POINT:

Physician-Assisted Suicide is a Slippery Slope Toward a “Right to Die” for People Who Are Not Terminally Ill

To say I was alarmed after stumbling across the London Times headline, “Swiss crackdown on ‘suicide tourism’ could spell the end of Dignitas clinic” would be a vast understatement. I had never heard the phrase “suicide tourism” before. Apparently, people have been traveling to Switzerland to seek assisted suicide, as it is illegal in their home countries.

For clinics that have been seeing a lot of “suicide tourism,” the options are to close down or tighten up their regulations. This seems simple enough, except for the fact that Ludwig Mineli, the founder of Dignitas, one of the clinics in question, thinks that assisted suicides should not be restricted and should certainly not be limited to terminally ill patients. “By cutting off assisted suicide for chronically or psychologically ill people who are capable of informed choice the government will promote lonely suicides on train tracks,” Minelli said. In other words, according to his philosophy, suicidal people with non-terminal illnesses like clinical depression should be able to make the informed decision to commit suicide, and we should do nothing to stop them. If someone has decided that he or she would like to die, it must in fact be his or her time to die.

The ideas of “suicide tourism” and assisted suicide for the clinically depressed are certainly not ideas that I considered when I first became aware of the assisted suicide debate. It was always argued to me that this drastic measure would be used to give “dignity” to dying patients—to spare them painful deaths. Though some may have foreseen this current development, I don’t think many people would have received the pro-assisted suicide argument very well had they considered that one might qualify regardless of how treatable his or her illness might be.

The implication is that death, rather than being an unpleasant reality, is actually an individual right that we must claim. And yet in claiming that right, we necessarily sign our lives into someone else’s hands. The common mantra of the assisted suicide movement is “death with dignity.” I don’t know about you, but I’ve never felt dignified when I was helpless or at the mercy of another.

Hospice care provides more consideration for the dignity of human life by seeking to increase the quality of life of the dying instead of inducing death. Hospice care is a type of end-of-life palliative care: it seeks to relieve the symptoms of the terminally ill and works to make patients as comfortable as possible. It has a very holistic approach, going beyond medical care to ensure that the patient has a continuing network of family and friends who can provide emotional and spiritual support, while also providing that support from the caregivers themselves. In this way, hospice care fights for the quality of a human life and says that, rather than having a right to die, we have a right to live our lives to their natural fruition with as much comfort and joy as possible.

Assisted suicide, on the other hand, threatens the value of life. It says that the lives of those who are not in some way ill are worth more, and more worth fighting for, than the lives of those who are. Most people who are terminally ill have endured a great deal of suffering and undergone enumerable setbacks and disappointments. Consequently (and understandably), they often feel defeated and despondent. In seeking death, their state of mind is similar to that of a clinically depressed, suicidal person for whom there is no relief in sight. But as we know, it is far from natural to seek death: it contradicts the self-preserving aspect of our human nature. Anyone who is depressed enough to desire death deserves the appropriate care and treatment, even if natural death is only months away. The terminally ill have a right to develop emotionally and spiritually and to strengthen bonds with friends and family prior to death.

As for individuals who are suicidal but not terminally ill, I have this to say: just because you want to die does not mean it’s your time. You might feel attracted to the assisted suicide movement because it tells you that you have the right to claim your own death, but I want to tell you that you have the right to reclaim your life. If you’re suffering from suicidal thoughts, you have a treatable problem that can be further alleviated by a supportive network of friends, family and, if it applies, faith. Like each other person, your life is worth fighting for, and should be lived until it ends naturally.

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COUNTERPOINT:

Legal Euthanasia as an Option for the Terminally Ill is Essential for the Preservation of Patients’ Dignity

Liz Bowen, Opinions Co-Editor and Copy Editor
Published: November 19, 2009

The desire to be alive is something that most people take for granted. For a physically healthy, mentally stable individual, it’s easy to attribute this impulse to human nature—to some inherent, undeniable instinct to survive and perpetuate the species. After all, that’s what we’re supposed to do, right? We’re born, we reproduce and we die when it’s “our time.” It’s the circle of life—as simple as that.

The problem is that most of the people who have this mindset are not terminally ill. For those who are, things are often not quite so simple. To many terminally ill patients, life means unimaginable pain. On top of that hardship, they have been told without question that their tremendous sufferings will end in death. In states where euthanasia is legal, these patients are given a choice: to endure the agony of sickness indefinitely or to end their pain in death. Surely, this is one of the most difficult decisions a human could ever have to make. Because most people could never imagine being faced with this ultimatum, it is pure arrogance for any healthy person to pass judgment on a terminally ill patient’s will to live.

In some cases, after extensive and reasoned thought, patients truly believe that euthanasia is a dignified way to pass on. Rather than dying slowly and in agony, these people choose to spare themselves and their loved ones some pain by making an often communal decision—with the input of friends and family—to die on their own terms. Consider the case of Linda Fleming, the first person to die by assisted suicide legally in Washington state. In a statement that was released to the press after her death, she wrote, “I am a very spiritual person, and it was very important to me to be conscious, clear-minded and alert at the time of my death. The powerful pain medications were making it difficult to maintain the state of mind I wanted to have at my death.”

Those who make the incredibly difficult decision to end their lives in this way are not behaving irrationally. They are not pursuing death as an alternative to life, as a depressed individual would; in their cases, there is ultimately no alternative to death. Euthanasia is only a legal possibility if imminent death is guaranteed. Those who make the choice are selecting a peaceful death over which they and their loved ones have control, rather than an excruciating decline at the hands of a violent and uncaring disease.

This is not to say that those who decide to die “naturally,” without the aid of prescribed medication, are any less rational or moral than those who opt for euthanasia. Neither option is an easy choice; a patient’s strength and courage must be commended no matter what the outcome. Because of this reality, the choice of when to die should be reserved and available for the patient and his or her loved ones. Without legal physician-assisted suicide, many terminally ill patients are forced to die in ways that they feel are unnecessarily painful, prolonged and humiliating. If “natural” death strips the patient of his or her ability to die lucid, autonomous and spiritually/mentally prepared, then a lack of legal euthanasia is truly a denial of dignity.

The notion that euthanasia for the terminally ill is a slippery slope leading to universally legal suicide is plainly absurd. In every one of the locations where there are laws permitting physician-assisted suicide, the legislation explicitly states that there must be proof that the patient is indeed terminally ill and has been presented with all possible alternative measures. In the U.S., the patient must undergo psychological testing to ensure that he or she is mentally capable of making the decision. Thus, nowhere is it legal, nor will it ever be legal, for a depressed but otherwise healthy individual to take his or her own life with the aid of a physician.

The notion of a “right to die” has always been contentious with social conservatives who cling to the notion that euthanasia defies humans’ inherent impulse to survive. However, at the point at which physician-assisted suicide becomes an option, survival is no longer a possibility. Because those of us who are fortunate enough to be healthy cannot, in good conscience, judge the decisions of those who are experiencing such unbearable suffering, the only compassionate option is to let the patient make whatever decision will make his or her final moments most comfortable. Whether that means death by prescribed medications or by disease should be each patient’s choice—not the government’s.