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Drug Legalization: “My Body, My Choice”?

Few slogans are as rhetorically powerful as “my body, my choice.” It captures a fundamental intuition: that individuals should have control over what happens to their own bodies. People rightly recoil at the idea of being forcibly subjected to another’s will, and the phrase is often invoked to argue for bodily autonomy in areas like abortion and end-of-life decisions. The assumption is that, as long as an individual’s actions do not harm others, they should be free to do as they please with their own bodies.

Given this, some argue that drug legalization naturally follows from the “my body, my choice” principle. If a person wants to engage in the recreational use of drugs, the reasoning goes, that is his decision alone. As long as he does not harm anyone else, the state has no business interfering. The case seems simple enough — until we examine it more carefully.

The problem is that freedom is not just about making choices; it is about making choices rationally. True autonomy is not simply the absence of external interference but the ability to govern oneself through reason. A person who deliberately impairs his rational faculties through recreational drug use is not exercising freedom. He is attacking it.

To be clear, I am not making the case for any particular drug policy. My point is simply that we need to be honest about what drugs do and not dress up something destructive to freedom in the language of liberty, even if restrictive drug laws are ultimately unjustified.

Freedom Requires Rational Self-Governance

The conceptual justification behind the “my body, my choice” argument assumes that individuals possess and retain rational self-control over their decisions. However, the problem with recreational drug use is that it directly undermines this ability.

Mind-altering substances do not just create pleasurable experiences, they chemically alter the brain in ways that impair self-governance. Recreational drug use can distort judgment, suppress self-restraint, and, in many cases, create dependency that weakens one’s ability to make future choices freely. A person under the influence of drugs is not acting as a fully rational self-governing agent but as someone whose thoughts and actions are being heavily influenced by an external chemical influence.

This is true whether the drug in question is alcohol, marijuana, psychedelics, or harder narcotics. Even substances that supposedly “enhance” mental function (such as certain stimulants) often do so at the cost of rational self-regulation, increasing impulsivity and distorting judgment. When we speak of drugs altering rational agency, we are not only referring to substances that depress cognitive function but also to those that overstimulate it. Proper cognitive function depends on homeostasis, a balanced and well-ordered state that allows the mind to perceive reality clearly and process information accurately. The purpose of our rational and cognitive faculties is to enable us to (1) perceive reality accurately so that we can (2) deliberate soundly so as to (3) act in accordance with the truth. All of these functions are distorted by recreational drug use.

If freedom is about self-rule, then a person who deliberately places himself in a state where his ability to rule himself is severely diminished is not exercising freedom. Invoking drug use as an exercise of freedom makes as much sense as touting the benefits of drinking seawater as a remedy for thirst.

This is not abstract philosophical theorizing. The law already recognizes that a person who is mentally incapacitated cannot validly consent to certain decisions. Contracts signed under severe intoxication can be voided. A person high on drugs cannot give legally binding consent to medical procedures. The state intervenes when individuals threaten suicide by placing them in involuntary psychiatric holds. Why? Because we recognize that rational self-governance is a necessary precondition for meaningful autonomy.

How Drug Use Turns You Into a Slave

The defining feature of slavery is the absence of self-governance. A slave does not act according to his own rational will but is controlled by an external force that dictates his actions. The master determines what he does, where he goes, and how he lives. That is precisely what happens when someone consumes a substance that then overrides their rational faculties. While physical slavery is imposed by another person, chemical slavery is self-imposed. For both, the end result is the same: a loss of autonomy.

A person under the influence of drugs is no longer fully acting according to rational self-direction. His will is hijacked by a foreign chemical influence that suppresses judgment, distorts perception, and overrides impulse control. At that moment, he is not truly free. His actions are dictated by the effects of the substance rather than by reasoned deliberation.

This is not a metaphor. A person in the grip of a mind-altering substance literally loses self-mastery, even if it is just temporarily. The person who becomes addicted to drugs does not simply choose to continue using; his ability to choose is progressively eroded as the drug rewires his brain and makes rational self-control more difficult. At that point, he is no longer the master of his actions — the drug is his master.

John Stuart Mill, who first articulated the “harm principle,” recognized the problem posed by enslaving oneself. In On Liberty, Mill wrote that “The principle of freedom cannot require that [one] should be free not to be free.” In other words, freedom does not include the right to permanently destroy one’s own ability to be free. A person who permanently sells himself into slavery is not exercising freedom but abolishing it. The same logic applies to someone who places himself under the control of a substance that strips away his ability for self-rule. A person who willingly puts himself under the influence of something that systematically erodes rational control is doing the opposite of exercising freedom. Although Mill was talking about political slavery, his points apply just as equally to chemical slavery.

The Paradox of “My Body, My Choice”

The deeper irony of the “my body, my choice” argument is that the more a person engages in self-destructive drug use, the less able he is to make meaningful choices at all. A person addicted to meth, heroin, or even high-potency marijuana is not exercising greater autonomy; he is increasingly at the mercy of chemical dependency, impaired judgment, and distorted perception. His decisions are no longer fully his own. Instead, they are shaped and dictated by the drug.

If we reject political slavery because it violates autonomy, then we should likewise reject chemical slavery, because it produces the very same result: a person who is ruled by something other than his own rational will. A society that tolerates and normalizes widespread chemical enslavement is not a society that is maximizing freedom.

What About Alcohol?

Even alcohol is not immune from this critique. Alcohol, like any substance that affects the mind, can be used in ways that compromise rational self-governance. A person who drinks to the point of intoxication is, in that moment, undermining his own ability to think clearly and act rationally. A blackout drunk, a reckless binge drinker, or a person who routinely drinks to escape reality is no different, in principle, from the drug user who deliberately seeks intoxication. The problem arises when consumption crosses the line from responsible use to rational impairment.

However, the key difference between alcohol and hard drugs is that alcohol can be used in moderation without necessarily leading to impairment. A person can have a glass of wine with dinner, a beer at a social gathering, or a whiskey while unwinding after a long day without losing rational control. Unlike recreational drugs, which are taken precisely for their intoxicating effects, alcohol is unique in that it allows for consumption without cognitive dysfunction.

This is why alcohol is tolerated in a way that drugs like cocaine, methamphetamine, heroin, or hallucinogens are not. There is no responsible way to use these substances recreationally — their entire purpose in being used is to override rational agency. Unlike alcohol, which can be incorporated into normal life without necessitating impairment, the defining feature of recreational drug use is that impairment is the goal.

That said, alcohol abuse is clearly subject to the same concerns as other forms of intoxication. Alcohol, like any substance that affects the mind, can become a means of self-imposed enslavement when it is used to evade reason rather than complement normal, responsible living.

So while moderate alcohol consumption does not necessarily violate the principles of rational self-governance, its misuse certainly can. The fact that alcohol allows for some responsible use does not mean it is exempt from the general principle that true freedom requires rational control.

Freedom Requires More Than Just Choice

Recreational drug use is incompatible with freedom. The more a society tolerates and encourages such behavior, the less free that society becomes, not because the government is restricting choice, but because its citizens are actively degrading the very faculties necessary for responsible self-rule.

So does “my body, my choice” work as a defense of recreational drug use? No. It is logically incoherent and self-defeating. If we care about autonomy, we should reject the idea that freedom includes the right to systematically destroy the very conditions that make freedom possible.

Whatever we think about drug legalization, we should at least be honest about what drugs do. Freedom is not a magic word that turns self-destruction into autonomy.

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What It Means to Legalize Euthanasia

photograph of empty hospital room with flowers

Euthanasia and physician assisted suicide are gradually gaining acceptance: both legally and socially. As of 2016, Canadians have a right to assisted suicide. New Jersey may become the next American state to allow some form of medically assisted suicide, joining a list that includes California, Colorado, Hawai’i, Montana, Oregon, Vermont, and Washington. The national debate surrounding Dr. Jack “Death” Kevorkian, who oversaw the deaths of over one hundred people and was subsequently sentenced to 10-25 years in prison, seems like the distant past. But now it is time to shine that spotlight of public attention on euthanasia once more.

Dr. Kevorkian once explained his rationale for administering lethal injections: “My aim in helping the patient was not to cause death. My aim was to end suffering.” The arguments in favor of euthanasia (lethal injection administered by a physician) and physician assisted suicide (lethal prescription taken by the patient) are in ways difficult to combat. Who are we to deny a suffering soul an accelerated but peaceful passage to the Afterlife? Who are we to judge someone for exercising their right to a dignified death? Some argue that to deny euthanasia is to deny a permanent reprieve from suffering.

Proponents of euthanasia typically use terminally-ill patients who are enduring pain and have no prospects for improvement as the kind of patient who exemplify a situation in which euthanasia is the most merciful option. Few would not have sympathy for this request and might therefore approve of euthanasia in this limited circumstance. But it would be useful to explore how even this narrowly defined support can actually permit scenarios beyond terminal illness.

When introduced into legislation and enforced by governments, euthanasia fails to be constrained to that limited circumstance. Some may argue that this a misapplication of the ideal extent of permissible euthanasia. The legalization of euthanasia is a prime example of how the ideal application and the actual reality of a concept often fail to mirror each other perfectly. Indeed, even the most stringent restrictions on euthanasia allow for certain individuals to be euthanized when they ostensibly should not have been.

For example, the Netherlands – one of the first countries to decriminalize euthanasia – have very strict criteria for legal euthanasia. After the patient has been euthanized, the Regional Review Committee reviews the following “due care” criterion (if the case fails to meet the any of the criterion, the physician is to be prosecuted):

    • the conviction that there was a voluntary and well-considered request from the patient
    • the conviction that there was hopeless and unbearable suffering of the patient
    • has informed the patient about the situation in which it was present and about its prospects
    • the patient has come to the conclusion that the situation in which they found no reasonable alternative
    • has consulted at least one other independent physician , who has seen the patient and gave his judgment in writing about the aforementioned due care criteria.
    • has carefully completed the termination of life or assisted suicide.
  • In 2016, these seemingly restrictive criteria nevertheless approved Mark Langedijk for euthanasia not because of a terminal illness but because of alcoholism. The despondent 41-year old alcoholic, who entered rehab 21 times, conceded that “enough is enough” after his marriage ended and he moved back in with his parents. It appears that Langedijk displayed hopeless and unbearable suffering, yet it is doubtful whether he could have made a voluntary or well-considered decision because of emotional strain of his alcoholism and the related desperation. This particular case is relevant because it intersects with the suicide crisis facing middle-aged men.

But Langedijk should not be considered an exception to the rule in the Netherlands. The percentage of those euthanized because of terminal illness is dropping. People enduring psychological turmoil such as social isolation or loneliness, criteria that have not traditionally been  considered justification for euthanasias, are becoming a growing subgroup. And there is reason to believe that this gradual widening of the acceptable criteria is an inevitable phenomenon not unique to the Netherlands.

In Oregon, the latest report shows that over half of people given the lethal prescription in 2016 listed “burden on family” and “financial implications of treatment” as their end of life concerns. Neither of these reasons relate directly to the physical suffering of the patient or their state of health, yet it is becoming an increasingly accepted justification for physician assisted suicide.

When patient autonomy is held above all other concerns governing medicine, the physician must oblige the request of the patient, whether the patient is about to die in 3 weeks and is in tremendous physical pain or is simply depressed. When the vague notion of mercy for suffering individuals is held above all other concerns, one must accept the necessary conclusion that non-physical, non-chronic forms of suffering–such as psychological turmoil–fall under the expansive list of reasons that would permit euthanasia. In fact, it seems with either justification, there would be few instances in which euthanasia would be not be permissible. This trend should not come as a surprise. Therefore, those claiming that the legalization of euthanasia is for only terminally-ill patients in physical pain are being disingenuous. The Mark Langedijks of the Medical World are not anomalies of legalized euthanasia; they are, or will soon become, normalized.

This trend in and of itself may not be morally troubling for some, namely those who value patient autonomy or dignified deaths. But the implication of the legalization on the government-civilian relationship is morally significant. What does it mean when your government allows euthanasia? How does that shift the nature of the relationship between the state and the civilians?

Perhaps the legalization of euthanasia indicates that your government values your personal liberty. Perhaps it indicates that your government is progressive, on the cutting-edge of medical ethics. But it might also indicate that your government no longer values the unconditional protection of innocent human life. Maybe it shows that your government values certain lives over others.

When a state, such as the Netherlands, examines cases of euthanized people, it is indirectly making a judgment on whose life is worth living. If an individual fails to meet one of the six criteria, they cannot be euthanized and they are to be kept alive. It is the life of the individual who fails to meet the criteria that the state deems worth saving. Some argue that the converse is true: the lives that meet the criteria are the lives the state deems not worth saving.

Indeed, activists for the disabled fear that the legalization of euthanasia relegates the status of those with physical impairments. In his piece for The Guardian, Craig Wallace writes that offering euthanasia to the disabled is not “an act of generous equality” but a “fake cruel-one way exit for vulnerable people locked out of basic healthcare and other social and community infrastructure.”

Echoing the sentiment of Wallace’s op-ed, Jamie Hale argues that people with disabilities are the strongest opponents to assisted suicide. Hale addresses the “financial burden” concern expressed by those in Oregon and says that it would be felt by the disabled, too. “People who are disabled, ill or elderly are constantly taught that funding our health and social care is a burden – that we are inherently a burden,” she writes. “I am given so little of the social care that I need that I am forced to rely on unpaid care from friends to survive.” With physician assisted suicide as an option, insurance companies and socialized healthcare may be incentivized to pursue the far cheaper lethal prescription over actual treatment.

In California, this reordering of priorities has already occured. “Stephanie Parker was informed by her insurance company that the chemotherapy she requested to treat terminal Scleroderma was not an option they were willing to provide,” writes Helena Berger. “Packer’s insurer then offered $1.20 co-pay for a handful of life-ending prescription drugs.”

There is a specter haunting the world. But is the specter laws prohibiting euthanasia or laws permitting euthanasia?

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What Can be Done about Human Trafficking?

On July 23, 10 people were found dead in the bed of a swelteringly hot tractor-trailer found in a WalMart parking lot in San Antonio, Texas. Authorities found 39 people in the vehicle, but had reason to believe that there had at one time been as many as 100 in the small space.  All of the individuals appeared to be suffering from heatstroke, and many will likely have related injuries and other health problems from which they will suffer for the rest of their lives.  It appears that the individuals involved were undocumented immigrants, seeking to gain access into the country illegally.

Continue reading “What Can be Done about Human Trafficking?”