The British legal system has sentenced 23-month-old Alfie Evans to death; they say his death is for his own good. While the parents dispute that Evans has been properly diagnosed and the Italian government offers travel and medical care for the toddler, the British judicial system has determined that Alfie’s life is no longer worth living, and has withdrawn life support. He has survived for more than 24 hours nonetheless.
Suffice it to say that if Alfie’s parents took him home and refused to feed him, they would be prosecuted for child abuse. If a British hospital does it at the behest of British judges, they’re standing on the side of good and right.
Why? Well, because Alfie is supposed to “die with dignity.” According to hospital staff, their goal was to kill Alfie with “dignity.” Judge Hayden, the presiding judge in this case, talked similarly of “dignity.” An NHS doctor named Rachel Clarke wrote an op-ed for The Guardian (UK) suggesting, “Withdrawal of care is neither killing nor murder, but enables a patient to die with comfort and dignity.”
First off, that’s not what’s happening here.
Let’s distinguish between two terms: comfort and dignity. The courts and NHS seem to use these two terms interchangeably, but they are not interchangeable. Death with comfort is something that can be objectively determined – we can tell your pain level, the horrors you’re suffering, the alleviation of that pain from watching. We know that a woman dying of a bowel obstruction who chokes on her own bile is dying an objectively less comfortable death than that same woman being sent to hospice a week earlier and placed on morphine.
Dignity, however, is a state of mind and a state of being both to yourself and relatively to others. If you are dignified with respect to yourself, you are fulfilling your wishes – and those wishes may range from dying with palliative care to struggling until you take your last breath. If you are dignified with respect to others, you take their wishes into account. Great men and women die in horrible agony on a regular basis, and they are not less dignified for having done so. Comfort and dignity are not identical.
“Dying with comfort” might be a term applicable to Alfie Evans. “Dying with dignity” isn’t. Alfie doesn’t have a choice here. He’s 23 months old. So the question becomes – even assuming that he will die in the near future – whether his parents or the state gets to choose what “dignity” looks like. The answer should be that his parents get to choose. They get to decide the memories they have of Alfie. They are the people who will be visiting Alfie’s grave. And if they believe that the best – and most dignified – thing for Alfie is to fight for every last second of his life, that’s their perfectly understandable choice.
Death with dignity is a term utilized most often by advocates of euthanasia, who suggest that earlier death with comfort is preferable to later death with pain. That is a value decision, subjective in the extreme. But the logic of euthanasia has now infected the state apparatus, and so the state uses its own determination of “dignity” to apply the methodologies of death to children. That is truly evil, and dignity has nothing to do with it.