Alluring freedoms: Heideggerian possibilities for an ethical encounter with dying and death By Julia Brotea A thesis submitted to the Faculty of Graduate and Postdoctoral Affairs in partial fulfillment of the requirements for the degree of Doctor of Philosophy In Political Science Carleton University Ottawa, Ontario ©2011 Julia Brotea Library and Archives Bibliotheque et 1*1 Canada Archives Canada Published Heritage Direction du Branch Patrimoine de I'edition 395 Wellington Street 395, rue Wellington OttawaONK1A0N4 OttawaONK1A0N4 Canada Canada Your file Votre reference ISBN: 978-0-494-83239-4 Our file Notre r6f6rence ISBN: 978-0-494-83239-4 NOTICE: AVIS: The author has granted a non­ L'auteur a accorde une licence non exclusive exclusive license allowing Library and permettant a la Bibliotheque et Archives Archives Canada to reproduce, Canada de reproduire, publier, archiver, publish, archive, preserve, conserve, sauvegarder, conserver, transmettre au public communicate to the public by par telecommunication ou par I'lnternet, preter, telecommunication or on the Internet, distribuer et vendre des theses partout dans le loan, distribute and sell theses monde, a des fins commerciales ou autres, sur worldwide, for commercial or non­ support microforme, papier, electronique et/ou commercial purposes, in microform, autres formats. paper, electronic and/or any other formats. The author retains copyright L'auteur conserve la propriete du droit d'auteur ownership and moral rights in this et des droits moraux qui protege cette these. Ni thesis. Neither the thesis nor la these ni des extraits substantiels de celle-ci substantial extracts from it may be ne doivent etre imprimes ou autrement printed or otherwise reproduced reproduits sans son autorisation. without the author's permission. In compliance with the Canadian Conformement a la loi canadienne sur la Privacy Act some supporting forms protection de la vie privee, quelques may have been removed from this formulaires secondaires ont ete enleves de thesis. cette these. While these forms may be included Bien que ces formulaires aient inclus dans in the document page count, their la pagination, il n'y aura aucun contenu removal does not represent any loss manquant. of content from the thesis. 1+1 Canada Abstract In this study, I evaluate Jacques Derrida's claim that Martin Heidegger may provide us with a more appropriate language in which to discuss dying and death in our time. I begin each chapter by examining one of five end of life issues. These issues are the right to die, suicide, euthanasia, life support, and immortality. I draw from the work of bioethicists and, where appropriate, from the work of scientists working in the biotechnological and medical sciences. Occasionally, I also rely on historical accounts to trace changes in perceptions and practices related to some of these issues. Yet, the main method for this study is an exegesis of Heidegger's work. In the end, I argue that end of life issues can be used to reveal multifarious conceptualizations of freedom present in Heidegger's thought. These Heideggerian conceptualizations of freedom are dangerous either to elements of negative freedom, present in liberal thought, or to politics in general. If Heidegger's thoughts are indeed being used to enrich our modern ethical views about dying and death, then they are necessarily being used out of context and contrary to what Heidegger had actually intended them to mean. If, however, his concepts were to be taken integrally, respecting the larger context in which he conceived them, then they would prove corrosive to liberal democratic principles that modern medical ethics still strives to follow. in Acknowledgements Writing this dissertation on end of life issues has been a difficult, but tremendously rewarding, experience. Throughout this process, I was fortunate to be surrounded by people I could count on for support and encouragement. Among them, I am particularly grateful to have received guidance from my supervisor and kind mentor Professor Tom Darby. His willingness to share his powerful insight over the years, and his commitment to helping me along the way, made this experience less solitary and profoundly enriching. Professor Darby has taught me how to 'speak' about technology and about Heidegger's philosophy. In doing so, he helped me lay the foundation for this work. I wish to also thank Professor Peter Emberley for committing his time and effort to helping me understand the writings of St. Augustine. I found our discussions to be some of the most thoughtful and compelling I have ever had. I am also grateful for my family's loving support and encouragement. To my husband, Frangois Nadeau, for his clam and loving help as well as his careful editing and re-editing of this work in an effort to give it clarity. To my step­ father, Robert Sainsbury, for always providing me with the right perspective on things and for his comments and insight on my work. To my mother Despina Brotea, for being a powerful role-model and protective presence in my life. Most of all she taught me that I must always 'return to the world.' My thanks to my father Adrian Brotea, for showing me the beauty and the danger of disinterested learning often 'too far from the world.' And, special thanks to Pamela Huber, her friendship sheltered me from taking my readings too seriously. iv I am also indebted to the Canadian taxpayers, who, through Social Science and Humanities Research Grants and Ontario Graduate Scholarships, helped fund my doctoral work. Finally, this work is dedicated to my dear son Galen Nadeau, who is teaching me about the beauty of beginnings. v Table of Contents Acceptance form ii Abstract iii Acknowledgements iv Table of Contents vi Introduction 1 Cultural attitudes towards dying and death 4 The political challenges of biotechnology 6 Heidegger's discourse on de bene moriendi 11 Heidegger's conceptualizations of freedom 14 Breakdown of this work 20 Chapter 1. The fascination with freedom in the right to die 27 The right to die in brief context 28 Schopenhauer and the right to die 35 Metaphors of creation about the right to die 43 Freitod and deceptive freedom 53 Concluding remarks 57 Chapter 2. Suicide and Being-towards-Death 60 Categories of suicide 61 Brief history of suicide 67 Rationalizing suicide 70 The Meaning of Dasein 76 Dasein and Being-towards-death 79 The impossibility of suicide: Thrown in the world 85 Concluding remarks 89 Chapter 3. Euthanasia and judging 'the good death' 91 Historical overview of the 'good death' 92 The Christian death 93 The romanticizing of death 100 vi The institutionalization of tuberculosis 105 Euthanasia in Nazi Germany 109 Modern euthanasia 113 'The others' and 'the they' - empathy in Heidegger's thought 121 Historical resoluteness 132 The danger of 'the they' deciding 'the good death' 136 Concluding remarks 138 Chapter 4. Life support and technological thought 141 Overview of life support in the Intensive Care Unit (ICU) 143 Making decisions in the ICU 147 Ancient drama in scientific thought 154 The scientific method and the meaning of facts 158 Modern medicine and technological thought 162 The possibility for politics 167 Concluding remarks 170 Chapter 5. Physical immortality and the control of time 172 Immortal beings of an endangered species 175 Is immortality a good in itself? 181 Time as presence 187 Resolute time and Christian Influences 190 Dasein's resoluteness: a future to be mastered 194 Immortals without time 200 Concluding remarks 203 Conclusion 206 Bibliography 213 Vll Introduction Dying and death are not subjects that can be fully understood, nor can one desire to become an expert in these matters. Quite the contrary; human beings desire to know nothing of either dying or death and they hope to evade them both. Despite this, the subject is a resilient one, and it is also becoming a morally difficult and a politically contentious one. Aside from the inevitable confrontation with the dying and death of a loved one, advancements in medical technology also invite decisions in matters previously reserved for contemplation and final surrender to death. Thus, the threshold between life and death that is reserved for each one of us is now increasingly populated by machines, medical professionals, family members, and social workers that engage in political, moral, and scientific debates over dying and death, and that increasingly decide whether to accelerate or delay our final transition from life to death. These decisions are among the most formidable ones our generation has to make in the developed world and, in many cases, they lack a historical precedent. It is indeed historically unprecedented that the practice of children deciding to remove a parent from life support is becoming routine in our society. Not surprisingly, most parents want to shelter their children from this difficult choice and some opt for taking their own life instead or pressure their doctor to do so for them. Many doctors find this to be an affront to their commitment to saving lives and thus refuse the dying men and women their wishes. We would often prefer not making these choices, and we are sometimes willing to allow others to make them for us instead. This avoidance of 1 responsibility, however, can lead to the greater danger of forfeiting the freedom to decide for ourselves matters that are most important to us. The circumstances under which these decisions are made, and the motives behind some of them, reflect the dark side of technological progress in the medical sciences. Yet, it is a dark side we must reckon with nevertheless. The increasingly secular and culturally diverse society in which we live further complicates these decisions, and the circumstances surrounding them. Even leaving aside Michel Foucault's socio-historical explanation of biopower and the dangers of ubiquitous oppression he argues this power unleashes, there is still an easily identifiable fascination with health and medicine that is more prevalent in secular societies.