Choosing Death over Life and The Illusion of Liberty

A short while ago, a young Muslim woman from Canada sent me a message about a news report she saw on television involving someone with a Muslim name, Amir. It looked like this person is ethnically Persian. The gist of the news story is that this person suffered from a spinal injury that caused him chronic pain, but there were new circumstances in the life of this person that meant that he faced the danger of becoming homeless. He was going to lose his rental residence and be forced to live on the streets. As a result, he got his medical caretaker to approve his application for euthanasia via lethal injection under the assisted suicide law in Canada. According to this news report, Amir says that he does not in fact wish to die, but when faced with the real chance that he is going to become homeless, he sees that he has no other choice but to choose death.


The person who sent me this news story was asking if I knew anyone in Canada who could assist this fellow. But, God bless her heart, she alerted me to something that admittedly I was not aware of. Upon doing some research, I discovered that this is a very big story and a very big issue. Not just in Canada, but throughout Europe as well. In 2015, the Canadian Supreme Court ruled that a blanket prohibition against physician-assisted suicide is unconstitutional. In the Canadian Supreme Court's opinion, the state does not have the constitutional right to criminalize physician-assisted suicides. After that decision by the Canadian Supreme Court, the Canadian legislature responded by passing a law that permitted physician-assisted suicides for those with terminal illnesses. The law provided for this so long as the patient was able to get two medical caregivers, whether medical doctors or other caregivers, to sign off on the suicide with a 30 day waiting period, a “reflection period.” Eventually, even these restrictions were challenged in court. Once again, a Canadian court struck down some of these restrictions as unconstitutional and the Canadian parliament responded by passing a further law that now allows for physician-assisted suicides upon the signing off of just one medical caregiver, not two, and doing away with the 30 day waiting period. Nor does it just stop there. This new law states that the illness need not be terminal; the illness can simply be chronic. So a patient can choose to die even if they do not suffer from a terminal illness, but from a chronic, arguably incurable, illness.


Canada is not the first to pass laws like this. Belgium and the Netherlands had very similar laws before Canada, allowing physician-assisted suicides in cases of terminal illness and also in cases of chronic illness. But in Belgium and the Netherlands the legislature is even considering, and may likely pass, laws that go even beyond this in allowing for physician-assisted suicides in cases of mental illness and disability, including for children under 13 years old, and in “exhaustion of life” cases in which people simply say, "We are done living and do not want to live anymore."


The matter deserves a pause at so many levels. The Western civilization, which includes Canada and Europe, steers the morality of the world. There is no point in pretending otherwise. The morality of this world for the past few centuries has had the Western civilization at the helm. When Europe abolished the death sentence and said that it is immoral for the state to execute, that position resonated around the world. When Europe and the Western civilization said that sexual preference is a matter of personal choice and personal rights, that position resonated around the world. When Europe said that gender is a choice and has far more to do with personal autonomy and personal choice than biology, that position resonated in the world. Now, we have arrived at a very paradoxical situation. Now the world is led by a civilization that, while holding that the death penalty violates human rights, allows for physician-assisted suicides to opt for a dignified death rather than investing in a dignified life.


Why should we care? Consider the fact that in the Netherlands, 70% of those who opt for a physician-assisted suicide are women and the poor. Last year in Canada alone, 22,000 people opted for physician-assisted suicide. While it sounds like we are making a stand for personal choice, the position that allows people to opt for death reflects a social choice and, indeed, a social value. What happens in real life is that the state, whether in Canada, Belgium or the Netherlands, refuses to invest in palliative care. It refuses to invest in medical options that would elevate the quality of life for people who are facing terminal or chronic illnesses. Canada is now considering a law to extend the assisted suicide provisions to even the mentally disabled and mentally ill. 


The trajectory that we are heading to and the track record that we have created is that the state refuses to invest in the resources that would provide medical care to the weakest in society, those who are often forgotten by family and society, those considered no longer productive. So, no one cares. Instead of investing in life, it is far cheaper for the state to encourage and facilitate the option of death. Indeed, what becomes very clear, very quickly, is that so many patients choose death because they are so overwhelmed by the loneliness, negligence, lack of care, and the sheer cost of living. Some choose death so that they will not burden their children with the costs of their care. In many cases, sadly, the family itself suggests to the senior citizen that, "Perhaps you should help all of us out by choosing death, so we do not have to keep worrying about taking care of you." 


A profitable industry has developed in these countries. Countries like Canada have a vested interest in the choice of death. It is easy and quick money for mass productions. A doctor in this business can go through three cases of euthanizing human beings in a single day, and get paid with an easy and quick turnover from one case to the other. In many cases, I found that when confronted with incurable and painful conditions, patients were approached by so-called “medical providers” that counseled them and encouraged them to choose death. They confronted the patients with the cost of living and the lack of resources and social options. Vulnerable people in vulnerable positions are pressured into choosing death over life.


Remarkably, we have moved from the position of the state that does not kill to the state that kills, but indirectly. A state that can dedicate an enormous amount of resources to enriching the military industry, to making the elite richer, to prolonging the life of the elite, and making certain that all care options are available to the elite. Statistically, the elite rarely chooses death. That same state, however, fails to make resources available and encourages its citizens that have outspent their usefulness to choose death.


The problem is well illustrated in the opinion of the Canadian Supreme Court. What possible philosophical ground can one cite to argue against the option of physician-assisted suicide if morality comes from no place other than reason? Then, as the Canadian Supreme Court noted in its decision, there is no philosophically defensible position that can be relied upon to say that the state can prohibit medically-assisted suicides. Without God, without an authoritative frame of reference, we end up with a rather inevitable position. If people want to choose death, then why not? But the problem is that this works only in theory, in the academic articles published by law professors who want to compete with one another to appear progressive, pro-choice, and pro-personal autonomy.


In theory, we are honoring a human's choice on whether to live or die by saying it is up to them. But in practice, there is no way we can honor that choice without legitimating and validating another social choice. The social choice that we end up validating is the choice by the state not to invest in life, but to invest in death for the weakest elements in society. In practice, social mechanics work to target the most vulnerable and powerless, to effectively tell them, "You have no choice but to choose death, because if you choose life, you are on your own." What develops are social mores that look at the helpless and vulnerable and say to them, tacitly and implicitly, "Why are you bothering us with your problems? Why are you still around? Why are you demanding palliative care when you could have chosen to go away? Indeed, that is precisely what we expect from you." Instead of demanding that we invest more resources in taking care of the weak and vulnerable, and investing more resources in palliative care socially, we have created pressures to communicate, "Well, if you fail to choose death, then you have yourself to blame for continuing to be a burden upon society. You are no longer productive. You are now marginal."


Indeed, the more I read, the more I found families pressuring senior citizens to opt for death and circumstances pressuring the homeless and destitute to opt for death. But what is even more problematic is this: if we allow the option of death for those with terminal illness and those with chronic pain, then how about those with chronic emotional pain? How about those who say, "I do not have a spinal injury or a terminal cancer, but I hate life and I do not want to go on living"? Instead of investing in mental health, we will be philosophically obligated, in due time, to allow the sad, melancholy, and depressed to choose death.


Where do we stop? How about those in prison who find that there is no point in continuing to live because their prison sentences are endlessly long or because they have despaired in ever having a productive life? Again, we will find legal academics who are eager to make new arguments so that they can meet that tenure year mark that will extend the argument. Not because they are philosophically committed to the position, but often because that is the game that the academy imposes. These are the rules of the game of the academy: make original arguments, regardless of their social consequences. So we find young, eager, ambitious, and brilliant legal minds saying, "Why not allow prisoners the option to opt out? It makes perfect sense socially. Look at the cost of taking care of a prisoner for 20 or 30 years as opposed to the cost of allowing a prisoner to opt out." Society has already made the value judgment to invest money in life choices for the elite. The state has already poorly invested in its huge infrastructure of prisons and incarceration facilities. So it is only a matter of time. It is the same logic. Either through the courts or the legislature, we will allow the extension of the logic of death. This is like so many human actions in the Western civilization that leads the world morally, whether we like it or not. It is a dangerous precedent with repercussions that are even difficult to conceive of.


When we teach medical doctors that they are not bound by the centuries-old oath to do no harm, but that it is consistent with their job to administer death; when it becomes the progressive choice to tell doctors that they are not allowed to counsel or advise patients toward palliative care, rather than the death choice; when the state can solve the problem of the marginal subgroups within society by simply saying, "We will give you an opt-out choice, and thus, if we fail to invest in your care, do not blame us;" then it is a slippery slope, under the guise of supporting human autonomy, for the state to be oriented toward the life choices of the elite and, in a highly amoral fashion, allow for the dissolution of the marginal and the subaltern.


Read the opinion of the Canadian Supreme Court. Take God out of the equation, and it is extremely hard to rebut, refute, or take issue with the decision. All the Supreme Court is saying is that since the only moral right, the only clear morality that this court is aware of, is personal choice, so a human being should be free to choose whatever a human being wants to choose. Choose their government. Choose their occupation. Choose their sexual preference, gender, and whatever they wish to choose, including whether to live. The Canadian Supreme Court cannot think of a reason — a principled reason — to then come to this individual and say, "You must choose life." Although the Canadian Supreme Court's decision relates to terminal diseases, the application of the logic of the Supreme Court's decision is limitless. That is precisely why Canada went from the decision of allowing suicides for chronic cases to now considering, and likely passing, the allowance of suicides for mental diseases and “exhaustion of life” cases. 


The entire equation of reading through the Supreme Court decision is greatly changed when I anchor my choices in God, when I say that I must choose life because my life is not mine to terminate, and the life of others are not theirs to allow them to terminate. Suddenly, the theistic, God-based position seems to stand on crystal clear moral grounds. The danger is that this orientation has now set the life of the marginal and vulnerable to, effectively, be less worthy. The rich rarely, if ever, choose death. The poor regularly choose death. We are now in a situation in which Western civilization tells us, "This is moral and acceptable," and because we live in a world led by the Western civilization, this will eventually spread from Belgium, the Netherlands, and Canada to the rest of the world. Mark my words. We will see the parrots of the Western civilization, the intelligentsia that are mere mimics of whatever Western civilization says, defend euthanasia for human beings. And the time shall come when human beings will be put down as regularly as animals are put down at the vet.


The problem is in the myth of choice and consent. If I wake up one day to find my relatives are too busy with their own lives to care, and that even with modest medical insurance, every step that involves medical care is a hassle and a pain; if I am neglected by society and left without resources to make myself relevant or even engageable; if I wake up every day looking forward only to the struggle of finding resources to take care of myself; if that is my situation, and I then find a “medical caregiver” who tells me, "Do you know you can choose a dignified exit instead of all these medical visits, these constant back and forths with insurance companies, and constant applications to the government to provide you with care?" Then what do you think will happen? This is exactly what I read, in case after case. The suggestion for a dignified exit often comes from the same medical caregiver who would administer the euthanasia, because it has become a cottage industry. This business seeks out older, poorer individuals. Of course, there is also a racial element. But it is always minorities with either terminal or chronic illnesses. 


Companies invest a great deal of money to find out who these people are by finding out who were prescribed certain medicines. They invest a great deal of money in breaching the rules of privacy to get that medical information. They then approach these people and say, "For a fraction of the cost of what you spend currently, we can make your suffering go away. We can put you to sleep." This is exactly what the powerless and the vulnerable end up choosing. "Okay, fine, put me out of my misery." 


But the choice made by these vulnerable individuals is, in reality, a choice made by society. A society that chooses to invest in massive armies with endlessly destructive military technologies. A society that chooses to invest in making the rich ever more richer. A society that thinks it makes perfect sense to spend billions of dollars developing a new missile or a new fighter jet, but refuses to even dedicate a fraction of that cost to palliative care or quality of life care. A society that says, "Yeah, go ahead and die. It is fine with us because it is not the elite of society that is involved in these decisions."


It is not just that we are killing our planet with the civilizational values that we have developed, but we have reached a point in which our moral incoherence is killing the soul of humanity. But because the Western civilization continues to be arrogant, above reproach and accountability, the rest of the world is morally led in the same way that sheep are led by their herder. 


I do not think it comes as a surprise to anyone to read that global spending on the military industrial complex is the greatest contributor to environmental decay and destruction. If we compare the amount of pollution created by the totality of civilian aircrafts in the world to the same amount of pollution created by military aircrafts, then the percentages are incomparable. The countries that manufacture and sell the most weaponry in the world, including the United States, France, Britain, Russia, and China, through their investments in the military industry, contribute to the destruction of the world environment more than any other comparable factor in the world.


It is ironic when we put the picture together. There is a World Climate Conference being held in Egypt this year. The way these world climate conferences progress is that we have the same presentations put on. The same projectiles. The same statistics. The same images. The same films are shown year after year, after the same experts repeat the same presentations, adjusted for depreciation each year. Then the politicians have their turn and make the same declarations and empty commitments. After that, everyone packs and goes home. Because this is so farcical and so meaningless, the world did not care that this event is going to be hosted by one of the most fascist governments in our world today: a government in Egypt that has an abysmal human rights record, a horrible environmental record, is a huge importer of weaponry, and a great contributor to the destruction of environment, whether in Sinai, where the army has destroyed the environment, or in the urban centers of Cairo.


Because we are so oblivious and morally negligent, the conference next year is going to be held in the United Arab Emirates. Conferences in which we are supposed to repeat our commitments to the environment are being held in countries that have zero sense of honoring or respecting human values and human rights. Egypt this year, and the United Arab Emirates next year. Dictatorial governments have understood the game well. The UAE is already spending millions of dollars advertising for itself, using the climate conference this year in Egypt and next year in the UAE,  as propaganda opportunities for its own legitimacy and its own foreign policy objectives.


Internally, our societies are making the choice not to invest in the lives of the marginal and powerless, and to instead tell these groups, "We do not have resources for you. Do not expect us to invest in your care. Go ahead, choose death." When it comes to that critical choice of where we are going to spend our resources, we invest in the very thing that is going to cause the destruction of humanity and the destruction of life on this planet: the military industry. We are not spending the money to take care of the chronically ill, the terminally ill, palliative care, or those who need mental healthcare. Our resources instead are invested in the very industry that is destroying our planet. And we are so flippant about these immoral choices that we have no qualms about holding these conferences about the future of our planet in countries that have shown no commitment to human value or dignity, countries like Egypt and the UAE. We do not even stop there. Instead of millions of dollars being spent taking care of their own citizens, we allow them to spend millions of dollars to improve their image in Western societies.


I want to close with an example that could only be observed by a Muslim conscience, because non-Muslims, and sadly even most Muslims, do not have the conscience to even notice it. And it has not been pointed out by anyone. Much has been written about the fact that in order to have this environmental conference, the Egyptian government has gone on a repressive tirade. It has arrested and tortured dozens and silenced hundreds of people. Much has been written about the heroic struggle of a dissident named Alaa Abd El Fattah, a human rights activist that, for many years, has been jailed by the Egyptian government unjustly and inhumanely. 


Alaa Abd El Fattah has since gone on hunger strike. It looks like the Egyptian government is in violation of his human rights, because they are force-feeding the man to keep him alive. The Egyptian government will not allow any access to Alaa Abd El Fattah. So many articles have been written to the extent that he and his family garnished more attention during this environmental conference than any other issue during the entire proceedings. Delegates to the environmental conference are all aware of Alaa Abd El Fattah, his unlawful detention, his hunger strike, that he might die in custody, and of his extremely brave sister who spoke, with great danger and detriment to herself, about the plight of her brother and her family. Many articles have been published about how this is a huge embarrassment to the Egyptian government and how the Emirati government is spending millions of dollars to try to improve the image of the Egyptian government, its own image, and the game of dictatorship. 


Meanwhile, no one has noticed that in the past 48 hours, three other detainees in Egyptian prisons have died in custody, including a very distinguished ex-member of the Egyptian parliament, Ahmad Mahmoud Ibrahim, who used to be the Secretary General of the Muslim Brotherhood's political party. He and two others have died in the past 48 hours in Egyptian custody. He is the 37th detainee to die in Egyptian custody this year.


Why is everyone talking about Alaa Abd El Fattah, yet hardly anyone has mentioned Ahmad Mahmoud Ibrahim or the other two? Why is it that we find numerous articles about how Alaa Abd El Fattah embarrasses the Egyptian government, and nothing on these other three? One difference. Yes, Ahmad Mahmoud Ibrahim was a highly educated professor and medical doctor. But he was also Islamist, while Abd El Fattah is secular. No one cares when an Islamist dies in custody, even when under the same circumstances.


This is part of the value system of the civilization that leads our world, the civilization that has been in the driving seat for the past 300 years. Are we capable of moral critique? Can we display a level of moral autonomy and consciousness so that we can actually make a contribution that is not simply derivative or reactive? 


The challenge that confronts us as Muslims in the world today is nothing less than that. Are we capable of a moral discourse that is not simply derivative or reactive? Because the driver of this car has proven to be extremely dangerous and reckless for both humanity and the planet. But the sad reality is that Muslims are in the backseat in that car, entirely ineffective and discardable. God will not help us change the reality that we live in unless we first recognize what the problem is, where the moral failures are, and where our moral contributions must be. Not until we have a clear head and a clear vision of what that path is and where we should go.

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