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Euthanasia and Eugenics : Issues with Far-Reaching Effects

Jacques Dufresne

 

During the winter of 2010, the Government of Quebec made two announcements, almost simultaneously—the creation of a Parliamentary Commission on euthanasia, and of a public pre-natal program of screening for Down’s Syndrome. Everyone knows what the results of this second initiative will be: In France, where this kind of a screening program now exists, statistics show that more than 90 percent of women told that their baby has the genetic markers for Down’s Syndrome choose to have an abortion. This fact illustrates that the practice of eugenics is actually considered normal today. Euthanasia also enjoys a high approval rating in Quebec, as in many other industrialized societies. Euthanasia and eugenics are closely connected: Do we really know and understand the implications and consequences of our choices in these matters?

In the debate over euthanasia and eugenics, raging now for more than three decades, it is not enough for us to line up our arguments for or against a law that would legalize these practices. We must also understand the nature of the debate on which we have embarked, in what realities we are already complicit, and what we are renouncing when we adopt one position or another.

Our mission on this site is to reflect on belonging and, especially, to watch over the belonging – and, often, the “not belonging” – of the most vulnerable among us, those who are often the first victims of natural catastrophes as well as moral and social upheavals. “Lives without value,” “superfluous existences,” “dead spirits,” “empty human envelopes” – these are just some of the epithets reserved for them in Nazi propaganda, terms used in the effort to shift public opinion toward acceptance of the euthanasia the vulnerable ones were destined to suffer.

In relation to this Nazi propaganda and practice, to which European civilization did not just bow from one day to the next, George Steiner argues that the collective imagination had been prepared for the tenets of Nazism by the literary works of the Marquis de Sade—a comment that highlights the important role of the imagination, among a thousand other causes and historical events. We have said it before, and we reiterate it now: Ethics is a complex science. “No thinker would dare to affirm that the perfume of the hawthorn is useless to the constellations.”(1) So too, no one can hold, for example, that the disappearance of facial features from representations of human beings does not have some mysterious connection with the practice of “involuntary” euthanasia.

At the end of World War II in 1945, the world was frightened. People recognized that the wave that had swept over the world had been forming for a long time, and that there was no guarantee that the wave couldn’t reconstitute itself in an even more barbaric form. All we were able to hold up in opposition to this wave was the idea of dignity, an idea about which philosophers still have a great deal of trouble agreeing. Recently, in the interval between the two earthquakes in Haiti, the religious processions conducted were certainly moving, but insofar as their goal was to arrest the elements, they seemed merely laughable. Are we not equally ridiculous if we claim to be able to stop barbarism by opposing it with the icon of our dignity?

Euthanasia and eugenics enjoyed widespread approval at the beginning of the twentieth century, and this inseparable couple quickly reappeared after the short-lived burst of concern for human dignity that immediately followed World War II. Today, one cannot help but notice that it is really neither eugenics nor euthanasia in themselves that we ever rejected; rather it was the use made of them by a totalitarian state. These two same acts have suddenly, once again, become seen as good things, but only on the condition that they are the object of individual choice. And since they have thus been thus restored to the status of “good things,” it is only a matter of time before some state uses them for its own ends.

We will return to this question of individual choice later. For the moment, let us note the power of the wave that carries euthanasia and eugenics in its wake. This wave is the result of the convergence of a large number of currents. I will discuss five of them here, in the hope that they may shine some light on the far-reaching consequences of the issues they raise. It will obviously be impossible for me, within the confines of this article, to delineate the connections between and among these diverse currents, or to demonstrate the importance of each one in relation to the others, or the influence each has had on these events. My primary goal is to remind us that the changes in attitudes about death, objects or represenations of human beeings, have roots so far-reaching, so deep, and so decisive that if they once produced barbaric behaviour, we must presume that they will do so again, rather than pretend that we have averted the danger by attaching it to the shadow of totalitarianism. By far-reaching, I mean both their past consequences and those to come, and I would suggest that the further their antecedents are in the past, the more serious their consequences are likely to be in the future.

The Evolution of the Connection with Death and Suffering
The Evolution of the Connection with our Elders
The Evolution of the Connection with Objects
The Invasion of the Imagination by Mechanized Man and Robots
Freedom, increasingly assimilated into the notion of choice

The evolution of the connection with death and suffering
The cult of the dead has such a significant place in the ensemble of discoveries related to the past of our species that we are tempted to see in it an essential characteristic of the human being, to define mankind as an animal that honours its dead. This cult has been the subject of a large number of studies, of which we find a faithful echo in the material included on the l’Agora website that looks at death. Here, I will profile two heroic figures who illustrate the two poles between which attitudes toward death and suffering have moved: Sophocles’ Antigone (c. 2500 BCE) and Florence Nightingale (1820-1910), founder of the modern profession of nursing. Αntigone is, of course, a character in a play, but everyone would agree that there were real Antigones in the Greek world. Florence Nightingale, on the other hand, definitely lived. Why do I compare them? Because each demonstrated the highest degree of compassion for soldiers; in addition, religious motives were of the greatest importance to each woman.

Between the one and the other, however, lies a revolution: the first sacrificed her life for a dead man, her brother Polyneices; the second devoted herself to caring for dying British soldiers in a hospital in Scutari during the Crimean War. In according burial honours to her brother, Antigone opposed the will of the King, Creon, and risked her own life. Between Antigone and Florence Nightingale, we pass from the cult of the dead to care for the dying. I am not arguing that Antigone would not have preferred to care for her brother so as to heal him; nor am I saying that Florence Nightingale was indifferent to the care demanded by the dead. In her native country, the loveliest pieces of ground were chosen for cemeteries. What I am saying is that the story of Antigone illustrates a world where the accent was placed on the cult of the dead, whereas that of Florence Nightingale illustrates a world where the accent was placed on care for the dying. And, I would add, the dead have continued, since her time, to become less important than the dying. Of course, there still are cemeteries and, in the case of soldiers in particular, we see their coffins when they are brought home from the Front. We also continue to publish obituary notices about the dead in newspapers. Nevertheless, the retreat from death continues.

At the hospital in Scutari, soldiers could die with dignity, dignity in this case being something inside themselves, but they could not die in dignity, that is to say in physical conditions that included a minimum of hygiene, pure air, clean sheets, and proper bandages. Florence Nightingale’s contribution was to create such conditions and, in so doing, she succeeded on both the moral and the physical planes, for by virtue only of the improvements for which she fought, the survival rate of soldiers was raised almost to its current levels.

After Florence Nightingale, the movement intensified; the cult of death continued to diminish. Previously, if the soul was distinguished from the body and, if, as in Christian teaching, one believed that the soul was destined for the immortality accorded pure spirits, one continued nonetheless to watch over the condition of the body here below in the context of time and space, as if the soul retained the material reality of the breath to which it had been assimilated. The funeral monument, the tomb on which flowers were placed, the relics that were venerated, the masses said for the welfare of the deceased – all were ways of helping him become embodied anew, after the dis-incarnation of death, and thus to avoid the greatest misfortune of all—wandering restlessly across infinite space. This soul was revived first in the souls of his relatives who were faithful to him, and through them this soul enriched the life of the community. In the most ancient of cultures, it was believed that the souls of the dead took refuge in the stars.

In Rome, this close connection between the living and the dead was marked by the place occupied by the “manes” – the souls of dead loved ones – in the centre of each house; in Christianity, by the burial of the dead near churches and, sometimes, in the case of important persons, inside churches. The dead could thus participate in the prayers of the living. Having emotional connections with their dead, people were right to hope that they would be similarly cared for after their own deaths.

These realities are still so close to us that they are familiar even to a rational thinker like the French philosopher known as Alain. “So, it is sensible to ask what the dead want. And to look carefully, to listen carefully: the dead want to live; they want to live in you. They want your life to be enriched by the things for which they wished. Thus the tombs return us to life. Thus do our thoughts leap joyously beyond the coming winter toward next spring and even to the first leaves. Yesterday, I saw a stalk of lilac whose leaves were beginning to fall, and in it I saw a bud. (2)

Ludwig Klages, a contemporary of Alain’s, but one closer to German romanticism than to rationalism, evokes a distant past where “the living presence that man claims for the soul of the dead emerges, moment to moment, from a basic, erotic connection between the dead and those who are alive. The soul of the dead one dies when it is extinguished in the souls of those who commemorate it.” (3) And to this we would add that the soul of the living one dies in its turn when it ceases to love that of the dead.

For the red clay has swallowed the white kind;
Into the flowers that gift of life has passed.
Where are the dead? – their homely turns of speech,
The personal grace, the soul informing each? (4)

These are the words of poet Paul Valéry, still closer in time to us. In his verse, he draws connections between and among ancient cultures, including those of many Amerindian nations. The “gift of life” that he evokes here is another name given to the soul, and as far as we might push the instrumentalization of beings and of objects, we nevertheless still recognize the connection between flowers and death. The fact remains, however, that the dominant tendency of our culture distances us from this symbiosis with nature, which made the flower the symbol of the permanent presence of the disappeared, and that it is the cost of the flowers that we offer to the dead—rather than their symbolic portent—that makes them important in our eyes.

Of all this, only infinitesimal traces remain. Death used to be seen as a metamorphosis. It has become a rupture. May we believe that, before the rupture occurs, the presence of the dead in the community of the living helped them face death and resign themselves to the suffering that preceded it? Must we think that man, remaining subject to God, forbids himself from intervening in the major acts of nature? Whatever the case, since death has come to be seen as a rupture, humans look more and more to the day when they can put an end to their suffering and choose the hour and the form of their deaths. It is unfortunate, however, that this idea, which has seduced a great part of the West, was first applied under the sign of hatred by a totalitarian regime. There, it was a logical connection, for a certain Darwinian tendency was not foreign to the eugenics-euthanasia duo. It reappears today under the sign of compassion and of individual choice, but who can deny that its past still weighs heavily on it?

The Evolution of the Connection with our Elders
Even today, in Vietnamese families established in Canada, the eldest of the family must care for his or her parents until their deaths. This feeling of obligation with respect to the aged, which presupposes a profound respect for them, was and remains the rule in a number of cultures.

There used to be a similar custom in traditional families in rural Quebec. As the parents approached the age of 60, they effectively gave charge over themselves to the child who would inherit their house and their land. This child became responsible for caring for them, an agreement formalized in a contract witnessed by a notary. Today, relationships between parents and children are lived under the auspices of autonomy. Parents do what they must to ensure that their children become independent as soon as possible, and their children, later on, expect that their parents will likewise remain independent until death. What connections should we look for between this change of mentality and that change we have observed in relation to death? Where death is a wall, is aging a dead end? Whatever our response to this question, the current trend toward independence has a clear connection to the subject under consideration here.

The Evolution of the Connection with Objects
The idea of stimulating the economy by encouraging consumption and planning the obsolescence of goods appeared in the wake of the Great Depression, at the precise moment when “useless beings” were being presented as lives without value, as superfluous existences. A simple coincidence? Maybe, but that doesn’t eliminate the fear – that we will soon treat human beings like disposable objects when they become useless – from quickly spreading. “When we no longer respect objects,” Fernand Dumont would say, “men become pseudo-objects.”

The evidence is clear that there is a subtle link between the connections being made with death and with objects. If certain objects are unique or have character, we might say that they are living, that they have a soul, something which the artisan transmitted to the objects he made by hand. “Inanimate objects, do you therefore have a soul?” We are so un-resigned to the disappearance of inanimate objects that we act to conserve them from generation to generation. Museums, a word derived from the word “muse,” are full of them: they are, indeed, cemeteries for objects. By respecting objects, we respect the work of humans, and we prolong the life of artists after their death. We hope that the object endures; it was made to endure, like the old iron ring that symbolizes life in the eyes of the shipwrecked:

Horror! the man whose voice the waters drown
Feels rent and wrecked his vessel as it sinks;
Feels 'neath him gape th' abyss and night; and thinks
On the old iron ring, of the safe quay. (6)

This ancient ring is the quintessential object, in all the plenitude of its presence, and it is death that reveals it to us. But it will not endure; it will be taken away by the cult of novelty, which appeared in the same context as did obsolescence and production on the assembly line. The intent here is not to deny the blessings that mass production has brought to humanity, nor the contribution of industrial design to aesthetics, but rather to identify a tendency that, associated with others, could reduce man to a pseudo-object that we may dispose of at our pleasure.

The Invasion of the Imagination by Mechanized Man and Robots
From the man without a face to a life without value there is only, we would suggest, a single mysterious step. If in man there exists one infinitely precious thing that grounds his dignity, it is certainly that he expresses himself by his face above all, indeed so well that we are obliged to ask ourselves if we can represent man without a face without degrading him. Because it is the impact of the representation of human beings on the imagination that is at issue here, we must first consider the most dominant current expressions in this realm, those of film, television, and the Internet. On television, we see more and more frequently, in advertisements in particular, schematic representations of human beings. Pictograms that make people look like robots rather than beings able to express feelings and thoughts through and on their faces. If it is a matter of indicating an exit door, perhaps it is a better idea to use a schematic than a subtle design, because the representation is being used there only in the service of a utilitarian goal. But the use of the pictogram extends far beyond the utilitarian. We are complicit in the representation of the human being without a face.

The most prized trophy in the world of film is the celebrated “Oscar.” Originally, this statuette, made of gold-plated britannium, did not have a name, a reality well suited to the statue, because it had no face then and still has none. Harriet Herrick, a member of the American Academy of Motion Picture Arts and Sciences, saw a resemblance to one of her uncles, Oscar, in the statuette and so it received its nickname. Ever since, therefore, American cinema – and therefore the world’s cinema – has rested on a misleading symbol: the name of a person given to a thing, because a human body without a face is really only a thing. But let us be precise here: Oscar is not completely without a face. On the side of “his” skull, there are plated geometric figures resembling a mouth, eyes, and a nose–but this is a false representation. The figure remains denuded of all expression–it would have been preferable to leave it bereft of human traits. Oscar is a robot, the ancestor of all other robots who would thereafter people American cinema. And there are more and more of them. If we add to them all the monsters, all the machines, all the animals, more or less animated and disguised with comic faces that only reproduce the mechanical and schematic dimensions of feelings, one cannot but think that the robot has already won the battle for the imagination. The Internet has introduced the accomplice of the “emoticon,” the pictogram that can be manipulated, with the circumflex accent expressing gaiety or sadness depending on whether it is upright or inverted.

I will be reproached no doubt for not being “with it,” for not being in tune with the age, for not having understood that here–where I see a triumph of the robot–I should instead be amazed, confronted by life invading machines and humanizing pictograms. I respond only that the question of the man without a face demands to be asked, if only so that we might conceive of animations that enrich the imagination rather than cause it to wither.

One day I visited a friend in the hospital. He knew that he was fatally ill, and he received me while attached to a renal dialysis machine. He was mentally intact and only had one desire: to contemplate Van Eyck’s Mysterious Lamb. I offered to bring him a reproduction of the painting the next day. Other friends had done the same. Our dying friend was enraptured by them. Would the representation of a man without a face have brought him the same joy? Philosopher Jean Onimus thinks it would instead have plunged him into despair. “There is a painting of Picasso’s titled Portrait of a Man (a title of no small and sinister irony) that depicts a toreador. But of the man there is only a three-cornered hat and epaulettes: the rest is nothing more than a maze of flesh-coloured swirls, laboriously applied with meticulous care and artisanship. Instead of a face, a horrible wound, fascinating as a crime. To comment on such a painting solely from the point of view of art is, we believe, not enough. The work bears directly on the Spirit, and that is why it torments us, because we see in it long-savoured resentment, the frozen will of sacrilege.”(7)

This is why the man without a face terrifies me. It is yet one more risk factor on the slope of contempt on which the most useless and vulnerable people are often placed.

Freedom, Increasingly Assimilated into the Notion of Choice
The only difference, it is suggested, between the eugenics-euthanasia of the Nazis and that which is practiced today is that the second is legitimated by personal choice, whereas the first was debased by the use made of it by a totalitarian state. Is there in this distinction any real protection for the most vulnerable person, who is also the one least in a position to make choices? He is thus excluded from the right to euthanasia, unless the law authorizes his guardian or his delegate to make the choice, in his place, out of respect for his dignity. But how and under what conditions might the representative make a good decision?

The right choice in this case, as in all others, is that which gives love a final occasion to manifest itself. It was Victor Hugo who whispered this response to us in the poem in which he paints a portrait of a beautiful young man who, before leaving for the war, and remembering his first romantic turmoil, addresses this prayer to the sky: “I truly wish to die, O Goddess, but not before having loved.”(8) It is when they offer a place where the birth of love is still possible that the last moments of life are sacred.

But who could be sure of having loved? The one who loved wanted to love more, while the one who never loved is inconsolable as a result. If, on the very threshold of death, a mother still nurses the hope of reconciliation with one of her children, we must allow this hope to be realized, by reducing the dose of morphine even at the risk of increasing pain. But how far do we go? This final question of proportionality presupposes an intimate atmosphere that allows for a comprehensive respect to be paid the one who is suffering. The word “mystery” best captures such an atmosphere. According to Gabriel Marcel, a mystery is a situation in which I am emotionally and spiritually engaged. It is distinguished from a “problem,” which is what we call the objectification of the same situation. If they are part of the mystery because they know the sick person and his or her family well, the doctor and the nurse will exercise their sense of proportion, without having to fear that they will be accused of causing the death, or of having induced intolerable pain. According to historian Philippe Aries, starting in the nineteenth century, family doctors who made house calls offered this sort of palliative care confidently.

Alas! It is more and more difficult to assemble conditions that make such confidence possible. The organization of care services, more and more rationalized, more and more objective–death in hospital more often than at home, the isolation of many dying people–all are factors that make us think that the problem has virtually replaced the mystery almost everywhere. If this is the case, then has not the worst already been done? In the absence of mystery, of a truly human environment, the risk is significant that whatever decision is made will be experienced by the ill person as an attack on his or her dignity. Under these conditions, would it not be a lesser evil to enact a law that would put doctors and nurses more at ease? Where will they find the strength to resist the wave now pushing us in the direction of euthanasia?

We must nevertheless resist this wave, if only because it presents itself as inevitable, and man cannot concede to the inevitable without losing his dignity. We may resist it effectively through palliative care, at home or in a residence, on condition that the care offered is oriented toward the respect of mystery. Instead of a law that would objectify the situation even more, we must hope that someone very close to the dying person will come onto the scene. And if not someone close, then someone capable of awakening, through his or her own love, the final love of the person who is dying. And if someone does not appear? We may still hope that the dying person will find in himself the memories that will permit him to leave life blessing it, but being able to do that still presupposes that we surround him with great respect. “One should part from life as Odysseus parted from Nausicaa: with a blessing rather than in love.”(9) This is the meaning of care at the end of life; to encourage the final impulses of love, which may take the form of acceptance or of resignation, and might remain so internal and so secret that only someone who knows the person intimately would feel it. It is respect for this secret that grounds our obligations with respect to the most vulnerable.

In writing these lines, I have the feeling I am using a language that is no longer current, the equivalent of a dead language. Pierre Vadeboncoeur felt this way in 1978, when he wrote:
Mankind will continue to exist in the future. He will be created based on a strange model – established gradually – of utility, related to the functional ideas to which we will have reduced the moral rule. We will have, in particular, measured the utility of homicide and decided in its favour. It has already begun, coldly, as such a decision would be made in a laboratory. I cannot help feeling that the abortion debate is also related to this. My sorrow attests to it: modernity hurts me. This evil was a symptom, without a doubt. Of what do I feel deprived? From what deep part of my being, from what universal ground am I being torn away? What is peculiar to modern culture is that it constantly scoffs at the sacred that we carry within us. It amounts to a system of contempt – a system of contempt for, and ignorance of, all that our time cannot hold in the grip of its analysis. (10)

Notes
1. Victor Hugo, Les Misérables, Vol. 2, 1862, p. 80.
2. Propos sur le bonheur, Paris, Gallimard, “Idées,” 1969, p. 154-156.
3. Ludwig Klages, De l'Éros cosmogonique, L'Harmattan, 2008, p.199
4. Paul Valéry, Le cimetière marin.
5. Fernand Dumont, “Entretien, Les âges de la vie.”
Critère, No 16, 1977, http://agora.qc.ca/thematiques/inaptitude.nsf/Documents/Vieillesse--Laccomplissement_selon_Fernard_Dumont_par_Fernand_Dumont
6. Victor Hugo, Poor Men.
7. Jean Onimus, L'Art et la vie, Paris, Fayard 1964.
8. Victor Hugo, La Légende des siècles, La chanson de Sophocle à Salamine.
9. Frédéric Nietzsche, Thus Spake Zarathustra.
10. Pierre Vadeboncoeur, Les deux royaumes, Montréal, l'Hexagone, 1978, p.190
 

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The editor of L'Encyclopédie de L'Agora and well known newspaper chronicler and philosopher, analyses actuality through the looking glass of Belonging.
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