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The Lost Narrative

In their article “Autonomy vs. Selflessness at the End of Life” published in the Summer 2015 edition of Ethics & Medicine, Hannah Martin and Daryl Sas provide a useful foray into the battle over the meaning of human dignity.

The authors describe an alternative to the “flat” version of human dignity espoused by proponents of physician-assisted suicide (PAS)—a version based solely on self-determination. In other words, a human dignity reliant only on autonomy (or, control) in decision-making lacks the depth and breadth inherent in the actual human experience. Our own individual creation ought to be sufficient to convince anyone of our lack of control over the nature of life, and brief reflection on the sheer improbability that there is any life at all should be enough to cause one to ask if there is some other force behind it.

I would add that the concept is not just flat but paper-thin, and bases its appeal on what could be called “the lost narrative.” Martin and Sas refer to the “poignant narratives of dying” that drive state laws legalizing physician-assisted suicide. These narratives succeed when we fail to articulate an alternate, and in fact, accurate view of the human experience of dying.

The authors help greatly to provide the alternative, a view in which dignity is based on virtues such as love (and its selflessness), courage, humility, and blessings such as God’s grace. Without these, autonomy will push us towards the extremes of “absolutizing life’s sanctity by claiming autonomy in life and…absolutizing life’s dignity by grasping at autonomy in death.” In fact, without God, mankind could never find balance, but instead be driven (as we seem to be) toward the extremes.

And without proper balance, where would someone establish the threshold of sufficient suffering to warrant early death? And if selflessness is removed as motive, what horrors might the medical profession produce? The “suffering” of family members and medical staff would enter into the equation (unchecked by selfless love) and push the patient toward an earlier and earlier death.

For the proponents of PAS, suffering is only bad. Human dignity becomes simply avoidance of what we can’t control. Such a view robs mankind of any hope that anyone can be anything more than the person who flips his own switch. But for those of us who have been in the presence of dying, we have had the opportunity to see for ourselves what is and is not dignified. We see it in the selfless love of caregivers, of family, and of the dying, all cherishing those final moments, wishing there were more to spend together, and never ready to end it all too soon.

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