Flat White

Should people with ‘addictions’ be euthanased?

7 March 2018

7:46 AM

7 March 2018

7:46 AM

For all those who don’t think that the “slippery slope” argument is valid, just consider this. In Belgium and the Netherlands, the category of “addiction” is now valid grounds for euthanasia. And tragically, this has already started to occur.

As recently as 2016, a man named Mark Langedijk, who suffered from chronic alcoholism, was granted permission to be euthanased. This is how the heart-breaking scene of his death was described by The Independent:

On the day of his death, he “laughed, drank, smoked, ate ham and cheese sandwiches and soup with meatballs” until his doctor arrived at his parents’ home at 3.15pm.

His doctor explained the procedure, before telling Mr Landedijk to get into bed and to stay calm.

At this point, they all “started crying, my parents, everyone actually, even Mark”.

“We cried, told each other that we loved each other, that it would be all right, that we would care for each other, that we would see each other again, we held each other,” he said. “If it was not so terrible, it would have been nice.

“Mark’s eyes turned away, he sighed deeply. His last. Dr Marijke injected the third syringe. His face changed, lost color. My little brother was dead.”


Wayne Hall, Centre of Youth Substance Abuse Research, UQ, and Malcolm Parker, Emeritus Professor of Medical Ethics, Faculty of Medicine, UQ, have written that cases like these are far from being exceptions. They are instead, part of an international trend in relaxing euthanasia laws. As they explain:

The range of medical conditions for which patients can request euthanasia has expanded over time. It now includes not just terminal or degenerative illnesses but any condition that, in the patient’s view, produces unrelieved, intolerable suffering. The grounds for euthanasia in these countries have been taken recently to include intractable depression, chronic forms of addiction, autism and personality disorders and people who do not claim to have any disorder but are simply ‘tired of living’ and want to die.

For their part, Hall and Parker state that their “aims in considering this case are not to argue for or against euthanasia” but to “prompt discussion of this issue within the field of addiction” and “to identify important issues that need to be considered by physicians”.

Against the popular scholarly consensus, Hall and Parker challenge the “disease model” for understanding addiction. They have to do this because, as they themselves acknowledge, “…we recognise that chronic alcohol and other drug use can produce illnesses that may reduce capacity, such as severe depression or cognitive impairment.” What they suggest is their own ‘Twelve-Step Program’, similar to hugely successful Alcoholics Anonymous. Except, rather than helping people to be free of their addictions, it is a checklist to see if it’s valid to put them out of their misery.

Richard E. Ashcroft—School of Law, Queen Mary University of London, London, UK—has published an excellent, and concise, critique to Hall and Parker’s proposal, arguing that we should be extremely slow to “accept addiction as a reason for performing euthanasia”. Ashcroft makes two insightful and important points.

First, Ashcroft argues that, “If we are not willing to do so [to view addictions as a brain disease], we cannot see them readily as objects of treatment and medical care, and thus much of the medical model of care and treatment falls away, along with some of the medical, although not all the social, arguments for harm reduction, heroin (or other drug) prescribing in addiction treatment, and so on.”

Second, what happens if we say that addictions are not a disease? According to Ashcroft: “The reason for euthanasia, then, would not be the intractable nature of the disease, but rather the intractable nature of the suffering. This has proved highly controversial in discussions of euthanasia for other sorts of suffering.” The reason it’s “highly controversial” is because it’s hopelessly subjective. Just where do you draw the line?

For instance, the same article from The Independent that I referred to earlier goes on to state: “More than 5,500 people ended their life using Holland’s euthanasia laws last year. One of those who died was a sex abuse victim who suffered severe anorexia, chronic depression and hallucinations.” This is precisely the kind of example that Ashcroft is alluding too. As Ashcroft concludes:

The nature of psychological suffering is somewhat more elusive than physical pain, all the more so if we have bracketed off the question of underlying pathology. Although suffering has some strictly ‘mental’ features (involving thought processes, affect and moods), it also involves behaviours, social relations, social and economic context and so on, which it would be a mistake to see as purely intrinsic features of the patient.

How much longer will proponents of euthanasia hide behind the excuse of Godwin’s Law? Is euthanasia really the answer to those suffering from the pain of substance abuse and addiction? Should we get rid of Alcoholics or Narcotics Anonymous and just be done with them?

Just what kind of world have we come too when, as a former leader of my own denomination has provocatively argued, the medical solution for people’s suffering has morphed into, “…a legalised form of murder”?

Mark Powell is the Associate Pastor of Cornerstone Presbyterian Church, Strathfield.

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