Claremont Independent

Recently, Dr. Michael Uhlmann, visiting Government professor at CMC and part of the School of Politics and Economics at CGU, was kind enough to answer some questions for The Claremont Independent's David Daleiden about the issues surrounding physician-assisted suicide, or euthanasia. Washington became the second state to legalize physician-assisted suicide in the 2008 general election, and its law took effect at the start of this year. The following is transcribed from my interview with Professor Uhlmann.

David Daleiden: Thank you for sitting down with me for this interview Professor Uhlmann. Could you give our readers a quick background on how you got involved in this issue?

Dr. Michael Uhlmann: I've long had an interest in bioethical matters; I began working peripherally in the area back in the 1970s. This was in part through various court rulings dealing with the right to abortion, and various aspects of the so-called right-to-die, and I began reading around, taking courses, and talking to people who understood a good deal about the subject-moral philosophers. While I claim no particular expertise in the field, it has been a strong litigational interest of mine, and I've written about various aspects of this, dealing mainly with the legal aspects of bioethical questions.

I put together a collection of pieces on euthanasia, assisted suicide, ten or twelve years ago, which was put together as a book for classroom instruction. For a time it was rather widely used-when I did it, there was just nothing else of its kind out there. So it had a certain temporary currency, it may have done some good.

DD: Were you involved in the opposition to the Oregon and Washington laws legalizing physician-assisted suicide?

MU: I was peripherally involved in the opposition to the Oregon statute about ten years ago. Over the series of about a week to ten days, I conducted series of debates with a medical advisor who was one of the principal draftsmen and proponents of the Oregon statue. I had nothing to do with the Washington business, other than reading about it in the papers and journals of public opinion.

DD: Who are the people behind the push for physician-assisted suicide?

MU: The original organization was called Compassion in Dying, and that in turn was a spin-off of the Hemlock Society. A fellow by the name of Derek Humphrey wrote the first major popular book on the right-to-die, and it had rather wide currency.

A number of organizations cropped up seeking to mollify, at least rhetorically, some of the arguments made by Humphrey. He was a rather stern advocate of a rather aggressive form of assisted suicide and euthanasia. Organizations like Compassion in Dying basically took the Humphrey agenda and modified it rhetorically, but philosophically there's not much between the arguments that Humphrey and others of his stripe made in defense of assisted suicide and euthanasia and the arguments of Compassion in Dying. The Washington organization is in turn a spin-off of the original Compassion in Dying, but organizationally there's a great deal of overlap.

In Washington, it received a big boost from a former governor, who was afflicted with Parkinson's-Booth Gardner. Some years ago he was diagnosed with Parkinson's, which got him thinking about this issue and to advocate for assisted suicide, his point being that he did not wish to succumb to Parkinson's, at least at the point where he felt his life was unworthy, by modern standards, to be lived. Of course I don't make judgments about people afflicted with severe conditions of this sort, but one of the things that occurs to me is the very sharp contrast between Mr. Gardner's disposition on his attitude toward Parkinson's and the example of John Paul II, who very courageously confronted the affliction and sought to turn it into a kind of example for others on not only how to live, but how to die.

DD: I think people sometimes have a hard time grasping this-why, ultimately, is a law permitting physician-assisted suicide a bad thing?

MU: There are a number of reasons for it. The first, and to me the most dangerous reason, is what it does to the medical profession itself. There's a huge degree of trust that is so vast, it's like the air we breathe, that hovers, or ought to hover, above the medical profession.

When you trust yourself to the judgment and care of a doctor, you should not have to worry that he has any other purpose than to try to make you well, and if he can't make you well, then at the very least to make you comfortable-but above all, not to hasten you out of this vale of tears. I would hate to see the day when doctors are converted by public law in some fashion to become agents of death-I think that would horribly undermine faith in the medical profession.

My friend Leon Kass has remarked on a number of occasions that when we present ourselves to a doctor, we are in some degree or another vulnerable. We expose ourselves to him literally in our nakedness, in our total vulnerability, trusting that the judgment that derives from a doctor's special training will be devoted to our benefit, to our healing, and that that knowledge will not be used in a way that might injure us.

The whole medical ethos in the western world is built on that Hippocratic tradition, the first principle of which is "First, do no harm." And to the extent we pull away from that basic principle of medicine, I think we're running the risk of converting doctors into agents of social impulse or desire. Their real vocation should be to the healing arts, and should stay there. Once you've converted the medical profession into something beyond that, you're using this enormous power of medicine for social, personal purposes that are only peripherally related to making a patient well, and I should hate to see that happen.

DD: What other widespread harms can we expect from the legalization of physician-assisted suicide?

MU: Inevitably, two problems will be created. One, while these laws are advanced in the name of aiding people who are "terminally ill"-terminally ill being defined as someone who is likely to be dead in six months or less-you will note among various advocates of assisted suicide that that argument has already been extended to people who are not in fact terminally ill, but simply leading miserable or unhappy lives.

If you concede the premise on terminal illness, there's a certain inevitability of logic that leads to the next step: When somebody is not terminally ill, but nevertheless in great pain or otherwise miserable existence, if the claim is to be granted in the first instance, why shouldn't it be granted in the second instance? And that's a problem advocates of assisted suicide for the most part like to avoid, but the seed is already planted.

The second thing you need to worry about concerns surrogate decision-making. Many people who are terminally ill are really not in a position to make a clear-eyed judgment about the question of suicide. And they are, precisely because of their feeling miserable, very vulnerable to all sorts of suasion from relatives from friends and whatever, and from medical personnel who may consciously or unconsciously encourage them to take this step.

In many cases, you have people who are not physically or mental able to make this decision themselves, and the decision is made by surrogates, either medical professionals or next of kin. It is they-even more so than the person who is ailing-who may make the critical decision.

DD: Fascinating. So you would agree that there is a "disability discrimination" inherent in the laws and assumptions that permit physician-assisted suicide?

MU: I think there's some truth to that. There's a very effective, vocal group of handicapped folks called "Not Dead Yet," who have been very active in this whole area, and have argued with great cogency and power that once laws on assisted suicide are enacted, those with disabilities-and especially severe disabilities-will become very vulnerable.

I think there's a real risk there, and I greatly sympathize with the arguments that are advanced by people who are physically ill or otherwise afflicted. I think they are vulnerable in a regime where certain lives are deemed to be worth living and other lives are not.

The philosophical premise underlying assisted suicide is precisely that, that certain afflictions make human life not worth continuing. If one accepts that premise in an unquestioning way, that necessarily means that people who are in varying degrees less than perfect are, for that reason, leading less worthy lives. My view on that is that if is your belief, try it on somebody who is handicapped, and see what they think about it.

DD: Philosophically speaking, why is it wrong to say that I have a right to kill myself?

MU: The claim that one should be able to do with one's life whatever one wishes is a very old one. Nothing new about it, it's acquired a certain fashionable currency in our time, but it's a very old argument that goes back to the earliest days of philosophy. And indeed, one can say that the rise of Western philosophy, at least as it first appeared in Greece, is in major part a response to the claim that there are no moral obligations that affect you other than those that you choose to put upon yourself.

That claim has to be unpacked and examined to see if it holds water. There's a very rich and old tradition of surrounding thoughts on this subject. It is characteristic of the modern mind that it's always surprised to imagine that somebody actually had a thought prior to the last two weeks.

There are very few new ideas on this whole subject. What is new is the rather enthusiastic embrace of moral autonomy in our time, combined with moral relativism, and the insistence that the law cannot justly impose conditions on you when you with to do other things, whether it's aborting babies or taking your own life.

DD: Thank you so much for your time, Professor Uhlmann.

MU: Sure. No problem.

David Daleiden CMC '12 is a staff writer for the Claremont Independent and president of the Claremont chapter of Live Action, a life-rights advocacy group.