The Sacrament of Pharmakon: Euthanasia and Assisted Suicide as Medical Ersatz Liturgy
Kimbell Kornu, MD, PhD, Assistant Professor of Medicine and Health Care Ethics at Saint Louis University and a practicing Palliative Care physician
Religious arguments are typically excluded from the euthanasia and assisted suicide (EAS) debate because they rely on a particular tradition that is not universally acceptable to all. Yet many physicians and patients are deeply committed to religious beliefs that are constitutive for one’s being. I challenge the standard requirement of religious neutrality and argue that EAS is a religious practice because it assumes a view of the good life, which entails radical autonomy and freedom from pain and suffering. I argue that EAS is a medical ersatz liturgy that effectively administers the sacrament of pharmakon, meaning both poison and remedy in Greek. Drawing on Michel Foucault’s work on governmentality as pastoral power and Giorgio Agamben’s genealogy of technical effectiveness from Christian liturgy, I show three liturgical dimensions of EAS: (1) shepherding the patient unto salvation from suffering through death; (2) the physician- priest becomes an instrumental cause through the administration of the sacrament of pharmakon which heals through poison; and (3) legalization of EAS cultivates habits and practices oriented towards the “good life” of radical autonomy through the medicalization of death. I conclude that EAS as ersatz liturgical pharmakon extends medicine’s power over life and death, thereby restricting, not protecting, freedom.