Euthanasia

What Kevorkian had done was deliberately and mercifully hasten another person's death, an act of active "euthanasia," taken from the Greek word for "easy death." Acquitted of the charge of assisting suicide by three juries in the 1990s, Kevorkian crossed the line in 1998 by not only administering the lethal injection but also videotaping Youk's death and defying prosecutors to charge him. Kevorkian's goal in life is to overturn America's laws prohibiting both active euthanasia and assisted suicide, in which someone purposely asks another (most often a physician) for help in dying. But by killing Youk, he very well might have done irreversible harm to his life's mission.

Kevorkian's conviction and the backlash it triggered are among the most recent in a long series of events stretching back to the nineteenth century that represent attempts by numerous men and women to change the nation's attitudes and laws about euthanasia. A handful, like Kevorkian, have resorted to sensationalist, open defiance of the law in the effort to gain acceptance of an individual's unlimited right to choose the time, manner, and place of his or her death. Others have tried a quieter approach, but they too have shared Kevorkian's conviction that they were engaged in a revolutionary struggle to free Americans from ethical codes of conduct that date back to classical antiquity. They have been united by their commitment to fighting for "the right not to suffer," whether because of unwanted pregnancy, deferred sexual gratification, or a lingering, painful death. Still others agree that Americans have every right to refuse unwanted medical treatment, but believe that such a right is entirely different from a right to have a physician either administer or prescribe lethal drugs to a terminally ill patient. Today, as in the past, Americans sharply disagree over what constitutes death with dignity, but very few think that the question of how we die should be a hidden secret.

Attention to the discourse of autonomy behind the euthanasia movement reveals, however, some disturbing paternalist tendencies. While most right-to-die advocates today stress that they seek only the freedom of competent, terminally ill individuals to choose medical assistance in dying, up to the end of the twentieth century various proponents have also expressed a worrying willingness to extend the legalization of euthanasia to cover persons with disabilities, handicapped newborns, and unconscious geriatric patients, or to justify the right to die for social and economic reasons. This combination of a fervent quest to maximize human freedom and the reformist urge to socialize individual identities in the service of utilitarian goals is as old as the Progressive era of the early twentieth century. The enduring nature of this current within America's euthanasia movement justifies the concerns of some, more recent, interested parties that legalizing physician-assisted suicide or active euthanasia will lead to a "reduction of respect for human life," ultimately affecting the disabled and other vulnerable persons in society. The right to die can all too easily become "a duty to die."

At the same time, however, there is little historical evidence that the right-to-die movement in America, if unchecked, will lead inevitably to genocide, as some alarmists believe. This line of argument is based on comparisons between the history of the euthanasia movement in the United States and what transpired in Nazi Germany. Comparisons between German and American euthanasia are not illegitimate; indeed, given the stark contrast between the enormous scholarly literature on Nazi euthanasia and the meager literature on Anglo-American euthanasia, they are long overdue.

In fact, American euthanasia proponents from time to time have uttered statements that share a troubling similarity with those of German physicians before and after Hitler. However, such comparisons run the risk of confusing many important distinctions that emphasize the uniqueness of Nazi medicalized murder and the exceptionalism of American political culture, with its repeated invocations of personal liberty and freedom of choice, to say nothing of its robust religiosity. "Playing the Nazi card" also potentially poisons the chances of a reasoned debate over a health care question that at the turn of the twenty-first century is far more complex than was the case in the war-torn Third Reich. Not every slope is slippery, and not all medical abuse is tantamount to Nazism.