Everyone concerned with issues of assisted suicide, euthanasia, medically assisted suicide — or whatever words you want to use to characterize or categorize that very pressing issue, usually buried beneath the phrase “right to die” — should read this book. It is a stark and vivid portrayal of what a slippery slope is really all about.
The Netherlands is the leading edge, the frontier, of this movement toward regularizing and institutionalizing all the scary, horrific ramifications of putting death on a timetable or worksheet or to do list.
For more than a quarter century the Dutch — through court cases, prosecutorial discretion and legislation — have managed to create a society where physicians regularly end the lives of those who plead for such help. Now, increasingly, they take the lives of those who are incapable of asking to die or more importantly pleading for the right to live. If you need a sense of where Canada is headed in light of last February’s Supreme Court decision on Lee Carter’s request for death, this book is a chillingly factual account of a country that has been there and done that.
Van Loenen is a Dutch journalist who for much of his adult life believed or accepted the idea that a progressive, liberal society was one where the value of self-determination meant people in the grip of a disabling disease or terminal illness should have the autonomy to choose the moment of their death. When his partner was severely disabled following brain surgery, van Loenen was shocked to hear a mutual friend suggest that the partner would be better off dead. This casual caustic dismissal of a life caused van Loenen to search his own soul, his own reasoning and subsequently the nature of Dutch reasoning and decision-making in an effort to understand the origins of the idea of assisted suicide.
What he charts is a journey that began in the Netherlands in the late 1960s with a small pamphlet denouncing the ability and power of medicine to keep people alive indefinitely, regardless of the pain and suffering a person might be experiencing. From that point, Dutch progressives elaborated the theory that a truly caring society would be one where no one suffered needlessly.
In the 1980s a series of court cases led to the conclusion that if a doctor was forced to choose between doing no harm and watching a patient suffering intolerably, then arguably the doctor could most rightly do no harm by ending the suffering.
Ironically, self-determination gave way to pity and increasing the power of the medical community. But right-to-die activists weren’t derailed or dismayed. Arguments were made that all competent adults should be able to determine their own deaths. As van Loenen points out, through a detailed review of philosophical papers, the evolution of ethical codes and legal guidelines and even popular films, novels and documentaries, the lines ostensibly designed to set out who might be assisted in their deaths were not so much insurmountable walls as they were suggestions.
Once the idea that a competent adult could ask for an end to personal suffering was accepted, that led to the argument that it was unfair to deny the same relief to the mentally incompetent or comatose.
Once an adult could choose to end excruciating pain, what reason could be offered to deny the same relief to a child?
Most alarming is the way van Loenen traces how a belief that if people can decide that their own life is not worth living, they will quickly expand their conviction into the belief that someone else’s life is clearly not worth living. If the national standard is that intolerable pain is a valid reason for dying, then eliminating pain in everyone becomes equally valid. This is the essence of the slur in the title of the book, Do You Call That a Life?
There is one last reason you should read this book. Every argument made — that there is no slippery slope, that this is about autonomy, that doctors can be trusted, that the disabled, the infirm, the vulnerable have nothing to worry about — has already been made in the Netherlands and effectively done away with.
This book is a call to arms.
(Kavanagh is a journalist and author. His most recent book is The Man Who Learned to Walk Three Times.)