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A sermon has religious stuff in it (Sermon prep III).
More of my argument about assisted suicide follows. This part is really long, so I'm putting it behind a cut tag. This is also the part that needs the most work, [N.B.: Michael says no, it's the last section (not posted yet) that needs the most work. So watch for something worse than this.] because I'm not used to making religious arguments - there are so few contexts in which they are appropriate. (Of course, a sermon would be one of them.)
Opinions and argument continue to be welcome.
Why is physical decline considered so different from other negative events that we consider setting it apart as the only acceptable justification for suicide? I have some ideas.
We live in a society that values independence so much that parents of month-old babies are cautioned not to let them get too dependent on their mothers. A society that finds dependence so humiliating a condition that "Depends" is the name of an adult diaper. We live in – we are raised in – we continually breathe the air of a society in which our worth is fundamentally seen as coming from what we do. "What do you do? When are you going to do something with your life? What contributions can you make to society?" Our abilities and our actions are the most important things about us... right?
So that when we cannot do, when our capabilities become disabilities, when we can no longer preserve the rugged independence that is the American ideal… we may not know anymore what we have left.
Or perhaps we don’t put much stock in the abilities of our bodies, but we feel that our primary value lies in our minds, our intellects. I might be able to accept the idea of using a wheelchair, but feel that if I could no longer put together an incisive argument, or read The New York Times, or balance my checkbook, my worth as a person would be degraded.
We may fall into this way of thinking - which some call ablism or disablism – about ourselves. And more gravely: when other people can no longer do, when they are not capable, when they face increasing dependency as they age or become disabled... it may seem to us, through the lens of our independence-and-action-prizing culture, as if it would be perfectly rational for them to conclude that their life is not worth living. A conclusion we would never accept from a physically healthy person.
Where do our UU values lead us, on these issues? That’s a complicated question to answer, and it is clear that where assisted suicide is concerned different members of our congregation have looked within themselves and found very different answers. We may also perceive conflict between different UU values. Our Unitarian forebears were Puritans; from them we may have inherited a sense that our works are what give us value. Unitarians have long prized intellect and rationality; excellent values, but ones which may leave us vulnerable to losing our sense of worth if our intellect fades.
More generally, our Unitarian emphasis on rationality may mean that when someone presents an apparently rational argument that their life is not worth living, it is difficult for us to look deeper beneath the surface of that rational argument, to test the assumptions on which it rests.
And as religious liberals, we may shy away from a position on assisted suicide which would appear to put us on the same side as the right-to-life movement and the Catholic Church. If they’re opposed to assisted suicide on religious grounds, doesn’t that automatically mean that we ought to favor it?
No. I want to call for us to re-examine this issue, approaching it with Universalist hearts as well as Unitarian minds. The First Principle reminds us that we have inherent worth. "We affirm the inherent worth and dignity of all people." Not because of their actions or capabilities, but as an integral part of their very being. Our UU values tell us that we do not have to do to have worth. We simply have to be. Our UU values direct us to honor the lives of people who are disabled, frail, depressed, mentally incapacitated, to the same extent that we value the lives of people who are healthy, vital, confident, intelligent.
To me, the First Principle unequivocally says that when someone tells me that their life is worthless, I cannot agree with them. I must find a way to support and affirm their worth.
The Second Principle guides us toward justice, equity, and compassion in human relations. I want to spend time talking about this, because assisted suicide is often framed as the "compassionate" answer to suffering at the end of life. So let’s consider those problems in greater depth, and the solutions to which the Second Principle may lead us.
So far I’ve focused on the emotional and existential challenges of people facing death or severe disability: a sense of meaninglessness, hopelessness, loss of personal value. We know those are far from the only challenges. People struggle with pain, which is often inadequately controlled. They fear that they will be a care burden for relatives and friends, or that they will have to give up their freedom for the restrictions of a nursing home. They fear that they will be poorly treated when they are helpless. They fear leaving their spouse with tremendous medical debt, or wiping out the estate they hoped to leave to their children. These are not irrational fears. They are often very real. They may seem overwhelming when we, or our loved ones, are facing them.
What, then, is the just, equitable, and compassionate response to someone who says that "the circumstances of my life are intolerable"?
When I look back at UU history, I see that we have faced that question again and again. Our UU forebears have answered that question with their social action work for abolition, for civil rights, for women’s rights, for immigrants, for lesbian, gay, and transgendered people, for oppressed people all over the world. We have fought to relieve suffering and increase freedom and improve living conditions in the most desperate and hopeless of circumstances.
Only with this issue, as far as I can tell, have UUs been encouraged to come to the conclusion that when the conditions of someone’s life are intolerable, the just and compassionate response is to kill them.
That doesn’t make sense to me. To me that is a profound rejection of our responsibilities under the First and Second Principles, and a profound rejection of our denominational history as agents of transformative social change. I don’t know how we got here, except that – as Aaron Beck warned us – on this issue we’ve gotten sucked into agreeing with helpless, demoralized, and oppressed people that their situation is truly hopeless.
I say to you that it is not. When faced with the suffering of people who are disabled or dying, we have options beyond reframing "compassion" and "dignity" to mean fatal overdoses for those who lose hope.
(Then I have stuff about what we need to do to support people who are dying and transform end-of-life care, which I'll break off into a fourth sermon prep post.)
Opinions and argument continue to be welcome.
Why is physical decline considered so different from other negative events that we consider setting it apart as the only acceptable justification for suicide? I have some ideas.
We live in a society that values independence so much that parents of month-old babies are cautioned not to let them get too dependent on their mothers. A society that finds dependence so humiliating a condition that "Depends" is the name of an adult diaper. We live in – we are raised in – we continually breathe the air of a society in which our worth is fundamentally seen as coming from what we do. "What do you do? When are you going to do something with your life? What contributions can you make to society?" Our abilities and our actions are the most important things about us... right?
So that when we cannot do, when our capabilities become disabilities, when we can no longer preserve the rugged independence that is the American ideal… we may not know anymore what we have left.
Or perhaps we don’t put much stock in the abilities of our bodies, but we feel that our primary value lies in our minds, our intellects. I might be able to accept the idea of using a wheelchair, but feel that if I could no longer put together an incisive argument, or read The New York Times, or balance my checkbook, my worth as a person would be degraded.
We may fall into this way of thinking - which some call ablism or disablism – about ourselves. And more gravely: when other people can no longer do, when they are not capable, when they face increasing dependency as they age or become disabled... it may seem to us, through the lens of our independence-and-action-prizing culture, as if it would be perfectly rational for them to conclude that their life is not worth living. A conclusion we would never accept from a physically healthy person.
Where do our UU values lead us, on these issues? That’s a complicated question to answer, and it is clear that where assisted suicide is concerned different members of our congregation have looked within themselves and found very different answers. We may also perceive conflict between different UU values. Our Unitarian forebears were Puritans; from them we may have inherited a sense that our works are what give us value. Unitarians have long prized intellect and rationality; excellent values, but ones which may leave us vulnerable to losing our sense of worth if our intellect fades.
More generally, our Unitarian emphasis on rationality may mean that when someone presents an apparently rational argument that their life is not worth living, it is difficult for us to look deeper beneath the surface of that rational argument, to test the assumptions on which it rests.
And as religious liberals, we may shy away from a position on assisted suicide which would appear to put us on the same side as the right-to-life movement and the Catholic Church. If they’re opposed to assisted suicide on religious grounds, doesn’t that automatically mean that we ought to favor it?
No. I want to call for us to re-examine this issue, approaching it with Universalist hearts as well as Unitarian minds. The First Principle reminds us that we have inherent worth. "We affirm the inherent worth and dignity of all people." Not because of their actions or capabilities, but as an integral part of their very being. Our UU values tell us that we do not have to do to have worth. We simply have to be. Our UU values direct us to honor the lives of people who are disabled, frail, depressed, mentally incapacitated, to the same extent that we value the lives of people who are healthy, vital, confident, intelligent.
To me, the First Principle unequivocally says that when someone tells me that their life is worthless, I cannot agree with them. I must find a way to support and affirm their worth.
The Second Principle guides us toward justice, equity, and compassion in human relations. I want to spend time talking about this, because assisted suicide is often framed as the "compassionate" answer to suffering at the end of life. So let’s consider those problems in greater depth, and the solutions to which the Second Principle may lead us.
So far I’ve focused on the emotional and existential challenges of people facing death or severe disability: a sense of meaninglessness, hopelessness, loss of personal value. We know those are far from the only challenges. People struggle with pain, which is often inadequately controlled. They fear that they will be a care burden for relatives and friends, or that they will have to give up their freedom for the restrictions of a nursing home. They fear that they will be poorly treated when they are helpless. They fear leaving their spouse with tremendous medical debt, or wiping out the estate they hoped to leave to their children. These are not irrational fears. They are often very real. They may seem overwhelming when we, or our loved ones, are facing them.
What, then, is the just, equitable, and compassionate response to someone who says that "the circumstances of my life are intolerable"?
When I look back at UU history, I see that we have faced that question again and again. Our UU forebears have answered that question with their social action work for abolition, for civil rights, for women’s rights, for immigrants, for lesbian, gay, and transgendered people, for oppressed people all over the world. We have fought to relieve suffering and increase freedom and improve living conditions in the most desperate and hopeless of circumstances.
Only with this issue, as far as I can tell, have UUs been encouraged to come to the conclusion that when the conditions of someone’s life are intolerable, the just and compassionate response is to kill them.
That doesn’t make sense to me. To me that is a profound rejection of our responsibilities under the First and Second Principles, and a profound rejection of our denominational history as agents of transformative social change. I don’t know how we got here, except that – as Aaron Beck warned us – on this issue we’ve gotten sucked into agreeing with helpless, demoralized, and oppressed people that their situation is truly hopeless.
I say to you that it is not. When faced with the suffering of people who are disabled or dying, we have options beyond reframing "compassion" and "dignity" to mean fatal overdoses for those who lose hope.
(Then I have stuff about what we need to do to support people who are dying and transform end-of-life care, which I'll break off into a fourth sermon prep post.)
no subject
To whom do you extend the right to self-determination when in comes to suicide? It is current practice to allow (and in some cases, require) involuntary hospitalization of suicidal people for psychiatric treatment. Do you oppose those laws, in favor of a universal "right to die?" Or do you support the right to suicide only in cases of terminal illness and/or severe disability?
Also: if you go down into the basement and shoot yourself in the head without involving or warning anyone, I suppose you might argue that this is no one's business but your own. (Your family and friends would probably disagree.)
Proponents of assisted suicide aren't arguing for their right to do that. They're arguing for the right to have socially sanctioned, medically supported suicide. They're arguing that although some suicides may be irrational, others are not. That puts society into the position of judging which is which. The only real way to do so is for some outside person or group to decide whether there is indeed no possible value to the suicidal person's future life.
As a member of the society involved, I absolutely have a say in whether we should be sanctioning some suicides. By asking for social approval, assisted suicide proponents have officially made it my business.
Conversely, I think that the belief that the greatest priority of one's life should be to preserve one's life is no less an error. [..] For myself, I'd rather spend my estate endowing a college scholarship than paying hundreds of thousands of dollars to extend my life beyond my body's natural ability to live.
This is a false dichotomy. The choice isn't between, on the one hand, being compelled to pursue every possible medical intervention no matter how painful and futile, or on the other hand, demanding a suicide pill from your doctor. Every person has the right to refuse medical treatment. Every person has the right to decide at which point to allow nature to take its course. There is no positive duty to accept potentially curative medical treatment.
If you are terminally ill and you decide at some point that you aren't going to go into the hospital anymore, and you choose to receive symptom-relieving treatments and pain control at home until such time that you die at home, I fully support that.
If you are terminally ill and you decide that you want some hospital committee to make an official determination that the rest of your natural life wouldn't be worth anything anyway, such that a doctor should be given the all-clear to violate the Hippocratic Oath and kill you while everyone else is forced to stand by and do nothing, then you and I are going to have a fight.
no subject
A decision to allow assisted suicide is not a determination that the rest of the patient's life is worthless, it is a determination that the patient is capable of deciding this for themselves. In Oregon it seems that many such patients obtain comfort from the knowledge that they have the control to end life should they wish to, yet never exercise that option.
I'm afraid that your statement that I don't have to agree with you is not quite true. If your position prevails I DO have to agree with you because I will have no choice.
no subject
Furthermore, from reading the alz.org caregivers forum, it appears that a number of people with dementia live in their homes and receive 24/7 care from their own families along with specialized care from doctors and therapists. And they still spend a great deal of time feeling frightened, lost, and lonely.
no subject
My mom was never content. Withdrawal of her treatment would have meant more psychotic episodes, not death. That is why her children dread the possibility of this outcome for ourselves. What are the real choices someone in that position has?
no subject
But I do not believe that being in the final stage of a terminal illness should be the requirement. I think that someone in a lucid phase of a degenerative dementia-causing condition should be allowed as well, and heck I think that an Olympic skier who loses her legs in a car accident should be allowed to ask (although I would be sad if the counseling didn't change her mind). To fully lay out the depth of my feelings, I think that a guy going through a midlife crisis should be allowed to ask, on the grounds that the methods that laymen choose to take their lives is often more socially disadvantageous than a medical procedure would be. That's dangerous in the sense that people in my society might make choices that I or someone else might disagree with. But, you know, that puts it in line with the right to an abortion or gender transitioning or plenty of other things where I think that conservatives need to STFU about how someone else making personal choices is somehow harshing their squee. It isn't -- the world sees a free society and the people whose opinions matter thank you for preserving it.
Also, I'm sure I don't need to mention that the Hippocratic Oath forbids doctors from performing abortions (to say nothing of surgery), except that it doesn't any more. It's an evolving document, and I think that we should discuss whether it needs to evolve again on this issue. I don't want to force my doctor to give me a suicide pill upon the diagnosis of early-onset Alzheimers (which is a condition that is totally abhorrent to me), but if Doctor K down the street is comfortable with making that diagnosis, I don't think that the medical complex should prevent a doctor and a patient from reaching a mutually acceptable benevolent medical outcome just because it hastens death. It overcomes an unpleasant disease with no cure, and that should be enough.
To answer your question (which probably goes far beyond the scope of your sermon), I believe fundamentally that it is foolish to deny that anyone has the capacity to follow through on the choice to end their life. Suicide itself has been decriminalized throughout the United States, and I welcome those decisions. Of course, attempted suicide remains a crime, and I generally approve of that as well. If someone chooses to end their life in a way that makes a public nuisance of themselves (by standing on a bridge snarling rush hour traffic or tying up a 911 line in an effort to be talked down), I think that the state has a right to end that nuisance, and further that they have the obligations to prevent the death of anyone in their custody and also to perform psychiatric evaluations of anyone accused of a crime. I once had a roommate who went through this process, and I am glad that it exists because it was the first step in that person coming to wellness.
However, I think it would be better yet if suicide were not a dirty little secret that only comes up in crisis situations. If my roommate had the option of candidly pursuing a medically assisted suicide only on the basis that life was mentally unbearable, then my roommate's wellness would have come sooner and without the involuntary institutionalization that was a burden on my roommate, the state, and everyone else. Again, I would suggest a comparison to the liberalization of abortion access and how that ended the horrors of self-induced abortion and medically unlicensed procedures in exchange for safe medical procedures even if they were abhorrent to a portion of society. I would suggest that we would see similar increases in the social outcomes of suicide if we had a more pragmatic and healthy outlook on its access.
no subject
Also: the medical profession should implement guidelines as a check against coercion or depression.
Please explain how one would go about certifying that a person who says "my life is awful and there is no hope of improvement, so much so that I want to kill myself" is not depressed.
If my roommate had the option of candidly pursuing a medically assisted suicide only on the basis that life was mentally unbearable, then my roommate's wellness would have come sooner
"Wellness" does not mean what you seem to think it means.
no subject
It bothers me greatly. That's why I want people who want to commit suicide to feel welcome in the system instead of made to feel like their only solutions must come from themselves.
Anyway, I'll stop trying to express my viewpoint, as you are more versed on the subject and your sermon says what you intend it to.