Embryos Are Human Lives—And So Are Five-Year-Olds

Hypothetically weighing the same as
a five-year-old child. 

My attempts to maintain my Christian integrity include regularly asking myself two questions. “What do I believe?” and “Do I do it?” These apply to a wide range subjects and are important applications of the overall question, “What would Jesus have me do?”

Why This Came Up Recently

Those two questions are at the heart of an exercise in ethics put forth on October 18 by “author” and “comic” Patrick S. Tomlinson in a series of tweets. (For other middle-aged white guys and our elders, that means short, 140-word-or-fewer posts to the social media platform called Twitter.)

Why bother with Tomlinson’s hypothetical? Two reasons. First, the question he asks has value in forcing me to consider those two questions again, this time with regard to my belief in the sanctity of life from conception through natural death. The second reason is that, with over twenty-five thousand followers, and friends of mine reposting commentaries on the discussions he has sparked, it seemed appropriate to answer his question, even for my significantly fewer friends and followers.

I admit. I would save the five-year-old.
And not just because I hope
he'll be mowing my lawn before long.

His hypothetical (You can find it here: https://twitter.com/stealthygeek/status/920085535984668672) pits the life of a five-year-old child against “a frozen container labeled ‘1000 Viable Human Embryos’” in the midst of a choking cloud of smoke in a burning fertility clinic. The question is, “Which do you save?”

Tomlinson claims that he has never received an honest answer to his question. He supposes that my choice of the one child over the other 1000 human lives in the container either makes me a monster, or proves that I do not really consider the embryos to be human lives. I disagree with his conclusion for several reasons—some of which I am going to subject you to here.

The Shifting Scenario

If you read even the comments Tomlinson allows to be posted, every time he does get someone’s honest answer, he adds another qualifier to the question. And it's a hypothetical question to begin with, which has no basis in objective reality. Still, be that as it may, it's a provocative-enough exercise to have value for examining one's integrity. But the examination should consider the integrity in his logic, at least as much as a Christian’s ethics or morality.

Logically speaking, his question can be compared to asking whether you would risk your own life to rush into a burning building to save your worst enemy. Most followers of Christ's teachings would know what the answer is supposed to be and say, "Yes." Whether they would actually do it...well, that's why we like that it's a hypothetical.

But if you deny those believers' ethical and moral claims by changing the logic of the situation you present, that's disingenuous. It's like asking whether you would rush in to save your enemy, getting the "right" answer, and then adding "but that means you'd have to stop doing CPR on his child that you just rescued from that same burning building."

"Who would burn down
a fertility clinic?"

Answering the Question as the Monster I Am

Tomlinson says he has never once received an honest answer to his initial question. He later redefines “honest” to include a willingness “to accept responsibility for their answer,” but I hope I do both. Still, my honest answer is based on several important distinctions, some of which have to do with the “facts” presented in the hypothetical scenario he presents.

The environment in which an embryo is "viable" and may potentially survive beyond the fire, and beyond the misfortune of having been conceived artificially in a laboratory, is to be implanted inside a uterus. To my knowledge, suggesting otherwise, even hypothetically, currently works only in science fiction stories (author Tomlinson’s chosen genre). Therefore, on the basis of correcting the “viable” terminology of the hypothetical, the five-year-old will always get the nod. Tomlinson counters this argument, already made by others in comments tweeted back to him, by claiming the right to create whatever reality he chooses in his hypothetical. Even granting him that right, accepting that “viable” applies with the standard definition, “capable of surviving or living successfully, especially under particular environmental conditions,” I will still save the five-year-old.

Why?

My decision to save the five-year-old does not negate the fact that each embryo is still a human life, even as frozen in a stainless-steel container. So, why save one life and leave 1000 to die? Am I a monster?

During my stint in law-enforcement chaplaincy I was trained for first-responder rescues. In Professional-Rescuer CPR/Basic Life-Support—nothing really fancy—I was taught to apply a severe and arguably “monstrous” logic to situations such as what Tomlinson describes. (When I had opportunity to apply that logic, and made what I am convinced was “the right choice,” I did ask myself, “How did I end up here?” But that’s another story for another time. I survived, and so did the victim.)

You might want to ask the man holding the flame.
(Yes, that's really Patrick S. Tomlinson's
current profile picture.)

The key concept that applies even in Tomlinson’s fanciful hypothetical is called "triage." You save the save-able, even over the more severely injured; you choose those whose survival is most assured, even over larger numbers whose survival is questionable. The same equation applies to the embryos and the five-year-old. The child who has survived to age five also has greater odds (1:1) than the thousands of embryos that were already destined (with only a handful of potential exceptions) to be disposed of by the fertility clinic in which this is supposed to be occurring, and to which, presumably, they would be returned once the fire is extinguished.

(I will add here that believing in the sanctity of life from conception through natural death means that I also oppose the creation of so many lives that are destined for destruction in the process of this particular means of treating infertility. Again, though, another discussion for another time.)

Who Will You Save?

In either case, the surviving child gets prioritized over the already-condemned embryos, the successfully developing child gets prioritized above even the potentially developing embryos, and certainly reality gets prioritized above the hypothetical (especially when the hypothetical has no corollary in the real world).

So, who wants to apply these arguments to the life of the mother who will die without an abortion? Because while those cases occur far more rarely than most would imagine, that circumstance actually exists.

Life-and-Death Differences: How do I know whether I need Hospice, Palliative Care, Terminal Sedation, or Physician-Assisted Suicide?

Doesn't it seem like there should be
at least one more option than this?

Those of us who discuss dying on a regular basis sometimes forget that terms we use very specifically can have a much broader range of meaning for most other (i.e., “normal”) people. For example, grieving, mourning, and being bereaved are often used interchangeably as synonyms (i.e., words with essentially the same meaning). Is it helpful to identify the particular definition of each one? I believe it is, especially for those who are experiencing all three simultaneously, and trying to find a safe course to navigate through them. Technically, then, but briefly: Bereavement = the condition of having experienced a significant loss. Grief = the involuntary reaction we experience when we are bereaved. Mourning = the voluntary actions we take that help to process our grief.

Vocabulary for the Dying

If the terms describing the experience of loss and its aftermath are important to distinguish from one another, then it is even more important to do so when the terms apply to our own experience as an imminently dying patient. Most of us would like to know only what it means to have symptoms, receive a diagnosis, follow a course of curative treatments, and be restored to health. And yet, the reality is that most of us, either in our own life or the lives of those closest to us, will hear some form of that dreaded sentence from our doctors: “I’m sorry. There’s nothing more we can do to make you well.” What are we supposed to do when “there’s nothing more we can do?”

The important distinction, even when you are diagnosed with a terminal disease, is that while there is nothing else to be done that will cure you, there is far more that can be done to ensure that you continue to live the best possible life until that terminal disease (or some other cause) ends your life. The next step, especially for those whose terminal or chronic illness is likely to end their lives within six months or so, is usually a referral to “Hospice.”

Well, this is a third option, but it's not exactly
what hospice care is all about.

Hospice: What it is, and why.

The best definition of hospice says more about what it is not than what it is. “Hospice exists not to prolong your life, nor to hasten its end, but to help you live until you die.” When curative measures are no longer possible, or desirable (since some patients find the treatments more difficult, debilitating, or even deadly than the disease), hospice can provide patients with symptom-management and pain relief throughout the natural, physical process of dying. But just as importantly, and sometimes more so, hospice provides support for the mental, emotional, social, and spiritual needs of the patient, their family, friends, caregivers, and others. The focus on a patient’s personal preferences includes determining how best to provide service in either the patient’s home or in a medical facility. The support for the many peripheral needs can include discussions with insurance providers, referrals to funeral planners, and coordination with the appropriate faith communities for spiritual support as well.

Why am I so concerned that you understand what hospice is and does? First, you or someone you know will likely need hospice services someday. Second, there are other alternatives becoming more popular, primarily because people are unaware that hospice care is available to them. And third, I want you to understand what hospice is and does because I hear too often, “If we’d only known everything hospice could do, we would have called you in much earlier.” Sadly, I also have to hear people say, “I wish we’d known about hospice when our loved one was dying.”

At least when it's prescribed in California,
it still has to be suicide, not homicide (so far).

“Turn Out the Lights; the Party’s Over”

To fully understand what hospice is and does (and isn’t and doesn’t), there is another pair of terms that are often confused (Palliative/Terminal Sedation and Physician-Assisted Suicide), and a third (the Dual Effect) that needs to be clarified as well.

These distinctions are very important, especially for those exposed to recent references in popular Christian books. In Rob Moll’s The Art of Dying, he quotes from Dallas Willard’s The Divine Conspiracy (before repeating the phrase as his own perspective) to portray hospice as employing “the widespread use of heavy sedation.” No wonder, then, that some patients, friends, and family members imagine that once hospice service begins the patient’s conscious existence becomes a thing of the past. But in actual practice, even what is called the “dual effect” of a patient becoming unconscious (or dying) as a side-effect of sufficient doses of pain medication is rare. When it does occur, it results from attempts to relieve distressing symptoms and/or unbearable pain. Further, it is almost exclusively occurring at the very end of a terminal illness’s progression. And yet, even when diseases have done nearly all they can do to us, hospices routinely accommodate the preferences of patients who, willing to endure higher levels of pain than others might, want to stay as awake and alert as possible. This is sometimes a temporary preference that allows, for example, one last visit with distant relatives or friends, and sometimes a distinct desire to experience as much as possible of the life remaining to them.

But there are, occasionally, physical symptoms that are “intractable.” Sometimes the extraordinary panoply of medications and techniques available are unable to provide the level of symptom management and/or pain relief that the patient desires. Palliative/Terminal Sedation (usually referred to as either Palliative Sedation or Terminal Sedation) is necessary for those patients who can only be made comfortable by rendering them unconscious. This is “palliative” in that it is a means of relieving pain and/or other symptoms. It is “terminal” because, unless there are measures to provide nutrition and hydration (food and water) artificially, the patient does not regain consciousness. Death occurs within a matter of days once there is no further fluid intake.

Is Palliative/Terminal Sedation, then, a form of Physician-Assisted Suicide? Some would see any claim to a difference between them as merely splitting hairs. In practice, however, there is a vast difference between the prescription of pain relief that may result in diminished or lack of consciousness (as can be a side-effect of effective Palliative Care), the prescription of unconsciousness as the only means of relieving pain (Palliative/Terminal Sedation) and the proactive ending of one’s life in order to preemptively avoid whatever symptoms may or may not accompany the progression of a terminal disease (Physician-Assisted Suicide).

So, we have made some progress.
(In grammar, punctuation and spelling, too, it seems.)

One Last, Unfortunate Distinction

While all hospices provide palliative care (relieving pain and symptoms), not all palliative care should be confined to hospice. There are patients for whom symptom-management and pain-relief should be provided, even as they pursue curative care. This is not currently the case for most patients. There are hopes for change, and some signs of progress. But currently both public and private insurers are hesitant to cover palliative measures for non-terminal patients. Still, palliative specialization in the medical community continues to be developed in anticipation of one day overcoming the legislative and regulatory roadblocks to a more enlightened public policy.

This bears careful attention as the push toward suicide continues to grow (as with California’s recent passage of the End of Life Options Act). If our society continues to advocate for hastening the deaths of the terminally ill, we are morally obligated to allow all patients the option of pursuing a cure for their disease and the restoration of their health. Unfortunately, patients too often abandon that curative care due to the debilitating side-effects or devastatingly difficult life-adjustments necessitated by otherwise effective treatments. As the proponents of Physician-Assisted Suicide disregard hospice, offering instead a “get well or die” paradigm, every opportunity should be provided to those patients who would seek to get well, were they not asked to endure torturous treatments unmitigated by palliative care.

On Attending an Intentional Death: Some things to consider before you invite me to join your friends and family for your premature send-off

If all you can see is death,
then I would suggest you look more closely.

I was recently honored to consult on a blog post by my friend, Paul Louis Metzger, entitled “Lights Out: Shining a Light on Caring for the Dying in a Multi-Faith World.” (It can be found here.) He begins by asking, “What would you do if you were a chaplain or pastor or trusted friend given the honor of caring for someone of another faith tradition who is approaching death?” For some, there would be some complications, or obstacles that might prevent them from doing so. For me? Well, I have cared for many outside my faith community, including some whose beliefs differ greatly from my own. But recently, a similar question has been asked, and I now am the one facing the complications and obstacles.

The question is deceptively simple. Would you attend the patient’s death? The answer should not be all that complicated, either.

Can you make death out of life?
Certainly. But why would you?

After all, I have attended myriad deaths, from a variety of causes, in many different venues. As a hospice chaplain, most of the deaths have been serenely accommodated with a gathering of loved-ones clearly aware of the impending last breath. As a police chaplain and as a pastor, however, I have been present when life ended traumatically, amidst the valiant efforts of emergency medical professionals. In a hospital waiting room, I have notified next-of-kin of their loved-one’s death when it was our own law-enforcement officers who fired the fatal shots. I have left the bedside of the woman wounded by her suicidal son, just long enough to confirm that her husband, in the emergency suite next to hers, had not yet succumbed to his wounds. When he died a short time later, I was there to tell her so. I have participated as a first responder and in critical-incident stress debriefings with witnesses to horrific carnage literally on the front porch of police headquarters. There are more and more scenes that come to mind even as I write this, so before I lose track of my point, let me hope that I have clearly illustrated it. There are very few kinds of death that I have not already witnessed.

So, to my ears, the subtext of the deceptively simple question above is this: “Given that I have attended all these deaths under so many and widely-varied circumstances, why would there be any death from which I would choose to be absent? Especially if it is a patient or parishioner with whom I have an ongoing relationship?”

The complications and obstacles I face occur in the specific context of this simple question. My struggle arises primarily from the fact that I have attended some spectacularly overwhelming non-deaths. Those have included SWAT-calls, hostage rescues, and other interventions where the survival of those involved was far less than guaranteed. I have been present when lives were saved by extraordinary medical interventions. And I have been called to the scene when we simply needed someone to argue in favor of life with someone who was intent on ending their own. And that brings me to the reasons you do not want to invite me to your suicide, physician-assisted or otherwise.

I will try to stop you.

Sometimes what we see is not really life.
So, definitely not a time to choose death.

I was one of the founding members of the board of directors and executive committee of The Suicide Task Force of Larimer County. It later became The Suicide Resource Center. Now, since October, 2011 it has a new name. In order to differentiate themselves from other organizations that want to provide you with the resources by which you may commit suicide, the team is called the Alliance for Suicide Prevention. Due to excellent training, and whatever it is about God’s will that passes for “luck,” as both a police chaplain and as a pastor I have yet to lose the argument on behalf of life. Do not mistake me, though. I have friends and colleagues who have lost that argument, though. They were in attendance at a completed suicide and, had I continued in that field, it would only be a matter of time before I was, too. But in each case, we say and do all we know to prevent that suicide from being completed.

That is what I have done in the past; it is what I will continue to do in the future.

So, imagine for a moment that you are not the dear friend invited to attend, but the patient preparing to implement your legally-protected, physician-prescribed, self-administered, and invariably-lethal solution to an unacceptable life. Try to visualize yourself terminally ill, told that your life retains far too much quantity for the declining level of quality—and that the logical decision is to proactively and preemptively end your life? Do you have that picture of a life-not-worth-living firmly in your mind? Good. Now, consider whether you want me to be there.

Please understand, I would be very honored to receive your invitation to be present in that very special moment. But I would also hope to bring your breakfast in the morning, and to be present with you for many more days, weeks, or months.

Don't fear the reaper, but don't rush the hourglass.
What do you need with all that extra sand?

No matter how convincing the arguments in favor of death may be, I will argue in favor of life. No matter how others seek to terrorize you with wild fantasies of unmitigated agony, I can testify to you that it is only the rarest of patients who choose to experience higher levels of pain as a trade-off against greater awareness of the dying process (or simply being as mentally acute as possible for the visit of one more friend or family member). As a hospice chaplain I have seen the life-enhancement that is possible through palliative care (including psycho-socio-spiritual assistance far beyond what most would imagine could ever be made available in our cost-benefit-ration-driven healthcare system) even when the experience surpasses the worst physical deterioration that suicide advocates promise you. You have the option to accept care that neither prolongs your life nor hastens its end, but helps you to live until you die.

So, yes, please, do invite me to attend your going-away party. Just understand that I will still want to win the argument. I will plan to visit with you some more on the morning after. I will never stop encouraging you to give life one more try.

Toward Building a Better Human Race: Two Key Prerequisites to Effective Eugenics

In a recent post to his blog, “Uncommon God, Common Good,” Paul Louis Metzger asks in the title “Should Ethics Be ‘Biologicized’? What Might that Mean for Eugenics?” It’s a good question. But even for those of us who understand that ethics involves determining what is good or bad and what our moral obligations are, grasping the idea that they could be “biologicized” would require a careful reading of Dr. Metzger’s post (which I recommend, and it can be found here). For now, I hope only to discuss, as briefly as possible, the challenges posed by eugenics, especially with regard to my particular ministry context.

“Eugenics” is a term coined in 1883 to describe (according to Merriam-Webster’s Collegiate Dictionary—Eleventh Edition) the “science that deals with the improvement (as by control of human mating) of hereditary qualities of a race or breed.” In some instances, as with Germany in the late-1930s and early-1940s, eugenics sought to improve the human race as noted in Webster’s definition: by controlling who was allowed to procreate with whom. This selective breeding was enforced by prohibiting intermarriage between various groups in order to maintain purity in the traits identified as belonging to the Aryan race.

Others more recently have identified as eugenics a practice of unnatural selection subsequent to mating, but prior to the birth of a child. It is becoming more common to abort pregnancies when particular traits are identified as potentially diminishing the quality of the child’s (or parent’s) life. The range of factors seen as being sufficient to warrant these actions include not only what some call “birth defects,” but also the selective elimination intended to provide a couple with either a male or female child as they prefer.

In my ministry context, however, what is more often discussed is not the question of significantly improving the quality of life in the coming generations. Among hospice personnel, we face challenges from those who would define what constitutes an insufficient quality of life in members of the current generation. We do not tend to identify this as eugenics, though, even though the proponents of pre-emptively ended the lives of human persons intend to elevate us to a “good race” (with eu = Greek for good, and genea = Greek for race or generation), at least for those of us with sufficient “quality of life” to survive. Instead, those promoting the removal of living human persons claim to be motivated by a vision for euthanasia: ensuring a good death for those adjudged to be living a bad life.

Whether ostensibly prohibiting procreation by outlawing certain marriages, or preempting pregnancy’s natural outcome by killing unborn human persons, or prematurely ending the lives of the infirm, ill, injured, or otherwise disenfranchised, there are two key prerequisites to enacting effective eugenics outside the ethical considerations that constrain science to be practiced for the common good.

First, we would have to accept the dangerous optimism of democratically-governed science. We would have to believe that the majority of voting citizens were well-informed enough to look beyond the corporately-sponsored marketing messages and exercise some control over otherwise unabated experimentation. Only then could we do as Metzger’s subject, Dr. Edward O. Wilson recommends and remove ethics “temporarily from the hands of philosophers” to be “biologicized.” Eugenics necessitates that we allow those who can (or are willing to try) to do as they wish, without interference from society’s professional thinkers, but still under the influence of our nation’s diminishing ranks of voters.

"They told us to just sit back and watch what happens."

Second, for eugenics to be enacted effectively, we would have to continue to promote the fantasy that love and hate are merely emotional conditions and thus uncontrollable responses for which we bear no personal responsibility or obligation. That way, when we find that we do not have a fond sense of affection toward total strangers who would be eliminated from society, we can excuse our hateful acts of willful indifference as having just as little effect as our sentimentality would. Somehow we would have to allow our hatred to still remain an action, while our love became an even greater illusion. But we have managed it so far.

What would be the results of this unrestrained experimentation and willful indifference toward others? Eugenics seeks the elimination of those unfit to reproduce, or whose mothers are unwilling to nurture them until birth, or all of us who will eventually be in a position to continue usurping resources from the healthier members of the population. If more effectively pursued than is currently the case, then we would be left with an ever-increasing percentage of society for whom anything less than robust health, strength, wealth, and youth would put them at risk. But since that last category ebbs-away from each of us even now, perhaps we might want to steer a better course while there are still enough of us to object to eugenics.

To Darwinians, Dawkins, Humphry, et al. – May the Quality of Your Life Be Not So Strained As Your Mercy

The quality of mercy is not strain’d, It droppeth as the gentle rain from heaven Upon the place beneath: it is twice bless’d; It blesseth him that gives and him that takes.

—William Shakespeare, “The Merchant of Venice,” IV.1.184-187.

Maggie Smith as Portia in
William Shakespeare's
"The Merchant of Venice"

In Shakespeare’s “The Merchant of Venice,” the judge, Portia, pleads for the plaintiff to temper his legal claim to justice with mercy for the defendant. In a recent post, “Abortion & Down Syndrome: An Apology for Letting Slip the Dogs of Twitterwar,” Richard Dawkins begs mercy from “the haters,” those “who go out of their way to find such tweets” as he posted publicly, despite his intention to share only with “the minority of people who follow both her [a woman who had expressed her uncertainties about aborting her child if she were to learn it would be affected by Down Syndrome] and me.” (You can find his full post here.)

In response to her uncertainties, Dawkins had Tweeted™, “Abort it and try again. It would be immoral to bring it into the world if you have the choice.” In seeking to quench the fiery response to his Twitterpations (limited as they are to 140 characters), he offered a 255-word explanation. It suffers from certain anachronisms and additions which would understandably be seen as belated revisions or even second-thought afterthoughts in the eyes of even his most ardent supporters.

Most importantly to my friend and mentor, Paul Louis Metzger, is Dawkins’ rebuttal of the accusation that he was advocating eugenics. Eugenics can be narrowly defined the process of selecting preferable traits, especially within human persons, and seeking to enhance those traits within a population by encouraging procreation by those who possess those traits. Most, however, consider the eugenics that has been practiced to be a clearer indicator of the process: removing from the procreating gene pool those deemed to possess less desirable traits, either through forced sterilization (as has occurred among the developmentally disabled in the United States) or outright genocide (as is the more frequently employed means).

Richard Dawkins

To be clear, neither definition would apply to the decision to advocate aborting the lives of children found to be affected by Down Syndrome. Dr. Metzger is correct to point out that Dawkins’ position is not one of eugenics, but of mere utilitarianism. Guided, as Dawkins claims to be, by “a desire to increase the sum of happiness and reduce suffering,” he holds that “the decision to deliberately give birth to a Down baby, when you have the choice to abort it early in the pregnancy, might actually be immoral from the point of view of the child’s own welfare.”

Dr. Metzger is careful and correct in admonishing us “to practice the Golden Rule (Matthew 7:12) and do to others what we would want them to do to us. We should try and interpret their claims in keeping with their intended aims rather than with how we might wish to interpret them for partisan purposes, just like we would want others to interpret our positions as we intend them.” (Dr. Metzger’s full post can be found here.) I whole-heartedly agree with Dr. Metzger, and am often indebted to those who are willing to engage in dialogue with me, especially when they request clarification when my points are vague or muddled—or even when they are not unclear, but merely objectionable to those dear friends.

Derek Humphry

Among the conversation partners with whom I am currently engaged, though, are those who are seeking to navigate the very difficult and narrowing channel between hospice care and physician-assisted suicide (PAS). With the recent passage of California’s End-Of-Life Options Act, there is an assumption that hospice providers will become what we are already often mistaken to be: “the black-pill people,” aka “the death-squad.” Hospices have traditionally followed the pattern set by Dame Cicely Saunders (more about the founder of the modern hospice movement here). We seek neither to hasten nor postpone a patient’s natural death. Why? Because, in the words of Dame Saunders, “You matter because you are you, and you matter to the end of your life. We will do all we can not only to help you die peacefully, but also to live until you die.”

This basic philosophy is being attacked by those who want hospice to “evolve” in order to cooperate in accommodating and referring, if not actively providing, physician-assisted suicide. Now legalized in six of the United States, and moving toward legalization in fifteen more, PAS is advocated strongly by an organization now known as “Compassion & Choices.” (Their website can be found here; I have addressed my concerns with what was previously called “The Hemlock Society” in a post you can find here.)

I find a striking similarity between the position that Dawkins takes, and the one taken by the organization founded by Derek Humphry. In both cases, they advocate that there are human persons who would be better off dead than alive. For Humphry, the choice is presumably in the hands of the human person who experiences a life-threatening diagnosis and chooses, like Brittany Maynard (Compassion & Choices’ fundraiser, “The Brittany Maynard Fund,” eulogizes her here), to proactively end her life by committing suicide (to express it in terms most of us would use). Dawkins, however, prescribes death as the moral choice “from the point of view of the child’s own welfare.” In short, others should decide on behalf of the child that she would be better off dead than alive.

Brittany Maynard

Some would see a difference between these two decisions. On the one hand, there is the exemplary suicide of Brittany Maynard, intended to preclude her own suffering by choosing to die while she was still able to increase the sum of her happiness by doing so. On the other hand, Dawkins recommends the homicide of a child in order to preserve someone else’s happiness by preventing what he would presume to be their suffering, caused by failing to end the life of their child.

But there is less difference here than you might imagine. Dawkins has backtracked from his earlier statement. He claims that while the woman in question could end the life of her child, he was not deciding for her that she should “Abort it and try again.” Those claiming to offer Compassion & Choices would say they merely want others to know they could end their life. But if I read Dawkins’ intent correctly, what he meant to say privately has changed, now that it has been heard publicly. If what Humphry’s progeny are saying publicly is any indication, then it should not surprise us that some whose lives are considered to lack a sufficient level of quality…well, the message we are hearing is that we should end our lives.

Shakespeare’s Portia wanted mercy to temper justice. Dawkins wants mercy to temper reactions to his inadvertently public position on aborting lives of insufficient quality. And where do we find the mercy of Humphry & Company? “Compassion” would seem to include Choices that foster mercy toward the terminally ill, but not what amounts to mercy-killing—even if, as the current PAS laws require, you make the patient administer their own hemlock.