The landscape of assisted suicide


The Landscape of Asisted Suicide imageComing to the conclusion to end one’s life is an arduous decision. Death conquers us all at some point whether we like it or not. It is the ultimate unknown and our fear (or understanding) of death causes most to seek longevity. From solely a transactional perspective, suicide becomes a serious option when the pain and debilitating anguish from whatever one is suffering becomes intolerable.

The greatest compliment one can pay to one’s life is the simple act of not wanting it to end. We hang on as our physiology fails for many reasons, from ethical/religious beliefs about suicide, the small joys or memories that we still find, to averting the sadness and pain suicide would cause to our loved ones. Under agonizing or terminal circumstances, however, the desire to endure is surmountable by the desire to end pain or indignity. Those with terminal illnesses and the long-term informed know these considerations all too well. So too do their families and physicians. At some point one wonders which path is more humane.

For the able-bodied, the choice is personal. Suicide (and attempted suicide) is outlawed in some jurisdictions, but not for the reasons you would think. The trend to de-criminalize suicide and attempted suicide has been pervasive throughout the West, with most countries opting to administer psychiatric treatment. Having the stigma of illegality is mostly political symbolism of embracing the sanctity of life than preventing death. Judeo-Christian beliefs have also influenced perceptions of suicide’s in the public sphere historically.

The legal status today has more to do with the handling of the deceased person’s assets (including the payment of insurance money). When you think of it, how can you really prosecute a situation where the victim and perpetrator are the same person? There’s no justice for the state to seek for the victim, and the perpetrator must be dead for it to be a crime and thereby will not be subject to imprisonment. The legal status of suicide as a preventative measure can only play into an individual’s consideration of consequences. By making suicide an illegal act, instruments such as life insurance do not have to pay out. As such, if the potential suicide is done for financial reasons, the treatment in respects to insurance helps ensure that the individual is not worth more dead than alive. It also helps against faked suicides or murders disguised as suicides.

For those without a physical disability, end of life choices intersect the fields of medicine, ethics and law. Needing another person to administer lethality complicates the act of suicide because it brings into play another party’s motives. This is why there are serious consequences for doctors or regular citizens assisting a suicide, even in countries where suicide itself is de-criminalized. Physicians have more legal leeway but also face more stringent rules relative to someone committing suicide themselves. One of the chief principles applied to medically-assisted suicide is an overt, mentally-competent confirmation that the patient would like to die. This takes away most of the in-fighting between relatives that result in legal challenges to medical treatment such as ending life support to those in a vegetative state. Second, there needs to be confirmation that the medical situation is confirmed terminal, often needing two independent doctors, and sometimes restricted by the life-expectancy of their diagnoses (e.g. under six months remaining). From a Hippocratic Oath perspective, the situation must generally be that the patient wants it, and the relief of pain trumps the benefits of prolonging life.

We’re all heading to an inevitable conclusion, and I’m sure when one’s time comes we’d like to have a say. To paraphrase a page from Hamlet, we know not whether ‘tis nobler in the mind to suffer the slings and arrows of outrageous fortune, or to take arms against a sea of troubles and by opposing end them.

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