In Brittany Maynard, advocates of assisted suicide have found their ideal spokeswoman. She is not an aging hippy embittered by her loss of energy. As far as one can tell, she is neither a radical individualist nor a nihilist. She is, by all appearances, a loving, life-embracing young woman. Before she was diagnosed with brain cancer, she and her husband were, in her words, “trying for a family.” She continues to enjoy activities with loved ones.
She took up the cause of assisted suicide after she was diagnosed. Despite the promises of contemporary palliative care, she faces an uncertain future that might well contain pain and indignities that none of us would wish upon our enemies, much less a newly wed young woman. Because of her youth and overall health, her death in hospice might be prolonged.
The prospect of illness and death found Brittany Maynard; she did not go seeking it, at least initially. But now she seeks something at least as dreadful as death. She has sought and obtained the assistance of medical professionals in committing suicide. In an essay published by CNN, she recently declared that she moved to Oregon to secure drugs with which to kill herself. She has chosen to perform the deed shortly after her husband’s birthday. A celebration of the anniversary of his birth will be suffused with the prospect of her death. She did not seek death, but as it now seems inevitable, she has sought and obtained the means with which to hasten it in order to avoid its most brutal ravages.
Brittany Maynard’s story is perhaps the most emotionally compelling case one could make for legalizing assisted suicide. As she notes, her circumstances are unique, and she is not arguing that physician-assisted suicide is right for all, or even for most. But why, she asks, should she not have a right to choose?
This is a fraught question. It must be answered with care. But it must be answered.
A Right to Choose to Kill
To answer Brittany Maynard’s question, we must first understand it. And to understand it we must first get clear what it is that she has chosen. She has not chosen death. Death comes to all of us. Death is going to come to Brittany Maynard, no matter what. Nor has she chosen death-with-dignity. One does not dignify death by hastening it.
Brittany Maynard has chosen to become the cause of her own death. She has chosen to step into the role of cancer, to do the job that cancer threatens to perform. If she follows through on her commitment, then Brittany Maynard will not die of cancer. She will not die of complications from cancer. She will not die of pain or suffering. She will not die of insufficient palliative care. She will die because she has chosen to end the life of Brittany Maynard and has taken those actions that are necessary to bring the life of Brittany Maynard to an end.
Furthermore, Brittany Maynard will die because physicians have given her the means to perform those actions. She has chosen to allow medical doctors to become another cause of her death.
We ought to demonstrate compassion for Brittany Maynard, but we must not allow our compassion to obscure the nature of her choice. Brittany Maynard has chosen to kill a human being and to involve doctors in that act.
Most of us cannot imagine the pain and fear that would drive someone to that choice, and we naturally recoil from judging her. But she has not sought our moral approval. She has sought the approval of law. Brittany Maynard asks that those of us outside Oregon change our laws to ratify her choice by creating in our laws a right to receive the assistance of medical professionals in killing a human being. When she is gone, those laws will not govern her choices and actions. They will govern the rest of us.
In order to ratify Brittany Maynard’s choice in law—to create a legal right to receive the assistance of medical professionals in committing suicide—we must do away with the legal prohibition against participating in intentional killings. That is what Brittany Maynard is asking us to do.
Brittany Maynard’s story is being used by proponents of assisted suicide to achieve a political objective. To understand what they seek, one must get beyond outward appearances. The case for assisted suicide depends on concealment. It requires confusion between acts of compassion and acts of violence. It involves false assurances that suicide is clean and easy. It generally ignores the experiences of those who choose life in spite of suffering. It depends on euphemisms, confusion, and sometimes outright deception.
Indeed, advocacy for legalizing assisted suicide generally conceals more than it reveals. Hidden are significant costs. Before accepting the invitation to change the law, we would do well to consider those costs.
The first cost is the distortion of law, particularly those parts of the law that protect human life. The right to end one’s life cannot be secured in law without eradicating the law’s commitment to life’s inviolability. And the inviolability doctrine is the only effective and principled protection for human life in law. Other than a blanket ban on intentional killing, no position of the law can control killing as a matter of logic or practice.
The CNN essay describes the suffering that Brittany Maynard is likely to endure, suffering that no rational persons would choose for themselves or for anyone they love. But it fails to consider the costs of lost opportunities for love and compassion in the midst of pain. Another cancer patient, who has made a very different choice than Brittany Maynard, recently described the place of suffering as “the place where true beauty can be known.” Our response to suffering need not be defined by our experience of pain. It can be defined by courage and love of life, even to the end.
Brittany Maynard’s life is not hers alone. The most profound cost of her suicide will be the loss of her life. And that will be a real loss, because she is valuable, in and of herself.
Although Brittany Maynard controls the time and manner of her death, the aftermath will belong to her family and friends. When one loses a friend to suicide, it is natural to wonder what more one might have done to affirm that friend’s life. Brittany Maynard’s handlers at a pro-suicide advocacy group have stated that “in our time on earth all that counts are the people you love and the people who love you.” Those people do not cease to love us after we are no longer on earth.
And what of the medical professionals who are implicated in Brittany Maynard’s suicide? Her essay makes a passing reference to a physician, but Oregon law requires that at least two physicians and two additional witnesses be involved in the process that results in her suicide. One assumes that those doctors have staff assisting them. If the law has been followed, then some group of medical professionals in Oregon participated in her planned suicide.
As professionals, those doctors are not isolated individuals. They are participants in dozens of interdependent practices, associations, and institutions, which are designed to serve everyone in Brittany Maynard’s community. Brittany Maynard’s choices belong to her. The medical profession does not. And the costs will not be limited to her physicians.
Once assisted suicide is a legal option alongside palliative care, then it is likely to displace palliative care in the market competition for resources. It is far less costly. Why should investors invest in improving palliative care, and why should insurance companies pay for it, if all of its attendant expenses can be eliminated by means of which the law approves?
When assisted suicide is a legal option, everyone has an interest in it—not only financiers, pharmaceutical companies, physicians, nurses, hospitals, and insurers, but also private caregivers, friends, and family members. For the law to authorize assisted suicide in any circumstance is for the law to communicate to citizens that assisting a suicide is an option that at least some people should consider. So, one must ask: “Why not this person beside me?”
The Costs on Display
The State of Oregon decriminalized assisted suicide two decades ago. Look what the lawmakers of Oregon have wrought: the law of Oregon both enabled and encouraged Brittany Maynard to make a commitment to end her life. It has helped her and her doctors to set themselves in opposition to the life of a young woman named Brittany Maynard. The law of the state of Oregon told Brittany Maynard and her doctors that her life need not be worth living. They accepted that claim and acted upon it.
Within the medical profession in Oregon, there now grows a cancer. This is not a cancer of the body, but of the mind, the will, and therefore of the character. This cancer is making healers into people who are willing to destroy human lives. Brittany Maynard did not cause this cancer; she has contracted it. She is twice sick.
Brittany Maynard deserves our compassion but not a right to choose to kill herself. That right would not involve her alone. We must live in the world that she will leave behind.
Adam MacLeod is an associate professor at Faulkner University’s Thomas Goode Jones School of Law.