Assisted Suicide in Select Cases? by Stephanie Gray







If suicide is wrong, why is assisting it right?


     Last week I gave a presentation to teenagers on the topic of assisted suicide and euthanasia.  Afterwards, a student had a question for me: She said she was against euthanasia in the vast majority of cases, but said that, for a minority of cases, if someone is at the end of his life and his last dying wish is to have assistance with suicide rather than continue “waiting” for life to naturally end, shouldn’t we give it to him?

     That question can be answered by asking a series of questions:

     *If we refuse to assist with some deaths, but not others, we are making a value judgment about peoples’ lives—whether we realize it or not.  In other words, we are making the call that some lives are worth preserving and some aren’t.  Who are we to decide that?

     *Moreover, who’s to determine which people would be close enough to death to get assistance with suicide?  Would natural death need to be hours, days, weeks, or months away?

     *Even if we could get consensus on how close to death a patient ought to be to qualify, what if the estimated time is wrong?  My friend’s father was told he had days left to live.  Three years later, he is alive and living back at home.

     *But, for the sake of argument, if we could get accuracy on proximity to natural death, and if the only assisted suicide cases allowed had to be within weeks of natural death, then what harm, in the grand scheme of things, is a few more weeks on earth—especially when compared to the harms of introducing killing as a solution to problems?

     *If the concern is that the person, in his final weeks, would suffer, then shouldn’t we provide palliative care which alleviates suffering instead of eliminates the sufferer?

     *If we argue that we ought to act on someone’s wishes just because he wishes it, we need to be reminded that we humans can have disordered desires.  A case in point is regarding those struggling with Body Integrity Identity Disorder (BIID).  Consider the story of Jewel Shuping, who had her psychologist put drain cleaner in her eyes because she wanted to be blind.  Intentionally maiming a healthy part of one’s body may be the desire for someone with BIID, but isn’t this proof that not all humans’ desires should be acted upon?

     *If we say it’s okay to assist with some suicides, then what if another person, because of this, asks for assistance with suicide out of guilt, out of thinking he’s a burden and that he should do what others before him have done?  He may even claim to want assisted suicide, but deep down he is asking for it out of duty, thinking he ought to because others have done so already.  Since death is permanent, shouldn’t we err on the side of caution?  In other words, if we had to choose between a society that either a) deprives someone of death when he wants it, or b) gives someone death before he actually wants it, which should we pick?  The person being “deprived” of assisted suicide will still get death—just not at his own, personally-calculated time.  But the person being deprived of life will never get that living time back.

     *If we don’t think health care professionals should be involved in terminating guilty criminals’ lives, why do we think they should be involved in terminating innocent patients’ lives?  In 2016, the New York Times reported that the pharmaceutical company Pfizer “had imposed sweeping controls on the distribution of its products to ensure that none are used in lethal injections.”  More than twenty other drug companies had done the same.  And the American Medical Association has also raised concerns, stating, “The AMA's policy is clear and unambiguous — requiring physicians to participate in executions violates their oath to protect lives and erodes public confidence in the medical profession.”  Couldn’t the same be said about health care workers’ involvement in assisted suicide?

     Finally, it is worth considering this insight from palliative care physician Dr. Margaret Cottle:

     In places where euthanasia and physician-assisted suicide are legal, there has been a rapid expansion and total absence of enforcement of the so-called ‘safeguards.’ Patients with mental illnesses, early stage eye disease and even ringing in the ears have been euthanized. Children and patients with dementia, neither of whom can provide meaningful ‘consent,’ have also been targets. In one study published in the Canadian Medical Association Journal in 2010, the physicians who reported that they caused the death of patients admitted anonymously that one in every three of those patients never gave explicit consent.

      A study published in the New England Journal of Medicine in March 2015 reviewed the most recent data in Belgium around hastened death. It showed that 4.6 percent of all deaths in Belgium were euthanasia deaths, while 1.7 percent of all deaths were euthanasia deaths without the explicit consent of the patient.

     While these percentages seem rather small, serious concerns emerge when compared to the mortality statistics in the U.S. There were 2,596,993 deaths in the U.S. in 2013, and 4.6 percent of that is almost 120,000 deaths. This would qualify physician-assisted suicide and euthanasia as the sixth leading cause of death in the U.S., almost as many as the fifth leading cause of death, strokes, with about 129,000 deaths...

      Patients do not need hastened death; they need excellent care and a deep understanding of their difficult situations. They need all of us to be present with them in profound solidarity. They need the palliative care resources that the majority of patients and families do not have. It is a major human rights violation to be suggesting death as an “answer” to our society’s lack of commitment to care for our vulnerable citizens!

     Every physician knows it is frighteningly easy for patients to die – keeping them alive is the hard work, and caring for them respectfully and compassionately in the process is even tougher. It takes courage and hope to treat patients, especially when the outcome is far from certain.

     Agreeing with patients that their lives are not worth living and helping them die destroys the trust between patients and physicians, while also revealing a distinct lack of ingenuity in our treatments.

     Real compassion is shown by finding ways to be innovative in our approach instead of just following a set of guidelines, thereby reaching people in despair, both at the end of life and in other circumstances, and making it clear they matter to us, their lives are important and we will be with them in their troubles.


Image Source: Public Domain