The Presumption of Life No More: The "Safe, Legal, Rare" Misnomer of Euthanasia

Editors' Note: This article is part of the Patheos Public Square on the Faith and Aging. Read other perspectives here.

Euthanasia or "Physician-Assisted Suicide" continues to gain traction across American culture. Many states now have laws on the books allowing for citizens to end their lives. Framed as a compassionate alternative for those staring down the future of a terminable disease, the "rights" regime attending to American democracy is now offering a "right to die" as a solution to suffering.

Opponents of the practice (of which I consider myself) warn that going down a path of state-sanctioned suicide will have unintended and inhumane consequences. Political communities that permit euthanasia tend toward ever-greater expansion of the practice, and with the difficulty of capping its use, legal regimes find themselves in a newfound presumption against life. Indeed, states that go down the path of euthanasia have a difficult time limiting its eligibility criteria over time; for if autonomy and the elimination of the category of suffering is the measure of its application, what is the limiting principle that prevents some people's experiences from justifying euthanasia?

The chain of consequences from introducing euthanasia as an alternative to suffering are becoming a reality.

In Belgium, a legal minor was granted the right to suicide.

A Christian nursing home in Switzerland lost a court battle in its objection to being required to offer euthanasia to residents who requested or else risk losing its legal status as a charity.

A female sexual abuse victim in Holland was permitted the right to suicide after it was determined that the ongoing trauma of her post-traumatic stress disorder was incurable.

The latest news story, which is what I want to focus on in particular, brings euthanasia as a factor into medical insurance and demonstrates how the dignity of life becomes subject to the utilitarian calculations of an actuarial table.

A California (where euthanasia is now legal) woman with a terminal illness—Stephanie Packer—was denied chemotherapy medication by her insurance company that would potentially prolong her life.

Can you guess what the company did approve paying for? A cocktail of drugs that would end Packer's life.

Let's make the moral calculus of this situation very clear: Because the state of California is now in the business of regulating suicide, an insurance company has done the actuarial math and has pitted life-saving drugs against life-ending drugs. For cost-saving purposes, denying coverage in order to end life is a more effective business strategy than offering coverage to prolong life.

On the one hand, it is barbaric that such considerations were ever possible. On the other hand, insurance companies are trying to cut costs where possible in order to reduce cost and increase profit. But something changed that made these considerations a reality.

The introduction of euthanasia into public policy brings with it a new regime of calculations that had not previously been considered. Why? Because the dignity and inviolability of life is no longer the assumed default. The presumption of life that undergirds the philosophy of medicine is slowly being upended. This has enormous repercussions on questions related to human dignity, autonomy, and the purpose of medicine. It naturally follows that once euthanasia is permitted, insurance companies will take such legalities into consideration.

In the case of Packer, a person not wanting to die was confronted with the option of necessary dying in order to assuage the concerns of third parties with vested financial interests. Had the presumption of life remained, financial calculations would never have entered the equation.

Thankfully, Packer's insurance company overturned their original decision after Packer threatened to tell her story to the media.

Nonetheless, the moral calculus for determining whether to end a life or save a life now has precedent in the insurance company world.

What does this episode confirm? That the Culture of Death that Pope John Paul II warned of is upon us. Such a culture makes utilitarian calculations about the measure of dignity it is willing to extend to its citizens; but that is not a humane culture.