24 March

Practical Reasons for Rejecting Physician Assisted Suicide

We have argued previously on this blog against Physician-Assisted Suicide (PAS) (here and here). In both instances we sought to make a rational case against based on the premise that helping anyone to end his or her life is contrary to the value of liberty: with destruction of an individual’s life goes destruction of the same person’s freedom.

There are, however, pressing practical concerns that may for many represent a stronger case for continuing the ban on PAS. The ban, after all, exists so that vulnerable persons, especially those coming towards the ends of their lives, cannot legally be done away with under guise of ending their suffering.

While many will naturally shrink from such thinking we must accept existence of the temptation to value money and resources over a dying person’s last few incoherent, incontinent and perhaps pain-filled months. Coercing someone into suicide is not very different from murder: indeed in some ways far worse.

The existing ban on PAS safeguards against coercion. In practical terms, advocates of PAS are trying to find a way to legalise assisted suicide without utterly abandoning the safeguarding. Safeguards of some kind will have to be components of proposed legalisation.

These should include prohibition of accepting requests for PAS from persons incapable of making a decision rationally. In particular, the mentally incapacitated and sick would surely have to be excluded.

At present, it should be noted, wishing to die is in fact widely considered symptomatic of mental illness. This amounts to quite a dilemma. How can procedural safeguards ensure not only that the mentally ill are deemed ineligible for PAS, but also that those actually considered eligible have not become mentally ill as a result of their medical conditions or even in consequence of their wish to die?

Definitions of mental health and illness, moreover, remain highly fluid and subject to change. Public understanding has advanced enormously in the last century, but there remain significant areas of disagreement as to what actually constitutes a ‘healthy mind’. Given the hotly contested grounds, how can safeguards for PAS be other than unworkable?

One PAS campaigner, Paul Lamb, has urged that we should not allow our pet animals to roll around in agony, but would rather put them out of their misery. This is all well and good for domestic animals, but, in any event, how does one know how many cats or dogs have been ‘put to sleep’ that were really happy to go on living. Will the situation of human persons be really any different if PAS is legalised?

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