A few days ago the Canadian House of Commons rejected an assisted suicide bill. The proposed legislation would allow doctors to help terminally ill patients or people in unrelenting pain to end their lives. Currently, doctors or nurses or anyone else who helped someone die would be liable to murder or manslaughter charges and perhaps civil damages. Very few jurisdictions in the world authorize assisted suicide, which seems to be a “victimless crime.†The recent failure of this bill in Canada is a good opportunity to review reasons why society denies us an inalienable right to control our own death.
The dying person certainly has an interest in the right to end own life. First, suicide would stop unimaginable suffering. Second, the debilitating suffering is an affront to the patient’s dignity. Third, the dying person may want to accelerate the transfer of his or her property to the heirs. Fourth, the patient desiring suicide may wish to spare his or her loved ones the mutual torture of the situation. Finally, the patient may want to cap his or her health care bill. That of course is not very relevant in Canada unless your province refuses to pay for a life-saving cancer drug.
Not all public interest is against the dying person’s wish. Respect for private will and the freedom to choose is an important part of the Western way of life. But the difficulty here is that dying patients and people in unrelenting pain may have lower decision-making capacity so the society must take extra steps to ensure it understands the will of the patient correctly and that the patient is capable of forming decisions.
Generally, all issues that the society has with assisted suicide are rooted in the overarching interest to protect human life. Death is irreversible, so the risk of mistake is unacceptable even if the risk is small. The harm from assisted suicide based on a mistaken conception of the true will of the patient is enormous. People in great suffering are vulnerable and may have a lower capacity to make decisions or to communicate their true will. It is reasonable to speak of a slippery slope where we take less and less precautions or where our precautions are not enough in harder cases, which we cannot recognize. That path will take the society to where it may kill people who do not really want to die but simply cannot tell us about it.
That’s why, incidentally, the death penalty should be abolished: unless we can guarantee guilt, every time we kill a convict we risk killing an innocent man. Unless a convict’s life is less valuable than a patient’s, our highest duty to preserve life must make any risk of unjustified killing, including in the death penalty, unacceptable.
Another slippery slope argument is that the society will be seduced into tolerating more relaxed requirements for assisted suicide to lower the high cost of caring for the dying. The flip side of this argument is that we should prohibit assisted suicide to protect our standards of caring for the dying.
Our society is extremely complex and it is far from perfect. We make mistakes all the time. Sometimes, politics, ideology, or emotion influence decisions that should be exclusively technical. The risk of killing a dying patient who may not really be willing to die is too high given our paramount social duty of preserving life. Besides, modern science can certainly come up with means of reducing or eliminating suffering on the death bed, if not push the death farther away. Authorizing assisted suicide (just like authorizing the death penalty) is not a good idea.
(Post sponsored by AdviceScene)
To understand the issue of assisted suicide there’s no better place to look than Oregon. That state introduced physician-assisted suicide some years ago. It’s a tightly regulated process. The patient must apply to the government and then undergo counselling and examination by independent physicians. The patient must be terminal and have less than six months to live. There is a second, follow-up round of counselling and examination. Then, and only then, is the patient provided with a prescription for lethal medication.
The patient is under no obligation to have the prescription filled and, if filled, of course under no obligation to take it.
Oregon’s experience is (as I recall) about half of those who get prescriptions have them filled and, of those, a relatively small percentage take the drugs. This is very telling.
What the experience shows is that the “end of life” option actually eases the mental suffering of terminal disease. The patient knows that, if the suffering becomes too great, there is a way out. They have that ‘way out’ before they become too debilitated to seek it. Most find they don’t need it and don’t follow through with it.
Can there be a more powerful case made out for assisted suicide than this? Governments that deny this are brutal and inhumane.
The argument I hear most often is that assisted suicide would be used to euthanize people who are inconvenient and therefore the law protects the vulnerable. Personally, I feel this argument conflates assisted suicide and euthanasia – two very different concepts.
I blogged about this many months ago, and things have changed since that time. My friend Amy, who was suffering from ALS, took her life. She had to dupe her husband into providing the opportunity (she could barely mover her hands – taking her own life was an enormous logistical challenge). She also had to leave overwhelming evidence behind to exonerate her loved ones, and it was a good thing she planned it well. When her husband and daughter were dealing with the unimaginable trauma, they were also being interviewed by the police as murder suspects.
Under the current law, Amy had to act while she had some motor control. If she had access to assisted suicide, it is possible that she would have chosen to wait longer. As well, she could have informed everyone, and we would have had the chance to say goodbye. There would have been no horrible surprise, no murder investigation etc. The whole affair would have been much more civilized.