By Miguel A. Endara, Ph.D.
On November 1, 2014, Brittany Maynard, under Oregon’s euthanasia law, ended her life. Prior to this event Compassion & Choices International produced a video where she gave her reasons for wanting to commit physician-assisted-suicide. Maynard was a soft-spoken and articulate 29-year-old woman who claimed to want to “die with dignity.” She was suffering from a rare form of aggressive terminal brain cancer. Another woman, a 51-year-old Christian, Maggie Karner, suffers from the same type of terminal brain cancer. However, she plans to die a natural death from it. She connects dignity with her battle with cancer and with the appreciation of people who care for her. She claims that, as a baptized child of God, she places her dependence on Jesus and others and looks forward to the day when she will rise again, as her savior did.
This contrast brings up questions such as, what is human dignity and, by implication, what does it mean to die with dignity?
In a sense, yes, it is certainly undignified to have to give up one’s hopes, dreams, and goals. Further, it is undignified to feel helpless, useless, and burdensome, while being subjected to seemingly innumerable medical exams. What is the use of living under these conditions? Why bother? The physical and emotional suffering that may accompany the process of dying sometimes seems overwhelming. It is understandable, then, that under these conditions some feel that their life has lost its value or worth and its dignity is slipping away. In order to salvage at least a vestige of dignity, some may believe, it is best to take one’s life.
But, is this the way we should think about human dignity? This understanding of dignity is subjective, for it governed by the worth or value that we humans confer on ourselves; it depends, entirely, on one’s current feelings and understanding of what is of value in regard to our being. Further, it connects with our sense of worth, self-sufficiency, and our understanding and feelings regarding the meaning in life. As we might expect, this type of dignity, which we may call attributed dignity, fluctuates with experience, understanding, and mood.
However, there is another type of dignity, intrinsic dignity. Those of us who are Christian recognize that as creatures created in God’s image and likeness, we possess dignity within ourselves. Nonetheless, non-believers may also recognize that we human beings have special standing due to our capacities for will and reason. We possess, as a species, in other words, the ability to choose to engage in rational thought and deliberation. Through these we engage in many valuable endeavors such as love and concern for others. No other earthly creature has these capacities. Thus, these endow us, as a species, with dignity. Dignity, According to its Latin cognate, refers to nobility, honor, or worthiness. We human beings, then, possess special or elevated worth, value, or status.
This special worth inheres in our being. Dignity is a composite part of our humanity; it is a constituent of our human nature. As such it does not depend on whether we reach on hopes, dreams, or goals; it does not depend on whether we feel helpless, useless, or burdensome. It stands outside the scope of whether we are subjected to onerous medical exams or not. We possess intrinsic dignity due to the type of being we are, human beings.
Therefore, it is important to distinguish between one’s sense of dignity, attributed dignity, and one’s genuine or real dignity, intrinsic dignity.
How, then, should we understand the phrase “death with dignity”? We ought to think of this phrase in human terms, in terms consistent with the salient features of our humanity, reason and will and all that derive from these. As such, am I expressing my dignity, my special worth, by taking away my life? Can I promote my dignity by extinguishing those capacities that give me dignity in the first place? Can I, in other words, establish dignity by extinguishing the very basis for it?
This would seem contradictory. If we did not possess intrinsic dignity and our only dignity was the one that we could conjure for ourselves, attributed dignity, then, we human beings would possess no value or worth in ourselves, in our being. As a leaf that is tossed to and fro by the prevailing winds, so also, would our value and worth be subject to our prevailing beliefs and feelings, given our circumstances, moods, and worldviews. Moreover, in a world such as this, we are rife to be subjected to any type of treatment that the political regime de jure sees as legitimate.
How, then, might we affirm our reason and will so as to act in accord with the fullness of our intrinsic dignity? What might this look like?
In his daily struggle for life while in Auschwitz, Viktor Frankl tells us that he frequently thought of a passage from Dostoevsky, “There is only one thing that I dread: not to be worthy of my sufferings.” Maggie Karner is bravely confronting the cancer that plagues her. She is bearing her suffering in a manner consistent with her dignity, as she struggles to exercise her God imaging capacities over against the forces of cancer that beckon her to the grave. By acting in accord with her inherent worth, she extends this worth to her actions, to her struggle against the disease. She, thereby, imbues her plight with meaning and purpose; she invests her tragedy with human dignity. Karner is an example to admire and emulate. Frankl’s concern is the correct one to have when confronting our mortality. As such, we do well to pray that we, also, be worthy of our sufferings.
 Catherine E. Shoichet, “Maynard, advocate for ‘death with dignity,’ dies,” CNN website, http://www.cnn.com/2014/11/02/health/oregonbrittanymaynard/, 11/2/14.
 The Brittany Maynard Fund, an initiative of Compassion & Choices, http://www.thebrittanyfund.org/category/videos.
 Maggie Karner, “Brain Cancer Will Likely Kill Me, But There’s No Way I’ll Kill Myself,” The Federalist, 10/10/14, http://thefederalist.
 Viktor E. Frankl, Man’s Search for Meaning, (New York: Pocket Books, 1963), p. 105.
Miguel A. Endara earned his Ph.D. in Philosophy from Saint Louis University. He is a college philosophy instructor and he writes and speaks on issues dealing with bioethics, ethics, and theology. For further information please contact Scholl at 310-671-4412.
PHYSICIAN ASSISTED SUICIDE (PAS)/EUTHANASIA – DANGEROUS Directions for Society
quotes from a brochure by California Nurses for Ethical Standards
Why or how could euthanasia and PAS be considered dangerous for society?
• Changing the role of healer into the role of killer poses serious societal risks.
• The traditional doctor-patient relationship will be seriously undermined.
• Allowing physicians to assist in suicides becomes difficult even impossible to control.
• End-of-life becomes less challenging if a life can be ended rather than aggressively treated or cured. Incentives for innovative improvements slowly disappear.
• These practices can become an excuse for rationing care, especially if cost containment is an issue.
• The most vulnerable are at particular risk, and may feel pressured into thinking it is their “duty to die.” This is specially so if they feel they’ re no longer productive members of society or burdens to their families.
• It is possible to hide intentional killings if they occur, and impossible to prove medical malpractice in deaths that are questionable.