Denial of the Soul

Denial of the Soul (1997) M. Scott Peck

My introduction to M. Scott Peck was the abridged audio version of this book, purchased when I regularly listened to books on tape at work, and preferred non-fiction to fiction. I listened to it several times, but when I chose physician assisted suicide as my topic for my legal/ethical issues in public health class, I felt that I wanted to read the entire book, and have it as a reference, for although I do not agree with all of what he says, I felt that he made many good points that I would want to expand upon for my project.

He takes an in-depth look at euthanasia, and the spiritual side to dying.

I found one paragraph most interesting, solely for is seeming prediction of the two major PAS cases that went before the Supreme Court, Washington v Glucksburg and Vacco v Quill.

(I)n my best case fantasy the Supreme Court issues a majority opinion holding that physician-assisted suicide is not a constitutional right for a variety of reasons, including the perfect legitimacy of the double effect, which may be used to ensure that a natural death need not be a painful one.

The fact that this is almost precisely what the was ruled is slightly eerie and gave a strange legitimacy to everything else he said, whether I accepted it or not.

Not that there was much to argue with as far as his support for palliative care goes. He fully supports terminal sedation and the upholding of the double effect as an ethical principle for that. He says that “(t)he first order of business should be to establish that dying patients have a constitutional right to competent hospice care.” Although there is not a legal right, there has been a huge shift in recent years, with the Medicare Hospice Benefit becoming more and more generous. And hospice itself becoming more common.

I was less comfortable with the more spiritual aspects of the book, and found them less convincing.

Like much of the research available, he states that many who request PAS and euthanasia do so not out of fear of physical pain, but because they fear emotional pain. I even like his quotation of Seneca:

Throughout the whole one must continue to learn how to live and, what will amaze you even more, dear friends, throughout life one must continue to learn how to die.

What bothers me may be something that is probably not an issue for the intended audience, those who have deep religious faith. My problem is that I am not certain that the best argument against euthanasia and physician assisted suicide is a religious one, yet this is the primary argument that he makes in the book.

But he makes many good and important points, the foremost of which is that it is futile to have a debate about PAS and euthanasia until we have provided adequate end-of-life care to everyone.

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