On not serving Kant in the euthanasia (or rather PAS) debate | Michael Grech

Michael Grech is a member of the Faculty of Education at the University of Malta

This article is not about whether the proposal concerning physician assisted suicide (PAS) is sound or not. It is about the type of ‘debate’ kick-started by the government that also set an expiry date, which ended recently.

For starters, there was lack of truthfulness regarding the issue at stake. What was proposed is not actually euthanasia, where someone other than the patient (even if possibly instructed by the latter) acts or stops some procedure with the intention of bringing about the patient’s death on grounds of mercy. What was proposed is PAS, where it is the patient themselves, aided by medical practitioners, that terminates their existence. So, the first question that arises is why this conceptual inaccuracy? Is it due to some discomfort with the word ‘suicide’?

Moreover, a debate about the feasibility of legalising X should involve different sides putting forward their arguments, an ensuing discussion, and then, having weighed the different views, legislators determining whether X is to be legalised or not.

In our case, it is obvious even from the pathetic and annoyingly repetitive TV ads, involving so-called personalities who introduce this grave and momentous issue with a grin and in the same tone of voice as a teleshopping feature, that the government is set on introducing PAS without weighing the pros and cons. The two benchmarks mentioned in the ads suggest the same conclusion—the deal is done and dusted, except for trimmings and trappings. Instead of these shenanigans, the government should have discussed a bill in parliament, passed the relevant legislation, and then left it to those groups within civil society who oppose such legislation to militate against it, possibly through an abrogative referendum.

Many movers and shakers then, turned the supposed debate into a bad episode of the Don Camillo and Peppone saga. This time around, the latter is middle-class and ironically probably educated at a church school, rather than the pleasant portly communist mayor. The debate was narrowed down to a discussion between one side supporting the proposal on grounds of compassion and autonomy, and possible opposition on Catholic grounds. That the debate could be more nuanced is an avenue that no one explored. 

For instance, one can have a secular argument against PAS (or euthanasia) based on Kantian philosophy. Despite his Christian faith, Immanuel Kant’s moral philosophy is not based on any appeal to God, revelation or creed, but involves moral laws that result from the operations of pure practical reason. These laws are universal and make no exception. For Kant, the idea of a moral law admitting exceptions is irrational; as irrational as thinking that scientific or mathematical laws making exceptions. They demand obedience regardless of the consequences that result from following them. Also, within this philosophy, humanity is never to be treated as a means, irrespective of the benefits that may result from this.

On these bases, in works like Groundwork of the Metaphysics of Morals, Kant rules out suicide regardless of any reason or motive one might adduce to terminate one’s existence. Regarding dignity and autonomy—terms that proponents of the law throw liberally into the debate—Kant holds that these are respected only if one abides by the moral law regardless of the painful consequences this might have. Now, one may find fault in the way Kant draws moral laws, in how he conceives the laws in question, in what he takes to be the essence of morality, in how he conceives of autonomy and dignity, and in other features of his moral philosophy. Yet, regardless of whether one considers a Kantian argument against PAS or euthanasia to be sound or not, one cannot dismiss it for relying on religious premises or presuppositions. So, claiming a-priori that any argument against PAS is by nature religious, is trivialising and, I would add, dishonest.

Even classifying the Catholic take on the matter as mere catechism-based opposition is, to say the least, reductive. Undoubtedly, the Catholic Church has a definite view of PAS and euthanasia, namely as: “gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator” (Catechism of the Catholic Church 2324). Yet, some Catholic thinkers believe that Christian compassion warrants different conclusions, and invite the Magisterum to further reflection and discernment on such topics. The former Abbott of San Paolo Fuori Le Mura Giovanni Franzoni for instance, claims that: “In dealing with issues which have to do with the end of life the official church fails to… giv[e] due consideration to the quality of life and to the fact that, if life is a gift, it involves fee acceptation by the one to whom the gift is bequeathed. Now one may have good reasons to refuse a gift or to renounce the gift after some time if the gift in question becomes exceedingly burdensome and ignominious. It is up to the individual to decide in a responsible, thoughtful and intimate manner whether or not to accept such gift” (Koinonia, 2010).

Franzoni made this reflection in relation to the death of Pier Giorgio Welby in 2006. Welby was diagnosed with muscular dystrophy and was no longer able to breathe on his own as of 1997. In 2006, after the disease had paralysed most of his body except for his eyes, an Italian doctor Mario Riccio stopped the medical ventilators that were keeping Welby alive. Franzoni’s Christian community organised a religious service for Welby after a Roman parish had refused him a Catholic funeral. Incidentally, Welby would probably not have qualified to have his life terminated given the bill being discussed locally.

Again, one may find fault in this conclusion, but it represents a Christian take on the issues, which an intelligent debate should not dismiss.

Moreover, with regards to religious reflections about the bill, what stood out is the almost total lack of consideration by movers and shakers of religious views other than that of the Catholic Church. And this includes not merely no reference to the possibly divergent views of non-Christian communities, but also failure to query Christian groups that are not Catholic who locally have hundreds of members.

In this regard, the article on MaltaToday by Imam Mohammad Elsadi and Samir AbouHussein presenting an Islamic take on the proposed law stands out as a welcome exception. Regardless of whether I agree with their conclusion, or with the reasons they bring to sustain this, their inclusion in the debate is to be commended. Yet, this was an exception.

The question as to why this lack of inclusion suggests various possible answers. Could it be the implicit belief that, despite all the talk about inclusion and diversity, these are not really ‘Maltese’ (despite including members who were born and bred in Malta)—they are in Malta but do not really belong here? Or is it because it is implicitly assumed that there is nothing these communities could offer to the debate? Or could it be because, following the Catholic Church being cut down to size after the divorce referendum this has become a safe dog to beat, whereas engaging with some other communities on issues on which they might harbour opposite views to the ones held by the liberal part of the island, a chunk of which is keen on their integration, might not be politically correct or, worse, raise prejudiced fears that provoking such an engagement would lead to some fatwa? Or could it be because engaging with these communities on such issues would reveal that those views that are represented by this segment of the media as obvious for everyone except some Catholic diehard, are not as obvious as they are made to be?

Be what it may, I hope that the exclusion of these communities from the debate is not evidence that, rather than moving towards a truly pluralistic society, we might just be switching from one monolithic way of dominating public discourse to another.