Part 17

It will be conceded, then, on all hands, that the proposition that life is sacred must be accepted with many limitations: the proposition, in fact, amounts only to this, that life must not be voluntarily laid down without grave and sufficient cause. What we have to consider is, whether there are present, in any proposed euthanasia, such conditions as overbear considerations for the acknowledged sanctity of life. We contend that in the cases in which it is proposed that death should be hastened, these conditions do exist.

We will not touch here on the question of the endurance of pain as a duty, for we will examine that further on. But is it a matter of no importance that a sufferer should condemn his attendants to a prolonged drain on their health and strength, in order to cling to a life which is useless to others, and a burden to himself? The nurse who tends, perhaps for weeks, a bed of agony, for which there is no cure but death--whose senses are strained by intense watchfulness--whose nerves are racked by witnessing torture which she is powerless to alleviate--is, by her self-devotion, sowing in her own constitution the seeds of ill-health--that is to say, she is deliberately shortening her own life. We have seen that we have a right to shorten life in obedience to a call of duty, and it will at once be said that the nurse is obeying such a call. But has the nurse a right to sacrifice her own life--and an injury to health is a sacrifice of life--for an obviously unequivalent advantage? We are apt to forget, because the injury is partially veiled to us, that we touch the sacredness of life whenever we touch health: every case of over-work, of over-strain, of over-exertion, is, so to speak, a modified case of euthanasia. To poison the spring of life is as real a tampering with the sacredness of life as it is to check its course. The nurse is really committing a slow euthanasia. Either the patient or the nurse must commit an heroic suicide for the sake of the other--which shall it be? Shall the life be sacrificed, which is torture to its possessor, useless to society, and whose bounds are already clearly marked? or shall a strong and healthy life, with all its future possibilities, be undermined and sacrificed _in addition to that which is already doomed?_ But, granting that the sublime generosity of the nurse stays not to balance the gain with the loss, but counts herself as nothing in the face of a human need, then surely it is time to urge then to permit this self-sacrifice is an error, and that to accept it is a crime. If it be granted that the throwing away of life for a manifestly unequivalent gain is wrong, that we ought not to blind ourselves to the fact, that to sacrifice a healthy life in order to lengthen by a few short weeks a doomed life, is a grave moral error, however much it may be redeemed in the individual by the glory of a noble self-devotion. Allowing to the full the honour due to the heroism of the nurse, what are we to say to the patient who accepts the sacrifice? What are we to think of the morality of a human being who, in order to preserve the miserable remnant of life left to him, allows another to shorten life? If we honour the man who sacrifices himself to defend his family, or risks his own life to save theirs, we must surely blame him who, on the contrary, sacrifices those he ought to value most, in order to prolong his own now useless existence. The measure of our admiration for the one, must be the measure of our pity for the weakness and selfishness of the other. If it be true that the man who dies for his dear ones on the battlefield is a hero, he who voluntarily dies for them on his bed of sickness is a hero no less brave. But it is urged that _life is the gift of God, and must only be taken back by the Giver of life_, I suppose that in any sense in which it can be supposed true that life is the gift of God, it can only be taken back by the giver--that is to say, that just as life is produced in accordance with certain laws, so it can only be destroyed in accordance with certain other laws. Life is not the direct gift of a superior power: it is the gift of man to man and animal to animal, produced by the voluntary agent, and not by God, under physical conditions, on the fulfilment of which alone the production of life depends. The physical conditions must be observed if we desire to produce life, and so must they be if we desire to destroy life. In both cases man is the voluntary agent, in both law is the means of his action. If life-giving is God's doing, then life-destroying is his doing too. But this is not what is intended by the proposers of this aphorism. If they will pardon me for translating their somewhat vague proposition into more precise language, they say that they find themselves in possession of a certain thing called life, which must have come from _somewhere_; and as in popular language the unknown is always the divine, it must have come from God: therefore this life must only be taken from them by a cause that also proceeds from _somewhere_--i e., from an unknown cause--i e., from the Divine will. Chloroform comes from a visible agent, from the doctor or nurse, or at least from a bottle, which can be taken up or left alone at our own choice. If we swallow this, the cause of death is known, and is evidently not divine; but if we go into a house where scarlet fever is raging, although we are in that case voluntarily running the chance of taking poison quite as truly as if we swallow a dose of chloroform, yet if we die from the infection, we can imagine the illness to be sent from God. Wherever we think the element of chance comes in, there we are able to imagine that God rules directly. We quite overlook the fact that there is no such thing as chance. There is only our ignorance of law, not a break in natural order. If our constitution be susceptible of the particular poison to which we expose it, we take the disease. If we knew the laws of infection as accurately as we know the laws affecting chloroform, we should be able to foresee with like certainty the inevitable consequence; and our ignorance does not make the action of either set of laws less unchangeable or more divine. But in the "happy-go-lucky" style of thought peculiar to ignorance, the Christian disregards the fact that infection is ruled by definite laws, and believes that health and sickness are the direct expressions of the will of his God, and not the invariable consequence of obscure but probably discoverable antecedents; so he boldly goes into the back slums of London to nurse a family stricken down with fever, and knowingly and deliberately runs "the chance" of infection--i e., knowingly and deliberately runs the chance of taking poison, or rather of having poison poured into his frame. This he does, trusting that the nobility of his motive will make the act right in God's sight. Is it more noble to relieve the sufferings of strangers, than to relieve the sufferings of his family? or is it more heroic to die of voluntarily-contracted fever, than of voluntarily-taken chloroform?

The argument that _life must only be taken back by the life-giver_, would, if thoroughly carried out, entirely prevent all dangerous operations. In the treatment of some diseases there are operations that will either kill or cure: the disease must certainly be fatal if left alone; while the proposed operation may save life, it may equally destroy it, and thus may take life some time before the giver of life wanted to take it back. Evidently, then, such operations should not be performed, since there is risked so grave an interference with the desires of the life-giver. Again, doctors act very wrongly when they allow certain soothing medicines to be taken when all hope is gone, which they refuse so long as a chance of recovery remains: what right have they to _compel_ the life-giver to follow out his apparent intentions? In some cases of painful disease, it is now usual to produce partial or total unconsciousness by the injection of morphia, or by the use of some other anaesthetic. Thus, I have known a patient subjected to this kind of treatment, when dying from a tumour in the aesophagus; he was consequently for some weeks before his death, kept in a state of almost complete unconsciousness, for if he were allowed to become conscious, his agony was so unendurable as to drive him wild. He was thus, although breathing, practically dead for weeks before his death. We cannot but wonder, in view of such a case as his, what it is that people mean when they talk of "life." Life includes, surely, not only the involuntary animal functions, such as the movements of heart and lungs; but consciousness, thought, feeling, emotion. Of the various constituents of human life, surely those are not the most "sacred" which we share with the brute, however necessary these may be as the basis on which the rest are built. It is thought, then, that we may rightfully destroy all that constitutes the beauty and nobility of human life, we may kill thought, slay consciousness, deaden emotion, stop feeling, we may do all this, and leave lying on the bed before us a breathing figure, from which we have taken all the nobler possibilities of life; but we may not touch the purely animal existence; we may rightly check the action of the nerves and the brain, but we must not dare to outrage-the Deity by checking the action of the heart and the lungs.

We ask, then, for the legalisation of euthanasia, because it is in accordance with the highest morality yet known, that which teaches the duty of self sacrifice for the greater good of others, because it is sanctioned in principle by every service performed at personal danger and injury, and because-it is already partially practised by modern improvements in medical science.

_Euthanasia is an interference with the course of nature, and its herefore an act of rebellion against God_. In considering this objection, we are placed in difficulty by not being told what sense our opponents attach to the word "nature"; and we are obliged once more to ask pardon for forcing these vague and high-flown arguments into a humiliating precision of meaning. Nature, in the widest sense of the word, includes all natural laws: and in this sense it is of course impossible to interfere with nature at all. We live, and move, and have our being in nature; and we can no more get outside it than we can get outside everything. With this-nature we cannot interfere: we can study its laws, and learn how to balance one law against another, so as to modify results; but this can only be done by and through nature itself. The "interference with the course of nature" which is intended in the above objection does not of course mean this impossible proceeding; and it can then only mean an interference with things which would proceed in one course without human agency meddling with them, but which are susceptible of being turned into another course by human agency. If interference with nature's course be a rebellion against God, we are rebelling against God every day of our lives. Every achievement of civilisation is an interference with nature. Every artificial comfort we enjoy is an improvement on nature. Everybody professes to approve and admire many great triumphs of art over nature: the junction by bridges of shores which nature had made separate, the draining of nature's marshes, the excavation of her wells, the dragging to light of what she has buried at immense depths in the earth, the turning away of her thunderbolts by lightning-rods, of her inundations by embankments, of her ocean by breakwaters. But to commend these and similar feats, is to acknowledge that the ways of nature are to be conquered, not obeyed; that her powers are often towards man in the position of enemies, from whom he must wrest, by force and ingenuity, what little he can for his own use, and deserves to be applauded when that little is rather more than might be expected from his physical weakness in comparison to those gigantic powers. All praise of civilisation, or art, or contrivance, is so much dispraise of nature; an admission of imperfection, which it is man's business, and merit, to be always endeavouring to correct or mitigate.*

* "Essay on Nature," by John Stuart Mill.

It is difficult to understand how anyone, contemplating the course of nature, can regard it as the expression of a Divine will, which man has no right to improve upon. Natural law is essentially unreasoning and unmoral: gigantic forces clash around us on every side unintelligent, and unvarying in their action. With equal impassiveness these blind forces produce vast benefits and work vast catastrophes. The benefits are ours, if we are able to grasp them; but nature troubles itself not, whether we take them or leave them alone. The catastrophes may rightly be averted, if we can avert them; but nature stays not its grinding wheel for our moans. Even allowing that a Supreme Intelligence gave these forces their being, it is manifest that he never intended man to be their plaything, or to do them homage; for man is dowered with reason to calculate, and with genius to foresee; and into man's hands is given the realm of nature (in this world) to cultivate, to govern, to improve. So long as men believed that a god wielded the thunderbolt, so long would a lightning-conductor be an outrage on Jove; so long as a god guided each force of nature, so long would it be impiety to resist, or to endeavour to regulate the divine volitions. Only as experience gradually proved that no evil consequences followed each amendment of nature, were natural forces withdrawn, one by one, from the sphere of the unknown and the divine. Now, even pain, that used to be God's scourge, is soothed by chloroform, and death alone is left for nature to inflict, with what lingering agony it may. But why should death, any more than other ills, be left entirely to the clumsy, unassisted processes of nature?--why, after struggling against nature all our lives, should we let it reign unopposed in death? There are some natural evils that we cannot avert. Pain and death are of these; but we can dull pain by dulling feeling, and we can ease by shortening its pangs. Nature kills by slow and protracted torture; we can defy it by choosing a rapid and painless end. It is only the remains of the old superstition that makes men think that to take life is the special prerogative of the gods. With marvellous inconsistency, however, the opponents of euthanasia do not scruple to "interfere with the course of nature" on the one hand, while they forbid us to interfere on the other. It is right to prolong pain by art, although it is wrong to shorten it. When a person is smitten down with some fearful and incurable disease, they do not leave him to nature; on the contrary, they check and thwart nature in every possible way; they cherish the life that nature has blasted; they nourish the strength that nature is undermining; they delay each process of decay which nature sows in the disordered frame; they contest every inch of ground with nature to preserve life; and then, when life means torture, and we ask permission to step in and quench it, they cry out that we are interfering with nature. If they would leave nature to itself, the disease would generally kill with tolerable rapidity; but they will not do this. They will only admit the force of their own argument when it tells on the side of what they choose to consider right. "Against nature," is the cry with which many a modern improvement has been howled at; and it will continue to be raised, until it is generally acknowledged that happiness, and not nature, is the true guide to morality, and until men recognises that nature is to be harnessed to his car of triumph, and to bend its mighty forces to fulfil the human will.

_Pain is a spiritual remedial agent, inflicted by God, and should therefore be patiently endured._ Does anyone, except a self-torturing ascetic, endure any pain which he can get rid of? This might be deemed a sufficient answer to this objection, for common sense always bids us avoid all possible pain, and daily experience tells us that people invariably evade pain, wherever such evasion is possible. The objection ought to run: "pain is a spiritual remedial agent, inflicted by God, which is to be got rid of as soon as possible, but ought to be patiently endured when unavoidable." Pain as pain has no recommendations, spiritual or otherwise; nor is there the smallest merit in a voluntary and needless submission to pain. As to its remedial and educational advantages, it as often as not sours the temper and hardens the heart; if a person endures great physical or mental pain with unruffled patience, and comes out of it with uninjured tenderness and sweetness, we may rest assured that we have come across a rare and beautiful nature of exceptional strength. As a general rule, pain, especially if it be mental, hardens and roughens the character. The use of anaesthetics is utterly indefensible, if physical pain is to be regarded as a special tool whereby God cultivates the human soul. If God is directly acting on the sufferer's body, and is educating his soul by racking his nerves, by what right does the doctor step between with his impious anaesthetic, and by reducing the patient to unconsciousness, deprive God of his pupil, and man of his lesson? If pain be a sacred ark, over which hovers the divine glory, surely it must be a sinful act to touch the holy thing. We may be inflicting incalculable spiritual damage by frustrating the divine plan of education, which was corporeal agony as a spiritual agent. Therefore, if this argument be good for anything at all, we must from henceforth eschew all anaesthetics, we must take no steps to alleviate human agony, we must not venture to interfere with this beneficent agent, but must leave nature to torture us it will. But we utterly deny that the unnecessary endurance of pain is even a merit, much less a duty; on the contrary, we believe that it is our duty to war against pain as much as possible, to alleviate it wherever we cannot stop it entirely; and, where continuous and frightful agony can only end in death, then to give to the sufferer the relief he craves for, in the sleep which is mercy. "It is a mercy God has taken him," is an expression often heard when the racked frame at last lies quiet, and the writhed features settle slowly into the peaceful smile of the dead. That mercy we plead that man should be allowed to give to man, when human skill and human tenderness have done their best, and when they have left within their reach no greater boon than a speedy and painless death.

We are not aware that any objection, which may not be classed under one or other of these three heads, has been levelled against the proposition that euthanasia should be legalised. It has, indeed, been suggested that to put into-a doctor's hands this "power of life and death," would be to offer a dangerous temptation to those who have any special object to gain by putting a troublesome person quietly out of the way. But this objection overlooks the fact that the patient himself must _ask_ for the draught, that stringent precautions can be taken to render euthanasia impossible except at the patient's earnestly, or even repeatedly, expressed wish, that any doctor or attendant, neglecting to take these precautions, would then, as now, be liable to all the penalties for murder or for manslaughter; and that an ordinary doctor would no more be ready to face these penalties then, than he is now, although he undoubtedly has now the power of putting the patient to death with but little chance of discovery. Euthanasia would not render murder less dangerous than it is at present, since no one asks that a nurse may be empowered to give a patient a dose which would ensure death, or that she might be allowed to shield herself from punishment on the plea that the patient desired it. If our opponents would take the trouble to find out what we do ask, before they condemn our propositions, it would greatly simplify public discussion, not alone in this case, but in many proposed reforms.

It may be well, also, to point out the wide line of demarcation which separated euthanasia from what is ordinarily called suicide. Euthanasia, like suicide, is a voluntarily chosen death, but there is a radical difference between the motives which prompt the similar act. Those who commit suicide thereby render themselves useless to society for the future; they deprive society of their services, and selfishly evade the duties which ought to fall to their share; therefore, the social feelings rightly condemn suicide as a crime against society. I do not say that under no stress of circumstances is suicide justifiable; that is not the question; but I wish to point out that it is justly regarded as a social offence. But the very motive which restrains from suicide, prompts to euthanasia. The sufferer who knows that he is lost to society, that he can never again serve his fellow-men; who knows, also, that he is depriving society of the services of those who uselessly exhaust themselves for him, and is further injuring it by undermining the health of its healthy members, feels urged by the very social instincts which would prevent him from committing suicide while in health, to yield a last service to society by relieving it from a useless burden. Hence it is that Sir Thomas Moore, in the quotation with which he began this essay, makes the _social authorities_ of his ideal state urge euthanasia as the duty of a faithful citizen, while they yet consistently reprobate ordinary suicide as a _lese-majeste_ a crime against the State. The life of the individual is, in a sense, the property of society. The infant is nurtured, the child is educated, the man is protected by others; and, in return for the life thus given, developed, preserved, society has a right to demand from its members a loyal, self-forgetting devotion to the common weal. To serve humanity, to raise the race from which we spring, to dedicate every talent, every power, every energy, to the improvement of, and to the increase of happiness in, society, this is the duty of each individual man and woman. And, when we have given all we can, when strength is sinking, and life is failing, when pain racks our bodies, and the worse agony of seeing our dear ones suffer in our anguish tortures our enfeebled minds, when the only service we can render man is to relieve him of a useless and injurious burden, then we ask that we may be permitted to die voluntarily and painlessly, and so to crown a noble life with the laurel wreath of a self-sacrificing death.

ON PRAYER.

THE mania for Prayer-meetings has lately been largely on the increase, and the continual efforts being made to

"Move the arm that moves the world,"

naturally draw one's attention strongly to the subject of Prayer; to its reasonableness, propriety, and prospect of success. If Prayer to God be reverent as towards the Deity, if it be consistent with his immutability, with his foreknowledge, with his wisdom, and with every kind of trust in his goodness--if it be also, as regards man, permissible by science, and approved by experience, then there can be no doubt at all that it should be sedulously practised, and should be of universal obligation. But if it be at once useless and absurd, if it be forbidden by reason and frowned at by common sense, if it weaken man and be irreverent towards the Being to whom it is said to be addressed, then it will be well for all who practise it to reconsider their position, and at least to endeavour to give some solid reason for persisting in a course which is condemned by the intellect and is unneeded by the heart.