Canada has recently been in the news due to its imminent legal expansion of assisted suicide to include the mentally ill, beginning in March 2023. The Canadian government specifies that an “expert panel” will be used to evaluate the requests of the mentally ill “in a safe and compassionate way.” The virtue of compassion, which the Canadian government here invokes on its own behalf, is concerned with the best interests of the sufferer. So the question naturally arises: is it really “compassionate” for the state to offer death as an aid to the sufferer? Is it just?
To answer these questions, one must consider the state’s duty to its citizens. On this topic, there are few better guides than the Roman statesman and philosopher Cicero. Some things he gets right (the state’s duty to preserve justice and protect the well-being of its citizens) and others he gets wrong (the occasional permissibility of suicide). But if Cicero’s teachings are supplemented with Christianity’s teachings on suicide, we get a clear understanding of why assisted suicide cannot be counted among the state’s duties to its citizens.
In Book 1 of On Duties, a truly indispensable landmark in the history of political ethics—and Cicero’s last philosophical composition—Cicero says this (all translations in what follows are my own):
Absolutely all those who intend to preside over the commonwealth must observe Plato’s two precepts: first, that they guard what is useful for the citizens in such a way that they refer all of their actions to it, having forgotten about what is advantageous to themselves. Second, that they care for the entire body of the commonwealth, lest, while they guard some part of it, they abandon the rest. (On Duties 1.85)
Prima facie, this perhaps lends some support to the Canadian government. After all, those who are seeking death certainly believe that that is what is most useful to them; the government is merely assisting them in obtaining what they find useful. This would appear to fulfill Plato’s first precept as Cicero describes it.
And indeed, when it comes to suicide, Cicero allows that it is sometimes licit when done for the sake of honor. In On Duties 1.112, he points to Cato the Younger’s preference of death to subjection to Julius Caesar—“since nature had bestowed unbelievable seriousness on him”—as an example of honorable suicide. So if the magistrate is responsible for safeguarding what is advantageous for citizens, perhaps virtuous suicide should be legal. In other words, can suicide be both honorable and useful?
To answer this question, we must consider how honor relates to expediency.
Cicero devotes the third and final book of On Duties to showing that the useful and the honorable are never in conflict. If they were, injustice might sometimes be advantageous, as Thrasymachus argues in Book 1 of Plato’s Republic. But Plato has Socrates argue that any such advantage is merely apparent, for acting unjustly harms both the perpetrator and the victim. Cicero stands in this broad Socratic tradition: the one who commits an injustice for the sake of advantage is prevented from being a good man (On Duties 3.76); his victim suffers the consequences in his life, his property, or his reputation. Furthermore, unjust actions destroy fellowship among human beings, and thus contradict our very nature as social creatures. Therefore, they can never be useful.
From the foregoing discussion, it becomes clear that the state cannot facilitate suicide without committing a grave injustice. Despite Cicero’s exemption for honorable suicide, even these are not just: all suicide is by definition the extrajudicial killing of a person who, in legal terms, is innocent. Cicero is right that the useful and just, ultimately, cannot conflict. Therefore, even if someone’s self-slaughter seems convenient and advantageous—perhaps because his suffering is great, or because his quality of life is low—it can never be so since it is unjust.
Here, Christianity’s tradition of political and moral reflection can provide further guidance. The late Roman church father Augustine takes up the question of suicide in the first book of his City of God in dealing with the question whether consecrated virgins who had been raped had justification for killing themselves. The question may strike modern ears as absurd, but it was not a crazy one at the time given that the Roman tradition answered questions like this in the affirmative, as the example of Lucretia shows.
But Augustine disagrees with his Roman forebears on the basis of the Ten Commandments of the Old Testament and the Two Great Commandments of the New Testament. He remarks,
For it is not for nothing that nowhere in the Holy Scriptures can we find God commanding or permitting us to inflict death upon ourselves either for the sake of gaining immortality or for the sake of keeping or freeing ourselves from any evil. For in fact it must be understood that we have been prohibited from doing this when the law says, “You shall not kill,” especially because it did not add, “your neighbor,” as it does when it forbids bearing false witness: “You shall not,” it says, “bear false witness against your neighbor.” Nevertheless, it does not provide grounds for someone to think himself innocent of this crime if he has borne false witness against himself, since he who loves has received the rule that guides the love of one’s neighbor from himself, since it has been written, “You shall love your neighbor as yourself.” (City of God 1.20)
In this passage, Augustine draws attention to two of the Ten Commandments: “You shall not kill” (or “murder”) and “You shall not bear false witness against your neighbor.” He notes that the latter includes a qualification that the former does not, and yet this does not mean that one can bear false witness against oneself; such dishonesty would obviously still be wrong.
Why? Because self-love—that is, the high regard in which we naturally hold ourselves—provides the standard for the love of one’s neighbor: “You shall love your neighbor as yourself.” If we are forbidden to tell lies about our neighbor, then we are by implication forbidden to tell lies about ourselves because of the necessary ethical link between treatment of self and treatment of neighbor.
In the same way, if we were explicitly forbidden to kill our neighbor, we would by implication also be forbidden to kill ourselves, and the latter prohibition would be the ethical and logical foundation of the former. But the commandment against killing does not even offer the kind of apparent grounds for casuistry that the commandment against bearing false witness does, because no qualification is made with respect to one’s neighbor. It simply states that all unjustified killing is wrong, with no exceptions—including killing oneself. Therefore, suicide violates the Ten Commandments. Not even Cato, says Augustine, is off the hook.
The Ten Commandments are especially helpful in this discussion because they are summaries of the moral or natural law. Human societies have generally acknowledged that unjustified killing is wrong. When they make exceptions for the sake of expediency, they need to be reminded of what the moral law requires. This is true regardless of whether the inquiry concerns the killing of others or of oneself: both involve the taking of an innocent human life, and thus the same standard should be applied to each.
What does such a suggestion yield, if we combine the insights of Cicero and Augustine? Cicero teaches us that the conflict between true expediency and justice is an illusion. Augustine reminds us that killing the innocent is wrong. Physician-assisted suicide is ultimately the killing of the innocent. Therefore, any attempt to justify such an action on the grounds of apparent utility—here represented by two impulses that are good in themselves, that is, compassion and a desire to alleviate suffering—must be found wanting. If suicide is an action that is unjust in itself, no utilitarian arguments in its favor, however rhetorically compelling or seemingly ethical, can transform it into a just action.
The first and most important purpose of the state’s laws is to establish justice, the most basic principle of which is the protection and preservation of life. Canada’s regulations regarding so-called “medical assistance in dying” are fundamentally contrary to this purpose. In a just political order they would be overturned.