Assisted Suicide Society Law Ethics

¶ … Suicide, assisted or otherwise, is a contentious issue in modern society. While most people would be upset if a loved one killed himself or herself, there is nonetheless widespread recognition that people's right to autonomy might supersede such concerns, especially when the choice is between a dignified death by suicide and a prolonged and painful terminal illness. However, there are still those who disagree and who believe that suicide is always or usually wrong. This ongoing debate is reflected in laws, societal values, and the philosophy of ethics.

Euthanasia, from the Greek words for "good death," is an old concept: in Sir Thomas More's Utopia, written in the time of Henry the Eighth, citizens of Utopia may end their lives with permission from religious and governmental officials (Minois 2001, 67). The concept of medically-assisted suicide is a largely late twentieth century invention (Minois 2001, 328). Proponents argue that -- despite continuing legal and religious prohibitions -- it should be lawful for someone with a terminal or progressive illness to end his or her life, with proper medical assistance to ensure a painless exit. Opponents generally point to the Hippocratic Oath -- the basis for modern medical codes of ethics -- which begins "First do no harm." (Weir 1997, 140). The question then becomes, what is more harmful, helping a patient to die, or forcing that patient to live in agony or incapacity? In the United States, the issue crystallized around the controversial figure of Dr. Jack Kevorkian. A medical doctor whose specialty was forensic pathology, Kevorkian became interested in the issue of terminally ill patients who wished to end their lives before the onset of unbearable pain or loss of faculties (Weir 1997, 219). Kevorkian took part in a number of well-publicized assisted suicides, in an attempt to force courts or legislatures to revise the laws against suicide. He was eventually convicted and forced to serve time in prison. The end result of Kevorkian's campaign was that individual states made contradictory decisions. In some states, like Alabama, there is no legislation or mention of suicide (assisted or otherwise) in the legal code, leaving suicide subject to common law, which considers it illegal. As a positive response to Kevorkian's efforts, Oregon passed the Death With Dignity Act in 1997 (Weir 1997, 130). This Act allows terminally ill people within the state to seek out physician-assisted suicide in order to end their suffering. This differs wildly from the situation in Ohio, where assisting a suicide is grounds for professional discipline for health care professionals (PRC). Clearly, there is very little legal agreement between states when it comes to suicide and euthanasia, just as there is in the philosophical tradition.

Opinions on the ethics of suicide diverge into two schools. Ethical arguments against suicide generally derive from the philosopher Immanuel Kant, while arguments that suicide can be an ethical act tend to derive from the Existentialist philosophy of Jean-Paul Sartre. Kantian ethics proposes the "categorical imperative": an act is only ethical if it would be acceptable if everybody did it (Minois 2001, 273). Thus, telling the truth is ethical because we would be satisfied if everybody told the truth; lying is not, because if everybody lied all the time, society would cease to function. This ethical school argues against suicide, but it is a weak argument for assisted suicide, which is only permitted on those with terminal or incurable diseases. Sartre's philosophy defends the right to suicide on the grounds of individual freedom of choice (Minois 2001, 326). However, even those who hold that assisted suicide is ethical can find troubling examples. For example, in the country of Belgium, assisted suicide is legal, based largely on Sartre's philosophy of freedom of choice. But most American proponents find the Belgian freedom troubling, for several reasons. In 2013, Belgium extended the right for assisted suicide to terminally ill children, for example (Braw 2013). And several cases have received international attention. In 2015, Belgian doctors agreed to permit assisted suicide for a 24-year-old woman who was physically healthy but suffering from severe depression (Buchanan 2015). And in 2013, Belgian doctors approved assisted suicide for a 44-year-old transgender patient, who had undergone gender-reassignment surgery but afterwards felt that the surgery had been a mistake (Gayle 2013). In 2012, Belgian doctors approved 1,432 assisted suicides -- representing about 2% of all deaths in the country (Gayle 2013).