Most of us are familiar with the famous phrase no man is an island. What many might not know is that it was penned during a time of extreme illness and suffering. Staring at his own possible death, John Donne famously wrote that “no man is an island,” that all mankind are connected in God, bound to each other like a continent. The death of one person then, like a bit of land swept out to sea, affects us all. Bioethicist Gilbert Meilaender would agree with Donne, writing that “the lives of fellow citizens may be bound together in such a way that all are aggrieved by the death of one.” He goes on to note that such sentiments might seem strange to moderns, coming across like quaint relics from a time when religion was more than merely a set of opinions to be held in private. To think that what one does in private, especially if one dies, somehow has an effect on everyone? This seems to fly in the face of our experience today. This is because we live in an age that is preoccupied with autonomy.
Complete autonomy – the freedom to do what we want with our lives, the freedom of comprehensive, unfettered and unhindered self-determination – is the real myth, not the lovely metaphors of Donne. Meilaender reminds us that “our identity is not an individual achievement but is socially formed from the very beginning,” being born (without consent!) into a family as utterly dependent, and dying in old age in a similar state. This is the danger that the myth of autonomy poses for us, for in its unquestioning obsession with individual freedom it fails to recognize that it “presupposes a metaphysic and a view of human nature” that is demonstrably false and dangerous when taken to its logical ends. This metaphysic presupposes a radical dualism that arbitrarily separates the human person into a lower realm of meaningless matter and an upper realm of value grounded solely in cognitive abilities. The upper realm is the seat of autonomy, and it is free to do what it wants with the lower, valueless realm of the body. This fallacious view of human nature is being worked out right before our eyes in the ethical dilemmas presented to us by things like abortion and assisted suicide – two issues that claim autonomy as one of their foundational principles.
The presuppositions of extreme autonomy are ultimately self-defeating and incoherent, and nowhere is this more evident than in the question of assisted suicide. Here it is asserted that the right to self-determination is so important, so key to our personhood, that we should be free to choose when we die. In essence, we should have the right to end our personhood. The irony here is that at the very moment we demand a right to control the limits placed upon us we run up against the ultimate limit on our finite nature – death – and are, thus, permanently limited. Death is a limit, indeed, and it serves as a reminder that we do not choose to come into existence and, fight as we may, death is our future. “Therefore never send to know for whom the bell tolls; it tolls for thee,” Donne would write.
Ultimately, the telos or aim of complete autonomy is self-destruction and absurdity, and it does not take long for a culture to work out its logic. The line of reasoning is quite easy to follow in the thinking of a bioethicist like Peter Singer. Using personhood theory, he begins by arguing for euthanasia for disabled babies. With the widespread acceptance of prenatal diagnosis, he writes, pregnant women are already “offered, and usually accept, abortions in order to avoid giving birth to children” with disabilities. Why not extend the logic to children outside the womb, he asks? It’s the will of the parent that determines the morality of such an action, after all. The children themselves are hardly persons of moral value by the standards of personhood theory. He concludes that “killing a disabled infant is not morally equivalent to killing a person.”
He then simply extends the logic of personhood and autonomy to all people. For persons, respect for autonomy should compel us to allow (and even help) them to do what they want with their lives, even end them! He writes,
… the principle of respect for autonomy tells us to allow rational agents to live their own lives according to their own autonomous decisions, free from coercion or interference; but if rational agents should autonomously choose to die, then respect for autonomy will lead us to assist them to do as they choose. So, although there are reasons for thinking that killing a self-aware being is normally worse than killing any other kind of being, in the special case of voluntary euthanasia most of these reasons count for euthanasia rather than against it.
In Begotten or Made? theologian Oliver O’Donovan notes that our society’s obsession with autonomy is at least partly the result of our technology. We are overwhelmed with the activity of making and consuming in our daily lives – activities that are not bad in and of themselves but create blind spots in some key areas. O’Donovan writes that “the fate of a society that sees, wherever it looks, nothing but the products of the human will, is that it fails when it does see some aspect of human activity which is not a matter of construction, to recognize the significance of what it sees and to think about this appropriately.” The limits of the human will tend to be blurred. In particular, we tend to instrumentalize all of our activity, viewing every situation in which we act as “raw material, waiting to have something made out of it” for our own consumption. He warns that “if there is no category in thought for an action which is not artificial, then there is no restraint in action which can preserve phenomena which are not artificial.” This applies to birth and death.
O’Donovan also noticed that technology has an effect on how we relate to our own bodies, hinting at the radical dualism already mentioned. Personhood theory allows us to instrumentalize ourselves and other human beings. He warns that “our assertion of ourselves against nature becomes an attack upon ourselves” if we do not enter some activities with an acknowledgment of their givenness. This the self-destructive telos of complete autonomy restated.
Most importantly, a society that accepts something like euthanasia has introduced a new tension in the ties that bind us. Even the mere option of assisted suicide (and abortion), especially how it tends to be portrayed as courageous and selfless, creates a kind of pressure on those that find themselves losing their autonomy. Ultimately it communicates that we are not to be a burden on others, that our value resides solely in our autonomy and ability to control our own lives.
What is a more excellent way, then? As Christians, we must reject the myth of autonomy because it does two things: it paints dependence on others as something to be avoided, and it communicates that we lose value as our independence decreases. It is precisely in times of suffering that, like Donne, we realize that autonomy has been a lie all along – the dependence inherent in our creaturely nature is unavoidable. This is not the time, then, to abandon each other by minimizing suffering with death. Rather, we should maximize care, coming alongside one another, carrying one another’s burdens in love. Instead of asking if any given life is worth living, we should ask if any given action will benefit a person that is suffering. In other words, our ethic takes aim at the action, not the life. We must begin from a standpoint that our actions should communicate, “it is good that you exist,” regardless of your level of dependence of us.
We serve a God, after all, whose “perfection and power … is displayed in the acceptance of neediness, dependence, and even suffering.”
 Gilbert Meilaender, Bioethics: A Primer for Christians, Third Edition (Grand Rapids, MI: Wm. B. Eerdmans Publishing Co.) 61.
 Ibid., 64.
 Peter Singer, Practical Ethics (Cambridge University Press) Kindle Edition, 187.
 Ibid., 191
 Ibid., 170.
 Oliver O’Donovan, Begotten or Made? (Oxford: Clarendon Press, 1984), 3.
 Meilaender, 130.