STUDIA 2020, 18, 5: 155-170 ECOLOGIAE ISSN 1733-1218 ET BIOETHICAE DOI: https://doi.org/10.21697/seb.2020.18.5.14

New humanism or posthumanism? Ethical and legal aspects of the legalisation of in the world in the years 2000-2015*

Nowy humanizm czy posthumanizm? Aspekty etyczno-prawne legalizacji eutanazji na świecie w latach 2000-2015 Andrzej Kobyliński Institute of Philosophy, Cardinal Stefan Wyszyński University in Warsaw, Poland ORCID: https://orcid.org/0000-0003-2252-8634 • [email protected]

Abstract: The main aim of this article is to outline the discussion on euthanasia that affects the basic aspects of human life – the foundation of human dignity, sense of pain and suffering, the conception of the , quality and value of life, etc. All the indi- cations are that the process of the legalisation of euthanasia will develop in the coming decades. Today we need a new paradigm of , built on the basis of a new humanism, which will allow us to adequately analyse such phenomena as , suffering and dying. The new paradigm of bioethics can be an effective tool in the dispute over the death on request.

Keywords: bioethics, euthanasia, Hans Küng, new humanism, posthumanism, persistent therapy

Streszczenie: Głównym celem tego artykułu jest przedstawienie dyskusji dotyczącej eutanazji, która dotyka fundamentalnych aspektów życia człowieka: podstaw ludzkiej godności, sensu bólu i cierpienia, rozumienia życia wiecznego, wartości i jakości życia itp. Wszystko wskazuje na to, że proces legalizacji eutanazji będzie postępował w najbliższych dziesięcioleciach. Dziś potrzebny jest nowy paradygmat bioetyki, zbudowany na nowym humanizmie, który pozwoli na adekwatną analizę fenomenów śmierci, cierpienia i umierania. Ten nowy paradygmat może być efektywnym narzędziem w dyskusji nad śmiercią na życzenie.

Słowa kluczowe: bioetyka, eutanazja, Hans Küng, nowy humanizm, posthumanizm, terapia uporczywa

Introduction law. Euthanasia in the strict sense is to be In the last few years, the process of legal- understood as an act or omission which, izing euthanasia has significantly acceler- by its nature or in the intention of an actor, ated in many countries around the world. causes death in order to eliminate all suf- The year 2000 was a breakthrough in this fering. Euthanasia means to bring death to respect, as the first legal act in the world oneself by a terminally ill person. It also legalizing termination of life on request was adopted in the . The year *This article was originally published in Polish as 2015, in which various forms of voluntary Kobyliński, Andrzej. 2015. “Nowy humanizm czy termination of human life were consid- posthumanizm? Aspekty etyczno-prawne legaliza- ered legal in several other countries of the cji eutanazji na świecie w latach 2000-2015.” Studia world, will probably also go down in histo- Ecologiae et Bioethicae 13(4): 85-114. The transla- ry in the dispute over legal euthanasia. tion of the article into English was financed by the Euthanasia is currently very often pre- Ministry of Science and Higher Education of the Re- public of Poland as part of the activities promoting sented as the right of a sick person to die, science - Decision No. 676/P-DUN/2019 of 2 April which should be sanctioned by a specific 2019. Translation made by GROY Translations. Andrzej Kobyliński 156 means to terminate life of a terminally ill for the growing acceptance of the human patient, at their request, by medical per- right to death on demand. sonnel (Demmer 2004, 455-458). 1. The Dutch Revolution of 2000 The severity and complexity of the cur- rent dispute over legal termination of life The Netherlands is the first country in on request is well illustrated by the unu- the world to legalise euthanasia (Chabot sual discussion that took place on 13 No- 2007; Callebert en Van Audenhove 2012). vember 2014 in the German Bundestag. The discussion about the “ with In many comments, it has been described dignity” began in the country of tulips in as the most exciting debate in Germany the mid-1990s. In this country, already in over the last years. The discussion lasted 1990 euthanasia performed by physicians five hours and was attended by 50 German was no longer punishable. In practice, parliamentarians. The great debate was such a solution meant allowing physicians even accompanied by the tears of some to “assist” terminally ill patients in speakers, which is extremely rare among if they “unambiguously and repeatedly” politicians in the Rhine country. demanded voluntary death. Another con- In Germany, the term “assisted dying” dition for the impunity of euthanasia was (Sterbehilfe) is most often used to describe an incurable disease, causing unbearable a voluntary termination of life. Due to his- suffering. The physician, before admin- torical circumstances, the word “euthana- istering poison to the patient, also had to sia” is very rarely used in German. In the consult another physician (Fenigsen 1997). era of National Socialism, the Germans In the Netherlands in the 1990s, each implemented a programme of physical case of death upon request had to be re- “Elimination of life unworthy of life” (Ver- ported to a special committee that exam- nichtung von lebensunwertem Leben). The ined whether euthanasia was justified in programme was called “Aktion T4”. This a given case. Unfortunately, in practice, action was also called “euthanasia” of the physicians have quite often given up in- handicapped - hence the abbreviation forming the committee about their ac- “E-Action”. Under that programme, at least tions to avoid additional formalities. Only 100 thousand sick and disabled people were in 1999, there have been more than 2,000 killed in Germany and in the areas occu- officially registered cases of physician-as- pied by German troops. In 2015, the major- sisted suicide in the Netherlands, which ity of Germans were in favour of legalising probably accounted for only half of the termination of life onrequest and active as- euthanasia cases actually performed. At sisted suicide in the form of lethal injection the end of the 1990s, public support for by a physician on demand when the patient euthanasia reached as high as 92% in the sees no reason for further treatment. country of tulips. What conclusions can be drawn from le- On 18 November 2000, the lower cham- gal acts legalizing euthanasia in some coun- ber of the Dutch Parliament legalised eu- tries? How to morally judge euthanasia of thanasia with 104 votes in favour and 40 children? Will the contemporary cultural against. The Senate confirmed the decision trend, emphasizing the importance of the of the lower house on 10 April 2001 with quality of life and the human right to death 46 votes “in favour” and 28 “against.” The on demand, also dominate in the coming Act came into force on 1 April 2002. The decades? How to respond to Hans Küng’s law legalizing euthanasia is called: “Termi- challenge presenting religious arguments nation of Life on Request and Assisted Su- for the right to voluntary death? The article icide (Review Procedures) Act” (in Dutch: aims to analyse the process of legalizing eu- Wet toetsing levensbeëindiging op verzoek thanasia in many countries of the world in en hulp bij zelfdoding). the years 2000-2015 and to show the need The analysis of the law legalizing eu- for a new bioethical paradigm as a remedy thanasia in the Netherlands leads to two New humanism or posthumanism... 157 important conclusions. Firstly, the word able to express their will directly. In such euthanasia does not appear in the whole a case, a written statement requesting the text at all. Secondly, the act contains 24 ar- acceleration of death, previously signed by ticles, of which only the first two deal with the patient consciously and voluntarily, is the conditions and criteria for shortening sufficient. It should be added that only the the life of a sick and suffering person. The attending physician can be the one who de- remaining provisions concern purely tech- cides to terminate life or assist the patient nical issues that regulate, inter alia, the in suicide. In the legislator’s opinion, only manner of informing about the patient’s such a doctor knows the sick person well death and the functioning of committees enough to be able to assess whether the supervising the cases of “unnatural death” patient expresses their request voluntarily, reported by physicians. whether they considered it carefully and It is worth emphasizing that the legis- whether their suffering is really unbearable lator does not define “termination of life and without any prospect of improvement. on request”, which should be understood However, a second physician, who acts as as euthanasia. In the first article of the a consultant, cannot be involved in the Act, however, “” is defined treatment of the patient. Their task is only as voluntary assistance to other people to assess the patient’s health condition and in committing suicide or preparing the the voluntary nature of their request for means for committing it. The second ar- death, as well as to express their opinion in ticle of the act includes six criteria of “re- writing (Wet 2014). liability, prudence and professionalism” In the Netherlands, a patient can submit which must be met by a physician in the their request for euthanasia orally or in event of termination of life on request or writing. A written statement is especially assisted suicide so that “unnatural death” important when a physician decides to ter- is lawful (Wet 2014). minate life when the patient can no longer First, the physician must be convinced verbally express a request for euthanasia. that the patient’s request is voluntary, If, on the other hand, we are dealing with well-thought-out and final. Secondly, the a patient’s mental illness and suffering that physician must be sure that the suffering does not originate from the body, the phy- is unbearable, with no hope of improve- sician who decides to terminate the life ment. Thirdly, the physician should inform must consult two independent experts, the patient about their health situation and one of whom should be a psychiatrist. of the consequences thereof. Fourthly, the In the Netherlands, any case of “unnatural physician - along with the patient - must death” must be reported to one of the five be convinced that, apart from accelerat- regional committees the task of which is to ing the process of death, there is no other control on request. The members of reasonable solution. Fifthly, the physician the committees are appointed by the state must consult another independent phy- authorities for a six-year term. The com- sician who shall visit the patient and ex- mittee must include a lawyer, a doctor and press their opinion in writing with regard an expert in ethics. Based on the reports re- to respecting four previous principles of ceived, the committees shall assess whether “reliability, prudence and professionalism”. the physician terminated lives or helped to Sixth, termination of life on request and commit suicide in accordance with the six assisted suicide should always be accom- principles of “reliability, prudence and pro- panied by observing the principles of good fessionalism”. If any irregularities are found, clinical practice. the case is referred to the prosecutor’s office According to Dutch law, which legalizes (Wet 2014). euthanasia, a physician is allowed to fulfil The legalisation of euthanasia in the a patient’s request for voluntary death also Netherlands was accompanied by a special in a situation where the patient is no longer information policy of the government of Andrzej Kobyliński 158 that country. In this respect, the document lives there voluntarily. In the following year, prepared by the Ministry of Foreign Affairs there were 1,035 patients, 232 of whom was particularly important, as it precisely chose to die on request (Faverzani 2015). explained - in the form of 18 questions and In the country of tulips, this kind of hospi- answers - all the most important issues re- tal death is more and more often treated as lated to the legal transformation that took a right for all citizens. place in 2000. In this document, which 2. The problem of child euthanasia was specifically addressed to international public opinion, the concept of euthanasia The second country in the world to intro- appears (The Netherlands Ministry of For- duce legal euthanasia, in 2002, was Bel- eign Affairs 2012). The Ministry of Foreign gium. On 2 March 2014, King Philip of Affairs describes it as “termination of a pa- signed the act amending the law tient’s life by a physician”. According to the of 2002. The new solution adopted by the Dutch government, the primary objective authorities in Brussels makes it possible of the new law is to ensure maximum pru- to apply legal euthanasia also to children. dence in situations of “medical termina- Earlier, on 13 February 2014, the House tion of life”. The Ministry of Foreign Affairs of Representatives adopted the act by an made it clear that it was no longer possible overwhelming majority. In the vote of the to turn a blind eye to the well-known fact lower house of the Belgian Parliament, 86 that euthanasia had long been practised in MPs voted in favour of the new law, 44 the country of tulips - hence the need for were against and 11 abstained. In this way, legal regulation of that phenomenon. Belgium became the first country in the The state document explains that a physi- world to allow the euthanasia of children, cian cannot be forced to perform euthana- without any age limit. sia or assist suicide. Physicians and nurses In 2002, also in the Netherlands, the pos- are allowed to refuse to participate in the sibility of euthanasia of minors was intro- preparation and cause of ‘unnatural death’. duced, but this did not apply to children The basis for such a ruling is the belief that under 12 years of age. If the patient in the “the patient does not exercise the right to Netherlands is 16-18 years of age, their re- euthanasia and that the physician is not quest for termination of life is fulfilled pro- obliged to practice it”. In this context, the vided that parents or legal guardians were principle of conscientious objection ap- involved in the decision-making process. On pears, understood as the right of medical the other hand, in the case of children and personnel to refuse to take actions contrary adolescents aged 12-16 years, the request to their own moral and religious principles. to terminate life or assist in suicide may be The Dutch Act of 2000 has become an met by a physician only if the parents or legal important reference point for many similar guardians simultaneously agree. solutions adopted in other countries. In the The legalisation of child euthanasia in Netherlands, the law allows thousands of Belgium in 2014 was hardly noticed by the people to die on demand each year . Studies European public opinion. On the other show that currently one case of “unnatural hand, a serious worldview discussion has death” accounts for 30 natural deaths. One swept through the Belgian society over the of the latest consequences of legal euthana- past few years. In 2013, representatives of sia was the opening of the End of Life Clin- all the major religious denominations in ic (Levendseindekliniek) in March 2012. It Belgium were among those who signed is run by a very strong and influential or- a protest against the new bill: Catholicism, ganisation called the Dutch Voluntary End Lutheranism, Orthodoxy, , of Life Association: NVVE - Nederlandse and . The joint document con- Verenging voor een Vrijwillig Levenseinde tains a warning against the logic that leads (NVVE 2015). In 2013, the clinic admit- to the destruction of the foundations of ted 749 patients, 134 of whom ended their social life. New humanism or posthumanism... 159

In the Belgian Act of 2014, the only cri- In this way, one of the forms of eutha- terion for a decision concerning death on nasia, which previously was legal in the request is the so-called ability to judge or province of Quebec only, was de facto le- discern. It occurs when there is a guarantee galised. The Supreme Court has legalised that what the child expresses is that what the so-called assisted suicide by remov- the child understands. The assessment of ing the prohibition of such practice from judgemental capacity is the responsibility the Canadian Penal Code. In the opinion of appropriate psychologists and psychia- of the judges, such a prohibition violated trists of developmental age. The consent of individual freedom, which also means the the parents was not necessary in the earlier right to take one’s own life (Scandroglio bill. This meant that even a very young child 2015a). The solution adopted in Canada could claim euthanasia for itself. At the fi- means the possibility for an adult affected nal stage of the parliamentary discussion, by a fatal illness and unbearable suffering, however, a clause concerning the need for who has expressed their wish in writing, to parents’ consent was added and a fragment take their own life. was drawn up about psychological suffer- In practice, a physician prescribes the ing, very common among adolescents, as medical means necessary for killing, while one of the reasons justifying euthanasia. the patient takes their own life. In a writ- In June 2015, Dutch Association of Pae- ten justification of the judgment, the Su- diatrics (Nederlandse Vereniging voor Kin- preme Court of Canada confirmed that life dergeneeskunde) has advocated extending is an inalienable good, but at the same time the possibility of euthanasia to minors un- stated that the expression the “” der 12 year of age. According to the Asso- by no means implies an absolute prohibi- ciation, the age limit should be lowered in tion on receiving assistance in terminating those cases where the child under 12 year one’s own life, nor does state that an indi- of age shows the ability to understand the vidual cannot voluntarily give up their life. consequences of their decisions and the The court gave the Canadian parliament relevant medical choices. Thus, the coun- a year to pass a law on this matter. try of tulips took the first step to “enter the Opponents of this solution, united in the road of Belgium, which in 2014 allowed the Euthanasia Prevention Coalition, called euthanasia of minors” (Schoepflin 2015b). on the federal government to establish 3. The legalisation of euthanasia a special commission in Canada to protect people with disabilities, the elderly, men- worldwide in 2015 tally ill and those at risk of suicide. In the 2015 was extremely important for the summer of 2015, Euthanasia Prevention development of the phenomenon of le- Coalition organized a campaign to send gal euthanasia in the world. Appropriate special postcards to the Canadian Justice acts, legalizing different forms of volun- Minister Peter MacKay, which called for tary death, were adopted, among other, appropriate care for the old, sick and suf- in Canada, France, Colombia and Argen- fering people. tina. On 6 February 2015, by a judgment The authorities in Paris also adopted of the Supreme Court of Canada, the so- an act legalizing some forms of death on called assisted suicide was legalized in this request. On 17 March 2015, after the re- country. Nine judges passed the sentence jection of the draft law on assisted suicide unanimously. In this way, the Supreme a few days earlier, the lower chamber of Court supported the British Columbia the French Parliament adopted, by a large Civil Liberties Association, which in 2009 majority, the act on the rights of patients filed a complaint requesting the possibili- in the final phase of their lives. The new ty of euthanasia by Kay Carter and Gloria act allows terminally ill persons to benefit Taylor, two women affected by neurovege- from “deep and lasting sedation” if they ask tative diseases. for it constantly, consciously and repeatedly Andrzej Kobyliński 160

(Scandroglio 2015b). Article 1 of the define the rules for practising euthanasia. Act states that all persons have the right In Colombia, the parliamentary process to a dignified end of life. Article 3 is the was completely omitted when legalizing most debatable one, allowing the death of death on request. It is an absolute prec- the patient if he or she so wishes, through edent on a world scale when it comes to the process of sedation, which consists in regulating such a delicate sphere of life as reducing the activity of the central nerv- the process of dying. ous system due to the administration of The document states that euthanasia strong doses of analgesics. The act stipu- might be requested by a terminally ill adult lates that with the commencement of deep who has clearly expressed their will to end and permanent sedation, the feeding and their life. If the patient has expressed such hydration process of the patient who has a decision, the treating physician is obliged decided to terminate their life must be dis- to inform them about the possibilities of continued. . If the patient upholds their French discussion on the deep and last- request, the attending physician prepares ing sedation is accompanied by the dispute a report on the objective state of their over the dramatic fate of Vincent Lambert, health. The case is then dealt with by who since 2008 - as a result of a serious a three-person interdisciplinary commit- car accident – has been in a state of the tee, composed of a specialist doctor, law- so-called minimal consciousness at the yer and psychologist, who again ask the University Clinic in Reims. The patient is patient if they confirm their will to take breathing on his own, reacts to stimuli. His their own life. After the discussion with condition can be described as a profound the patient, the committee prepares an ap- disability. Several years ago, the hospital propriate report, which is accompanied by authorities wanted to interrupt the pa- the report of the attending physician. If the tient’s assisted nutrition and hydration. patient does not change their mind, they Vincent Lambert’s parents objected to this can be euthanised within 15 days. solution, while his wife accepted it. The group of countries accepting the A long and tumultuous judicial war be- right to voluntary death was also joint by gan, culminating in the judgment of the Argentina. On 7 July 2015, the Supreme European Court of Human Rights of 5 June Court of that country (La Corte Suprema 2015, which stated that it would not be il- de Justicia de la Argentina) allowed the legal to interrupt nutrition and hydration interruption of nutrition and hydration of in this case. After this sentence, however, Marcel Diaz, who had been in a vegetative Vincent Lambert was not killed. At the end state for 20 years. The patient died on the of July 2015, doctors from the University same day. Marcel’s sisters had been solicit- Hospital in Reims requested the French ju- ing such termination since 2011. This way, diciary to appoint an official legal guardian the door to the so-called passive euthana- for the patient to defend his interests. In sia was opened. It was a turning point in the summer of 2015, approx. 1700 patients the dispute over the legalisation of death in France were in a similar situation to that on request in Argentina. La Corte Supre- of Vincent Lambert (Vinai 2015). ma de Justicia allowed voluntary death, Colombia has recently become anoth- even if the judgment assures that it is not er country with legal euthanasia. In April a form of euthanasia. According to Argen- 2015, the Ministry of Health of this coun- tinian judges, that case is similar to the try has adopted guidelines on euthanasia story of Terry Schiavo from the USA, Elau- (Verrazzo 2015). The decision, announced na Englaro from Italy and recently Vincent in the ministerial bulletin, was taken fol- Lambert from France (Schoepflin 2015a). lowing the judgment of the Constitutional Italy is also another country in which Tribunal of that country, which in Febru- there is currently a significant political and ary 2015 gave the government 30 days to political controversy over the legalisation New humanism or posthumanism... 161 of death on request. In early 2015, the Ital- the development of medical knowledge - ian opinion-making daily La Repubblica between justified treatment and persistent has published a series of articles promot- therapy. It is very often an extremely diffi- ing the legalisation of euthanasia in the cult task because it involves both compe- country on the Tiber. A heated discussion tence and conscience. Increasingly, medical on this topic began with the printout of an personnel fear that they may be sued for anonymous letter from one of the nurses acting in accordance with their own moral at Careggi Hospital in Florence. In the let- or religious beliefs. It seems particularly im- ter, it was stated that euthanasia had been portant today to ensure that the conscience de facto practised in this hospital for a long clause is respected in the healthcare system time. At the same time, an anonymous so that decisions of doctors and nurses - in nurse expressed her opinion that by sup- Italy and many other countries in the world porting the patient artificially, we take the - can be taken professionally and in accord- place of the Creator (Scandroglio 2015c). ance with conscience. After the letter was published, in the “La The Science & Life Association (Associa- Repubblica”daily, euthanasia was strongly zione Scienza & Vita) also took a voice in supported by, inter alia, prof. Umberto Ve- the Italian discussion on euthanasia. The ronesi - Italian oncologist, politician, sci- organisation was established in 2005 as one entific director of the European Oncology of the fruits of the nationwide discussion Institute. The well-known Italian writer, conducted in Italy in preparation for the re- journalist and politician Corrado Augias ferendum concerning the act regulating the took a similar position. One of the most use of assisted reproduction methods. The important topics related to euthanasia, mission of the Association is to create dialo- discussed in Bel Paese in the first half of gue and reflection on human life and dignity. 2015, was the issue of developing criteria In practice, this means, inter alia, providing to distinguish genuine euthanasia from reliable information on bioethical issues, or- discontinuation of persistent therapy. How ganizing scientific conferences, expressing do we understand today to sustain life to bioethical positions in the context of various the very end? What should natural death types of manifestations of the contemporary be nowadays, when medicine has devel- biotechnological revolution. oped such excellent ways of prolonging life In press release 173 of 27 February 2015 that we can already speak of many levels of entitled “Euthanasia in hospitals? Doc- the artificial and the unnatural? tors and nurses heal, not kill”, the Asso- In some of the statements for “La Repub- ciation responded to press releases about blica”, a postulate of legalisation in Italy of the practice of euthanasia in the Careggi the so-called euthanasia by omission (eu- hospital in Florence (Associazione Scienza tanasia omissiva) was postulated. In such & Vita. 2015). According to the Science & case, the medical personnel ceases to pro- Life Association, many mass media delib- vide the patient with the means necessary erately manipulated the public opinion in to support the life process. That type of eu- this matter, because cases of justified dis- thanasia should be distinguished from dis- continuation of persistent therapy were continuation of persistent therapy (rifiuto equated with the practice of euthanasia. dell’accanimento terapeutico), which con- Healthcare professionals must not suc- sists in the abandonment of administration cumb to this pressure. “The Hippocratic of the means that are no longer relevant for Oath and the Nurses’ Oath are not option- the improvement of the patient’s condition al, but are significant and distinguishing and life. In the first case, the death is caused, features of men and women who are at the in the second case, the death is accepted as service of others to help them live, not die” an inevitable phenomenon. (Associazione Scienza & Vita 2015). Undoubtedly, the task of doctors is to de- The problem of legalizing euthanasia fine the boundary - at the present stage of was also taken up by Great Britain. 26 July Andrzej Kobyliński 162

2015, the in England and supervised assistance to end their own life. Wales celebrated the Day for Life. The topic In practice, this means that physicians le- of this year’s celebrations was: “Cherishing gally administer lethal drugs to terminally Life - Accepting Death”. As part of the cele- ill patients who are expected to die within bration of the Day for Life in 2015, 300,000 six months, so that they could commit su- postcards devoted to defending the dignity icide. The Marris Bill is in fact a copy of of life of the elderly and the ill were distrib- the law currently in force in the US state of uted in England and Wales. This is one of Oregon. It is also a continuation of the Fal- the many initiatives of Catholics in these coner Bill, which was previously rejected countries as part of a broad public aware- twice by the UK House of Commons. ness campaign on death and dying issues. 4. The Hans Küng challenge Just before the Day for Life, the Euro- pean Court of Human Rights rejected the In 2013, Hans Küng - a Catholic priest request for the legalisation of euthanasia who had been publicly questioning some submitted by some British activists who of the contents of the Magisterium of the demanded the introduction of legalisation Catholic Church for many years - seri- of assistance in the death of terminally ously challenged Christian thought when ill people. The Strasbourg Court rejected it comes to approaching euthanasia. The complaints brought by Jane Nicklinson, Swiss intellectual in the third volume of whose husband Tony is paralyzed and his memoirs entitled Experienced Human- suffers from Locked-in Syndrome, and by ity made a strong stand for the human Paul Lamb, who is paralyzed after a car ac- right to voluntary death (Küng 2013). This cident. In 2002, the Supreme Court of the was the first time a Catholic clergyman United Kingdom has denied Tony Nicklin- and a well-known theologian has shown son the so-called the right to euthanasia. his affirmative position so clearly when it The Strasbourg Court did not consider comes to a form of termination of life on these cases when it sent them to the Brit- request. A year later, another book by this ish Parliament (Del Soldato 2015). author was published, entitled Dying hap- In August 2015, Lord George Carey, re- pily?. It is entirely devoted to the issue of tired Anglican Archbishop of Canterbury, the human right to a and has spoken out in favour of medically as- develops the argumentation contained in sisted . In his opinion, there is the third volume of memoirs (Küng 2014). nothing noble about enduring excruci- The Swiss theologian’s position on death ating pain. Deeply Christian and moral on request is presented in his declaration: would be the establishment of a law that “Since I believe in eternal life, I am allowed would allow those who choose to end their - when the time is right - to make a deci- lives in dignity. Archbishop Carey is ac- sion, on my own responsibility, about the tively involved in the campaign to legalize moment and manner of my dying” (Gerade assisted suicide. Meanwhile, the current weil ich an ein ewiges Leben glaube, darf Archbishop of Canterbury and the head ich, wenn es an der Zeit ist, in eigener of the Anglican community, Justin Welby, Verantwortung über Zeitpunkt und Art vehemently opposes legal liberalization in meines Sterbens entscheiden). In his opin- this regard. ion, everyone has the right to end their On 11 September 2015, the House of life voluntarily when pain and suffering Commons started a parliamentary discus- becomes unbearable. What is the essence sion on the draft law on the legalisation of of the challenge posed by the Swiss cler- assisted suicide. The bill, prepared by Rob gyman and intellectual? Some kind of Co- Marris, deals with the matter of assisted pernican Revolution, in this case, consists dying. The core of this project is to create in religious and theological arguments in legal opportunities for terminally ill adults favour of the right to voluntary death. The to choose to be provided with medically Swiss theologian advocates the right to die New humanism or posthumanism... 163 on request because he is a believing Chris- rity and the free development of their per- tian who recognizes that death is not the sonality, as long as they do not infringe the ultimate end of man. rights of others. No human has the right to Küng links the problem of death and dy- physically or mentally torture other peo- ing very closely with his religious and the- ple. Precisely because the human person is ological views. He argues that his concept infinitely precious, it is imperative to pro- of dying in dignity and “a dignified end of tect their dignity until the very end. Today, life” (ein menschenwürdiges Ende des Leb- in the era of rapid medical development, ens) has nothing to do with suicide or eu- it is necessary to carefully consider what thanasia. He claims that a happy death to it really means to die with dignity, when him does not mean dying without melan- modern medical procedures can make dy- choly or pain, but leaving, accompanied by ing a painless process or are able in many the reconciliation with fate, deep satisfac- cases to significantly delay the moment of tion and inner peace. In his opinion, this our death (Jens and Küng 2009). is what the Greek word euthanasia means The Swiss theologian does not deny the - happy, good, just and beautiful death. religious truth that life is a divine gift. Yes, The Swiss theologian believes that the it is a gift from God, but God has put it right of man to decide when they die does at man’s responsible disposal. This also ap- not contradict the Christian religion and the plies to the last stages of the process of life duty of respect for life. The Christian God and death itself. A man should make an in- is merciful and he is not a cruel tyrant who dependent decision on the determination wants his children to suffer, which becomes of the moment of their death in the spirit a goal in itself. This author’s current atti- of moral autonomy and self-determination tude to death results from his many years (Selbstbestimmung des Menschen), which of intellectual and spiritual effort to under- for Immanuel Kant was the source of hu- stand issues such as the existence of God, man dignity. the essence of Christianity, eternal life, the How to “independently” (eigenständig) de- Church, ecumenism and world’s religions. fine the moment of one’s own death? When Küng’s current position on the right to is the right time to leave the Earth’s life? One voluntary death was also greatly influ- should read it in own conscience in order to enced by his personal life stories, including responsibly say goodbye to the earthly ex- the disease of his brother George who died istence. In November 2013, at the German of brain cancer at the age of 23, and the Society for Human Dying (Deutsche Ge- long-standing dementia of a close friend sellschaft für Humanes Sterben) conference Walter Jens. The Christian faith and life speaking in Bonn, Küng publicly confessed experiences led the Swiss theologian to that God had not yet given him any direct the conviction that a dignified death on re- sign from heaven in this matter. He added quest is an inalienable human right (Wehr- that he hoped that God would give him the li, Sutter, and Kaufmann 2015). grace to recognise the right moment - the The author of the book Dying happily? latest moment would undoubtedly be the was long a member of the Swiss “Exit” onset of dementia. Association, which is one of the most 5. The need for a new bioethical paradigm world-renowned organizations that as- sist terminally ill in suicide. Küng says he The wave of legalisation of various forms agrees with the declaration of the Parlia- of voluntary death sweeping through the ment of the World’s Religions, issued in world raises the question about the type Chicago in 1999, which commits a culture of bioethical analysis and argumentation of respect for all life - in line with the state- that we will need in the coming decades. ments: “Don’t kill!” and “Respect every life”. The year 2015 clearly showed that the hy- They mean that all people have the right to potheses that various kinds of anti-eutha- life - to preserve their own physical integ- nasia actions “may bring about any change Andrzej Kobyliński 164 of tendency in the foreseeable time” are age incurable diseases. The idea behind the totally unrealistic (D’Agostino 2015). In programme is very simple - teams of spe- many countries of the world, the vision of cialists from many branches of medicine medicine in the spirit of Hippocrates is be- are formed for the care of terminally ill pa- ing abandoned more and more often, for tients and visit patients in their homes. It whom the doctor’s duty should always be is primarily about changing the approach to take action that serves life, not death. - the goal is not a medical procedure, but Francesco D’Agostino claims that today “it care for the person we help to meet their is imperative to take a step forward which is personal expectations. extremely difficult because it is completely The new method of care not only empha- new: it is not necessary to reformulate but sizes the dignity of ill and suffering people to formulate a new bioethical paradigm at but also extends their lives and brings sig- the conceptual and communicative level, nificant savings to the health care system - which will not consist in re-proposing the in the US, 5% of terminal patients generate so-called traditional values. It is necessary over half of all health care spending. On 23 to develop proposals for actions and new August 2015, Stuart presented his mod- values - inspiring, provocative and radical- el of palliative care in Rimini, Italy, at the ly antithetical to those practices and values “Meetings of Friendship between Nations” that led to the adoption of laws for euthana- (Meeting per l’amicizia fra i popoli). sia” (D’Agostino 2015). The development of a new bioethical D’Agostino believes that an example of model is also associated with the intel- such activities under the new bioethical lectual challenges of modern atheism. In paradigm may be the relation between many regions of our globe, an atheistic the health care system and the third age. vision of the world and man has recently The last stage of human life in the secular- been strengthened. One of such countries ized societies of Western civilization has is the . The so-called Straton- been almost entirely dominated by medi- ic Atheism, which refers to the views of the cine and bureaucracy. We have to get out Greek philosopher and perpathet Straton of this road and make a gradual positive of Lampsak (335-269) has been recently “privatization” of our life, and especially of very fashionable there. Straton was pri- our death, because the only truly human marily concerned with the natural scienc- place for our dying is the family life full of es. Like the atomists Leucyp and Dem- good feelings. More and more doctors in ocritus of Abdera, he was a materialist and the world are convinced that the hospital believed that everything in the universe is not a good place for the elderly or ter- was built of matter and energy. minally ill people. The abandoned sick and Straton interpreted the universe as old people dying in loneliness are a conse- a mechanism in which no forces of a divine, quence of the family crises. According to transcendent or religious nature existed. D’Agostino, it is necessary to expose con- Straton and his followers today believe that temporary individualism, revealing a new each rational discussion about God should horizon of human rights and emphasizing begin by assuming the truth of atheism as the inalienable essence of our humanity. a common sense view. In this perspective, One of the American models of care for the atheistic vision of the world and man the elderly may prove the effectiveness of is presented as the only rational and obvi- the new bioethical paradigm. One of its ous concept. As a consequence, the duty to creators is Brad Stuart - a doctor, special- prove the opposite thesis, i.e. the rationality ist in palliative medicine, working in the of the arguments concerning the existence network of hospitals and clinics of Sutter of the Supreme Being, rests with those who Health, which has its facilities in 100 cities adhere to religious beliefs. in California (Molinari 2015). Stuart cre- Such theses are presented, among oth- ated the first in the USA program to man- ers, by two atheistic American philoso- New humanism or posthumanism... 165 phers Scott F. Aikin and Robert B. Talisse in es in the author’s thinking that followed his a book published in the USA in 2011 enti- abandonment of Catholicism and the con- tled Reasonable Atheism (Aikin, and Talisse version to Orthodoxy in the mid-1990s. 2011). According to these authors, atheism Engelhardt claims now that Christianity is an absolutely rational attitude. The only has de facto collapsed. A similar fate be- problem is to convince the adherents of the fell modernity, in which moral rationality theistic worldview of the internal rationality disintegrated into a kind of polytheism of of the atheistic worldview. The monograph ethical concepts. In his opinion, a civiliza- of American authors is “apologetic” in its tion built on a Christian foundation has nature - its main purpose is to philosophi- practically ceased to exist, but God still cally prove to theists that the choice of athe- exists and remains our ultimate point of ists has an exceptionally solid rational basis. reference today (Engelhardt 2014). Therefore, an atheistic vision of the world The author of “The foundations of Chris- should be considered an attitude worthy tian bioethics” claims that human reason is of respect from a moral and intellectual not able to cognize the Supreme Being in point of view. The book is a kind of reversed a natural way. Engelhardt sharply criticizes fundamental theology - it is a new summa Western Christianity, which he accuses of atheologica that demonstrates the rational- having throughout history preferred Ath- ity of atheism as the most convincing philo- ens over Jerusalem, opening the way for the sophical position. primacy of reason over faith. Consequent- Unlike Richard Dawkins and many other ly, today we face the need to dehellenise so-called new atheists who present hos- Christianity. There is no moral philosophy tile attitudes towards religion, Aikin and that is universal in nature. So it is impossi- Talisse avoid aggressive or offensive tones ble to build any rational ethics in the plane- towards people with religious beliefs. They tary dimension. In his opinion, secular bio- prefer the soft approach - in their opinion, ethics and secularized Christian bioethics one should respect different views, and are not able to effectively protect the sancti- nobody should be offended. The main pur- ty and dignity of human life today. The only pose of the book is to show the adherents solution is to replace human reason by the of the theoretical vision of the world that Orthodox Christian faith and by Tradition. such ideas as the existence of the Supreme Engelhardt claims that only such strictly re- Being, sin, and miracles are contrary to ligious bioethics can effectively defend hu- reason. This means deconstruction of all man dignity today. kinds of ontological, cosmological or an- 6. New humanism versus posthumanism thropological arguments for the existence of the Supreme Being (Timossi 2015). The search for a new bioethical paradigm Stratonic Atheism poses a serious intel- is closely related to the contemporary re- lectual challenge to bioethics and today’s flection on new humanism and posthu- disputes over euthanasia, because it forces manism. Many interesting comments on to deeply reflect on the foundation of hu- this subject have recently been formulated, man dignity, the meaning of suffering and among others, by French intellectual Julia dying, and the perspective of the afterlife. Kristeva. One of the authors who perceive the Based on what vision of man a new challenge of contemporary atheism is the bioethical paradigm will be built in the fu- American philosopher H. Tristram Engel- ture? Which trend will dominate the next hardt, who published in 1986 his widely decades: new humanism or posthuman- commented book “The foundations of bio- ism? How to justify human dignity and ethics” (Engelhardt 1986). In 2000, his next the meaning of suffering and dying, if the work titled “The foundations of Christian posthumanist vision prevails in the com- bioethics” was published (Engelhardt ing times? The answers to these questions 2000). It is a testimony to the many chang- will depend on, among others, bioethical Andrzej Kobyliński 166 analysis of the euthanasia phenomenon the demonstration, one million people pro- and the quality of the law created in this tested against the bill on the legalisation of matter. single-sex couples and the introduction of In 2015, the issue of new humanism gender ideology into Italian schools. and posthumanism became an extremely In preparation for the 5th National important element of public debate in It- Church Convention, many books and ar- aly - especially thanks to the 5th National ticles have been published in Italy. One of Church Convention (Convegno ecclesiale the most interesting items is the study by nazionale), which took place in Florence Giuseppe Savagnone entitled Quel che res- on 9-13 November 2015. The previous edi- ta dell’uomo. È davvero possibile un nuo- tion of this extremely important event in vo umanesimo? (What remains of man. the life of the Catholic Church in Italy was Is a new humanism truly possible?) (Sav- held on 16-20 October 2006 in Verona. agnone 2015). According to the author, During the National Church Conventions, humanism involves the content of the na- Italian Catholics seek answers to the most ture of a human being, human nature, the pressing moral, religious, social, cultural meaning of human life, a vision of a ful- and philosophical challenges of the pres- filled and happy life or a model of collec- ent time (Diaco 2015; Tommasi 2015). The tive life. The deepest essence of the present theme of the 2015 Convention was: “In crisis of modern humanism lies in a kind Jesus Christ, a new humanism” (In Gesù of ambiguity or uncertainty about what is Cristo il nuovo umanesimo). genuinely human and which is testifying to Preparations for the Florence Conven- our identity. tion took many years. As part of the prepa- “There is a risk,” says Giuseppe Savag- rations, many scientific symposia were none, “that instead of facing real challeng- organized. One of such conferences took es and seeking answers to the questions place on 24-27 August 2015 in Collegio posed by the culture of our time, they are Rosmini in Stresa near Milan. It was the treated negligently, taking the necessary 16th Rosmini Symposium (Simposi Ros- solutions as simple and obvious. If this miniani), the topic of which was: “Person, happened, the formula of the new human- psyche and society. In search of what is hu- ism would be held hostage to a certain pas- man” (Persona, psiche e società. Sulle trac- toral practice that feeds the superficiality ce dell’umano). Many of the issues raised and mental laziness of the majority of the during this conference were an anticipa- faithful, tacitly accepting their lack of cul- tion of the debate and reflection that took tural commitment and exempting them place at the National Church Convention once again from the effort to overcome the in Florence. On the first day of the sym- gap that now separates, in many respects, posiums, an extremely important lecture the contemporary world from the Gospel” on the concept of person, personalism and (Savagnone 2015, 5). contemporary ideological colonialism was Savagnone understands the new human- delivered by Nunzio Galantino, Secretary ism as a rediscovery of the nature of Chris- General of the Italian Episcopal Confer- tian humanism, the nature of which is the ence (Galantino 2015). idea of the Incarnation and the divinity of The problem of the new humanism as man. In this perspective, the relationship a response to the contemporary axiologi- with the Supreme Being is the source of cal crisis was also present in the discussion human dignity - God became man so that that took place in Italy in connection with in their human face “man could recognize a demonstration that took place on 20 June their own divine face” (Savagnone 2015, 2015 in Rome on St. John’s Square in the 176). According to this author, an authen- Lateran. The demonstration was organized tic search for a new humanism must take by the “We Defend Our Children” Com- into account the five most important is- mittee (Difendiamo i nostri figli). During sues nowadays. New humanism or posthumanism... 167

The first concerns the relationship -be similar with posthumanism - within this tween humanism and ecology and an- trend, one can find a great variety of vi- imism. These two currents of modern sions of the future, the common element thought strike the very heart of the unique- of which is the belief that the human being ness of human existence and its superiority as we know it today - with his existential to other living beings. Can human dignity fragility and various types of limitations be valued in dialogue with ecology and an- – is approaching the moment of radical imism? How to maintain the distinctness transformation in the coming decades. of the human being? According to this vision of the future, the The second issue relates to the relation- technological development of our civiliza- ship between human nature and the world tion will make the human subject “posthu- of technology. Are we able today to defend man” (postumano), and humanism will be the notion of human nature as the es- defined definitively as a closed heritage to sence of humanity, which is not subject to which there is no return (Grion 2012). change, as modern technological develop- Another Italian intellectual, Vittorio Pos- ment blurs more and more the distinction senti, also draws attention to the challeng- between what is natural and what is artifi- es posed by posthumanism in his writings. cial and man-made? In his opinion, posthumanism is one of the The third issue concerns the relationship forms of development of secular human- between the individual and society. How ism which strongly emphasizes the role to protect the autonomous existence of of science and technology. “Technophiles, a human being against the threat of indi- futurists, prometists, technognostics - says vidualism and the lack of social ties? How Possenti - form a galaxy of the posthu- to stop the advancing crisis of family life manist movement, for which scientific and that has a colossal impact on living out old technical rationality is the root of the West age and understanding death and dying? - possibly combined with utilitarian ration- The fourth issue concerns the person’s ality and, above all, with the libertine idea identity based on biological gender and of man As a consequence, posthumanism the problem of sexual orientation. Does is considered a natural consequence of all sexuality naturally define a person’s identi- Western culture. In posthumanism there ty or is it a historical and cultural structure are also tendencies hostile to religion, es- that now needs to be broken down so that pecially towards Christianity, while here people can freely choose their own sexual and there the pagan and neo-pagan roots orientation? of Europe are sought” (Possenti 2013, 41). The fifth point relates to the challeng- Proponents of posthumanism are es posed by posthumanism nowadays. Is convinced that the development of tech- there any sense in talking about humanism nology allows us to overcome diseases in in the era of posthumanism today? Are the future, solve the problem of old age the humanistic ideas still valid? If they are and develop our memory. Posthumanists in fact historically and culturally condi- believe that our psychological identity will tioned, perhaps they will end just as they be transferred to digital media. The future once began? outlined by the gurus of posthumanism is One of the authors analysing the phe- to some extent fulfilled before our eyes. nomenon of posthumanism in the country The methods of artificial insemination on the Tiber is the Italian philosopher Luca and genetic engineering already allow for Grion. In his opinion, posthumanism - as designing a new generation of children a current of thought that seeks to strength- that can be created according to the par- en human nature and expand its possibil- ents’ expectations. Large research projects ities - is like an archipelago that consists (e.g. US Brain Iniziative or Human Brain of many islands surrounded by the waters Project) seek to create digital brains that of the same sea or ocean. The situation is would be equivalent to human minds. Andrzej Kobyliński 168

Extensive research on the possibilities of or disproportionate to the expected results anti-aging process is currently being con- is the discontinuation of persistent thera- ducted by, among others, the American py and has nothing to do with euthanasia. Department of Defense. It is not intended to inflict death in this The dispute between the new humanism way; it is merely assumed that it cannot be and posthumanism is of decisive impor- prevented in this case. Developing clear tance for the future of euthanasia in the criteria to distinguish euthanasia from world. Based on the ideas of the new hu- discontinuation of persistent therapy has manism a new bioethical paradigm can be been one of the most important bioethical created that could be an effective remedy challenges today. for the developing process of the legali- The global process of legalizing various sation of death on demand. The possible forms of voluntary death highlights the domination of post-humanist ideas will role of palliative care. In France in 2015, make it extremely difficult to oppose var- there were opinions that the adoption ious forms of voluntary death. of the End of Life Act in this country is, Conclusions among other things, the result of years of neglect in the field of palliative therapy. In The worldwide process of legalizing var- many countries, a multitude of doctors, ious forms of death on demand requires nurses, psychologists and volunteers par- extensive interdisciplinary research. Deep ticipate in palliative care. The aim of pallia- philosophical and cultural reflection is tive therapies is to alleviate the suffering in needed, among other things, to analyse the final stage of disease and to provide the the conditions of extremely broad social patient with the support it needs. In this consent for practising euthanasia. One of context, the problem of the fair use of var- the main reasons for this situation is un- ious types of painkillers and tranquillizers doubtedly the progressive technological- emerges, when it is associated with the risk isation of life and the crisis of the family of shortening life. and people-to-people links. Today, due to Unfortunately, everything seems to in- the rapid development of medicine and dicate that the process of legalisation of weakened sensitivity to transcendence, euthanasia will develop in the coming the experience of suffering, pain and dying decades. A serious challenge to bioethics takes on a completely new meaning. If the and Christian thought are, among others, tendency to consider life as valuable only proposals by Hans Küng, who presents to the extent that it is a source of pleasure, religious arguments in favour of the hu- happiness and prosperity begin to prevail, man right to voluntary death. The Swiss then suffering and old age appear to be an theologian questions the position of unbearable burden, from which one must the Magisterium of the Catholic Church be freed at all costs. Then death on request on euthanasia. To effectively challenge becomes a form of liberation. Hans Küng’s approach to voluntary death, The legalisation of euthanasia in many a very clear bioethical argumentation is countries of the world draws attention to needed to show various forms of euthana- the need to effectively promote the idea sia as a violation of the holiness and dig- of discontinuing persistent therapy (Abel nity of human life. There is no doubt that 2004, 4-7). Unfortunately, very often it is what we need today is a new bioethical a completely forgotten or marginalized paradigm, built based on a new human- category. Therefore, in many cases of ism, which will allow us to adequately an- death on request, euthanasia is completely alyse such phenomena as death, suffering wrongly referred to where there has only or dying. The new bioethical paradigm been the discontinuation of persistent may help to stop the wave of legalisation therapy. Discontinuation of medical pro- of various forms of euthanasia in many cedures that are costly, risky, extraordinary countries of the world. New humanism or posthumanism... 169

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