IN AMERICA, QUIPPED WILL ROGERS, Everything has a slogan, and, of all the bunk in America, the slogan is the champ... Congress even has slogans:
'Why sleep at home, when you can sleep in Congress?'; 'Be a politician no training necessary!' "1
I would add that, of all the bunk in America, our champion slogans are about drugs and medical ethics: "Just say 'no' to drugs," "the sanctity of life," "pro-choice," "the right to life," "the right to die," "the right to treatment," "the right to reject treatment"-slogans all, some contradicting others and yet all coexisting comfortably in mindless harmony. If the right to autonomyðto our bodies, minds, and selves means anything, it means a right to suicide. And if pro-choice means anything, it must mean the right to use or abstain from using any particular drug. And yet these are precisely the rights no normal Arnerican endorses. Indeed, we are so phobic about suicide that we fear even knowing about it. According to a survey reported in the May 18, 1992 issue of U.S. News b World Report, 71 percent of Americans would like libraries to ban "books describing how to commit suicide."2 I suggest, then, that fear of the temptation to comrnit suicide is a critical, yet rarely considered, facet of drug controls.
The right to do X does not mean that doing X is morally meritorious. We have a right to divorce our spouse, vote for a politician we know nothing about, eat until we are obese, or squander our money on lottery tickets. Thus, the phrase right to suicide does not mean that suicide is a morally desirable or meritorious act. It means only that agents of the state have no right or power to interfere, by prohibitions or punishments, with a person's decision to kill himself. Those who desire to prevent a particular person from committing suicide must content themselves with their power, such, as it might be, to persuade him to change his mind.
Because we have a free market in food, we can buy all the bacon, eggs, and ice cream we want and can afford. If we had a free market in drugs, we could similarly buy all the barbiturates, chloral hydrate, and morphine we want and could afford. We would then be free to dieðeasily, comfortably, and surelyðwithout any need for recourse tO "death doctors" or violent means of suicide, and without fear of being kept alive against our will to die a protracted, painful, and extravagantly expensive death in a building misnamed a "hospital."
We would then no longer have to complain about doctors, nurses, relatives, hospitals, and courts overtreating us, undertreating us, withholding pain medications from us, keeping us alive, and depriving us of our "right to die."3
How did the idea of a right to die arise? How can the inevitable biological destiny of all living beings be a right? What does the phrase mean? Acalally, the phrase refers primarily to our confused rejection of the spectacle of doctors keeping moribund persons alive with the aid of modern biotechnological machinery. Why do physicians do this? Because they enjoy the powers science and the state have put in their hands; because they often have both professional and economic mceneves for it; because they assume that is what the patient would want; because courts or kin command them to do "everything possible" to lLeep the patent alive; and, lastly, because withholding life-sustaining measures could be regarded as deliberately killing the patent. In short, we prattle about a right to die because we prefer mouthing uplifting slogans to thinking seriously about the meaning of life.
For most of us today, the term sanctity of life has lost virtually all meaning. We cling to lifc- up to a point. After that, we want to be "allowed" to dieðan imagery that falsely implies that we are mescapably bound to persons determined to prevent us from dying. To deny them that role, we have complemented the proposition that we have a right to life (which has become the code phrase of the antiabortion movement), with the seemingly contrary proposition that we have a right to die.
However, the similarity between these two semantically reciprocal rights is illusory. Each addresses a completely different set of existential choices and ethical perplexities. The phrase right to life refers to the ("natural") inception of life; moreover, this "right" is ascribed to all unborn fetuses and belongs to each unconditionally. Whereas the phrase right to die refers to the ("unnatural") termination of life; and this "right" is ascribed only to terminally ill persons and, in practice, often belongs to their relatives.4
Thus, the phrase right to die is emblematic not only of our skittishness about suicide and our long;-ng for good doctors to kill uso at just the right time and in just the right way, but, more fundamen-tally, of our reEdiation of bodily self-ownership and the responsi-bilities that go with it. It~remains to~be seen how many Americans prefer legalizing doctors to kill them to legalizing themselves to own drugs, and shouldering the responsibilities which the ownership of such a valuable property entails.
So long as the phrase right to die does not include an unqualified right to suicide a subject its supporters never mention it is destined to be nothing more or less than just another step in the medicalization of life and in our headlong rush into the deadly embrace of the Therapeutic State. On the other hand, if the phrase is intended to encompass the right to suicide, thenðlest it be an empty slogan the right to die must include the right to drugs. We know, however, that most people especially in the United States consider the desire to commit suicide, much less the act itself, not a right but a symptom of preventable and treatable mental illness. As against this view, I hold that the option to commit suicide is inherent in the human condition; that committing suicide ought to be considered a basic human right and may sometimes be a moral duty; and the expectation or threat of suicide never justifies the coercive control of the (allegedly) suicidal person. At the same time, I consider it a basic moral wrong for a physician to kill a patient, or anyone else, and call it ''euthanasia.''S This does not mean that "pulling the plug" on a dying patient is (necessarily) an immoral act; it means only that doing so does not (necessarily) require medical expertise, should not be defined as a medical intervention, and should not be delegated (specifically) to physicians. I maintain that our longing for doctors to give us lethal drugs betokens our desire to evade responsibility for giving such drugs to ourselves; and that so long as we are more interested in investing doctors with the right to kill than in reclaiming our own right to drugs, our discourse about rights and drugs is destined to remain empty, meaningless chatter.
Of course, people cannot expect to regain their right to acts and objects unless they are willing and prepared to assume responsibility for the conduoct of the acts and the care of the objects in question.
Since the most important practical consequence of our loss of the right to bodily self-ovfnership is the denial-of legally unrestricted access to drugs, the most important symbol of the right to our bodies now resides in our reasserting our right to drugs -to all drugs, not just to one or another so-called recreational drug. At this point, we come face-to-face with our real drug problem namely, that most Americans today do not want to have legally unrestricted access to drugs. On the contrary, they dread the idea and the prospect it portends.
In sum, it seems to me that we have launched ourselves on a self-contradictory quest-that is, for an America where no one "abuses" drugs because doctors effectively control drug use, and where everyone dies a painless and pleasant deai because doctors compassionately kill "dying" people who want to be killed. Having combined a dread of dying a protacted, pointless, and perhaps painful death with a fear of living with a free market in dmgs, we have negated our chances for attaining pharmacological autonomyð that is, freedom and responsibility vis-a-vis ie drugs we take similar to the freedom and responsibility we have vis-a-vis the foods we eat, the books we read, and the religions we profess.
W. Rogers, "Slogans, Slogans Everywhere (1925)," in Bryan B. and Frances N.
Sterling, eds., A Will Rogers Treasury (New York: Bonanza Books, 1982), 71.
2"Banishing books?" U.S. News e World Report, 18 May 1992, 76.
3See, for exarnple, J. Somerville, "Illinois task force issues model right-to-die bill,"
American Medical News, 20 April 1990, 20.
4See T.S. Szasz, Li7ving With It (Buffalo: Prometheus Books, 1991), 204.
5See T.S. Szasz, 'The ethics of suicide (1971)," in The Theology of Medicine
(Syracuse: Syracuse University Press, 1988), 68-85; "The case against suicide prevention," American Psychologist 41 Uuly 1986): 806-12; and The Untamed Tongxe: A Dissentinz Dictionary (LaSalle, Ill.: Open Court, 1990), 245-52.©html 1995 drugtext web-lab