The Right to Die

Recently I was asked by a journalist what I thought of assisted suicide and the right to die. Here's what I told them: everyone has a right to die at whatever time they choose and for whatever reason they think is sufficient to warrant their wish to end their life. Unless, that is, there are special circumstances which impose a moral duty on them to stay alive. For instance, you may have a duty of care for your children or spouse, or you may have incurred debts that others will have to pay off when you are gone. Yet in the absence of such special circumstances you have the right to die, and nobody has a right to forcefully prevent you from bringing about your own death. They may do their best to persuade you to change your mind, but they have no right to force you to stay alive if you really don’t want to. Of course, it may not always be wise to throw your life away. Things may appear gloomy, but sometimes things change for the better, so that if you still could, you would later regret your premature decision. But then again, that possibility is not always there. Sometimes we can be reasonably certain that the situation will stay just as bad as it is, if it’s not getting worse. In that case we should be allowed to set an end to our life. This, however, does not necessarily mean that, when we wish to die but cannot do so without the help of other people, we also have a right to be assisted by them. It is never my duty to help you to die, though I may choose to do so out of love, or out of compassion. How we regulate assisted suicide, though, is a different question entirely.

Shirley Jackson's Lottery and Other Stories

Prompted by my students’ reading of John Harris’s “The Survival Lottery” (see previous blog post), I got hold of Shirley Jackson’s The Lottery and Other Stories, published by Penguin. I had never read any of Jackson’s stories or novels before, and in fact only knew about her from Stephen King who has often praised her. And rightly so, as I know now. Without ever explaining or commenting on the events that she narrates, Jackson makes the ordinary appear uncanny and reveals the cruelty, the violence and the emptiness that lurk below the thin surface of what we call civilization, not overcome or even tamed, but merely hidden away or temporarily channeled into the all-pervasive, stifling structures of oppression that regulate our lives and that we think of as normal.

In Jackson’s stories, people are monsters wearing the mask of humans, or they are victims, sometimes both. In “The Witch”, the kindly, elderly man “with a pleasant face under white hair” tells a little boy whom he meets on a train journey about his little sister who was “so pretty and so nice that I loved her more than anything else in the world”. So, he says, he bought her a rocking-horse and a doll and a million lollipops and then he took her, put his “hands around her neck and pinched her and pinched her until she was dead”. Then he “cut off her head and her hands and her feet and her hair and her nose”, and “put her head in a cage with a bear and the bear ate it all up”. The boy finds this pretty exciting, but is, unlike his mother, neither frightened nor shocked by the story or the idea of someone cutting their little sister up in pieces. We don’t get to know what the boy is thinking (nor do we know why the man said those things or whether or not they were true), but we can imagine him thinking about his own little sister and about cutting her into little pieces. It is the ultimate alienation: to discover that even your own children are not immune to the possibility of evil.

In “The Renegade” a young family, the Walpoles, have just moved to the country and are still trying to settle in when Mrs Walpole is being told by one of their new neighbours that their dog, affectionately called Lady, has been seen chasing and killing chickens. Within a couple of hours everyone in the little community knows about it, and although Mrs Walpole apologises profusely and promises to make amends, everyone she meets tells her that she needs to do something about the dog: either kill her or make it impossible for her ever to kill a chicken again. Asking her neighbours for advice, the suggestions she gets become increasingly cruel. Nobody pays the slightest attention to the welfare of the dog or to the bond that exists between her and the family – although even that bond, or the reality or thickness of it, is quickly called into question: when the two Walpole children come home from school, they already know all about it and cheerfully announce to the dog that she will be shot or worse. A neighbour, “a genial man who lived near the Walpoles and gave the children nickels and took the boys fishing”, had told them they needed to get a collar for the dog, hammer big thick nails all around inside it, put it around the dog’s neck, get a long rope, fasten it to the collar, take her where there are chickens, turn her loose, and then, when she gets really close, pull on the rope, hard, so that the spikes cut her head off. Again, the children don’t find this prospect frightening or at least alarming at all. Rather, they think it’s absolutely hilarious. “They both began to laugh and Lady, looking from one to the other, panted as though she were laughing too. Mrs. Walpole looked at them, at her two children with their hard hands and their sunburned faces laughing together, their dog with blood still on her legs laughing with them. She went to the kitchen doorway to look outside at the cool green hills, the motion of the apple tree in the soft afternoon breeze. ‘Cut your head right off,’ Jack was saying. Everything was quiet and lovely in the sunlight, the peaceful sky, the gentle line of the hills. Mrs. Walpole closed her eyes, suddenly feeling the harsh hands pulling her down, the sharp points closing in on her throat.”

This last vision, where the mother sees herself cast in the role of the dog, more or less comes true in Jackson’s best known story, “The Lottery”. The story starts innocuous enough. “The morning of June 27^th was clear and sunny, with the fresh warmth of a full-summer day; the flowers were blossoming profusely and the grass was richly green.” It is clearly a lovely day, a day to enjoy, and it appears that that is exactly what the inhabitants of a small village who are gathering for some annual event they refer to as “the lottery” intend to do. People greet their neighbours and chat amicably about everyday things. Gossip is exchanged, children play. The atmosphere is not unlike that which we would expect at a country fair. What they are going to do has been done every year for a very long time. Nobody remembers the origins of the tradition, when it started or why exactly it is being done at all. There is an old saying that suggests that the success of the harvest might depend on it, but it doesn’t really matter if it’s true or not. It is simply the way things are being done; the way things have always been done. It then turns out, towards the end of the story, that what is being decided by means of the lottery is who is going to be killed this year. Everyone takes a slip of paper from a black box. One of them has a black dot on it, and whoever gets this paper will be stoned to death by the other villagers.

This year it is Tessie Hutchinson, well-liked wife and mother of three, who is unlucky enough to draw the losing ticket. Once it is clear that she’s the one, her friends and neighbours, and with particular glee the children, including her own, take stones from the ground and, without any hesitation and despite Tessie’s anguished cries of protest, throw them at her until she is dead. “Tessie Hutchinson was in the center of a cleared space by now, and she held her hands out desperately as the villagers moved in on her. ‘It isn’t fair,’ she said. A stone hit her on the side of the head. (...) ‘It isn’t fair, it isn’t right,’ Mrs. Hutchinson screamed, and then they were upon her.”

There is no indication, however, that Mrs. Hutchinson would have protested if somebody else had been chosen. If one of her friends had had the bad fortune of losing the lottery, she would have thrown stones with the others. It is only by being personally affected that she comes to realise the wrongness of the whole procedure, or if she herself doesn’t, then at least we do. It isn’t fair, it isn’t right, not that this particular person has to die, but that someone is randomly picked to die. I almost wrote “for no good reason”, but that would be a mistake, because it seems to me that the whole point of this story is to show that even if there were some useful purpose to the whole procedure, even if it were, say, true that the success of the harvest depended on the annual ritual sacrifice of one of them, even then would it remain a terrible, nightmarish thing to do. Something that can never be justified. And in that respect it is exactly like Harris’s survival lottery. Certain things must not be done no matter how useful they appear to be. Nobody should be sacrificed for the alleged good of the community. An evil act remains an evil act even if someone benefits from it. Utility is not the measure of all things.

The Allure of the Number Game

Many people still die of organ failure whose lives could be saved if there were only enough organs available for transplantation. Unfortunately, there aren’t. Various solutions to the problem have been proposed, but those that promise to be most effective also tend to be rather unpalatable. Thus Dominic Wilkinson and Julian Savulescu have recently suggested that we suspend the dead donor rule (i.e. the rule that we should not remove organs from patients prior to death), and instead of merely withdrawing life support from critically ill patients in intensive care whose lives are deemed to be no longer worth living, we should just kill them and harvest their organs as long as they are still fresh and in good working order. Alternatively, we could establish a system of organ conscription, where you can no longer even opt out: never mind what you or your family want, once you’re dead your body belongs to the state (“Should We Allow Organ Donation Euthanasia? Alternatives for Maximizing the Number of Organs for Transplantation”, Bioethics 26/1 (2012): 32-48).

The typical bioethicist is rather fond of radical solutions. He dislikes waste, has no patience with what he sees as people’s squeamishness, and believes that we should be rational about things, which mostly means that we should rethink our morality, our established views of right and wrong, if there is no other or better way to solve a problem quickly and efficiently. Do you believe that people should have a say in what happens to their bodies when they are dead? - But then they may not allow us to use their organs, which we urgently need. To save lives! To help people! So we really cannot afford letting those organs go to waste, and that means we cannot afford allowing people to decide for themselves whether they want to “donate” their organs or not. Do you believe that organs should only be taken from dead people who no longer need them? - But some who are still alive are in fact as good as dead, so that they would not really miss those organs. And besides, we urgently need them now. We really cannot afford to wait until people are completely dead. After all, there are people’s lives at stake here. Actually, come to think about it, we cannot even afford to wait until people are almost dead. It would be so much more efficient if we could just take the organs we need from the living, if we could kill a few to save many others. It’s all for the greater good. Yes, of course, killing people for their organs is currently frowned upon, but hey, it doesn’t have to stay this way. Sometimes sacrifices have to be made for the common good, and anyway, we may quickly get used to it and see the error of our previous ways.

This is what the Manchester-based philosopher John Harris suggested in a paper published almost 40 years ago (“The Survival Lottery”, Philosophy 50/ 191 (1975): 81-87), in which he proposed that we solve the problem of not being able to procure enough spare organs to save the growing number of people who need new organs to survive by establishing a lottery. Each of us is assigned a number, and whenever there is a shortfall of organs, a number is drawn and the lucky bastard whose number it is gets killed (or rather called upon to “give his life”). All his organs can then be used to preserve the lives of those who need them. This way a lot less people would have to die.

To me this is the stuff that dystopian nightmares are made of. Yet when I put the question to my students, asking them in an exam whether they thought that Harris’s survival lottery was “a morally acceptable way to tackle organ shortage”, I once again found that a majority of them did not only think that it was morally acceptable, but in fact that it was clearly what was morally required. They showed themselves quite convinced by Harris’s utilitarian reasoning and the crucial assumption that there is no morally relevant difference between killing and letting die, so that if we have to kill one to prevent two or more people from dying, then that is exactly what we should do. The numbers speak for themselves. They appear to have an enormous persuasive power. As one student put it: “Such massive consequential benefits to society as a whole seem to me to rather morally outshine the far rarer occasional acts of killing.” As if the legalisation of “occasional acts of killing” by an agency of the state could ever be justified. That is the kind of argument that Hitler and Stalin must have used when they justified their policies before themselves and others. It blindly follows the imperative of maximisation. And I think I get its allure. It makes things so much easier. Who needs a conscience when we’ve got numbers, right? But I’m still surprised, and also dismayed, by how easily people can be persuaded to endorse inhuman practices and how willing they are to believe that everybody is expendable and that to be treated solely as a means to an end is perfectly all right, so that the state should have the power to take our lives whenever it is deemed expedient. As another student put it: “As utility is the maximisation of pleasure, then people can rightly be viewed as interchangeable parts in a mechanism, designed to promote as much happiness as possible.” Rightly! How can people be so willing to give up their most basic rights, to see themselves as an interchangeable part in a mechanism? We are all oil on the wheels of the great utilitarian happiness machine. Is that really what we are or how we want to see ourselves? And for whose sake really? Other people’s lives? But those other people are just as expendable as we are. Surely there is a contradiction at the heart of this terrifying proposal: human life is proclaimed to be so important that anything is acceptable to save it, including the killing of a healthy, innocent and perfectly alive human being. But by finding this acceptable we implicitly declare the life of that human (and with it the life of any human) for disposable. If the individual human life doesn’t count, then we don’t seem to have a good reason to want to save it at all costs. Then we can just as well let people die. The truth is that the reason why we think that we should save people’s lives if we can is in fact the same reason that makes us (or, if we were thinking straight, should make us) reject Harris’s proposal.

Sometimes I think that, on the whole, applied ethics might be doing more harm than good, that more often than not it doesn’t aid our moral thinking, but corrupts it. It makes the unthinkable thinkable. I used to believe that this was an advantage. I’m not so sure anymore. 

Primo Levi on (Not) Understanding the Holocaust

I remember vividly the heated argument that German historians and philosophers were having in the late 1980s, when I was an undergraduate at the University of Bonn, over the question whether the Holocaust committed by the Nazis was a “unique” event or rather comparable to other mass murders committed by other regimes throughout the 20^th century. The so-called Historikerstreit was started off by the conservative historian Ernst Nolte, who tried to explain the Holocaust as a defensive reaction to the forced labour camps of Soviet Russia. In response, the liberal philosopher Jürgen Habermas accused Nolte of downplaying the enormity of the event and trying to shift blame away from the Germans and onto the Russians - as if the Germans had been driven to it, and in fact had no choice or at least excellent reasons for acting the way they did. Habermas insisted, as did many others, that the Holocaust was “unique”, could not be compared with any other crime, and could, and should, never be “understood”. I, for my part, didn’t think that Nolte intended to justify what the Nazis did, and I couldn’t quite see why any attempt to understand what happened should be in itself morally wrong and blameworthy. Clearly an explanation is not necessarily a justification. It seemed to me that to insist on the Holocaust’s radical uniqueness and the impossibility to understand it was not only silly, but in fact highly dangerous: if something is “unique”, we don’t have to fear that it might happen again. The unique only happens once. If something cannot be understood, then we don’t have to bother trying to prevent it from happening again, because even if it could happen again its very inexplicability would make it impossible for us to do anything about it. If we cannot determine its causes, then we cannot fight them. Therefore, I thought, we had a moral duty to understand what had happened and why it had happened.

Now, I’m not so sure anymore, and the reason is that I have just read Primo Levi’s account of his time in Auschwitz (If this Is a Man, 1947), and of his long journey home to his native Turin after the war had ended (The Truce, 1963). In an afterword to the Everyman edition of these two books, Levi gives answers to his readers’ questions. Asked about how the Nazis’ fanatical hatred of the Jews could be explained, he emphasises the importance of not explaining and not trying to understand that hatred:

“Perhaps one cannot, what is more one must not, understand what happened, because to understand is almost to justify. Let me explain: ‘understanding’ a proposal or human behaviour means to ‘contain’ it, contain its author, put oneself in his place, identify with him. Now, no normal human being will ever be able to identify with Hitler, Himmler, Goebbels, Eichmann, and endless others. This dismays us, and at the same time gives us a sense of relief, because perhaps it is desirable that their words (and also, unfortunately, their deeds) cannot be comprehensible to us. They are non-human words and deeds, really counter-human, without historic precedents, with difficulty comparable to the cruellest events of the biological struggle for existence. The war can be related to this struggle, but Auschwitz has nothing to do with war; it is neither an episode in it nor an extreme form of it. War is always a terrible fact, to be deprecated, but it is in us, it has its rationality we ‘understand’ it. But there is no rationality in the Nazi hatred: it is a hate that is not in us; it is outside man, it is a poison fruit sprung from the deadly trunk of Fascism, but it is outside and beyond Fascism itself. We cannot understand it, but we can and must understand from where it springs, and we must be on our guard. If understanding is impossible, knowing is imperative, because what happened could happen again. Conscience can be seduced and obscured again – even our consciences. For this reason, it is everyone’s duty to reflect on what happened.”

Levi contrasts understanding with knowing. The latter is a duty, which includes knowing the causes of what happened to make sure that it doesn’t happen again. But understanding is more intimate, it bridges the reflective distance between the subject and the object of understanding. By “understanding” the Holocaust we would acknowledge it as a real human possibility, as something that is understandable for humans to do. But it is important to reject this possibility, to preserve an image of the human that positively excludes it. Humans ought never to be able to do such things. Whoever shows himself capable of it (and this may very well include us) has given up their humanity, and they have given it up precisely because they have ceased to see and treat the other as human. We become (or stay) human by treating other humans as humans.

How did he survive Auschwitz, Levi is asked, and he replies: lots of luck, a desire to bear witness to the events, and finally “the determination, which I stubbornly preserved, to recognize always, even in the darkest days, in my companions and in myself, men, not things, and thus to avoid that total humiliation and demoralization which led so many to spiritual shipwreck.”