SASKATOON - Ethicist Margaret Somerville was welcomed as the 28th Michael Keenan Memorial Lecturer at St. Thomas More College Nov. 24, offering a public lecture entitled, “The Song of Death, the Lyrics of Euthanasia versus The Song of Life, the Lyrics of Love and Hope.”<
As the Samuel Gale Professor of Law Emerita, Professor Emerita in the Faculty of Medicine, Founding Director Emerita of the Centre for Medicine, Ethics and Law at McGill University in Montreal, Somerville has established herself as one of the most respected bioethicists in Canada. Given the new reality in Canada of an amended Criminal Code allowing for medically assisted death, Somerville was invited to share her reflections.
“I want to discuss the legalization of euthanasia as a prime example of what has happened and what is happening to our shared values,” she began. “I believe that the future world will review (the decision to sanction physician assisted death) with regret because it represents a seismic shift in our foundational values.”
Exploring how legalized euthanasia came to be, Somerville began by outlining progressive (liberal) vs. restrictive (conservative) value stances. “The people who sing the song of death call themselves progressives,” commented Somerville, while those against euthanasia typically hold values indicative of restrictives.
Quoting the research of social psychologist Jonathan Haidt, Somerville said that progressives generally favour individual autonomy to a greater extent than restrictives, and that restrictives favour the common good more than progressives.
“In relation to euthanasia, this translates into a conflict between respect for individual autonomy, a pro-euthanasia value, and respect for human life, which is what people like me believe should be the priority value.”
According to Somerville, calling the legalization of euthanasia a “progressive value” tells us that individual autonomy takes priority over other values such as respect for human life. We must, however, consider the impact of legalizing euthanasia at levels other than just the individual one, “which is the sole focus of the pro-euthanasia lobby.”
Somerville proposed examining the issue of euthanasia at the “meso” or institutional level, questioning what it will look like for hospitals and hospices, what it means for freedom of conscience and/or religion, and what it means for institutions of law and medicine that reflect the value of respect for life for society as a whole.
“In the past, religion was the main carrier of the value of respect for life, now it's law and medicine. Until this past year (in Canada) these institutions have upheld the value, 'Thou shall not kill.' That has all changed. The fact that the state is authorizing the medical profession to (euthanize), seriously damages respect for life in society as a whole.”
The issue of legalized euthanasia raises the question: will our societies and ultimately our world become less compassionate, and what will be the impact be on fragile and vulnerable people?
Somerville stressed the importance of language. “Words matter,” she said.
“Consider describing euthanasia as 'state-sanctioned suicide' or as 'physicians killing their patients,' ” she continued, as compared to the language of “medically assisted death.” “Using terms such as euthanasia and suicide reduces support for inflicted death.”
Somerville went on to ask: what will be the impact of euthanasia on our future? Will the option become normalized? She proposed some ways to minimize the damage of the “song of death” with approaches that embody the “song of life.”
“Both pro-euthanasia advocates and anti-euthanasia opponents are responding to the same question: how do we deal with death in a postmodern, pluralistic, democratic society such as Canada, and in particular, how should we respond to suffering? Where the pro-euthanasia answer is a lethal injection, the anti-euthanasia answer is with hope and love.”
In light of this, how do we generate hope and what does love require in the context of terminal illness? For Somerville it requires access to good palliative care, which is the best response to euthanasia in her estimation, and in particular it requires access to adequate pain management.
“We know from research that even among those who ask for euthanasia, the vast majority change their minds when given good palliative care” explained Somerville.
She went on to quote the Declaration of Montreal, which was adopted by delegates of the International Pain Summit of the International Association for the Study of Pain in 2010, which states, “it is a breach of fundamental human rights for a health care professional to unreasonably leave a person in serious pain.”
Yet in Canada, Somerville pointed out, “only 16 - 30 per cent of people who need palliative care actually get it. So the first thing we've got to do is pressure government and hospitals and institutions to get fully adequate palliative care for everyone who needs it.”
Somerville concluded by referencing Jean Vanier, the founder L'Arche. “The ethical tone of our society is not set by how it treats its strongest, most powerful, most privileged members, but by how it treats those who are weakest, most vulnerable and in need. We need to reopen a sense of enchantment with the world - we need to reclaim amazement, wonder and awe and put into practice a little sign of love.”