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An American Reply to Karsai’s Arguments for Assisted Suicide

The issue of assisted suicide or euthanasia has been a hot topic of the rights discourse in the US as well as in Europe for decades. Most recently, the Hungarian human rights lawyer, Daniel Karsai has reignited the debate all over Europe, when he was diagnosed with ALS and petitioned Europe’s highest human rights court in his case. The following represent an American philosophical take on Karsai’s arguments.

“I have affected more lives than I would have if I was walking….When you are in the trenches you don’t see that.” Anthony Orefice, motorcycle accident survivor living with spinal cord injury

Does assisted suicide ever benefit a human person? I mean, can it actually make them better off than they were before? In some ways this is a funny question. Many things can make you better off––a better job, higher salary, deeper friendships, falling in love, helping the poor, defending the defenseless, growing in virtue, etc. But practically nobody thinks assisted suicide actually makes them better off financially. Nor can it ever grant them more friends or family––in fact, it permanently severs such persons from them. Ironically, living with a terminal illness or permanent disability can do the opposite, by uniting others to them more intimately––suffering can create deeper, more meaningful connections with family, make opportunities to utter words of love you’ve been too afraid to say, and instill greater appreciation for lasting immaterial goods like kindness, compassion, and forgiveness.

Today many believe assisted suicide is good and ought to be pursued. Daniel Karsai, a prominent Hungarian attorney, is currently suing Hungary at the European Court of Human Rights (ECHR) over this issue. Karsai is suffering from a condition called amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease. At present there is no cure. Karsai believes that given the gradual worsening bodily deterioration and pain involved in ALS at some point he will be better off dead. But is that really true?  Can a person be better off dead?

An adequate answer to that question depends upon what follows death. I mean it’s not like we’re comparing a life with pain to the same life with no pain. We’re comparing life to, well, whatever happens after death. But for a person to be better off, there must be a person that exists who is made better off. So, if there is no afterlife, assisted suicide doesn’t benefit anybody who chooses it.

Karsai’s view depends upon unproven claims about the afterlife. He’s assuming that after killing himself, he’ll wake up in no pain, in some sort of afterlife wherein he is better off. 

With all due respect though, how on earth does he know that he’ll be better off? Karsai claims he believes in God and in human rights.  Does he think destroying the greatest gift God has given him won’t be punished? God is supremely just. Any just punishment must be proportionate to the crime; if taking your own life offends the infinite dignity of God, might the punishment be infinite in duration?

Further, if his religion teaches him that God’s merciful and basically everyone will go to heaven, then why do good deeds and avoid evil ones? If ALS isn’t a life worth living, then on Karsai’s reasoning all such people should kill themselves.

I don’t wish to argue extensively with Karsai here over his religious beliefs, but I do wish to point out that mere intuitions about what God will or won’t do (apart from deep philosophical or theological argumentation) are about as shaky as sand in an earthquake. God allowed the destruction of the dinosaurs. God allowed the Great Lisbon Earthquake of 1755. God allowed the Holocaust. So, why couldn’t he punish someone with everlasting fire for destroying the greatest gift he has given them? Historically, most people in Europe who believed thought everlasting fire was the punishment for suicide.

If it’s even probable that intentionally killing innocent human beings is wrong, then it’s also probable that Karsai intentionally taking his own innocent life is wrong. He is a human after all. Taking his own life increases the probability that his afterlife will be worse off. A better option is for Karsai to take courage, change his mind, find good caregivers, increase the dosage of pain medications as needed, and let nature take its course. At the very least, even permanent sedation to numb the pain is less risky than assisted suicide regarding its potential effects upon the quality of the afterlife.

Surprisingly though, Karsai’s main arguments aren’t about being better off in the afterlife. Instead he makes three main claims:  he wishes to die with dignity, he has the right to self-determination, and that “the Hungarian state imposes a de facto life sentence on me – imprisoned in my own body – without the prospect of release.”

Regarding dignity, Karsai states that “For me, the final state of ALS described above does not constitute real life but merely a simple existence stripped of all dignity. A dignified life is one where an individual can set and pursue meaningful goals.”

This is puzzling. Persons with ALS have zero dignity at all? What about the tens of thousands of people who have gone before him living with ALS? It’s currently estimated that over 200,000 across the world are living with the condition. Is he saying that none of these people have a “real life” or a meaningful existence?

Dignity isn’t something only the healthy possess. Dignity isn’t reducible to mere bodily functions, or looking beautiful, or possessing full health. Human dignity is something more intrinsically possessed by us as human beings, not human doings. 

As for the self-determination argument, destroying his own life, and risking the betterment of his afterlife, hardly seems like something that helps self-determination. If this existence is all there is, why undercut the very condition that makes self-determination possible in the first place? And if there is an afterlife, as Karsai seems to believe with a God who metes out rewards and punishments according to our actions, why risk losing self-determination there? 

Ultimate self-determination, untethered from the good, is not needing anyone else or being hindered by anyone else’s causal influence. In that case, the only truly free person is an island unto himself. But persons are relational beings, dependent creatures, determined, but also constantly influenced by others. This relationality and influence aren’t inherently bad; it’s part of what it means to be human.

Finally, Karsai’s claim that Hungary is imprisoning him in his own body is highly problematic. The errors of Cartesian dualism aside, it hardly makes sense to say you’re imprisoned in your body. You are your body, or rather your body is essentially a part of you. Saying you’re imprisoned in a part of you is much like saying water is imprisoned in hydrogen. Water is likely in part hydrogen, to be human is in part to be bodily. A whole can’t be imprisoned in what essentially constitutes it.

Dear Mr. Karsai, nobody is claiming that having ALS entails you exist for the sake of suffering and pain. Life is more than just suffering, and dignity is more than suffering. Plenty of persons suffering from ALS have found meaning in their suffering, in their life, and still desire to live beyond the pain. As Chanel Hobbs, living with ALS, says, “I think we are our worst critics and sometimes establish unrealistic expectations….if I can go out and let others see me with all my stuff, I made a difference and it’s a lovely day….The thing to remember is you are enough.  You are human.  And you make a difference.” 

Hopefully the ECtHR will see through Karsai’s weak reasoning, and see that life is worth living, even in the midst of great suffering, for there too meaning can be found.

John Skalko, PhD, is a Professor of Philosopher at St. John’s Seminary. Recently, he has been working on a book against assisted suicide.

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