The Case for Pain Director's Cut (Featuring 1813 extra words and a bibliography) David Elliot Orriginally published in Issue XXII of Vulgata, Nov. 2009

The Problem

An acute observer if not always a hopeful thinker, Albert Camus wrote in The Myth of Sisyphus that “There is but one truly serious philosophical problem, and that is suicide.”ⁱ Because suicide is a problem which society is debating today in a most unphilosophic way, arguments surrounding it tend to generate more heat than light. My goal in this paper is therefore to provide some argumentation and lucidity in what is likely to become the most contested turf in tomorrow’s “culture wars”. The Roman Catholic tradition to which I belong holds that in moral matters one need not simply utter “Thus saith the Lord” to convince a public which may not even believe in the Lord. Instead, we hold that “natural law” – reason’s ability to perceive and prove salient ethical truths – is our best tool for persuading secular society to accept what makes moral sense.ⁱⁱ

In order to persuade society we must have good arguments, and after having surveyed the pro-life animadversions of the euthanasia position, I am convinced that these are few. Most cases against euthanasia are either badly argued, have a suppressed religious premise, base themselves upon a “slippery slope”, depend upon a palliative care only available in affluent societies, or are implicitly consequentialist in nature. None that I have seen sufficiently demonstrates that both euthanasia and suicide are everywhere and always wrong regardless of the circumstances.ⁱⁱⁱ

In my opinion the most important reason why arguments against euthanasia are typically flawed is because they fail to refute the underlying ideology which euthanasia presupposes. That ideology is broadly one of Utilitarianism, which is the belief that pleasure is the great good in life, and that our sole duty is to aim for the maximum amount of pleasure for the greatest number of people.^iv As should be obvious, such a state of affairs favours euthanasia, because it renders self-evident the conclusion that a life with more pain than pleasure is not worth living, and that we should tolerate the autonomous choices of those who want to terminate a life so reduced.

Exposing the Utilitarian premises of the euthanasia movement is too little done by defenders of life, and the omission is fatal to our position. All of the big name philosophers who eventually made suicide and euthanasia a pet cause of the academy (David Hume, J.S. Mill, Bertrand Russell, A.J. Ayer, J.L. Mackie, and Peter Singer come to mind)^v and who have been lionized by the media, are Utilitarians. The immediate source of most people’s opinions is the media, which itself takes its cues from university experts so as to acquire a veneer of intellectual panache. Thus fashionable transgressions of taboos by seemingly outlandish professors tend to percolate downward and become mainstream opinion a generation or so later through media popularization. This is happening right now with euthanasia.

This popularization of the transgressive takes place for two reasons: i) society’s main opinion-moulders are no longer religious and civil institutions, but academic and entertainment institutions. Today’s great teachers are not Church and State, but Harvard and Hollywood. ii) Both universities and the media believe, and have the power to communicate, the idea that pleasure is the great good in life, and therefore our only duty is tolerance, because tolerance means not meddling with other people’s autonomy when it comes to their pursuit of pleasure. In other words, those with the greatest influence are Utilitarian, and are making society Utilitarian.

So far I see little awareness of the fact that to debate the euthanasia lobby while leaving their Utilitarian premises intact is like sitting down to play chess with an opponent who is certain of checkmate because he has unfairly changed the rules of the game. In order to counter this, the “change in rules” must be exposed or else defenders of life will have stacked the deck against themselves from the outset. That is why I think that those who argue against euthanasia without exposing the Utilitarianism behind it inadvertently undermine the case for life itself. By leaving the main justification for euthanasia intact while claiming to have refuted it, they make defenders of life look like mere obscurantists hampering the march of progress. As Voltaire showed in mocking the Jesuits of his day, the limits of rhetorical gain are boundless when you can make your opponents look like superstitious rubes.^vi This aim of this paper is therefore to mount a fresh natural law argument which seeks to refute, on purely rational grounds, the case for euthanasia as well as its underlying Utilitarian premises. This last part is especially necessary. It is like the difference between pulling a trespasser out of a tree that they can climb back into, and cutting down the tree altogether.

Why the Argument from Autonomy Proves Too Much

To begin with, it must be acknowledge that the main thing all defenders of euthanasia must agree upon is that some people are better off dead. If they did not believe this, then why would they support having them killed? Their position compels them to think that in those cases where euthanasia is deemed fitting, death would be preferable to life for those who qualify. The only other justification for suicide would be the belief that everyone is his own master and so the choice to die is the private matter of a person’s free will. But sheer autonomy or the mere fact of choice is not enough to justify euthanasia. The reason for this requires some explanation.

To destroy a thing, surely one must have a right to destroy it. To have a right to destroy something, it must either be something that no one values at all, or else something that you both value and own, or otherwise have justifiable cause to destroy (e.g., throwing an insane man’s shotgun from a cliff). In the first category would fall things like weeds and mosquitoes; in the second would fall things like cars and jewels. Notice that it is difficult to place persons in either of these categories. A person might be valued by no one at all, but we do not thereby conclude that they may be killed. When warlords in rogue states murder orphaned children that they see only as an economic drain, we do not respond by saying that the murder was unjust because somebody valued those children’s lives. We say that the murder was evil because the children’s lives were valuable whether anyone recognized it or not. After all, if the value of a person’s life depended upon whether another person valued them, then logically this would lead to an infinite regress. If people are not valuable in and of themselves, then someone’s valuing of another person could not make them valuable since the person who valued them would be worthless in the first place. In other words, if people are not truly valuable simply as people, then belief in any kind of ethics is just the fever of a deluded brain.

We cannot object to destroying something that has no value, since the basis of objecting to something’s destruction is an appeal to its worth. Thus if human beings are not intrinsically valuable, morality is just a shell game. We could no more object to the Holocaust, slavery, child-torture, or rape, than we could object to talking a walk on the beach or eating an ice-cream cone. Thus in order for the debate about euthanasia to be justified at all, it cannot be made simply by an appeal to pure autonomy, since this will ignore the person’s own intrinsic value. The result will be to make nonsense of the whole situation, for if the person was not valuable to begin with, then why are the choices issued by their wills to be respected? And if their free wills are not to be respected, then that is the end of any appeal to autonomy.

In that case, the real reason society would allow people to have themselves killed is not out of respect for their autonomy, but out of a prior belief that they were worthless to begin with. Far from being the philosophical wonder of the universe, mankind would then only be so many million tons of human trash. And no hackles need be raised over discarding mere waste. The argument here would be that since people have no intrinsic worth, it would be absurd to object to their disposal. To argue in this vein euthanasia advocates would have to admit that their motivations were frankly malevolent. But I do not believe this is at all the case. Instead, defenders of euthanasia want to argue that some people are objectively better off dead, and that to ignore this would be traduce their value, because it would be to flout their wishes in cases where they are suffering horribly. Thus they do not make of autonomy such a sacred shrine that it can override any considerations concerning health and age.

Most say they support euthanasia only in circumstances where someone is terminally ill, very old, with no future hopes, little support, and when they have shown a consistent desire to die over an extended period of time.^vii This is very different from allowing anyone to die, and does not mean that they are worthless. The very fact that we wish to help them escape misery implies that we regard them as valuable, since we respect their choice to die. So the argument goes.

The purpose of such qualifications is to banish from our minds the horrible specter of teenagers, youngs adults, the clinically depressed, those in a midlife crisis, and everyone else in a temporary fit, rushing off to a euthanasia clinic. The idea is that in order to qualify for euthanasia someone must meet strict requirements for candidacy. Thus the “subjective” criterion of someone’s voluntary choice to die is regulated by the “objective” criterion of their being terminally ill and in old age. The appeal to autonomy is coupled with rigid external qualifications. My contention is that neither the subjective nor objective criterion will work because each, if pressed to its conclusion, negates the other. The result is that either everyone should have the right to euthanasia regardless of age or health, or those who meet some supposed objective criterion for euthanasia may be killed even against their will. The following will aim to demonstrate this.

The “objective” criterion for who may receive euthanasia fails because it is arbitrary. Why may only someone who is very old and terminally ill die? We know that everyone is going to die, and the fact of “terminal illness” does not change this. The phrase “terminal illness” just means that we have a better idea of when someone is going to die, and from what. If it is replied: “But suppose that the pain during the terminal illness is excruciating and unbearable?” If euthanasia is justified on that account, then it will have nothing to do with terminal illness or old age. Extreme pain can be experienced by those who are neither very old, nor terminally ill. Someone with a malignant tumor of the brain is “terminally ill”, but very possibly will experience no pain until the day of the fatal brain aneurism. Someone whose legs and arms have been amputated and who experiences constant pain may not be “terminally ill”, but surely their suffering is inestimably worse. Therefore the idea of “terminal illness” as an index of extreme suffering simply begs the question.

Clearly old age is of no relevence as a qualification. Because the older someone gets, the more likely they are to die, we tend to associate death with the elderly more easily than with the young in our minds. It is an interesting datum of our mental associations, but what does it have to do with euthanasia? Unless we believe that old people should die, it proves nothing. The statistical probability that the very old will wish to die more often than younger people furnishes no grounds for reserving the right to die to old people only. Indeed, the prima facie case for euthanasia might sometimes favour the young.

Suppose that a 90-year old man and a 30-year old man both had incurable third-degree burns that could not be sufficiently medicated, and which involved perpetual torment. The younger man differs from the older only in this: he has much more pain to look forward to, extended over a much greater period of time, robbing him of the best years of his life, and has no hope for a cure. How can someone who believes in “mercy killing” extend mercy to the older man who will suffer less, and withhold that same “mercy” from the younger man who will suffer more? They could only do that if mercy were not the real motive. Besides, many of the worst forms of pain are psychological, and some are most acutely experienced by the young. To ignore the dizzying variety of ages and conditions in which extreme suffering is distributed would simply be obtuse.

This means that either: i) it must be admitted that there is no “objective” criterion to qualify for euthanasia. The only remaining criterion will be “subjective”, so that anyone who chooses to die, may die. Euthanasia argued on the basis of sheer autonomy inevitably leads to this. Or ii) there is an “objective” criterion for deciding whether someone may be killed, but it doesn’t have to do with old age, terminal illness, or even with how much they suffer. Why would suffering not be a valid criterion? Because no one can say how much someone is suffering except himself, since suffering has to do not just with pain, but the reaction of someone’s consciousness to that pain, and no one knows another person’s consciousness except himself. Hence no one could prove how much someone was suffering contrary to how much they said they were suffering. This means that the only “objective” criterion necessary to be killed would be the patient’s attestation to their own extreme suffering. But since anyone who wants to be killed would necessarily believe that their sufferings are extreme, everyone who wanted to be die would be qualified for it by that very fact.

Hence the only “objective” qualification necessary to be killed would be the mere request for it, which is the same thing as saying there is no objective qualification. If one were to continue looking for an “objective” criterion for euthanasia, the search would have to be conducted in a much darker place. The question would have to do not with how much the person suffered, but with whether their life retained sufficient worth. That is a very different matter having nothing to do with rights.

If i) “subjectivity” is a viable criterion for euthanasia, then out of respect for people’s personal autonomy, everyone should have the right to die if they so choose, since choice is the basis of autonomy, and autonomy is the basis of the argument. This would include not just half-dead invalids, but also young and middle-aged men and women freely exercising their choices. If ii) “objectivity” is a viable criterion for euthanasia, then it would have to do with determining whether someone’s life has sufficient worth or not for them to be kept alive. If their life was judged worthless, then they could be killed even against their will, since the free choices of a worthless entity are themselves worthless. A betting man would wager that a lot of hospital beds occupied by the elderly and disabled would soon be freed up.

My argument here has only been a preliminary one designed to clear the air of all the cant and euphemisms designed to make the right to die movement sound like a bearer of sweetness and light. One cannot have it both ways: it the euthanasia cause wins out, then either all of us will be allowed to die, or some of us will be forced to die. Position i) rules out objective criteria, and position ii) rules out subjective criteria for preventing this. Advocates of euthanasia who do not come clean about this either do not understand the logic of their own position, or are just selling us rhetorical gimmicks. This does not of itself disprove their case, but it would, if more widely known, make it impossible for them to sell it to the public. And that would be no mean feat.

Having shown the arbitrariness and danger of any possible criteria for euthanasia, I turn now to the logical case against it. Euthanasia proponents argue that certain people experiencing unbearable suffering are better off dead than alive. My contention is that such a position can be shown to be fallacious, and that since it advocates a grave, permanent, and irreversible action on necessarily irrational grounds, it is morally irresponsible. Although we don’t empirically know what – if anything – awaits us beyond the grave, we know that there are only two possibilities: either death itself is the final end, or it is another beginning. Either it is the cessation of being itself, or there is some kind of soul that survives into an afterlife. And I believe it can be shown that suicide would be a bad choice to make no matter which of these is true. I will explain this beginning with the second alternative: the possibility of life after death, since this is the easier of the two to dispatch of.

The Appeal to An Afterlife

Suppose someone argues that suicide is a wise course for certain people because life here is a kind of Hell for them and life after death would mean eternal bliss in Heaven. This makes it sound like euthanasia is the equivalent of helping someone leave a rancid slum for a permanent holiday on the seashore. Of course, to speak in this vein is to immediately enter into religious speculation. But given that all the world’s major religions unequivocally condemn suicide and often attach to it the stigma of a grave sin leading to eternal damnation, speculation of this kind only provides evidence against, and not for, the euthanasia argument.^viii The proponent of suicide cannot be at ease in Zion – or Athens, or Mecca, or Benares. Speculation of this sort will inevitably turn against him, since all religions hold that the span of a person’s life is not their own choice, and that the premeditated hastening of one’s death will definitely not improve one’s fortunes in the afterlife. As Adam says to Eve in Paradise Lost: “Death so snatched will not exempt us from the doom we are by pain to pay.”^ix

From pagan figures like Plato and Krishna to monotheists like St. Thomas Aquinas and John Locke, religious thinkers argue that life itself is the post at which God or the gods have placed the mortal soul for a duration of divine choosing. To desert one’s post in life prematurely through suicide is held to be capital treason against the power that made you and therefore has a paternal claim on your very existence.^x Even a religion like Buddhism which does not speak of God or the gods nevertheless says that the act of suicide would mutilate one’s future karma, so that one might be reborn as a tree to teach you how much better it was to be a human even under the worst conditions.^xi

Of course the defender of euthanasia can, if he wants, dispute the unanimous testimony of humanity’s accumulated religions. The interesting question here will be on what grounds he will do so. The question is inherently religious. Is he going to start his own religion, and if so, is he sufficiently credentialed as a religious thinker to outweigh the combined authority of Moses, Mohammed, Confucius, Lao Tzu, the Buddha, Pythagoras, Socrates, Plato, and Jesus Christ? That seems to me to be an improbability bordering on the absurd. Even if it were not, could we really imagine a modern clairvoyant persuading a judge of the Supreme Court to admit the results of his seances as public evidence of posthumous bliss? No euthanasia defender would seriously argue their position on such grounds.

What If There is No Life After Death?

This leaves us with the second possibility: that death is the final irrevocable oblideration of the human being. Any purely secular account of reality will assume so, whether it is of Marxist, Freudian, Darwinian, or Scientific materialist stamp. The argument for suicide made here is that although life is good in general, there are some conditions in which it becomes unbearable and death as extinction is preferable to life as torture.^xii The justification here is the same as that which leads owners of pets to “put them to sleep”. No doubt in order to make people forget that they share the veterinarian’s rationale, euthanasia advocates have avoided that particular euphemism altogether. But the underlying idea is the same.

The cancer, the third degree burns, the death of one’s family members, or the perpetual loneliness of undignified subsistence in a cheap and abusive nursing home, have made life itself into a kind of sore or abscess. All joy is gone, and the memory of past joy only makes the present misery all the more keen, because the “good old days” are known to be lost forever. Nessun maggior dolore che ricordarsi del tempo felice ne la miseria. (“The greatest sorrow is to remember happy times in present misery”).^xiii Summer and Fall have given way to a Winter which will see no Spring, and so it seems like mercy itself to let the person die with some dignity intact.

“Dying with Dignity”

Before treating the philosophical presuppositions behind this view, I wish to deal with the notion of letting someone go with dignity rather than in the throes of some graphic, disgusting, and protracted illness. The defender of euthanasia often invokes the cant phrase “dying with dignity” as a justification for assisted suicide.^xiv But what can such a phrase mean? If it means that a person dies in a manner befitting human dignity, this will not mean that they die painlessly, without emotional disturbance and with tranquil expressions. Hardly any member of the human race has ever died this way. Most have died by terrible accidents or agonizing sickness. Are we to infer that humanity as a whole has been dying without dignity for thousands of years? That will happen only if we confuse dignity with decorum, as the Victorians confused decency with seemliness.

I think previous generations were right in seeing death as dignified when a person who had done his duty and who was at peace with himself died with sentiments of love for his own and with resolution to his fate. Dignity does not mean dying in a clean, clinical, placid manner; it means dying in a spirit of integrity, love, forgiveness, and peace of conscience. So our ancestors always understood it. Why? Because a person’s dignity is not contingent upon the accidents of fortune, but is a matter of their interior disposition. That is what separates a human death from the death of an animal. It is because of this that I would argue that the death of a St. Joan of Arc or of a Mahatma Gandhi – both of whom were murdered, and died forgiving their assailants – was more dignified, despite all the blood and horror, than the peaceful death of a tyrant in bed.

The very phrase we sometimes hear, “he died well,” doesn’t imply “he died quick, clean, and painlessly,” but “he rose to the occasion in a way we should all admire.” This is because the dignity of dying depends no more upon a clean and seemly death than the worth of a person depends upon their good looks. Of course we have a duty to reduce someone’s pain, but we should never infer that they have lost their dignity due to whatever pain is remaining. Those who deny this find themselves reproved by the great stories and ideals which humanity has always loved best. They go against not only the Bible, Homer, Shakespeare, Goethe, and Tolstoy, but also against the Tao Te Ching, the Bhagavad Gita, the Analects of Confucius, and even the Brother’s Grimm. Our great works have always told us that it is the disposition of the heart, not the manner in which we are dispatched, that shows forth a person’s dignity during death.

The Utilitarian Logic of Euthanasia

Those who do not believe in an afterlife and who still think that someone could be better off dead must give as their reason that if the net sum of one’s pleasure in life is less than the net sum of one’s pain, that life is not worth living.^xv They must think this or else they will be in the position of arguing simply and solely that nothing is better than something, that nonbeing is better than being, and that a person may improve their fortunes by ceasing to be a person. The latter notion is the result of a particular kind of sloppy thinking that it is easy to slip into: the notion that someone who is suffering may improve their lot by destroying themselves. There is a sophistry here. One has begun to think that their will be someone left to benefit by the improvement, as if psychological predicates could be applied to corpses.

The materialist argument for euthanasia must base itself on the pain-pleasure calculation of Utilitarianism in order to avoid sheer nihilism. So as to show the wrongness of such thinking, Utilitarianism as a theory must be dealt with in order to demonstrate its untenability for the purposes of this debate. There is no doubt that Utilitarianism has become the default position of society today, as staggering abortion rates, pan-sexual permissiveness, and now the push for euthanasia all show. As I argued in the introduction, it is here that our main attack against euthanasia should be directed, and it is to this I now proceed.

I consider Utilitarianism, as developed by J.S. Mill and Jeremy Bentham (but also present with a few modifications in Epicurus, Lucretius, Thomas Hobbes, David Hume, Bertrand Russell, and Peter Singer)^xvi to be both morally reprehensible and logically untenable. As to the first charge, the theory of moral values which aims only at the greatest amount of pleasure for the greatest number of people could easily justify monstrosities. (For the sake of argument I will agree here with Utilitarians that pleasure and pain can be quantified with some measure of accuracy, although that is itself questionable.)

Suppose for example that it could be proven that a man raping a little girl experienced in that rape 10 units of pleasure and she experienced only 9 units of pain. Are we therefore to say that all things considered, the rape was a good thing, since it maximized the quantity of pleasure over pain? Perhaps the Utilitarian would respond by saying that the pain experienced by the little girl’s family and by society scandalized as a whole would cumulatively outweigh the rapist’s pleasure. But then he would have to agree that the rape would be fine if it happened following a shipwreck on a desert island from which only the man and the little girl survived.

One defense could be mounted against this: the Utilitarian might say that even if the rapist’s physical pleasure was greater than the victim’s physical pain, no doubt her psychological pain was greater than his psychological pleasure. Since Utilitarians admit that psychological pleasures and pains are qualitatively higher than physical ones, the rape would then be construed to be a bad act. But what if the balance of psychological pleasure and pain they guess at were simply untrue? If the victim were sedated, comatose, brainwashed, handicapped, or too young to understand, the psychological pain during the act itself as well as later in memory would be kept to a minimum because the horror of the act wouldn’t be fully realized. If the perpetrator used contraceptives, the act might never even be discovered. Or what if a rapist were acutely sadistic to the point where his psychological pleasure in the act was greater than his physical pleasure or even than the victim’s psychological pain? I am not arguing that in a given case of rape this is probable, just that Utilitarian logic would have to approve of in principle if it did happen. Such rapes, from the Utilitarian viewpoint, would not only be excusable, but praiseworthy. Since they succeeded in maximizing the proportion of pleasure over that of pain, they would have to be considered moral acts.

Now I admit that this example does not of itself refute Utilitarianism as a theory of moral values. Truth might turn out to be terrible, just as Mother Nature herself can be terrible. No inference can be proven to be logically false by adverse consequences alone. As Hume said: “’Tis certain something is false, if ‘tis absurd; but ‘tis not certain something is false, if ‘tis of dangerous consequence.”^xvii And he was right. Fail to realize that, and we will end up producing fallacious arguments like the following: “If the volcano erupts, the village will be destroyed; we don’t want the village to be destroyed, therefore the volcano will not erupt.”

The permissibility of my above rape example, as well as all of the other horrid possibilities of Utilitarianism, might be the moral equivalent of the volcano, with ourselves as the unwilling villagers below. Utilitarianism would then be true, and that truth would have destroyed all the most generous, fruitful, and humane sentiments of mankind throughout history, yet still without rendering it false. The human race might have lost its soul, but it would have ‘come of age’.

Fortunately we don’t need to argue ourselves into that corner. There are theoretical difficulties with Utilitarianism. The first is simply its logical and mathematical untenability. For example, if it could be shown that the pain through annoyance and ill health of a greater number of people outweighed the pleasure through indoor smoking of a lesser number of people, the Utilitarian would say that indoor smoking should not be allowed. On the surface this appears plausible, but that will be shown to be false. The following figures are of course hypothetical, but for the sake of illustration they will do. Let us suppose that 10 smokers each receive 5 units of pleasure from smoking indoors, and that 75 non-smokers each experience 4 units of pain from it. It looks like there are 50 units of smoking pleasure versus 300 units of smoking pain, so that the non-smokers win by a sum of 250.

In reality there is no such equation. Because the pleasure or pain of a person is located within their own organism, it is experienced only by them. No one else has the pleasure or pain sensations of anyone else, but only of themselves. (It is a beautiful metaphor to say you feel someone’s pain, but in reality, you only feel your own pain, though it may have been caused by someone else’s). This means that individuals with their quantities of pain and pleasure do not multiply off one another to make a cumulative sum. If 10 smokers experience 5 units of pleasure, this does not mean there is a lump sum of 50 units of pleasure in the room, but only 10 instances of 5 that do not add up since the experiences are not commingled. Nowhere is there an experience of 50 units of pleasure, since no one else feels the pleasure of anyone else, let alone of everyone else.

The Utilitarian mistake is similar to the arithmetic of a Dr. Scholl’s advertizement. In this, we are told that just by walking an average number of steps every day, we put 10,000 lbs. of weight on our shoes. On the whole this may be true, but at no given moment is the pressure of 10,000 lbs. placed upon our shoes. There will only ever be 175 lbs. (or whatever it is we weigh) of pressure at each step we take. Likewise, with 10 smokers each experiencing 5 units of pleasure, the maximum sum of pleasure produced will be 5, not 50. Since the pain of the non-smokers is 4 units each, then even though there are 75 of them, the maximum sum of pain would still only equal 4. This means that the 10 smokers would trump the rights of the 75 non-smokers by a ratio of 5 to 4. Indeed, even if there were only a single smoker experiencing 5 units of pleasure, that one man or woman would have to outweigh the interests of 1000 non-smokers each experiencing 4 units of pain. Far worse illustrations could be made. For example, if the torture of the Earth’s 6 billion inhabitants produced 100 units of pain for each of them, but gave the mad scientist responsible for it 101 units of pleasure, then in order to arrive at the maximum sum of pleasure the scientist should be left undisturbed to ply his bloody trade.

Utilitarianism as a theory is demonstrably false and so we don’t need to worry about such conclusions. Hedonism begins with the premise that pleasure is the good as such, and Utilitarianism renders this conclusion social by saying that we should pursue the greatest amount of pleasure for the greatest number of people. But since there is no experience “pool” into which everyone’s individual pleasures are deposited to make a total sum, it is absurd to speak of maximizing the whole since none exists. And even if there were, then given that pleasure is the only good, why do I have a duty to worry about anyone else’s pleasure except my own? I won’t experience their pleasure, so why should I sacrifice some of my own for theirs? Mill and Bentham didn’t answer this, because they thought people were decent enough to help out their fellows.^xviii Fortunately this is true, but not on Utilitarian grounds.

In other ethical systems, pleasure is a good, but it is subordinated to greater goods like benevolence, justice, honesty, fidelity, mercy, and duty to one’s family and country. Therefore it makes sense for an Aristotelian, Stoic, Kantian, Thomist, or Confucian to sacrifice some of their own pleasure to benefit somebody else, because pleasure is not the only good, and it must be sacrificed when it conflicts with a higher good.^xix The Utilitarian is forbidden by his own premises to follow this same moral route.

The great irony here is that the only reason we would have a duty to increase other people’s pleasure is because there are higher standards than pleasure itself: because people are valuable and have dignity in and of themselves, are to be treated as ends rather than just as means, and so their pleasure and well-being becomes my concern too.. Thus the good impulse within Utilitarianism to increase the pleasure of other people is only coherent if one is not a Utilitarian. The sole reason I could be obligated to increase my neighbour’s pleasure is because there are higher standards than pleasure itself which oblige me to take care of my neighbour even at the expense of my own pleasure. Once this is admitted, a standard of moral measurement will have been introduced that is independent of pleasure itself and which stands over it in judgment. If the Utilitarian takes that step, he will have abandoned his theory.

Alternatively the Utilitarian may argue that people should behave kindly to each other out of enlightened self-interest; that basic decency is more likely to lead to an orderly society in which a lot of pleasure is available to people generally, and therefore to oneself specifically. This is a common enough argument, but it involves a subterfuge: by “decency” it really means “pretend as if you cared about people even though you don’t”, and therefore it implicitly admits that the older traditional morality (“decency”) works better than Utilitarianism. But if that is true, why would we want to abandon the old morality for a new one that only works insofar as we have not departed from the old?

Even if the “enlightened self-interest” appeal of the Utilitarian were accepted, it would not follow that I have to be one of the people who does behave decently. I could just bank on the majority doing so and let myself off the hook. And when an occasion of adultery, theft, fraud, cheating, or lying comes along that does not look like it will ruin society (eg., I commit adultery with perfect secrecy, or I steal from a rich old miser who doesn’t need the cash nearly as much as I do), then I don’t even need to give it a second thought.

If pleasure is the only thing I should seek to maximize, then since my own pleasure is the only one I experience, there is nothing compelling me to increase the pleasure of another. I may seek to do so when it is pleasurable for me, but then I am only gratifying my own need by giving. This means that even benevolence must be interpreted by the Utilitarian as a form of selfishness in disguise, since there are no plausible grounds for a duty to one’s fellow man in the theory.

The result is that one could not will another person’s good simply for their own sake, which means that love itself, in the sense of desiring what is best for someone regardless of whether it benefits me, is impossible. If this theory were true, any attempts to “help” someone else would really be attempts to benefit myself by pretending to help them. The question then is: if Utilitarianism carried to its logical conclusion implies this, then why would anyone ever listen to what a Utilitarian recommended? If someone by the standards of his own theory cannot possibly will my good, surely I should never take his advice. Any recommendation he made would have to be for his own advantage.

This means that someone arguing for euthanasia on Utilitarian grounds cannot advocate suicide for other people because they believe it is best for them. Their own theory tells them that whether someone else is better off or not in a given situation is something they couldn’t possibly care about except insofar as it increases their own pleasure. But once that is admitted, it is impossible for them to claim to be altruistic in any cause, whether euthanasia or something else. And certainly no one with a prior commitment to the belief that they cannot help me should be listened to when they claim to help me, especially when the form of “help” they offer is to have me killed. Since the euthanasia movement is claiming such a form of “help”, its overall ideology of helping by killing may be justly dismissed.

I do not want to be misunderstood here: I am not saying that supporters of euthanasia are actually malevolent. I believe they are subjectively compassionate in their motivations, although objectively wrong in their thinking. What I am saying is that a materialist worldview in which pleasure is the only good is one in which it is logically impossible to claim benevolence. (The fact that one can still be benevolent while holding a position which makes it impossible to believe in benevolence, points to the incoherence of this worldview). This means that the argument which holds that we may kill for motives of kindness those who have more pain than pleasure is self-contradictory. The ideology which tells me that they would be better off dead is the same one which tells me that I should not care unless it is to my own advantage.

The frightening thing here is that the death of those who are a burden upon the hospital system, and who are also an economic drain because they are no longer “productive to society” but still receive pensions from it, is very much to the advantage of a State which views itself in materialist and Utilitarian terms. But if euthanasia advocates want to argue their case on such grounds, they will have to strike a Machiavellian, rather than a humanistic, pose. Their whole movement will then come to nothing, because its stated purpose will be to make victims rather than to aid them, and this will be publicly exposed.

My purpose in this paper is not to embellish upon the whole literature of “slippery slope” arguments already in existence; but it is somewhat unnerving to think that the same worldview which justifies euthanasia as a right, could with equal logic demand it is a duty. To do so would not be to depart from Utilitarian premises, but to develop a congenial theme already latent in them. Whether or not this will happen is not my concern here. That it could do so on the grounds provided is frightening enough. Such considerations lead one to acknowledge the truth of the old saw about death that “He who would sup with that formidable host should use a very long spoon.”

I have argued that someone cannot advocate suicide for other people on the pleasure-pain principle while claiming benevolent motives. This means that euthanasia rights talk as a social advocacy movement is incoherent, because it is impossible for members of the movement to claim to care about those whom they are advocating for. Defenders of euthanasia who do not see this simply fail to grasp the logic of their own position. The upshot is that euthanasia advocates must either give up their Utilitarian worldview or give up advocating euthanasia. But if they give up Utilitarianism they will have no grounds upon which to argue for euthanasia, because they will have to admit that there are higher goods than pleasure and pain in life which are still available to those who are severely afflicted. Hence just as it cannot be argued that someone is “better off dead” on religious grounds, neither can we advocate that they are on secular or materialist grounds, for these grounds will have to appeal to a discredited Utilitarian ethic.

What About Solitary Suicide?

Setting aside those who advocate death for another, there is still the matter of someone who contemplates it in despair for himself. This still must be dealt with to prove that assisted and unassisted suicide are both intrinsically evil. When someone who does not believe in life after death is contemplating suicide to escape perduring misery, they too are using the pain-pleasure calculus of Utilitarianism. Since it occurs on a solitary rather than a social level, the proper word for it is “Hedonism”. Colloquially this usually refers to a glutton or a philanderer, but here is used in its proper philosophical sense in which pleasure is sought as the only good, but without a perceived duty to increase other people’s pleasure. (This is what distinguishes it from Utilitarianism).

My opinion is that almost all people who think they are Hedonists in fact are not. Very few people – perhaps only psychopaths – are true Hedonists. I mean the noun literally and not as a gratuitous ad hominem. After all, if someone truly believed that their own pleasure was the only moral concern in life, it would be the same thing as saying that there were no moral concerns in life. The word “moral” in that sense would simply mean “my desire to increase my own pleasure with no regard for anyone else”, which is what society means by the word “immoral.”

Insofar as someone is a true Hedonist they must be incapable of the generous and humane sentiments like sympathy and empathy which keep us from violating other people’s rights. To the degree to which they do this they would stand outside society’s moral bonds entirely, and in that regard they would be psychopathic. For if someone said that a serial killer who took exquisite pleasure in skinning someone alive was acting morally because he was acting to increase his own pleasure, and that he did not even need to take into account how much pain his victim felt, then how else could this be described than as “psychopathic”?^xx

This is why I think that most people who call themselves Hedonists are simply using language improperly, since they would no doubt vehemently reject such abominations. But if they are to reject such obvious evils, they must do so by believing that there are higher standards other than an individual person’s pleasure and pain, in which case they are no longer true Hedonists. If they are prepared to take this step, then they must admit that moral questions generally and therefore suicide specifically cannot be decided on the basis of a pleasure-pain calculus alone, because there are higher goods than pleasure and worse evils than pain to be considered.

The obvious question someone will raise at this point is: what are these other, so-called higher goods in life than pleasure? It would be a mere sophist’s trick to assert their authority without describing their nature. These higher goods are certainly no secret, since they are the kind of things held in common by all Western and Eastern, ancient and modern, pagan and Christian moralities fitting into a basic natural law tradition.^xxi They constitute the primeval moral platitudes or ethical first principles agreed upon by most of humanity at most times, and only where an unnatural devaluing of them has taken place will euthanasia or suicide even be considered seriously.

Thus life, being, or existence itself is everywhere considered the precondition of all goods, and its derivative goods are many: social and communal life with all of its friendships and civic pleasures, marriage and the family which are perhaps our greatest joy in life, as well as all of our many intellectual, aesthetic, cultural, and religious pursuits and aspirations.^xxii Then there are those goods which make you the kind of man or woman you truly are, and to which pleasure is also subordinated; such as integrity, duty, justice, truthfulness, loyalty, mercy, kindness, mercy, generosity, and love. It is in light of these higher goods that we curb the pleasure we seek for ourselves when it conflicts with the good of another, or with a higher good attainable for ourselves.

Since all, most, or - at the very worst - quite a few, of these higher goods in life are still available to someone even when the lesser good of pleasure is not, it would always be irrational to conclude that life was not worth living. Any such conclusion would be the result of mistaking a lower good for a higher good, or of ranking a higher good below a lower good. Lest this seem abstruse, let it be remembered that it is only by acknowledging these higher goods that one is free from the moral grammar of a Hedonism which would justify skinning someone alive for fun. Thus we cannot have it both ways. If we are going to justify suicide due to a presence of pain and an absence of pleasure, we must espouse Hedonism. But if we are going to object to grave evils like genocide, torture, and child-rape, then it must be because we are not Hedonists.

Once the logic of this is seen, then a decision must be made: either the thinking which justifies suicide must be rejected, or what every other generation meant by “morality” must be rejected. Either we become the kind of people our ancestors told fairy tales about to warn their children against, or we recognize that the broader ideology justifying suicide could also be used to justify Nazi morality, and then repent of it. Beyond this, no further argument can be made. If someone is willing to argue for euthanasia on Utilitarian premises that have been shown to be logically contradictory, or for solitary suicide on Hedonistic premises that would also endorse the Holocaust; then they have shown a willingness to either believe what they know to be false, or to endorse forms of behaviour that are known to be psychopathic. In either case, mere argumentation we would rendered inutile. To someone who persisted in such beliefs, we could only reply as Johnson did to Goldsmith: “Nay sir, if you will not take the universal opinion of mankind, I have no more to say.”^xxiii

In saying this I am not trying to vilify the euthanasia movement by foisting a grotesque psychological portraiture upon it. As individuals they may all be remarkably good-willed and well-intentioned. I am simply trying to draw their logic to conclusions I believe are latent in the premises they have accepted, but which they must not have seen lurking there or else they would not have accepted them in the first place.

The Search for Meaning

As to why there are “higher” goods than pleasure, and what it is that makes them higher than pleasure, I think we may take a page from Victor Frankl’s Man’s Search For Meaning. In this landmark book, Frankl recounts his experiences in two concentration camps; one Nazi and one Soviet. While cataloguing the grimmest horrors, he says that those who survived were invariably the ones able to perceive a deeper meaning in life beyond the immediate abundance of pain. Thus strong and hale young men of a nihilist bent would soon lay down to die, while withered old men of deep hope or faith lasted the longest. His conclusion was that “A man can survive any how as long as he has a why.”^xxiv

Surely Frankl was right in saying this. Why else would suicide rates be highest in opulent societies where a myriad of pleasures never before available in history are present, but where a deeper sense of meaning is absent? Statistics which show that the richer someone is the more likely he is to kill himself prove the same point.^xxv It is people who have mistaken pleasure for the only good, and who have the means to give themselves every pleasure the world can provide, who are statistically most likely to hang or shoot themselves. Thus not only Utilitarian theory, but Utilitarian practice, reduces itself to contradiction.

This essay has aimed to show that the terms in which the euthanasia movement has framed itself are false ones. In this, I have not relied overly much on secondary sources, partly because an original argument is often preferable to a recycled one, since glosses on existing arguments are rarely as good as the original arguments. But the essential reason for this is that the anti-euthanasia literature I have read left me unconvinced, so that I felt a fresh natural law argument would not be an impertinence. Although a Roman Catholic, I have tried to base my position on strictly rational grounds applicable to anyone who believes in goods higher than mere pleasure. The supposed restrictions which the euthanasia movement would put in place to limit death to the very old or terminally ill are arbitrary. The autonomy which euthanasia appeals to would quickly knock them down and allow for people of all ages and for any reason to be killed if they wanted. The only “objective” criteria that would not be purely arbitrary succeeds only by being consistently malicious: the notion that some are simply not worthy of life.

I believe I have shown that both the religious appeal to an afterlife, and the materialist appeal to Utilitarianism, end up reducing the euthanasia and suicide rationales to self-contradiction. Thus whether one believes in an afterlife or not, to kill oneself would always be contrary to reason, and you cannot argue in favour of something contrary to reason itself, because reason is the very thing by which you argue. If I have also succeeded in demonstrating that the Utilitarian premises of the euthanasia movement render beneficence logically impossible, and that the Hedonistic premises of solitary suicide could also justify monstrosities, then the one has been shown to be absurd, and the other potentially malignant. Neither should therefore commend themselves as responsible courses of action.

The fact that the first society in human history to want to legalize assisted suicide is the same one in which we have learnt to eliminate over 95% of all pain shows that pain is not the essential issue here. There were no anaesthetics in late Rome, barbarian Europe, medieval France, or Elizabethan England. Despite all the plagues, foreign invasions, primitive and horrifying surgical methods, and proliferation of untreatable diseases, no one lobbied to legalize assisted suicide. Why is that? Surely it is because what stands between them and us is the loss of a deeper sense of meaning due to the current belief that pleasure is the summum bonum of life. When life itself, devotion to the family, country, and God; loyalty to friends, love of truth, delight in beauty, and the commitment to benevolence, justice, honesty, and charity are lost; then pleasure will become the only good and pain the only evil. Meaning will have then been lost, with the consequence that any adverse how may prove too much for us, because we will have lost our why. The present crisis is not one of pain, disease, suffering, and death; which have always been with us. The crisis fueling the euthanasia movement is instead of crisis of meaning, and it is there that further work needs to be done. But before we can build up, we sometimes must tear down. And if we can confound the logic which has built the “culture of death”, it is a useful preliminary to laying the foundations for a “culture of life”.