In Vivo Public opinion is divided on the questions of euthanasia and therapeutic obstinacy. What is your position in this regard? Luc Ferry The concept of “dying with dignity” seems very fragile to me, not to mention that it often carries very distressing connotations. It seems to imply that human dignity is related to autonomy, and that such dignity can be lost through the extreme mental and physical dependence that old age and illness can sometimes thrust upon us. Quite frankly, I find the idea of drawing any equivalence whatsoever between “dependence” and “indignity” to be morally intolerable, as if a human being could “lose his dignity” on account of being weak, ill, old, and why not ugly, for that matter, and therefore thrust into a situation of extreme dependence. My question is: can a human being ever lose his dignity in such a way? He can probably lose it in another way, by becoming a scoundrel, but certainly not by being weak and dependent.

IV You then argue in favour of respect for life, whether or not it is difficult. LF I argue for a patient’s absolute right to even the most extreme form of dependence and weakness, in addition to the necessity, in such cases, of advocating understanding and support, even love, rather than trying to make others understand that it is better to make a clean sweep and stop bothering the world…

More generally, one could hope that society would stop being encouraged to consider old age as an “illness” that responds only to two treatments: DHEA (dehydroepiandrosterone, a hormone known for its anti-ageing effects, earning it the nickname of “the hormone of youth”, editor’s note) to begin with, and euthanasia to end with… I would say the same thing to “pro-suicide” arguments: the very notion of assistance indicates that we are not dealing with the exercise of a purely individual freedom. Assistance implies a relationship with others. Suicide supporters focus on the request for assistance and the guarantees offered by checking the merits of said request. However, by focusing mainly on the request, we almost forget the other half of the agreement: the answer to such a call for help. Far from arguing in favour of the ideal individual autonomy that all supporters of assisted suicide hold sacred, the truly desperate appeal on the other party shows that, in this case, the person making the appeal is essentially dependent – since he would otherwise simply commit suicide without assistance. As a result, it is the ethical problem of the answer provided which must be considered essential, and not the obsessive checking of the quality of the request. Who can claim in all certainty that death is the right answer to a call for help? Allow me at least to doubt it. We only have to think about those we love to shudder at the idea that they could, one desperate day, fall in the hands of those terrible doctors delivering the quick and painless “exit”…

IV But hospitals are not for desperate people, rather patients at the end of their lives… LF That is not true today: these clinics end the lives of people in perfect physical health who are only, as they say, “tired of life”. They are mostly the elderly, both men and women… But what proves to us that a lonely and slightly depressed old lady has more freedom to desire death than a young girl who is struggling to get over her cheating fiancé? So much has been said and done to make us think of the elderly person as useless, a burden, a piece of rubbish, less attractive and less independent than before; in short, undignified!In the end, the patient has no other choice but to die with this famous “dignity”, which ultimately becomes another word for indifference.

IV So, where is the dividing line? LF In any case, it is not merely a question of age, that would be absurd! The truth is that human dignity is not a quantitative question; it does not form part of the scale by which one measures – how, exactly? – pleasure and pain. The human being has something which surpasses the mere man: a certain transcendence that forces respect and deserves to be fought for. Some might say that this premise cannot be proven. Perhaps, as is always the case in matters of morality, which is not an exact science. But if I had to choose between a so-called humanitarian act consisting of killing and another consisting of saving and loving, you will forgive me for choosing the second option.

“We must stop considering old age as an illness.”

IV You have had the opportunity to work with many health professionals on the issue of therapeutic obstinacy. What struck you most during your discussions? LF Surveys conducted among doctors from some twelve Western countries show that over 40% of them admit to having been faced with euthanasia requests. Nobody knows how many responded favourably, but at a minimum, these figures show that the practice of euthanasia could easily become standard. What struck me most? First and foremost, the real and prevailing concern for humanity among health professionals, followed by their lack of a reliable reference framework for making decisions and, as a result, their request for clarification of all the different positions taken…

IV You often talk about different views on therapeutic obstinacy, which are necessary to understand requests from families. LF Yes. The first position is the one held by religions, which are mostly all hostile to euthanasia, all the more to assisted suicide, and also to therapeutic obstinacy. However, their definition of the latter is highly minimalist. Why? Because they are much more hostile to euthanasia than to therapeutic obstinacy and the two problems are related like two sides of the same coin.

IV Do you have any examples? LF For one, there is the Catholic Church, which has always been most radically opposed to euthanasia in all forms. The Church bases its position on a simple principle (which, moreover, should have opposed it equally to the death penalty, to which it has nevertheless always been favourable). This principle is expressed very clearly in paragraph 2280 of the official Catechism of the Catholic Church: “We are stewards, not owners, of the life God has entrusted to us. It is not ours to dispose of.” The Church naturally distinguishes between active euthanasia, which it strictly rejects, and the legitimate refusal of therapeutic obstinacy. However, “leaving to die” is only justified in extreme borderline cases, such that the decision to stop treatment may be very difficult to define in practice.

IV Illness also plays a unique role in this case. LF Most definitely. On the one hand, the illness could be a “road of conversion”: it can, once again according to the “Catechism”, “make a person more mature, helping him discern in his life what is not essential so that he can turn toward that which is. Very often illness provokes a search for God and a return to him.” The typically modern ideal of a quick and gentle death, if possible in a state of unconsciousness, is therefore not that of the Church which is keen to remind us how, in ancient times, people were less afraid of death than of what was supposed to follow it, such that the agony, far from being cut short, was an opportunity to make peace with oneself, others and God.