How then should we die?: California's "Death with Dignity" Act

The cultural significance of recent changes in medicine and advances in biotechnology can hardly be overstated. Such have stirred fresh interest in the moral foundations of ethical decision-making and lively debate has ensued as well over the basis of human dignity. Largely divorced from the distinctive moral and ethical commitments that once informed and directed medical practice, modern secular notions of bioethics collapse frequently into human philosophical models of rights and justice. The project of Western medicine now continues within the cultural framework of a radical postmodern agenda that calls for the critical deconstruction and absolute relativizing of all knowledge, and the thorough secularization of the public square. Truth, once understood as a fixed expression of a fundamental reality, has been eschewed in favor of personal preference, subjective experience, private interpretation, and radical perspectivism. Perhaps the greatest challenge facing contemporary culture is that of arriving at a clear and convincing consensus on what constitutes moral surety as well as agreement on what knowledge can serve as an adequate foundation for living the moral life. Having abandoned the reality of divine involvement in the creation and sustenance of human life, contemporary culture now toys with what it means to be human without God. Increasingly popular is the view that whether one possesses dignity or not turns on the question of suffering. Under modern parlance it is simply undignified to suffer. Suffering, somehow, is believed to reduce a person to a state that is incompatible with dignity. Therefore, it should come as no surprise that one of the most pressing social issues today involves the effort to legalize physician-assisted suicide--a project based upon the view that people ought to "die with dignity." In California this view is embodied in Assembly Bill 1592, The "Death with Dignity Act." It is intended to establish California as the second state in the United States to legalize physician-assisted suicide. Patterned closely after Oregon's groundbreaking law, the California bill provides for a terminally ill patient to end his or her own life when certain conditions exist. The purpose of this paper is to review the historical development of California Assembly Bill 1592. An evaluation of both the content of this bill and the process by which it was introduced to the California State Assembly will be offered. The student of bioethics will here find that the usual arguments in support of physician-assisted suicide in the United States, as well as euthanasia in the Netherlands, have been employed in support of AB1592; namely suffering and autonomy. Given the rather predictable pattern of argument advanced by advocates of physician-assisted suicide and euthanasia, this discussion will prove useful for those who wish to offer an informed and sensitive Christian response to similar legislative efforts in other states and countries.