The charge of fallacious slippery-slope reasoning that Jocelyn Downie, Udo Schüklenk, and other proponents of medically assisted suicide (MAiD) routinely direct at critics of the practice relies on an outdated juridical conception of power that has conditioned Western philosophy and on outmoded ideas about the self-originating character of the neoliberal subject’s freedom and autonomy that are integral to this conception. As Foucault pointed out, juridical conceptions of power, which construe it as repressive, as centralized, and as an entity that subtracts from the subject’s autonomy and agency, misapprehend the productive and diffuse character of relatively recent forms of subjecting power that operate primarily through the government of subjects, enabling them to act in order to constrain and control them. Indeed, Downie, Schüklenk, and other proponents of MAiD continue to argue that people who are given the procedure have freely chosen it, even as an alarming number of reports appear in the Canadian mainstream press and social media according to which a given disabled person has opted for medically assisted suicide because they (for example) were unable to secure chemical-free, affordable and accessible housing; could no longer bear to live in an institution; or believed that ending their life with MAiD was preferrable to continuing to live amidst grinding poverty.

In other words, these proponents of MAiD refuse to acknowledge the productive and coercive elements of the MAiD apparatus with respect to marginalized and vulnerabilized communities, preferring instead to represent these examples of coerced suicide as exceptional cases that can be dismissed or ignored. Insofar as these proponents of medically assisted suicide conceive of power, freedom, and autonomy in terms of negative liberty, they obscure the successful normalization of neoliberal relations of power by and through the effective inculcation and utilization of a relatively recent kind of subjectivity, namely, the self-determining and self-governing individual who is enabled to act in accordance with a narrowly circumscribed set of possible actions. For relations of power have always already conspired to put in place the options from which one may “autonomously” choose. In other contexts, I have argued that the idea of reproductive autonomy too works in the service of neoliberal governmentality and contributes to the production of subjects in this way (Tremain 2006).

In short, the charge of fallacious slippery-slope reasoning, which bioethicists direct at critics of medically assisted suicide, results from the intransigent refusal of these bioethicists to acknowledge that the arguments of their critics address the constitutive nature of force relations under neoliberal governmentality, including the constitution of neoliberal subjects whose management and modification of their biological life, through the exercise of their supposedly prediscursive autonomy and freedom, is fundamental to their notions of self-hood and responsible citizenship (see Tremain 2017; Pitts-Taylor 2010). The autonomous, informed, and consenting individual around which bioethical claims that promote medically assisted suicide revolve is a historically and culturally specific artifact of discourse rather than a prediscursive being/self endowed with intrinsic liberties and freedoms. That is to say, the self-determining citizen/patient that neoliberal bioethics upholds and claims to dignify through Bill C-7 in particular and medically assisted suicide more generally has a history, and a relatively recent and culturally specific history at that.

Now, the arguments that feminist proponents of medically assisted suicide endorse (and advance) tend to rely on beliefs about the value of care and compassion rather than convictions about self-determination and individual autonomy. As Lauren Berlant (Candace Vogler, Martha Nussbaum, and others) has pointed out, however, compassion is not a clear and simple human emotion. On the contrary, Berlant states rather that “there is nothing simple about compassion apart from the desire for it to be taken as simple, as a true expression of human attachment and recognition” (Berlant 2004, 7). For, as Berlant writes:

“[T]he aesthetics of compassion—the cultivation of the senses toward a more nuanced and capacious engagement with scenes of human activity—opens a hornet’s nest of problems about what responses should be desired and when private responses are not only insufficient but a part of the practice of injustice. Compassion turns out not to be so effective or a good in itself. It turns out merely to describe a particular kind of social relation. … Indeed, it would be possible to make an argument about the image of the human the compassion archive provides for us that could bring down on our heads the whole project of feeling committed to compassion” (Berlant 2004, 9).

Compassion, Berlant explains, implies an asymmetrical social relation between a spectator and a sufferer that privileges the spectator’s experience of feeling compassion and, ultimately, attendant (neoliberal) policies which thereby “relocate the template of justice from the collective condition of specific populations to that of the individual” (Berlant 2004, 2). Thus, Berlant rhetorically asks: “What is the relation between becoming capaciously compassionate and becoming distant from responsibility for what one experiences directly and indirectly about the populations relegated to social negativity?” (10). In a genealogical account of the vicissitudes of the term compassion, Marjorie Garber supplies a response to Berlant’s question by noting how, in the expression of compassion, pleasure and pain intermingle: “the pain of someone else provides an access of pleasure for the compassionate one” (Garber 2004, 20). In this regard, Berlant observes, furthermore, that:

“In the liberal society that sanctions individuality as sovereign, we like our positive emotions to feel well intentioned and we like our good intentions to constitute the meaning of our acts. We do not like to hear that our good intentions can sometimes be said to be aggressive, although anyone versed in, say, the history of love or imperialism knows volumes about the ways in which genuinely good intentions have involved forms of ordinary terror (think about missionary education) and control (think of state military, carceral, and police practices)” (Berlant 2004, 5).

Sentiments of compassion, although they may seem undeniably natural and intuitive, derive from a particular social training, emerge in particular historical moments, and are shaped by certain aesthetic conventions, none of which is universal or compelling in its own right (Berlant 2004, 7).