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EUTHANASIA AND THE GOOD LIFE TRUDO LEMMENS* Introduction In common parlance, it is often held that people die the way they live. Thejoker breathes his last with an ultimate gag. The violent robber gets killed during a hold-up, while a noble benefactor dies in peace at home with piously crossed hands. A less innocuous way of linking one's life with one's death is found in the moralistic association of certain deadly diseases with a specific lifestyle. Dying of AIDS, for example, has by some extremists been held to be people's own "choice," the result of a "morally wrong" lifestyle, and even God's punishment. The idea that our dying is always in accordance with the way we lived can of course easily be rebutted. Mahatma Gandhi was violently killed, while Stalin and Mengele died peaceful deaths. We also have to reject firmly the idea that disease, misery, or suffering is the normal pay-off for sins committed. What happens is that people easily find points of resemblance between one's lifestyle and one's death. The choice of our images for describing the way someone died is the result of the way we perceived the person's life to have been. It is not only other people who describe the way we die on the basis of how they perceived our life. Indeed, we all in a way create our own ideal moment and mode of dying on the basis of our image of what constitutes a good life. In the following pages, I will situate the growing claim for legalizing euthanasia within this normative view of life. The demand for euthanasia reflects our image of the good life. This image is the result of a combination of what Clifford Geertz calls "spheres of This paper was awarded the 1994 Student Prize of the Society for Health and Human Values (SHHV) and was presented at their annual meeting in Pittsburgh, October 8, 1994. The author is grateful for the advice and comments given by Professors Eric Beresford and Carl Elliott and by Charles Weijer and Pascale Chapdelaine, and C.R.D.P. of the University of Montreal. *Researcher, Clinical Trials Research Group, McGiIl University, 3690 Peel Street, Montreal , Quebec, Canada H3A 1W9.© 1995 by The University of Chicago. All rights reserved. 0031-5982/95/3901-0937$01.00 Perspectives in Biology and Medicine, 39, 1 ¦ Autumn 1995 15 meaning": modes of thinking that are the result of historical-cultural processes; developments that have gained a particular meaning; our relations with others, with modern technology, and with everyday reality , and so on. It is a complex set of interactions, the result of an interplay between a specific, partly inherited approach to the world, and meaningful practices that we develop on the basis of this approach. In turn, these elements tend to reinforce our own particular view of life. The claim that euthanasia is morally acceptable or even required can be situated within this framework. As often argued, developments in medical technology have indeed created specific problems related to aggressive and "blind" medical intervention . Confrontations between patient autonomy and the dynamics of science and medical progress are common place. But there is more than than. As Callahan argues, the demand for euthanasia is not so much the result of a confrontation between patients' desires and aggressive medical practice, but, on the contrary, fits perfectly within a medical mode of thinking [I]. I argue that there are also other conflicting elements that have influenced our view of euthanasia. On the one hand, there is hope and confidence that medicine will enable us to first understand and then control disease and aging processes. Scientific developments continue to pique our imagination. By attempting to preserve an optimal state of physical and mental health, medical research engenders a specific view of the desirable life. Medicine, itself the result of a particular approach to the world, thus accentuates the idea of the rational, self-determining free person, living his own, "ordinary" life. On the other hand, we are confronted with the obvious limits of technological progress and control of nature. In the context of medicine, the rapid expansion of knowledge has not enabled...

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