our society.
Moral and Pragmatic Arguments for Self-Determined Dying
Today's arguments for and against self-determined dying, like most important contested issues, are made up of a network of interrelated in·ter·re·late
tr. & intr.v. in·ter·re·lat·ed, in·ter·re·lat·ing, in·ter·re·lates
To place in or come into mutual relationship.
in claims, assumptions and foundational principles. Moral and pragmatic political considerations become conjoined conjoined /con·joined/ (kon-joind´) joined together; united.
two deformed fetuses fused together. . Emotional beliefs about the way the world operates, the purpose of life, human nature and the nature of evil, pain, suffering, death and compassion entwine. Practical assessments of the present and potential functioning of bureaucratic institutions, health systems and medical professionals also become a part of the debate over dying. Subtle and complex philosophical distinctions and ethical judgments are equally important: for instance, is an active lethal medical intervention morally the same as withdrawing a futile or burdensome medical treatment? (I would say no.) Can a patient's right to refuse treatment be extended to a right to demand a treatment, as in the demand for assistance in suicide or euthanasia? (Again, no.)
A complex array of major and minor arguments undergird the claims of the proponents for self-determined dying. But a core, or gestalt Gestalt (gəshtält`) [Ger.,=form], school of psychology that interprets phenomena as organized wholes rather than as aggregates of distinct parts, maintaining that the whole is greater than the sum of its parts. , of the general claims can be discerned which lies at the heart of the proeuthanasia movement, sometimes called "the right to die" movement. These essential moral and pragmatic claims are based upon the belief that the individual person has the moral right to decisively end his or her own life when he or she judges that it is no longer meaningful or has been reduced to an affront to human dignity Human dignity is an expression that can be used as a moral concept or as a legal term. Sometimes it means no more than that human beings should not be treated as objects. Beyond this, it is meant to convey an idea of absolute and inherent worth that does not need to be acquired and . Since individuals differ in their understandings of meaningfulness and in their attitudes toward suffering and human dignity, individuals must be allowed to make these decisions. Out of respect for autonomy and compassion, others in the society, particularly physicians, should comply with requests to die. An important pragmatic corollary claim in pro-euthanasia arguments is that adequate institutional safeguards and medical controls can be instituted. In the processes of changing the laws, abuses can also be avoided so that our society need not go down any slippery slope 'slippery slope' Medical ethics An ethical continuum or 'slope,' the impact of which has been incompletely explored, and which itself raises moral questions that are even more on the ethical 'edge' than the original issue .
It is also important to recognize that different proponents of the need for socially instituted assisted suicide and euthanasia may disagree among themselves as to what is needed. While most proponents of change invoke the general claims above, some take nuanced moral and practical positions. (15) There are persons, for instance, who make distinctions between approving physician-assisted suicide and approving active euthanasia active euthanasia Medical ethics The practice of injecting a Pt with a lethal dose of medication with the primary intention of ending the Pt's life. Cf Active euthanasia. . Others may differ over whether physicians, or some other group, would be the appropriate agents to administer death. There are also some who distinguish between private moral acceptance of suicide and euthanasia by individual physicians but do not wish to see the laws changed.
Another division between groups is between those who approve only of voluntary euthanasia by competent consenting patients and those who accept involuntary euthanasia decisions made by surrogates for neonates or in cases of incompetency The lack of ability, knowledge, legal qualification, or fitness to discharge a required duty or professional obligation.
The term incompetency has several meanings in the law. . Those who refuse to draw the line at voluntary consent argue that it would be wrong to deny incompetent persons or their families the euthanasia or mercy killings that competent individuals could procure. And as might be expected, there are many disagreements
about which legal requirements, social controls, medical safeguards and technical administrative procedures would be necessary to avoid possible abuses and harm. How close to the end of a terminal illness, for instance, must a requested decision to end one's life be allowed? Can severe psychosocial suffering or a resolute desire to die count as a valid reason to receive aid in dying, or must there be a terminal medical disease present? As for the problem of abuse, there are disagreements over what levels of abuse would e nsue, and what levels of abuse could be tolerated in order to procure what is judged to be a much needed reform. I cannot here address all of the complex issues involved, and so will only briefly outline my counterarguments to the claims made.
Moral and Pragmatic Arguments against Assisted Suicide and Euthanasia
I do not agree with the proposals for allowing assisted suicide and euthanasia; my position has been developed out of my feminist affirmations. I focus my moral and pragmatic arguments on 1) the individual's decision, 2) interpersonal effects, and 3) harmful outcomes in society.
Does an individual have a moral right to a self-determined death by suicide or euthanasia? Implicit in Adj. 1. implicit in - in the nature of something though not readily apparent; "shortcomings inherent in our approach"; "an underlying meaning"
underlying, inherent the claim is the assumption that an individual owns his or her personal body-self so completely that he or she can kill or extinguish life at will. This concept of absolute human ownership or property right appears morally misguided. Women, along with other formerly owned groups like Blacks, must protest that no body can be owned or destroyed by unilateral individual decision, even one's own. Whence would such an individualistic moral right or assumption of absolutely dominant power come from? After all, each individual self-consciousness, like each individual's body-self, has been created and received from one's parents and forebears and nourished by the community and culture in which an individual's life is organically embedded. A human life and identity is a gift from evolutionary biology Evolutionary biology is a sub-field of biology concerned with the origin and descent of species, as well as their change, multiplication, and diversity over time. , natural ecological conditions, parental procreative pro·cre·a·tive
1. Capable of reproducing; generative.
2. Of or directed to procreation. childrearing and collective cultural socialization, all transcend ing the individual power of a self-determining will claiming unilateral life-or-death powers.
Feminists have understood that individuals cannot be treated or treat others as though persons are alienated nomads cut off from all bonds with one another. Having received the gift of life and social identity, one has moral obligations to preserve and respect each human life and refrain from suppressing, killing or destroying self or others. What is permitted to the self and what is permitted for others to do to a human being cannot be morally or psychologically separated. Murder and suicide are irretrievably ir·re·triev·a·ble
Difficult or impossible to retrieve or recover: Once the ring fell down the drain, it was irretrievable.
ir linked acts. In ancient cultures such as Rome, where suicide was honored, it was also accepted that powerful elites could unilaterally kill slaves, children or troublesome women. To be a valid protective principle, the moral prohibition against killing a human being must have no exceptions -- neither for the self, nor for physicians.
For that matter, today's society and many feminists are even beginning to seriously question the claim that human beings can have property rights that morally allow them to kill members of endangered animal species This is a list of endangered animal species according to the World Conservation Union (IUCN) Red List. The list includes endangered species of the kingdom Animalia.
: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z • See also • External links
A or destroy rain forests. (16) With the growth of ecological consciousness, human beings are recognized to be existing in an interconnected life-sustaining environment which has been received from interacting natural patterns and must be respected and cared for, if human life is to be sustained. While no individual has ever given informed consent to become a member of earth's ecosystem, individuals can have moral obligations and duties to protect and exercise care for the earth's environment. Arrogant and destructive impositions of human will must be forsworn for·swear also fore·swear
v. for·swore , for·sworn , for·swear·ing, for·swears
a. To renounce or repudiate under oath.
b. To renounce seriously. . Surely the moral prohibition against willfully willfully adv. referring to doing something intentionally, purposefully and stubbornly. Examples: "He drove the car willfully into the crowd on the sidewalk." "She willfully left the dangerous substances on the property." (See: willful) destroying a human life must become universal.
While a human being has a body right to self-protection from intrusions and mutilations in order to protect one's life and well-being, these life-affirming rights can hardly be extended to demanding acts of bodily self-execution. Indeed, many proponents of euthanasia appear to deny the organic unity of an embodied self and believe in some dualistic du·al·ism
1. The condition of being double; duality.
2. Philosophy The view that the world consists of or is explicable as two fundamental entities, such as mind and matter.
3. , even spiritualistic spir·i·tu·al·ism
a. The belief that the dead communicate with the living, as through a medium.
b. The practices or doctrines of those holding such a belief.
2. , idea of a ghost in the machine. Typically, one respected physician, writing in Harvard Magazine Harvard Magazine is an independently edited magazine and separately incorporated affiliate of Harvard University. It is the only publication covering the entire University and also regularly distributed to all graduates, faculty and staff. of his own end-of-life beliefs, says, "It is my credo that assisting people to leave the dwelling place of their body when it is no longer habitable habitable adj. referring to a residence that is safe and can be occupied in reasonable comfort. Although standards vary by region, the premises should be closed in against the weather, provide running water, access to decent toilets and bathing facilities, heating, is becoming an obligation of the medical profession. It is part of the doctor's job." (17) He appears to assume that some disembodied person or brain-based mind temporarily dwells in his body and should be able to leave it at will. But where to? Many persons appear to accept another questionable assumption denigrating den·i·grate
tr.v. den·i·grat·ed, den·i·grat·ing, den·i·grates
1. To attack the character or reputation of; speak ill of; defame.
2. the body--i.e., that alive brains can somehow, like computers, operate separately from the rest of the bodily machine.
Such dualistic beliefs, from the time of the Stoics' view of the imprisoned im·pris·on
tr.v. im·pris·oned, im·pris·on·ing, im·pris·ons
To put in or as if in prison; confine.
[Middle English emprisonen, from Old French emprisoner : en- soul dragging around a corpse, until today, have helped to justify voluntary suicide and assisted dying. Such dualistic denigrations of the body have also justified less savory killing practices such as offering human sacrifices to the gods or burning heretics for the sake of their souls. Mere bodies can be disposed of in order to send souls on to the next, truly meaningful life. Unfortunately, when embodiment and a wholistic understanding of the human being is denied, then women's bodies too, along with their power to engender and nurture new embodied human beings, become discounted. When an ideological goal strives to dominate and master despised natural bodies at the behest of a higher will or spirit, then women will often find themselves part of the natural order which must be dominated, if not despised.
A dualistic assumption of a mind inhabiting a bodily dwelling place focuses attention on the intractable problem of obtaining fully informed consent. Even those who would prohibit killing another person claim that one can kill one's self because of the certainty of obtaining informed consent -- i.e., when the executioner EXECUTIONER. The name given to him who puts criminals to death, according to their sentence; a hangman.
2. In the United States, executions are so rare that there are no executioners by profession. and executed are identical. Or to use the term for suicide found in the literature of the Hemlock hemlock, any tree of the genus Tsuga, coniferous evergreens of the family Pinaceae (pine family) native to North America and Asia. The common hemlock of E North America is T. Society, in "self-deliverance" the deliverer and the delivered are one and the same.
Here again, however, the body-self must be objectified, alienated and viewed as a target split off from the mind. Bodily life becomes the enemy, or the obstacle which must be dominated and extinguished by technological means that will not fail. In many suicides, body-selves resist being killed and vomit pills, or claw off plastic bags, or lunge for air; therefore, the more violent or technologically certain the assault, the better. Experts or helpers also need to stand in readiness to complete the job. Better yet, physicians who will actively commit euthanasia can employ a highly lethal chemical technology that can bring a certain, swift death.
Viewing the body-self as a target to be dominated and killed differentiates an act of suicide or euthanasia from the morally acceptable practice of withdrawing futile medical treatments. Allowing a dying person to die without prolonging his or her irreversible death permits giving up useless and burdensome interventions. In a naturally occurring inevitable death, a whole person as a body-self dies from an irremediable ir·re·me·di·a·ble
Impossible to remedy, correct, or repair; incurable or irreparable: irremediable errors in judgment.
ir medical condition. If a treatment is withdrawn and death is not imminent, then the person continues to live. There is no danger of misread mis·read
tr.v. mis·read , mis·read·ing, mis·reads
1. To read inaccurately.
2. To misinterpret or misunderstand: misread our friendly concern as prying. signals.
The difficulty of ascertaining a persons consent to suicide or euthanasia cannot be overestimated. There are problems with comprehending internal self-self communications and external problems of receiving self-other signals. Self-knowledge is difficult because the ongoing stream of consciousness is so complex and made up of so many different dimensions. We now know that many different modal subsystems contribute to our unified experiential sense of a conscious self and identity. Arousal, memory, perception, affect, cognition and so on play a part in an ever-changing, ongoing flow of conscious experience. There exists a constant revising of interpretations of self-experience responding to the ways different systems of a person are functioning. Not only can biochemical imbalances and impairments create fears and depressions, but temporary disjunctions of impulse, illusions, imagery and false inferences can create erroneous and dysfunctional judgments.
Individual choices, preferences, plans and decisions are never simple or unitary, but exist as ongoing processes. Consciousness is constantly being self-created and recreated; and these individual inner processes are constantly affected by ongoing interpersonal and environmental interactions. To complicate the picture further, there are many nonconscious cognitive processes Cognitive processes
Thought processes (i.e., reasoning, perception, judgment, memory).
Mentioned in: Psychosocial Disorders , such as implicit memories, outside of full self-awareness which exist and contribute to functioning. An explicit self-aware accessible event in consciousness is not all that is operating within a person's mind-body-organism.
Therefore when a conscious decision, or choice, or plan is made to kill one's self, not only must one violently subdue one's body-self, but one must also extinguish all the other implicit stored dimensions of complex personal identity. Other dimensions Other Dimensions is a collection of stories by author Clark Ashton Smith. It was released in 1970 and was the author's sixth collection of stories published by Arkham House. It was released in an edition of 3,144 copies. of personal consciousness may resist dying, and, like the resisting body-self, call for help in the midst Adv. 1. in the midst - the middle or central part or point; "in the midst of the forest"; "could he walk out in the midst of his piece?"
midmost of a suicide attempt suicide attempt, suicide bid n → intento de suicidio
suicide attempt, suicide bid n → tentative f de suicide
. When people survive attempts at suicide, or their requests for euthanasia are denied, they often report that they have now "changed their minds." They no longer identify with the dimension of self that wanted to die. No one can ever certainly predict how a future self's stream of consciousness will construct or interpret experience. Even various kinds of suffering can be interpreted as meaningful and transcended by many human beings, as abundant testimony reveals. An irreversible conscious decision to end consciousness forever suppresses a core capacity and essential potential of a human being. A voluntary extinction of the meaning-mak ing faculty of persons also signals the meaninglessness of nonhealthy bodily life; it is a grave violation of human dignity. A steadfast living of each moment to the end not only displays more courage, but gives more meaning to the human condition. Death may forcibly take my life away from me, but why give death an easy victory by an irreversible act of self-extinction?
Of course many irreversible decisions short of death will have to be made, and inner conflicts exist in some decisions when some part of one's self by one's self; without help or prompting; spontaneously.
See also: Of may dread or shrink from Verb 1. shrink from - avoid (one's assigned duties); "The derelict soldier shirked his duties"
fiddle, shirk, goldbrick
avoid - refrain from doing something; "She refrains from calling her therapist too often"; "He should avoid publishing his wife's an act. Certain therapeutic medical decisions such as amputation amputation (ăm'pyətā`shən), removal of all or part of a limb or other body part. Although amputation has been practiced for centuries, the development of sophisticated techniques for treatment and prevention of infection has greatly might be cited, or, in an even more extreme case, giving up one's life for another or becoming a martyr may induce ambivalence. Yet these examples are not the same as choosing death by suicide or euthanasia. In irreversible medical decisions, the goal is to be able to continue life and thereby continue to experience or shape one's life. In a sacrifice for another person, or in martyrdom, death is really not being chosen but is imposed upon a person's altruistic act by external exigencies or persecutors acting beyond one's control. One is choosing loyalty or love, not death. A mother who chooses to risk a life-threatening pregnancy for the sake of her baby is not committing suicide or choosing death.
There are differences in human actions undertaken even when death as a final outcome can be foreseen. To withdraw futile treatment is not the same as killing. To give a dying person enough medication to relieve pain, an act that may also result in a less prolonged death, is not the same as intending to kill a person. Human acts are shaped by human intentions and characterized by the means employed. To judge only by ultimate outcomes or consequences is to take only the narrowest utilitarian perspective on causation. The bottom-line approach denies human subjectivity and makes no distinction between human beings and inanimate objects Inanimate Objects
the study of inanimate things.
the assignment to inanimate objects, forces, and plants of personalities and wills, but not souls. — animatistic, adj. . Human beings always act within a world of willed intentions, affective motivations, using differentiated means within cultural frameworks of meaning. To deny the complexities of human actions would mean denying the very judgments and desires to be merciful and compassionate which inform all the different arguments over what we should do to help each other to a good death.
Obviously all parties agree that there is a duty to comfort, care and relieve pain during the dying process. In an era of advanced palliative palliative /pal·li·a·tive/ (pal´e-a?tiv) affording relief; also, a drug that so acts.
Relieving or soothing the symptoms of a disease or disorder without effecting a cure. medicine, no one who is dying should have to die in pain. The increase of chronic illness in our society makes it clear that medicine's caring and palliative function is as important as heroic feats of curing and rescue. Yet the existential suffering accompanying illness and death can be a psychosocial challenge to individuals and their families. Unfortunately, physicians who become enamored en·am·or
tr.v. en·am·ored, en·am·or·ing, en·am·ors
To inspire with love; captivate: was enamored of the beautiful dancer; were enamored with the charming island. with the heroic role of fighting off death with dramatic high technologies may all too easily arrogate ar·ro·gate
tr.v. ar·ro·gat·ed, ar·ro·gat·ing, ar·ro·gates
1. To take or claim for oneself without right; appropriate: Presidents who have arrogated the power of Congress to declare war. to themselves the duty of relieving existential suffering by deciding when to end a life. In the process they may also foreshorten necessary processes of grieving and farewells.
Most worrisome, however, are the problems of communications in a crisis. It is very difficult to know one's own mind and heart or to internally assess the validity of the ever-changing dynamic processes of decisionmaking, much less read another's heart. Yet physicians in favor of euthanasia appear to have faith that they can tell whether the patient really means it when he or she requests to die. Why so? Why should physicians be accorded the power or ability to assess the quality of a life's meaning or judge the amount of subjective suffering that is really present? Those physicians who think that they would only be responding to a patient's "free" choice are naive about the dynamic processes of interpersonal communication Interpersonal communication is the process of sending and receiving information between two or more people. Types of Interpersonal Communication
This kind of communication is subdivided into dyadic communication, Public speaking, and small-group communication. . Subtle signals and suggestive signs are constantly being given by the phrasing of questions and a host of other nonverbal channels of communication. Ask any patient, or any woman in childbirth, for an account of how facial expressions, gestures or tones of voice are being scrutinized for s ocial meanings.
Interpersonal Social Dimensions of Self-Determined Death
When you seek or assist a suicide or act of euthanasia, you act to end all human relationships. No more comfort can be given or received; no more companioning or patient watching and waiting with another will take place. A decisive cutting off of interpersonal bonds will be effected. You don't see each other through to the end, you end life. All human dependence and interdependence is actively rejected. Such acts are not without interpersonal consequences because we do not exist alone. Feminists have always emphasized that supposedly abstract decisions are influenced by their pragmatic social context and covert meanings. Cultural scripts, background beliefs, social roles, status, perceived power and emotional histories, along with patterns of speech and symbolic interpersonal communications, will determine outcomes of events.
Ambivalence in motivation and ambiguity in meanings also characterize the human condition. When one decides to actively end one's life or requests euthanasia, the social support that can be counted on from others will be a crucial variable. How much care can the individual expect? Is it given grudgingly or with love? In the past the absolute fixed tabu against suicide or against euthanasia has served to make a patient's right to expect the care of her family or community fixed and unquestioned. As long as a human being's natural life exists the family and/or institutional caretakers are morally obligated ob·li·gate
tr.v. ob·li·gat·ed, ob·li·gat·ing, ob·li·gates
1. To bind, compel, or constrain by a social, legal, or moral tie. See Synonyms at force.
2. To cause to be grateful or indebted; oblige. to offer support and care. Whatever ambivalence exists must be suppressed in order to live up to the cultural ideal of helping those who are ill and suffering as their vulnerability increases and their life ebbs away.
When the option or choice to end a life is morally permitted, then the interpersonal situation changes. One must justify his or her choice to go on living and ask why one should voluntarily continue to exact care or be dependent upon others. Subtle internal pressures can all too easily emerge to stop being a burden on others by taking up resources and energy. Women who have been socialized to be self-sacrificing may be the most vulnerable to such pressures. After all, in India it was widows who were required to throw themselves on funeral pyres, not men. And surely in ancient Arctic societies more aged women ended up on those reputed ice flows going out to sea. The majority of Dr. Kevorkian's clients who have used his suicide machine also have been women. People request assisted suicide when they are not yet in pain, but because they fear future debilitation debilitation
being in a state of debility. and dependency. Fear of dependency is partly a fear of losing power and self-control, but it can also be a fear that others will not take care of you. It may also mask a displaced fear of death itself.
Unfortunately, the more ill or debilitated de·bil·i·tat·ed
Showing impairment of energy or strength; enfeebled. See Synonyms at weak.
Adj. 1. debilitated - lacking strength or vigor
asthenic, enervated, adynamic a person becomes the more distrusting, depressed or despondent de·spon·dent
Feeling or expressing despondency; dejected.
de·spondent·ly adv. an individual can become. Emotions and thought processes This is a list of thinking styles, methods of thinking (thinking skills), and types of thought. See also the List of thinking-related topic lists, the List of philosophies and the . regress REGRESS. Returning; going back opposed to ingress. (q.v.) in illness and it becomes more difficult to think clearly, much less assert one's claims for care. That is why each old person who goes to the hospital does well to have a family member present to be an advocate in the confusing system of modem American healthcare institutions. The idea that patients have one long-term physician who knows them well and will serve as their discerning protector is more or less a fantasy for most aging Americans. To become ill is to enter the land of vulnerability when what you need above all is an unconditional entitlement to receive appropriate care.
Families and caretakers also will not be unaffected by any new options instituted for assisted suicide or euthanasia. Today most families do take care of their aging and dying members, but they do so supported by tabus against all requests for death. The intergenerational in·ter·gen·er·a·tion·al
Being or occurring between generations: "These social-insurance programs are intergenerational and all reciprocal cycle of kinship obligations and care should remain undisturbed. Incompetent, vulnerable infants are nurtured, grow up, mature and care for incompetent, vulnerable and dying old persons. If and when possibilities for euthanasia arise as socially approved, there will be a whole new disturbing dimension to caretaking and family communication. Family conflicts can be expected over requests for death. Suicides leave their mark on their families and requests for euthanasia may also engender conflicts, regrets and models for imitation. The situation of dying by request is so emotionally fraught for caretakers that even proponents of euthanasia have recommended that families not be the agents involved. But individuals, families and caret akers will not be the only ones affected by social change.
Society and Community Effects of Self-Determined Dying
Arguments over what possible effects approving assisted suicide and euthanasia would have in our society depend a great deal upon assessments of what conditions already exist in our institutions, bureaucracies and professional communities. Feminists will be pessimistic if they look to the way powerless women have been treated in health-care facilities devoted to birth and reproductive health Within the framework of WHO's definition of health as a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity, reproductive health, or sexual health/hygiene care, or to the way women on welfare have fared. It is instructive also to look at the way abortion moved from being approved of as a tragic choice in exceptional cases to becoming a routinized necessity with only the most perfunctory of counseling or alternatives offered to women. Individual choices have a way of quickly becoming routine procedures in the larger institutions of society. A quick medicalized technological solution to problems can take over. Slippery-slope arguments often do apply when traditional moral prohibitions are breached. Think of the way the Allies began to justify bombing civilians in World War II .
Those who favor right-to-die measures claim that surely society can control practices because rational controls and legal supervision of professionals and institutions will work to keep abuses from occurring. Also, they claim, physicians will not be corrupted by becoming "death providers" instead of healers, because part of their role already includes relief of suffering. Providing the means to suicide or giving lethal doses to effect death will only be an extension of their current roles. Families and other caretakers of the dying will not be affected, it is claimed, any more than the current recognition of the patient's right to refuse or withdraw futile treatment has changed the supportive care supportive care,
n medical and other interventions that attempt to support and make comfortable rather than to cure. given to patients.
Most advocates of euthanasia do recognize that there would be a move from voluntary euthanasia to involuntary euthanasia of incompetents, but they are not alarmed. Their reasoning is consistent. If it is a good for competent patients to be able to end a meaningless life that is an affront to human dignity, then why should not those who are incompetent have the same freedom? Surrogates can usually make any decisions which are morally accepted for individuals to make, so this move to involuntary euthanasia would not be seen as a terrible danger. Those demented Alzheimer patients who no longer can recognize their families or even seem fully conscious are the most trying and burdensome patients. Perhaps this group could be most easily judged by surrogate decision makers to have a meaningless unacceptable quality of life.
In these debates the case of Holland's growing acceptance of euthanasia is argued over. Everyone agrees that more and more liberties and laxity laxity /lax·i·ty/ (lak´si-te)
1. slackness or looseness; a lack of tautness, firmness, or rigidity.
2. slackness or displacement in the motion of a joint.lax´
looseness. in professional requirements for euthanasia have taken place in Holland. Persons have been euthanized only because they claimed to be severely depressed, and family requests for involuntary euthanasia for incompetents and impaired neonates have been met. (18) Proponents of euthanasia may admit some abuses in Holland but also affirm that the extension of the right to die really reveals the need, heretofore suppressed, of increases in personal liberty.
Opponents of euthanasia would, like myself, point to the changes in Holland as an example of how a slippery slope works. Death begins to seem more and more of a seductive way to solve problems. The fuzzy criterion labelled "an acceptable quality of life" becomes ever more elastic. Pressures on older people or AIDS patients to request euthanasia will grow even in a well-organized, fully insured universal health system like Holland's, where no financial pressures are involved in these decisions. Habituation habituation
Reduction of an animal's behavioral response to a stimulus, as a result of a lack of reinforcement during continual exposure to the stimulus. Habituation is usually considered a form of learning in which behaviours not needed are eliminated. makes each new case easier to carry out. To my surprise, I once heard Timothy Quill quill: see pen. , a prominent physician advocate of assisted suicide, proclaim from a podium that a physician's fourteenth case of assisting a suicide would not be carried through with the same sensitivity as his first case.
In our own disorganized dis·or·gan·ize
tr.v. dis·or·gan·ized, dis·or·gan·iz·ing, dis·or·gan·iz·es
To destroy the organization, systematic arrangement, or unity of. , economically stressed, market-driven American health American Health Inc. is a company that manufactures health supplements. It is located in Holbrook, New York. One of its products is labeled the "Chewable Original Papaya Enzyme" with the attached registered trademark, "The 'After Meal Supplement'". system, with so many of the poor having inadequate health insurance, many abuses could be expected. Little legal supervision or regulation could really be effective. Physician education, with its technologically driven training, does not prepare doctors to be strong in communication skills or social sensitivity. Certain physicians would undoubtedly become known for the ease with which they approved suicide and euthanasia requests, and perhaps, as with abortion, special for-profit clinics would be set up. Poor and uninsured old persons--particularly women, minorities and the handicapped--would be most at risk.
Another reservation emerges from a consideration of symbolic cumulative effects of assisted suicide on our culture. Is it acceptable to retreat, withdraw or check out of a situation, a marriage or a life when troubles mount and suffering must be endured? Already the adolescent suicide rate has soared and depression rates have increased among the young. No one could look unmoved un·moved
not affected by emotion; indifferent
Adj. 1. at the abortion rate or contemplate our homicide statistics without a tremor. Unconditional respect for the gift of life is eroding; nonviolent struggles to patiently overcome a sea of troubles is not validated. Under the banner of increasing technological control and increasing liberty--live free or die--we have opened ourselves up to more and more pressures to die.
Ideals of individual domination and control of life have backfired in our society. Feminists have mounted a critique and reappraisal of our troubles. Feminist ideals of inclusive justice, caretaking and the interconnectedness of all the living require that we struggle against approving assisted suicide and euthanasia. Let there be no more recruits for the armies of domination and death.
(1.) Derek Humphry Derek Humphry (b. 1930 in UK) is an author and co-founder in 1980 (with second wife Ann Wickett), of the Hemlock Society in California and past president of the World Federation of Right to Die Societies. , Final Exit: The Practicalities of Self-Deliverance & Assisted Suicide for the Dying (New York New York, state, United States
New York, Middle Atlantic state of the United States. It is bordered by Vermont, Massachusetts, Connecticut, and the Atlantic Ocean (E), New Jersey and Pennsylvania (S), Lakes Erie and Ontario and the Canadian province of : Coral Publishing, Hemlock Society, 1991); Timothy E. Quill, M.D., Death and Dignity: Making Choices and Taking Charge (New York: Norton, 1993); Daniel W. Brock, "Voluntary Active Euthanasia
Voluntary Active Euthanasia is the name of a paper by Dan W. Brock in which it the morality and legality of Euthanasia is studied. ," Hastings Center The Hastings Center, founded in 1969, is an independent, nonpartisan, non-profit bioethics research institute dedicated to examination of essential questions in health care, biotechnology, and the environment. Report no. 2 (1992):10-22.
(2.) Deborah L. Rhode, Justice and Gender (Cambridge: Harvard University Press The Harvard University Press is a publishing house, a division of Harvard University, that is highly respected in academic publishing. It was established on January 13, 1913. In 2005, it published 220 new titles. , 1989).
(3.) Feminism & Philosophy: Essential Readings in Theory, Reinterpretation re·in·ter·pret
tr.v. re·in·ter·pret·ed, re·in·ter·pret·ing, re·in·ter·prets
To interpret again or anew.
re , and Application. Nancy Tuana and Rosemarie Tong, eds. (Boulder: Westview Press, 1995).
(4.) Susan A. Ross and Mary Catherine Hilkert, O.P., "Feminist Theology: A Review of Literature," Theological Studies 56(2):327-52 (June 1995).
(5.) Maria C. Lugones and Elizabeth V. Spelman, "Have We Got a Theory for You! Feminist Theory Feminist theory is the extension of feminism into theoretical, or philosophical, ground. It encompasses work done in a broad variety of disciplines, prominently including the approaches to women's roles and lives and feminist politics in anthropology and sociology, economics, , Cultural Imperialism Cultural imperialism is the practice of promoting, distinguishing, separating, or artificially injecting the culture or language of one nation into another. It is usually the case that the former is a large, economically or militarily powerful nation and the latter is a smaller, , and the Demand for 'The Woman's Voice'," Women's Studies women's studies
pl.n. (used with a sing. or pl. verb)
An academic curriculum focusing on the roles and contributions of women in fields such as literature, history, and the social sciences. International Forum 6(6):573-581 (1983); Yagori Matsui, "Violence Against Women in Development, Militarism Militarism
See also Soldiering.
leader of the Seven against Thebes. [Gk. Myth.: Iliad]
killed many enemies; led many troops to victory. [Ger. Lit. Nibelungenlied] , and Culture," Asian Women's Resource Center for Culture and Theology (Winter 1991).
(6.) Feminism as Critique: On the Politics of Gender. Seyla Benhabib Seyla Benhabib (born 1950, Istanbul) is a Turkish professor of political science and philosophy at Yale and director of the program in Ethics, Politics, and Economics, and a well-known contemporary philosopher. and Drucilla Cornell Drucilla Cornell is a professor of political science, women's studies, and comparative literature at Rutgers University. Education
She received her Bachelor of Arts (B.A.) in Philosophy and Mathematics from Antioch College in 1978, and her Juris Doctor (J.D. , eds. (Cambridge MA: Harvard University Press, 1982); Josephine Donovan, Feminist Theory: The Intellectual Traditions of American Feminism (New York: Frederick Unger Publishing Company, 1985); What is Feminism?, Juliet Mitchell and Anne Oakley, eds. (New York: Pantheon Books, 1986).
(7.) Jean Baker Miller, Toward a New Psychology of Women (Boston: Beacon Press This article or section needs sources or references that appear in reliable, third-party publications. Alone, primary sources and sources affiliated with the subject of this article are not sufficient for an accurate encyclopedia article. , 1976).
(8.) Nancy S. Jecker, "Physician-Assisted Death in the Netherlands and the United States: Ethical and Cultural Aspects of Health Policy Development," Journal of the American Geriatrics Society The American Geriatrics Society (AGS): a professional society founded on June 11, 1942 for doctors practicing geriatric medicine. Among the founding physicians were Dr. Ignatz Leo Nascher, who coined the term "geriatrics," Dr. Malford W. , 42(6): 676 (June 1994).
(9.) Marilyn Frye Marilyn Frye (born 1941) is a philosophy professor and feminist theorist. She earned her Ph.D. at Cornell University in 1969 and has taught feminist philosophy, metaphysics, and philosophy of language at Michigan State University since 1974. , "The Possibility of Feminist Theory," Theoretical Perspectives on Sexual Difference, Deborah L. Rhode, Ed. (New Haven New Haven, city (1990 pop. 130,474), New Haven co., S Conn., a port of entry where the Quinnipiac and other small rivers enter Long Island Sound; inc. 1784. Firearms and ammunition, clocks and watches, tools, rubber and paper products, and textiles are among the many : Yale University Yale University, at New Haven, Conn.; coeducational. Chartered as a collegiate school for men in 1701 largely as a result of the efforts of James Pierpont, it opened at Killingworth (now Clinton) in 1702, moved (1707) to Saybrook (now Old Saybrook), and in 1716 was Press, 1990), 174-184; Sandra Lee Sandra Lee might refer to:
(10.) Catherine A. MacKinnon, "Sexuality, Pornography, and Method: 'Pleasure Under Patriarchy,'" in Cass R. Sunstein, ed., Feminism and Political Theory (Chicago: University of Chicago Press The University of Chicago Press is the largest university press in the United States. It is operated by the University of Chicago and publishes a wide variety of academic titles, including The Chicago Manual of Style, dozens of academic journals, including , 1990): 207-39.
(11.) Alison M. Jagger, "Feminist Ethics: Projects, Problems, Prospects," In/Fire Ethics, 2(3): 6 (1993).
(12.) Sara Ruddick, "Maternal Thinking," in Joyce Trebilcot, ed., Mothering (Totowa, N.J.: Rowman and Allanheld, 1984): 213-20.
(13.) Riane Eisler Riane Eisler is an Austrian born American scholar, writer, and social activist. Born in Vienna, her family fled from the Nazis to Cuba when she was a child; she later emigrated to the United States. She has degrees in sociology and law from the University of California. The Chalice & The Blade: Our History Our Future (San Francisco San Francisco (săn frănsĭs`kō), city (1990 pop. 723,959), coextensive with San Francisco co., W Calif., on the tip of a peninsula between the Pacific Ocean and San Francisco Bay, which are connected by the strait known as the Golden : Harper & Row, 1987); Iris M. Young, Justice and the Politics of Difference (Princeton: Princeton University Princeton University, at Princeton, N.J.; coeducational; chartered 1746, opened 1747, rechartered 1748, called the College of New Jersey until 1896. Schools and Research Facilities
(14.) Margaret Farley, Second Opinion 17 (1991).
(15.) For a full discussion of these complex issues see Daniel Callahan, The Troubled Dream of Life: Living with Mortality (New York: Simon & Schuster Simon & Schuster
U.S. publishing company. It was founded in 1924 by Richard L. Simon (1899–1960) and M. Lincoln Schuster (1897–1970), whose initial project, the original crossword-puzzle book, was a best-seller. , 1993).
(16.) Ynestra King, "Healing the Wounds: Feminism, Ecology, and Nature/Culture Dualism dualism, any philosophical system that seeks to explain all phenomena in terms of two distinct and irreducible principles. It is opposed to monism and pluralism. In Plato's philosophy there is an ultimate dualism of being and becoming, of ideas and matter. ," in Feminism & Philosophy, 353-73.
(17.) Francis D. Moore, "Prolonging Life, Permitting Life to End," Harvard Magazine 97(6): 47 (July/August 1995).
(18.) Herbert Hendin, M.D., "Seduced by Death: Doctors, Patients, and the Dutch Cure," Issues in Law & Medicine 10(2): 123-68 (1994).