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Sunday, January 22, 2006

When society celebrates suicide

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"Assisted suicide" is both oxymoron and euphemism. Suicide is an intensely personal, individual and solitary act. The "assistant" does not put his life at stake. It more accurately ought to be called "state-sanctioned murder." That's where last week's Supreme Court decision puts it (stripped of euphemism).

Just as there are doctors who won't perform abortions, there are doctors who won't "assist" in suicide. The Supreme Court majority said, with a certain delicacy, their decision was "a very narrow one" based on the right of Oregon to decide that doctors may write prescriptions for lethal pills for patients reckoned to be dying, and the federal government cannot deprive such "assistants" from writing prescriptions under the Controlled Substances Act.

The dissenters -- Chief Justice John Roberts and Associate Justices Antonin Scalia and Clarence Thomas -- said such lethal "medicine" in their view does not serve a "legitimate medical purpose." The narrow technicality of the decision, however, does not go to the authentic heart(less) issue. The morality of care for the sick and aging in our society bears witness to how we see ourselves and the world we want our children to inhabit. How we answer this question tells us more about how we live than how we die, and tells us, literally, who cares.

We once depended on religion and laws of the spirit to determine how we put science and technology to use. That's difficult today when secularism has been elevated to the status of religion, reality has become virtual and technology drives our sensibilities about what it means to be human. Consider, for a moment, what some call, without irony, "nurturing technology."

Sherry Turkle, a psychologist at Massachusetts Institute of Technology, studies the psychological and social impact of technology. She tells of something she watched at a Boston nursing home. An elderly woman, abandoned by a son who once visited her but no longer does, became miserable and depressed. Paro, the "therapeutic robot," was assigned to visit the old woman in the son's place. The robot makes "eye contact" with the woman and responds to her touch as she projects her feelings on to him. "'Yes, you're sad, aren't you," she tells Paro. "It's tough out there. Yes, it's hard." She strokes Paro's mechanical head, as if attempting to comfort herself by showing concern for Paro.

It's not so far-fetched to imagine Paro as the future of nursing-home care for the abandoned old. We're compelled to ask whether we will allow science and technology to trump the human touch. Children who grow up with closer relationships to a screen or a cell phone than to a human may as adults have a very disturbing idea of what it means to be emotionally caring for another person.

The Greeks thought it important to "know thyself," to understand the relationship of humanity to the larger universe, but we may have to expand that to "know others" to develop more lasting human bonds. We have drugs already that can enhance physical and intellectual capabilities, insure greater happiness with the release of endorphins, to extend life -- and to end it. These advances aim to benefit mankind, but many move quickly into the mainstream (and bloodstream) merely to enhance selfish and narcissistic desires and wishes.

The ethics of "assisted suicide" lubricate the descent on that slippery slope, ever more dangerous as an increasingly geriatric society anticipates a crisis in long-term care. Relieving pain may not always be the only consideration in assisting another person's death. A lingering illness makes it easier for an adult child to become callous in the face of an elder's suffering. We value independence of body and mind, but in old age interdependence is crucial. Assisted suicide is merely the tip of a titanic iceberg.

In an aging society, we require more wisdom than Yahoo, Jeeves and Mr. Google can find for us. The findings of the President's Council on Bioethics ring with the eloquence of an Old Testament prophet and the savvy of New Age understanding in its report, "Taking Care," about "caregiving" in an aging society: "We will need greater ethical reflection on what the young owe the old, what the old owe the young, and what we all owe one another. And we will need prudence in designing effective public policies and in making loving decisions at the bedside, so that we accept the limits of modern medicine and economic resources while never abandoning conscientious and compassionate human care."

The newspaper stories about the Supreme Court's assisted-suicide decision were accompanied by creepy photographs of the winning plaintiffs grinning in triumph, free at last to kill themselves with the blessings of the state. Considerably more ominous, I thought, than uplifting.

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