The debate over assisted suicide, or euthanasia, strikes at the heart of what it means to be a person. The passing back into the dust from which we came is something we all share, the particularity of our time on this earth joined together by the final universality of our mortality. Questions of life and death speak to the fundamental nature of our existence and the grounds for our sense of self. It is not surprising therefore that questions of when and how we should die raise such levels of emotion. This debate demands that we consider what our ultimate conception of the good is, even whilst it is expressed in liberal terms that deny such a good exists. 

Liberalism is the instrument of euthanasia’s triumph. Euthanasia, or assisted suicide, is now legal in The Netherlands, Switzerland, Belgium, Spain, Australia, New Zealand, Canada and various U.S. states, with Oregon as the preeminent example. The link between all these places is the liberality of their political cultures. As Ilora Finlay and Robert Preston demonstrate in Death by Appointment, in country after country, what started as a measure intended only for extreme pain in old age or terminally ill youth expanded to non-fatal but painful conditions; then to non-fatal, non-painful ailments; then to those in psychological distress. In doing so it moved down the age-range to younger and younger cohorts, eventually to adolescents and even children. All despite incessant reassurances of guardrails and safeguarding. The slippery slope is not a fallacy. It is simply a fact.

What is being proposed is infanticide under the guise of care

We can see this unfolding disaster in a video from the Canadian Special Joint Committee on Medical Assistance in Dying (MAiD), featuring a representative of the Quebec College of Physicians, Dr Louis Roy. He recommends that euthanasia be extended to children under one year of age “with severe deformations and … grave and severe syndromes”. This is simply the bottom of a long slope. Concerning Canada more broadly, as Rupa Subramanya reports, the results of its permissive euthanasia laws are plain: “In 2017, the first full year in which MAiD, which is administered by provincial governments, was in operation, 2,838 people opted for assisted suicide, according to a government report. By 2021, that figure had jumped to 10,064 — accounting for more than 3 per cent of all deaths in Canada that year.” 

People are opting for euthanasia, with prompting or without, because they fall through the gaps in the social safety net, cannot afford healthcare or general cost of living, and are often isolated and atomised. Canada’s euthanasia laws are now seen as a threat to the disabled. The evolution towards euthanasia for non-fatal psychological suffering is seen in countries like Belgium and The Netherlands, where people can now be euthanised for depression, or simply “tiredness of life”. These countries have seen soaring rates of euthanasia overall. As Finlay and Preston write, if Britain were to implement a law “along the lines of the Dutch 2001 Act [this] would, on current death rates, result in some 23,000 deaths a year”. In our increasingly straitened, resource depleted times, how unlikely is it that we in Britain would see this happen? It would surely save expense to the public purse and deliver compassion into the bargain. 

Returning to the above video, however one dresses it up, what is being proposed is infanticide under the guise of care. People shouldn’t be surprised, however. For years this perspective has had legitimacy conferred on it by the height of academic institutional prestige. The Princeton utilitarian bioethicist Peter Singer has argued for similar measures, using my condition as his example of unbearable suffering that should be averted. He says of those born with Epidermolysis Bullosa, “objectively … that is not a good life and that it is better that that child, whenever born, or if they are born that they die swiftly and humanely rather than we try to prolong their life as long as we can.” I can testify to this condition’s brutality, particularly the more severe subtype that I have. It has caused huge pain and heartache down the years, and it will lead to an early death from aggressive skin cancer. This is all true.

Yet Dr Roy and Professor Singer’s way of seeing things is a narrow view of what constitutes the meaningful life. They deny the possibility of any good in an existence like my own, scarred by suffering but also redeemed by joy, defined by triumph and tragedy, mostly just living through the day-to-day grind like anyone else with the degree of stoicism required. In other words, it’s a heightened form of the human condition itself. In his essay, Dying in Time, Roger Scruton writes that we must always remember “that the value of life does not consist in its length but in its depth”. Those like Dr Louis Roy and Peter Singer are simply more explicit than most euthanasia advocates when they state that a life like my own cannot be one of depth and should be one of even lesser length than it is already. Never mind the richness and complexity of the human experience I’ve lived. This counts for nothing. Their humanism ends in depersonalisation. Under Dr Roy’s biomedical regime, I would have been euthanised at birth, immediately cast back into Chesterton’s wreck of non-existence.

This is what one would expect to see from countries that have gone the furthest in entrenching a public liberalism in the institutions of political, economic and civic life. Liberalism, from its beginning, denies that there is a highest good to political life, reduced to a social contract to which we gain membership by rational consent. As Pierre Manent writes, from John Locke on, liberalism presents the person as an individual shorn of all attachments to people and place, without a past or future, drifting in an eternal present. Social relations are consented to through rational choice, not inherited or passed down. The satisfaction of the individual’s individually defined desires is presented as justice itself. 

Mill proposed colonisation and slavery for those less capable of freedom

It is unsurprising that euthanasia consistently breaks its boundaries, always presented as an expansion of choice as the route to kindness. This is rooted in liberalism’s fundamental presuppositions, for as George Grant wrote, “it is the very signature of modern man to deny reality to any conception of good that imposes limits on human freedom … man’s essence is his freedom. Nothing must stand in the way of our absolute freedom to create the world as we want it. There must be no conceptions of good that put limitations on human action.” If there is no ultimate value towards which our lives point, then “the vaunted freedom of the individual to choose becomes either the necessity of finding one’s role in the public engineering or the necessity of retreating into the privacy of pleasure”. We are reduced to utilitarian measures of the good, achieved through harm reduction and happiness maximisation, materialistically defined.

The result of the liberal conception of the human person is expressive individualism, where “persons are conceived merely as atomized individual wills whose highest flourishing consists in interrogating the interior depths of the self in order to express and freely follow the original truths discovered therein toward one’s self-invented destiny”. This conception of the human person privileges cognition, will, rationality and autonomy in defining full personhood. Our nature as embodied souls is largely ignored: if one cannot employ one’s body to achieve the desires of one’s autonomous, rational, willed cognition, then one cannot achieve full personhood. 

As a result, the constraints of our existential finitude made so explicit by disability are seen as immoral barriers to maximal autonomy attained through rational will. The unchosen bonds of interdependence, obligation, reciprocity and mutual loyalty that comprise the texture and meaning of life are denigrated. Liberalism discards the weak just as the Greco-Roman world once did, now done for reasons of supposed benevolence. From Locke onwards, liberalism has always seen some more capable of, and suited to, forming political society than others. Mill took this furthest in his proposal of colonisation and slavery for those less capable of freedom. 

It is not such a stretch from liberalism’s definition of the individual’s capacity for personhood to advocating the killing of disabled infants deemed incapable of fulfilling this. As Leon Kass has written, it is no surprise that those Germans who coined the phrase “life unworthy of life” were two liberals: a jurist and an academic. Better to curb the depersonalised source of the suffering with all haste. James Burnham viewed liberalism as the ideological legitimator and enabler of Western suicide. I’m not sure he meant for the title of his book to be taken so literally, across so many countries. 

In place of liberalism’s view of the person as timeless and placeless, exercising a rational, autonomous and willed cognition, I would argue along with David McPherson for the adoption of what he calls the “accepting-appreciating” stance. This sees the existential limits inherent to life as orienting us to what is of value, answering the question of cosmodicy, the “problem of justifying life in the world as worthwhile in the face of evil and suffering”, by affirming life’s goodness even in the face of its tragic nature. Or we can continue with the depersonalisation intrinsic to euthanasia. One that wears a face of kindness, but which ends up condoning outright cruelty.