In Defense of Euthanasia: The Case of Célia Maria Cassiano

The suicide of Seneca, by Manuel Domínguez Sánchez

If there is an obvious and direct political consequence of the philosophical pessimism I constantly discuss and defend, that consequence is the defense of the right to assisted dying or euthanasia. And no, I'm not going to separate assisted dying from euthanasia, as many people do. I will use the terms synonymously. I believe that, as long as the dying person wants to die (or wanted to before becoming incapacitated), it doesn't matter whether or not they are physically capable of administering the drug that will allow them to rest forever. For me, dividing the legality of the matter based on the dying person's physical ability to press a button to inject themselves with certain pharmaceuticals is to make the damned irrational cult of life that exists throughout nature even more macabre, a cult that finds its biggest expression in the justifications that human beings give to affirm life even in the face of all proof of its malignant uselessness. I consider it barbaric to force anyone to live, even people who are not chronically or terminally ill. But forcing chronically and terminally ill patients to live goes beyond barbarism: it's pure sadism. It's monstrous. I have no doubt that whoever forces a dying person wasting away to stay alive in the name of the sanctity of life secretly salivates while imagining the poor soul's suffering.

For those who don't know, recently, Célia Maria Cassiano, a social scientist and college professor in the city of Campinas, in the state of São Paulo, underwent assisted suicide in Switzerland. She was 67 years old and had been living with amyotrophic lateral sclerosis (ALS) for a few years. ALS is a terrible disease also known as motor neuron disease. It is a horrifying malady. The most famous person to have had this disease was the physicist Stephen Hawking, who was incapacitated but lived decades with ALS. However, he was an extremely rare case. Almost all ALS patients die within 5 years of the first symptoms, and they die horribly, from starvation and suffocation, because the muscles responsible for swallowing and breathing gradually stop working. In Switzerland, assisted suicide for patients with terrible diseases like ALS has been legal since the 1940s. Here in Brazil, as in the vast majority of the world, assisted suicide is a crime. This is one of the main reasons why I assert, without fear of being wrong, that the vast majority of the world is officially dominated by barbarism. It's disgusting. Grotesque. Vile. But it is the reality.

Célia's attitude resonated because, after her death, a video of her talking about how she fought to obtain the procedure circulated on social media. She explained how she suffered terribly, wasting away with the disease. The suffering came not only from physical pain, but also from the lack of dignity. For example, she described how she needed three people to help her go to the bathroom and then clean herself. Furthermore, she spoke about how she had a beautiful voice before, which was slowly being destroyed by the paralysis of the muscles in her throat, including her tongue. Célia said she had lived a very good life and wanted to end things in a dignified and painless way. After trying every possible way to obtain the right to assisted dying in Brazil, she realized she would never succeed if she remained in this land that loves life, light, and hope so much (and woe betide anyone who says otherwise!). Célia then decided to lie to friends and relatives, saying she needed help to travel to Europe for an experimental treatment. In this way, she managed to gather the necessary documents, visas, and money to go to Switzerland and die with dignity. She apologized for lying, but said it was the only way she could find.

The first time I saw the news about her case was in a post by Folha de São Paulo on Instagram, in March. Folha de São Paulo is one of the most important Brazilian newspapers. One of the first comments on the post by Folha about Célia was from a young bearded guy, dressed like a businessman, named Isaac Levi. I didn't see anything else about him besides his profile picture and the comment. But, if I had to guess, I'd say he's a Christian and an entrepreneur. Maybe he's even a lawyer. Maybe he's a life coach. I don't know, and I don't want to know. He wrote the following about Célia Maria Cassiano:

She's in a worse place now...

After the ellipsis at the end of the sentence, he added a sad emoji. It's people like this I'm referring to when I say that irrational life worshippers salivate with lust at the thought of dying patients suffering and wasting away. It's certainly because of so many people who think like this guy that various news outlets felt compelled in the following days to post cute stories about other people who had ALS but, unlike Célia, decided to stay alive to try to see their children get married, graduate, and things like that. After all, we can't show a news story like Célia's without immediately showing that she's just one case among many, and that life is actually beautiful and doesn't crush anyone without purpose. Even before these life affirming cases by dying people, when the news was solely about Célia, news outlets always made a point of emphasizing that her disease was rare. Yes, in a way, it is rare. But it's much less rare than one might imagine. After Alzheimer's and Parkinson's, ALS is the third most common neurodegenerative disease. It is common enough that virtually no neurologist who sees patients daily will go weeks without seeing a few suspected cases.

This use of the term “rare” to reassure everyone is also quite common when talking about glioblastoma, which is the most common type of malignant brain tumor. Glioblastoma has no cure. After the first symptoms, if surgery and aggressive treatment with medication and radiation are not performed, death occurs within months. If surgery and treatment are performed, death comes after 1 or 2 years on average. My cousin, Juliana, woke up one day with double vision. At first, it was thought to be a stroke. Then they saw a mass in her brain and thought it might be benign. The biopsy destroyed everything. The doctor, correctly, told her to get her affairs in order. He was realistic. She died 7 months later, even with surgery and aggressive treatment. Including her, I knew three people who died from glioblastoma. In fact, when I wrote an essay about it at the time, titled Miracle Killers, I said that I had known two people who died from this disease. But later I discovered that there was another person, another young man, who died during surgery to remove the tumor. At the time, I didn't know it was glioblastoma. All three victims were between their early 40s and early 20s.

This nonsense of labeling these horrible idiopathic diseases that can affect anyone as rare is very much in line with the thinking of people like that Isaac Levi guy. It's because of people like him, people who represent stupidity and magical-religious thinking, that after showing the case of Célia, newspapers had to show a bunch of other people who, unlike Célia, chose to wither away with ALS because Jesus is good. It's not enough to just show that life sometimes ends and that there are people who fight for the right to end their lives with dignity, as in Célia's case. Most people are dumb and want newspapers to show that life is wonderful, yes, to the point that the best thing is always to fight for life even in the most undignified and grotesque conditions. After all, it's not just a matter of taste for these people. It's a matter of submitting to the will of God, who is the father of all life, and if God created life, then life is wonderful and should be preserved even when we are wallowing in shit.

Of course, these same people couldn't care less about the homeless suffering on the streets of their cities — that is when they don't hate them or even kill them, as in an infamous case that happened in São Paulo a few years ago, where the owner of a pizzeria shot and killed a homeless man in an alley near his restaurant. Just have faith and follow what the mercantile churches dictate; but if you need help to eat and have a roof over your head, go to hell and don't bother anyone! It's just like the debate about the legalization of abortion in Brazil: those who most vigorously oppose the right to abortion are the ones who hate homeless children the most and celebrate when they are killed. And this isn't something that happens in the shadows: they speak about it openly, even making fun of the contradiction of being against abortion and celebrating the death of homeless children. When it comes to terminal illnesses, these idiots must believe that all a person needs to do is have faith in God and attend a church with a millionaire child preacher with fake-ass white teeth, and they will be cured of their ALS or their glioblastoma. In other words, if a person chooses to die with dignity and cannot be miraculously cured, their soul is necessarily in hell, as Isaac Levi wrote.

In The New Gods, Cioran wrote something that I consider to be very relevant to the discussion about assisted dying, euthanasia, and the sacred right that I believe every sentient and self-aware being has to end their own lives at any moment, given that they were conceived and born without ever being able to consent in the first place. Cioran says the following:

The same man who says, “I don’t have the courage to kill my­self,” will the next mo­ment call cow­ardly an ex­ploit be­fore which the bravest would cringe. You kill your­self, we are for­ever be­ing told, out of weak­ness, in or­der not to have to face suf­fer­ing or shame. Only no one sees that it is pre­cisely the weak who, far from try­ing to es­cape suf­fer­ing or shame, ac­com­mo­date them­selves to such feel­ings — and that it re­quires vigor in or­der to win free of them de­ci­sively. In truth, it is eas­ier to kill your­self than to van­quish a prej­u­dice as old as man, or at least as his re­li­gions, so sadly im­per­me­able to the supreme ges­ture. So long as the Church was ram­pant, only the mad­man en­joyed the fa­vors of the regime, he alone had the right to put an end to his days: His corpse was nei­ther pro­faned nor hanged. Be­tween an­cient sto­icism and mod­ern “free thought,” be­tween, say, Seneca and Hume, sui­cide suf­fered — aside from the Catharist in­ter­lude — a long eclipse, a dark age in fact, for all those who, want­ing to die, dared not in­fringe the ban on putting one­self to death.

A little further on, in the same book, Cioran writes:

We have un­learned the art of killing our­selves cold. The an­cients were the last to ex­cel in it. The sui­cide we con­ceive of is ar­dent, fever­ish, an in­spired state; as for de­tach­ment, it is as con­vul­sion­ar­ies that we dream of it. Those sages who an­te­dated the Cross knew how to break with this world or re­sign them­selves to it, with­out drama, with­out lyri­cism. Their style has been lost, as well as the ba­sis of their im­per­turba­bil­ity: a usurp­ing Prov­i­dence came to dis­lodge Fa­tum from ev­ery cranny. And we rush to re­cover it, crav­ing sup­port there, when no other can guide or be­guile us.

Cioran speaks in these passages about how in antiquity, among Stoics and others, taking one's own life in the face of a terrible fate was common, acceptable, and courageous, because they understood that it wasn't so easy to divest oneself of one's own life. And it should be that way again, in my opinion. Despite admiring the Stoics, Schopenhauer opposed their idea that reason has the final say in reality. The foundation of everything, for him, lay in the will, which is blind and shoots in all directions until it hits something, not without leaving countless victims in its wake. He opposed the idea of ​​taking one's own life and the Stoics' defense that life could be abandoned when it was going badly, whether due to illness or other reasons. But there is a common mistake that many who study Schopenhauer superficially make: he wasn't complete against it. He was only against divesting ourselves of our own lives for common reasons, be it illness or dishonor, believing that in this way we would actually be affirming the will, whereas for him the correct thing is to deny the will. But for those who deny their will, Schopenhauer saw no problem whatsoever; indeed, for him it was the most natural path. He even discussed Indian ascetics who die of starvation, having already divested themselves of all will to live.

In a way, I think Schopenhauer was largely right. As I see it, a large portion, perhaps even the majority of those who take their own lives, do so for some reason that, upon closer analysis, is actually an affirmation of the will to live. They wouldn't commit the act if they were satisfied. On the other hand, the denier of the will to live is not dissatisfied, although they are not satisfied either: they know that existence is an eternal pursuit of desires that will never be fully satisfied. But I disagree with the idea that terminal patients cannot reach this conclusion, even in a purely intuitive way. If Schopenhauer thought this of all terminally ill patients, he was wrong, I think. In my view, Célia came to the conclusion that it was best to deny her own will, since it would only bring more suffering to her condition. It's obvious to me. It doesn't seem to me that she left in anger or resentment — the only possible resentment she felt was the resentment that any intelligent and sane person in the world feels towards existence: the resentment towards the reality that in this world there is endless pain and dissatisfaction.

by Fernando Olszewski