Austin O'Malley

The Ethics of Medical Homicide and Mutilation


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acknowledges its weakness.

      If there were only one man in the world, and no society or state, suicide would still be illicit, because its basic deordination lies deeper than society or the state. If suicide were a moral evil solely because it deprives the state of the suicide's life, then for the same reason no one might become a citizen of another state, emigrate, nor might man abandon society and live as a recluse. Moreover, if a man were detrimental to the state rather than beneficial, in this point of view that fact alone would justify suicide, and the state would then be justified in permitting or even commanding suicide; and we shall show later that the state has not this power.

      It is true that the injury done the state or society by loss of use and profit, by scandal and similar evils, is a solid argument against suicide, as such injury aggravates the deordination of suicide, but in itself the injury done to the state and society is not the fundamental reason against suicide.

      St. Thomas[4] argues against suicide because it is contrary to the charity a human being should have for himself. This is true ordinarily, and suicide takes on part of its guilt just because it is an offence against the rational regard a person should have for himself; yet this argument is not basic. We are told that if one sins against charity in killing his neighbor, a fortiori he sins in killing himself. Yet suppose just what the advocates of euthanasia suggest, viz., that a neighbor is in great agony and incurable: then the act of killing him takes on a quality of charity rather than of uncharity. And so for the suicide: if the patient is willing to be killed, there would be no uncharity; if he were unwilling, then homicide in any form would be uncharitable and unjust. The argument from charity, therefore, is too narrow to fit the whole case; and its very weakness is a source of error for the advocates of euthanasia.

      Still another argument is often advanced against suicide, viz., that a man is obliged to love his own life, since it is the foundation, or the necessary condition, to him, of all good and every virtue, and this circumstance makes the destruction of that life unlawful. That argument has solid truth, but if it held absolutely it would prevent us from desiring death in any case, and no one denies that there are conditions in which a desire for death is fully legitimate. No desire for death, however, can give the slightest justification for the destruction of life.

      Again, the argument that suicide is cowardice is not broad enough. Fortitude is a mean between fear and rashness, and this argument maintains that the suicide sins against fortitude by rashness. If we have good reason it is not rash to expose ourselves to death; the soldier may do so, the person struggling to save a neighbor's life, and so on; it may be the highest form of fortitude thus to expose oneself to death. If the suicide can persuade himself that by his act he is seeking greater good than the life he possesses he would have reason for his act, and at least be above cowardice. This argument is one that can be turned at times so as to cut the fingers of the man that uses it. The fundamental reason that suicide is not lawful is that man cannot be master of his own life, and therefore he may not dispose of it as he pleases.

      Suicide is the direct killing of oneself on one's own authority. A killing is direct when death is intended as an end, or chosen as a means to an end. Direct killing is positive by commission, or negative by omission. In such cases the will directly rests in the death as a voluntary and free act. A killing is indirect when the act of which death is the effect by its nature and the intent of the agent is directed toward another end, but concomitantly, or as a consequence, results in death. In such case death is an accidental effect, and comes indirectly from the activity of the will—it is not necessarily voluntary. If one has a right to do that other deed, or if it is his duty to do it, and there is a proportion between it and his life, he may do the deed and permit the consequent death.

      A direct homicide may be done on one's own authority, or on that of another person. It is done on one's own authority if the agent assumes a natural individual dominion over life, and by virtue of such dominion directly kills himself or another; it is done on the authority of another when a man directly kills himself or another by the mandate of a positive divine or human law, and in the name and on the authority of a positive divine or human legislator. It is evident that God, as Creator, has supreme dominion over human life, and therefore by his positive authority he may command a man directly to kill himself. God, however, does not by the natural law confer on man the right thus to kill. The question here is of the natural duty or right which comes from the natural law alone.

      Direct suicide on one's own authority may happen in two ways: positively, that is, by doing an act which is directly homicidal; or negatively, by omitting an act necessary for the preservation of life. That a negative homicide be direct, death must be intended as an end or means. If, however, one voluntarily intends an end or a means, but for the sake of antecedent good or evil omits some act necessary to preserve life, his suicide is indirect, per accidens, and not always illicit unless there is a precept against just such an omission. Man has no dominion over his own life, he has only the use of it; and the natural law obliges us while using a thing which is under the dominion of another not to omit ordinary means for its preservation. We are not, however, held to extraordinary means. His own death is criminally imputable to him who negatively and indirectly kills himself by omitting the ordinary means for preserving his life, because the precept he is under to preserve his own life makes his act voluntary. If he omits extraordinary means, the death is not criminally imputable to him because there is no precept obliging such means. Certain circumstances may by accident oblige one to use extraordinary means to preserve one's own life—a dependent family, a public office in perilous times, or the like. The proposition, then, is: The natural law does not give a man absolute dominion over his own life.

      I. The natural law gives no rights except such as are finally founded in human nature itself; but human nature cannot give a title to dominion over one's own life; therefore the natural law does not give man such a right.

      Every natural right is either congenital or acquired. The title to a congenital right is human nature itself; the title to an acquired right is some act consequent to the exercise of human activity. The right to such exercise is, in turn, congenital and founded in human nature.

      If nature established the title to dominion over one's own life it would thereby establish the power of destroying that life, and thus of removing the fundamental title to all rights; but nature exists as the foundation for rights, not for the subversion of rights; therefore human nature cannot give a final title to dominion over our own life.

      Again, this minor of the first argument is confirmed by the fact that if nature even remotely established the power of self-destruction there should be in nature itself some natural tendency to such destruction, but the direct contrary is the fact.

      II. The natural law cannot grant a right to man which is not a means to the common end of human life; but absolute dominion over one's own life is not such a means, therefore the natural law cannot give one dominion over his own life.

      The natural law is only an ordination of man to that common end of human life and to the means toward that end. As regards the minor of this second argument, an absolute dominion over his own life would give man power to stop all his human activity, yet the common end of human life is attainable only by man's activity. The stopping, or the power of stopping, all activity cannot be a means to that end.

      III. The natural law cannot give man a power which is opposed to the essential needs of human nature itself; but that a man should have absolute dominion over his own life is opposed to an essential need of human nature itself, therefore the natural law cannot give such a power.

      Dominion over his own life implies the power in man of rebelling against the subjection which he owes to God; but human nature essentially demands that man be in subjection to God, since dominion over one's own life and subjection to God are contradictory.

      Again, if man had absolute dominion over his own life he could stand aloof from all influx of the natural law and avoid every duty arising from that law. A law, however, cannot give a power which nullifies itself.

      The objection that suicide is licit because no injury can be done a man by an act if the man is willing to submit to the act, is irrelevant. The injury in suicide is not to man at all, but to God.

      There