Abstract

This dissertation examines the ethics of direct euthanasia and assisted suicide in regard to arguments based on self-determination and autonomy, particularly as articulated in the United States since the 1960s. Discussions of euthanasia are generally framed in reference to political and philosophical liberalism's conceptions of autonomy and freedom, or in terms of prohibitions against taking innocent human life. My project does neither of these. Rather, it concentrates on a theological study of free choice, which is joined constructively to the issue of euthanasia. ;After an introductory first chapter describing the study, the dissertation has two parts, with two chapters each. Part I. Overview of the Issues and Arguments is comprised of chapters two and three. Chapter 2 discusses the forces that have generated the momentum to legitimate physician-assisted suicide and direct euthanasia: medical technology, inadequate palliative care, death-with-dignity and right-to-die movements, and the loss or restriction of power to control the circumstances surrounding one's death. It also outlines the major arguments used to justify assisted suicide or euthanasia. Chapter 3 elaborates these arguments by analyzing how the concept of autonomy functions in them, particularly in reference to rights, pluralism, human dignity, and sanctity of life. It assesses the adequacy of the various positions with respect to the meaning of human freedom. Part II: A Theology of Freedom: New Perspectives on the Euthanasia Debate, consisting of chapters four and five, proposes an advance in the discussion by focusing on the notion of human freedom in Christian theology. Chapter 4 presents a theology of freedom based on Thomas Aquinas's analysis of free will and choice, supplemented by reference to Bernard Lonergan's more recent examination of these issues. The analysis is then joined to notions of respect for persons, relationality, mutuality, and embodiment, particularly, though not exclusively in selected feminist, psychological, and medical literature. I use all of these heuristically with a goal of fashioning a more adequate understanding of human freedom than is commonly espoused. My contention is that human flourishing and freedom always involve relationship and self-transcendence in knowledge and love, and that the Christian paradox of dying to self is an important realization of freedom and integrity. Chapter 5 discusses the experience of "suffering unto death," and in light of that experience, tests the adequacy of the theology of freedom proposed in chapter four. A Christian perspective on suffering is explored, particularly in reference to the Incarnation and Cross, followed by a discussion of its ethical implications. All of this is brought to bear on the contemporary United States' euthanasia debate, with recommendations for advancing and transforming discussions concerning the right to choose when and how to die