I
THE proposal to forestall a painful death by a painless one is not, to normal sensibilities, “shocking.” If persuaded of its expediency no physician should give it a hesitating advocacy through fear of being thought brutal. It is an error to suppose that familiarity with death and suffering exhausts the springs of compassion in one born compassionate. Like many other qualities, compassion grows by use: none has more of it than the physician, the nurse, the soldier in war. He to whom the menace of an injustice is a louder voice than the call of conscience has no standing in the House of Pain, no warrant to utter judgment as to the conduct of its affairs.
Pain is cruel, death is merciful. Prolongation of a mortal agony is hardly less barbarous than its infliction. Who when sane in mind and body would not choose to guard himself against a futile suffering by an assurance of accelerated release? Every memory is charged with instances, observed or related, of piteous appeals for death from the white lips of agony, yet how rarely can these formulate the prayer!
To its concession, regulated by law, there is the objection that law is frangible and judgment fallible. But that objection has no greater cogency in this than in other matters; laws we must have, and execute them with such care as we can. Our courts sometimes err in the diagnosis of crime, yet they warrant our trust in the general service of our need. The mariner’s compass is fallible, the winds baffle and the waves destroy; yet we have navigation. Even the anarchist cries out against law, not because it does not accomplish its purpose, but because, roughly, it does.
We build civilization with such tools as we have; if we waited for perfect ones the structure would never rise. The juror is no more nearly just and infallible than the physician; if we can entrust ourselves with death as a penalty for crime we need not shrink from the no more awful responsibility of according it as a boon to hopeless pain. In neither case can a blunder do more than hasten the inevitable. “When I was born I cried,” said a philosopher; “now I know why.” He did not know why; it was because at the moment of his birth Nature spoke the sentence of his death.
It may be that proponents of euthanasia for suffering incurables are pushing their adventurous feet too far ahead in the march of mind to expect anything better in the nature of encouragement than a copious dead-catting and bad-egging from laggard processionists arear. Sometimes, however, they get decenter treatment than they have the hardihood to claim: occasionally, through the roar of calumniation is heard the voice of dull and dignified protestation, even of argument. For example, The British Medical Journal once pointed out, with more gravity than grammar, that “the medical profession has always strongly set its face against a measure that would inevitably pave the way to the grossest abuses, and which would degrade them to the position of executioners.”
I don’t know that the medical profession speaks with any special authority in a matter of this kind. Perhaps it knows a little better than other trades and professions that cases of hopeless agony are of frequent occurrence, but as to the expediency of relieving them by the compassionate coup de grâce—of that a physician is no better judge than anyone else. As to the fear of being “degraded to the position of executioners,” the position is not degrading. The office of executioner—even when execution is punishment, not mercy—is, and should be considered, an almost sacred office. Its popular disrepute harks back to the bad old days when a majority of the people in countries now partly civilized were criminal in act or sympathy, living in hate and terror of the law—the days of Tyburn Tree with its roaring mobs, cheering the malefactor and pelting the hangman. It was not from fear of a merely social reprobation that the mediæval headsman wore a mask; it was from fear of being torn to pieces if ever recognized unguarded in the public street. A man of to-day, ambitious to prove his descent from a criminal ancestry, can most easily do so by damning the hangman. His humble origin is no disgrace to him if he is a good citizen, but it makes him invincible to the suasion of argument against his fad. One might as profitably attempt to reform the color of his eyes or dissuade him from the shape of his nose.
II
“It is a physician’s mission to cure disease and alleviate suffering,” says Dr. Nehemiah Nickerson. “There is a point beyond which he can not cure disease; after that it is his duty to alleviate suffering.”
A mission implies a mandate; a mandate an authority superior to that of the missionary. I do not know from what higher authority a physician derives his own, nor who has the right to lay down the lines within which his activity must lie. Within the civil and the moral law he is a free agent—free to observe or disregard the customs of his trade, as conscience may determine. He has no mandate, no mission.