Somerville is Samuel Gale Professor of Law, Professor in the
Faculty of Medicine, and Founding Director of the Centre for
Medicine, Ethics and Law at McGill University, Montreal. She
authored The Ethical Canary: Science, Society and the Human
Spirit and Death Talk: The Case Against Euthanasia
and Physician-Assisted Suicide; has edited Do We Care?
Renewing Canada's Commitment to Health and co-edited
Transdisciplinarity: reCreating Integrated Knowledge. Professor
Somerville regularly consults, nationally and internationally,
to a wide variety of bodies including governments and NGO’s,
especially regarding public policy, and has served on many editorial
boards, advisory boards and boards of directors.
She has been invited to give the 2006 Massey Lectures, which
will be broadcast on the CBC Radio One show IDEAS, from November
5th to 9th inclusive. The lectures are given across the country
in October from St. John’s, Newfoundland to Vancouver.
The dates, times and places will be advertised.
two major reasons against euthanasia and assisted suicide are,
first, that it is wrong for one human to intentionally kill
another, except in self-defense. And, second, that the harms
and risks of legalizing euthanasia and assisted suicide far
outweigh any benefits. (I
use the word euthanasia to include assisted suicide.)
our values were based on a shared religion, the case against
euthanasia was simple: God's command was "thou shalt not
kill." In a secular society based on intense individualism,
the case for euthanasia is simple: Individuals have the right
to choose the manner, time and place of their death. But, in
such societies the case against euthanasia is complex.
case for euthanasia is easily made by focusing on heart-wrenching
individual cases of very difficult deaths that make dramatic
and compelling TV footage. The case against euthanasia is much
more difficult to present because it depends on harm to some
of our most important societal values, to the important institutions
of medicine and law, and to present and future generations and
is intentionally killing another person to relieve their suffering.
It is not the withdrawal or withholding of treatment that results
in death, or necessary pain- and symptom-relief treatment that
might shorten life, if that is the only effective treatment.
is not, as euthanasia advocates argue, just another option at
the end of a continuum of good palliative care treatment. It
is different in kind from them. To legalize euthanasia would
damage important societal values and symbols that uphold respect
for human life. If euthanasia is involved, how we die cannot
be just a private matter of self-determination and personal
beliefs, because it involves other persons and society's approval
of their actions. It overturns the prohibition on intentional
killing, which the British House of Lords called "the cornerstone
of law and human relationships, emphasizing our basic equality."
and the law are the principal institutions involved in legalizing
euthanasia. In a secular, pluralistic society they are responsible
for maintaining the value of and respect for human life. Euthanasia
would seriously damage their capacity to do so. Paradoxically,
their responsibility is much more important in a secular society
than a religious one, because they are the "only game in
legalize euthanasia would fundamentally change the way we understand
ourselves, human life and its meaning. We create our values
and find meaning in life by buying into a "shared story"
-- a societal-cultural paradigm. Humans have always focused
that story on the two great events of every person's life, birth
and death. In a secular society -- even more than in a religious
one -- that story must encompass and protect the "human
spirit." By the human spirit, I do not mean anything religious.
Rather, I mean the intangible, invisible, immeasurable reality
that we need to find meaning in life and to make life worth
living -- that deeply intuitive sense of relatedness or connectedness
to all life, especially other people, the world, and the universe
in which we live.
are two views of human life and, as a consequence, of death.
One is that we are simply "gene machines." In the
words of an Australian politician, when we are past our "best
before" or "use by" date, we should be checked
out as quickly, cheaply and efficiently as possible. That view
favours euthanasia. The other view sees a mystery in human death,
because it sees a mystery in human life, a view that does not
require any belief in the supernatural.
converts the mystery of death to the problem of death, to which
we then seek a technological solution. A lethal injection is
a very efficient, fast solution to the problem of death -- but
it is antithetical to the mystery of death. People in post-modern
societies are uncomfortable with mystery, especially mysteries
that generate intense, free-floating anxiety and fear, as death
another objection to legalizing euthanasia is that abuse cannot
be prevented, as recent reports from the Netherlands show. And
they show that once euthanasia is legalized, its availability
expands. Originally, euthanasia was only available to dying
adults with unrelievable suffering who were competent to give
informed consent and repeatedly requested euthanasia. Very recently
the Groningen protocol has extended its availability to include
disabled newborn babies.
assess the impact that legalizing euthanasia might have, in
practice, on society, we must look at it in the context in which
it would operate: The combination of an aging population, scarce
health-care resources, and euthanasia would, indeed, be a lethal
advocates often argue, in support of legalizing it, that physicians
are secretly carrying it out anyway. But, even if that were
true, it does not mean that it is right. Further, if physicians
were currently ignoring the law against murder, why would they
obey laws governing euthanasia? Physicians' absolute repugnance
to killing people is necessary to maintaining people's and society's
trust in them. This is true, in part, because physicians have
opportunities to kill that are not open to other people. Experience
in both the Netherlands and Australia (euthanasia was briefly
legalized in Australia's Northern Territory in 1997) show that
people stay away from doctors and hospitals because of fear
of euthanasia. A serious public health problem arose in Australia's
aboriginal community because parents refused to have their children
how would legalizing euthanasia affect medical and nursing education?
What impact would physician role models carrying out euthanasia
have on students and young health-care professionals? Would
we devote time to teaching students how to administer death
through lethal injection? (In the Netherlands a patient who
was administered euthanasia but did not die, sued his doctor
for medical malpractice.) It would be very difficult to communicate
a repugnance to killing in a context of legalized euthanasia.
professionals need a clear line that powerfully proves to them,
their patients, and society that they do not inflict death;
both their patients and the public need to know with absolute
certainty -- and be able to trust -- that this is the case.
Anything that would blur the line, damage that trust, or make
them less sensitive to their primary obligations to protect
life is unacceptable. Legalizing euthanasia would do all of
is a simplistic and dangerous response to the complex reality
of human death. Physician-assisted suicide and euthanasia involve
taking people who are at their weakest and most vulnerable,
who fear loss of control or isolation and abandonment -- who
are in a state of intense "pre-mortem loneliness"
-- and placing them in a situation where they believe their
only alternative is to be killed or kill themselves.
a society treats its weakest, its most in need, its most vulnerable
members tests its moral and ethical tone. To set a present and
future moral tone that protects individuals in general and society,
upholds the fundamental value of respect for life, and promotes
rather than destroys our capacities and opportunities to search
for meaning in life, we must reject euthanasia.