“Can’t you at least die with a little dignity?” The Right to Die Debates and Normative Dignity

In recent decades, the right to die has emerged as one of the most divisive social and political questions in North America and Europe, one that involves the mobilization of numerous social actors and activists as well as several legal challenges. In Québec, the provincial legislature formed the “Select Committee on Dying with Dignity”, a group of legislators tasked with examining the issue. In their 2012 report, they recommend the legalization of “medical aid in dying” as an appropriate part of the continuum of care at the end of life. From a meta-analysis of the written and oral submissions collected by the Committee in different locations throughout the province, this article presents several competing meanings of what human dignity means at the end of life. Intrinsic definitions of dignity – whether religious or philosophical – often associate dignity with an acceptance of death. These definitions of dignity compete with more relative and contingent understandings of dignity. In such a view, dignity depends on the physical or mental condition of the individual. Here “dying with dignity” means dying without undue suffering or loss of autonomy. Whether “dying with dignity” is defined as having a peaceful or meaningful death or alternatively as an end-of-life without undue suffering or loss of autonomy, these normative calls all take for granted that human beings want to die with dignity. This article analyzes the multiple meanings of dignity in the right to die debate while challenging the assumption that a “good death” is necessary synonymous with “dying with dignity.