Helping human-animals to die

A French woman, Chantal Sebire with a disfiguring and painful terminal illness recently failed in her appeal for medical assistance to help her to die. Before her death Chantal Sebire was quoted as saying “We wouldn’t let an animal go through what I have had to endure”(1).
Euthanasia for animals is commonplace, and is widely accepted as a morally acceptable response to animals whose suffering is unable to be relieved. But, with the exception of a few places such as the Netherlands, Belgium and the US state of Oregon, euthanasia for humans is legally prohibited.
But is it speciesist to make a distinction between animal and human euthanasia? In the case of terminally ill humans who request medical assistance in dying we may have more reasons to permit euthanasia than in the case of animals. If the arguments against euthanasia are so forceful that it should not be permitted even in tragic cases like that of Chantal Sebire should animal euthanasia be prohibited?

Chantal Sebire had an advanced form of a rare tumour called esthesioneuroblastoma that arises from the lining of the nasal cavity. In Mrs Sebire’s case it had invaded her jaw and orbits leaving her blind and in pain, without senses of taste or smell. She complained that she was unable to take morphine because of side effects, that she had difficulty eating, and that she had to sleep sitting up. Under French law it would have been legal for doctors to withdraw life-support from her, had she needed it, however her condition was such that she did not have this option.

It is clear that if Chantal Sebire had been a monkey, a dog or a horse (or any other non-human animal) there would have been no ethical quandary about euthanazing her. In fact there would be strong arguments that to fail to do so would be unconscionable in view of the certain suffering that she would endure if she continued to live. It would be felt to be particularly cruel, even ‘inhumane’ to keep her alive.

Yet there may be more reasons to help a human to die with such an illness than a non-human animal. Though a non-human animal might be suffering at present, it would be unlikely to have the necessary self-concept to be able to imagine and fear future suffering. Mrs Sebire was all too conscious of her tumour's progression, and that her pain was only going to worsen. Furthermore her consciousness of herself as a being existing through time led her to be aware of her loss of capacities (sight, taste, small) and pleasures, as well as to be horrified by the change in her physical appearance. (She described children running from her in the street). For a non-human animal euthanasia is always non-voluntary since we are unable to know their wishes. In the case of a human we can have direct evidence from them of the nature of their suffering, and whether life continues to be worth living from their perspective. We can assess and treat depression and anxiety related to the illness if it is present, so that we can be sure that such wishes are rational.

On the other hand, some have suggested that “suffering is natural to the human condition”, and that “killing is not healing”. It is not clear why suffering (even more prevalent in the non-human animal kingdom) should be natural for humans and not for animals. However if it is morally important to continue the suffering of animals, and it is incompatible with the role of a healer to end life, then perhaps we should radically revise our attitude towards animal euthanasia.

Chantal Sebire died only days after the courts rejected her appeal. She was subsequently found to have died of an overdose of a barbiturate, pentobarbitol, that is commonly used for animal euthanasia.

(1) “On ne permettrait pas à un animal d'endurer ce que j'endure.”

Links

French euthanasia woman overdosed on barbiturates AFP 27/3/08

Disfigured French woman loses euthanasia bid Daily Telegraph 19/3/08

Euthanasia… ‘We don’t let animals suffer like this’ Cranmer – blog 19/3/08

Chantal Sebire “I can’t take this anymore” William Crawley’s broadcasting diary BBC blog 17/3/08

Chantal Sebire did not die in peace Le matin 20/3/08

Esthesioneuroblastoma eMedicine

Comments

[Arjuna]

Thank you for the thoughtful, sensitive analysis. I feel your argument's power lies in connecting so clearly our attitudes toward non-human animals with our attitudes toward humans. And it appeals to multiple values -- relief of suffering, quality of life in a broad situated, social sense, as respect for her Madame Sebire's own obviously informed wishes.

I'm wondering what sort of laws you would advocate for -- do you favor laws allowing for physician assisted suicide or something broader (i.e., laws allowing 'active' euthanasia)? And how do you address the concerns of those who are concerned with abuses -- those who fear the slippery slope?

[Dominic Wilkinson]

Arjuna,

I don't see any significant distinction between physician assisted suicide and 'voluntary' euthanasia. I think that the most important way to prevent abuse of euthanasia would be to very clearly legislate what situations are felt to be acceptable grounds for euthanasia, and what are not. For example in a patient like Chantal Sebire it would be important to have independent confirmation of the nature of her illness, that she was competent to make such a decision (in particular that any depression had been adequately treated), and that she had received all appropriate palliative therapies to manage her symptoms.
There are plenty of other areas of medicine where abuse could be imagined (for example with organ donation), but where legislation is able to define clearly permissible and impermissible actions such that abuse is unlikely. The mere possibility of abuse does not prevent us from permitting organ donation from brain dead individuals, and nor should it prevent us from ending the suffering of terminally ill patients where that is their rational and autonomous choice.