The right to assisted suicide is a significant topic that concerns people all over the United States. The debates go back and forth about whether a dying patient has the right to die with the assistance of a physician. Some are against it because of religious and moral reasons. Others are for it because of their compassion and respect for the dying. Physicians are also divided on the issue. They differ where they place the line that separates relief from dying--and killing. For many the main concern with assisted suicide lies with the competence of the terminally ill. Many terminally ill patients who are in the final stages of their lives have requested doctors to aid them in exercising active euthanasia. It is sad to realize that these people are in great agony and that to them the only hope of bringing that agony to a halt is through assisted suicide.When people see the word euthanasia, they see the meaning of the word in two different lights. Euthanasia for some carries a negative connotation; it is the same as murder. For others, however, euthanasia is the act of putting someone to death painlessly, or allowing a person suffering from an incurable and painful disease or condition to die by withholding extreme medical measures. But after studying both sides of the issue, a compassionate individual must conclude that competent terminal patients should be given the right to assisted suicide in order to end their suffering, reduce the damaging financial effects of hospital care on their families, and preserve the individual right of people to determine their own fate.
Medical technology today has achieved remarkable feats in prolonging the lives of human beings. Respirators can support a patient’s failing lungs and medicines can sustain that patient’s physiological processes. For those patients who have a realistic chance of surviving an illness or accident, medical technology is science’s greatest gift to mankind. For the terminally ill, however, it is just a means of prolonging suffering. Medicine is supposed to alleviate the suffering that a patient undergoes.Yet the only thing that medical technology does for a dying patient is give that patient more pain and agony day after day. Some terminal patients in the past have gone to their doctors and asked for a final medication that would take all the pain away— lethal drugs. For example, as Ronald Dworkin recounts, Lillian Boyes, an English woman who was suffering from a severe case of rheumatoid arthritis, begged her doctor to assist her to die because she could no longer stand the pain (184). Another example is Dr. Ali Khalili, Dr. Jack Kevorkian’s twentieth patient. According to Kevorkian’s attorney, “[Dr. Khalili] was a pain specialist; he could get any kind of pain medication, but he came to Dr. Kevorkian. There are times when pain medication does not suffice”(qtd. in Cotton 363). Terminally ill patients should have the right to assisted suicide because it is the best means for them to end the pain caused by an illness which no drug can cure. A competent terminal patient must have the option of assisted suicide because it is in the best interest of that person.
Further, a dying person’s physical suffering can be most unbearable to that person’s immediate family. Medical technology has failed to save a loved-one. But, successful or not, medicine has a high price attached to it. The cost is sometimes too much for the terminally ill’s family. A competent dying person has some knowledge of this, and with every day that he or she is kept alive, the hospital costs skyrocket. “The cost of maintaining [a dying person]. . . has been estimated as ranging from about two thousand to ten thousand dollars a month” (Dworkin 187). Human life is expensive, and in the hospital there are only a few affluent terminal patients who can afford to prolong what life is left in them. As for the not-so-affluent patients, the cost of their lives is left to their families. Of course, most families do not consider the cost while the terminally ill loved-one is still alive.When that loved-one passes away, however, the family has to struggle with a huge hospital bill and are often subject to financial ruin.Most terminal patients want their death to be a peaceful one and with as much consolation as possible. Ronald Dworkin, author of Life’s Dominion, says that “many people . . . want to save their relatives the expense of keeping them pointlessly alive . . .”(193). To leave the family in financial ruin is by no means a form of consolation. Those terminally ill patients who have accepted their imminent death cannot prevent their families from plunging into financial debt because they do not have the option of halting the medical bills from piling up. If terminal patients have the option of assisted suicide, they can ease their families’ financial burdens as well as their suffering.
Finally, many terminal patients want the right to assisted suicide because it is a means to endure their end without the unnecessary suffering and cost. Most, also, believe that the right to assisted suicide is an inherent right which does not have to be given to the individual. It is a liberty which cannot be denied because those who are dying might want to use this liberty as a way to pursue their happiness. Dr. Kevorkian’s attorney, Geoffrey N. Fieger, voices the absurdity of curbing the right to assisted suicide, saying that “a law which does not make anybody do anything, that gives people the right to decide, and prevents the state from prosecuting you for exercising your freedom not to suffer, violates somebody else’s constitutional rights is insane” (qtd. in Cotton 364). Terminally ill patients should be allowed to die with dignity. Choosing the right to assisted suicide would be a final exercise of autonomy for the dying. They will not be seen as people who are waiting to die but as human beings making one final active choice in their lives. As Dworkin puts it, “whatever view we take about [euthanasia], we want the right to decide for ourselves . . .”(239).
On the other side of the issue, however, people who are against assisted suicide do not believe that the terminally ill have the right to end their suffering. They hold that it is against the Hippocratic Oath for doctors to participate in active euthanasia. Perhaps most of those who hold this argument do not know that, for example, in Canada only a “few medical schools use the Hippocratic Oath” because it is inconsistent with its premises (Barnard 28). The oath makes the physician promise to relieve pain and not to administer deadly medicine.This oath cannot be applied to cancer patients. For treatment, cancer patients are given chemotherapy, a form of radioactive medicine that is poisonous to the body. As a result of chemotherapy, the body suffers incredible pain, hair loss, vomiting, and other extremely unpleasant side effects. Thus, chemotherapy can be considered “deadly medicine” because of its effects on the human body, and this inconsistency is the reason why the Hippocratic Oath cannot be used to deny the right to assisted suicide. Furthermore, to administer numerous drugs to a terminal patient and place him or her on medical equipment does not help anything except the disease itself. Respirators and high dosages of drugs cannot save the terminal patient from the victory of a disease or an illness. Dr. Christaan Barnard, author of Good Life/GoodDeath, quotes his colleague, Dr. Robert Twycross, who said, “To use such measures in the terminally ill, with no expectancy of a return to health, is generally inappropriate and is—therefore—bad medicine by definition” (22).
Still other people argue that if the right to assisted suicide is given, the doctor-patient relationship would encourage distrust. The antithesis of this claim is true. Cheryl Smith, in her article advocating active euthanasia (or assisted suicide), says that “patients who are able to discuss sensitive issues such as this are more likely to trust their physicians” (409). A terminal patient consenting to assisted suicide knows that a doctor’s job is to relieve pain, and giving consent to that doctor shows great trust. Other opponents of assisted suicide insist that there are potential abuses that can arise from legalizing assisted suicide.They claim that terminal patients might be forced to choose assisted suicide because of their financial situation.This view is to be respected. However, the choice of assisted suicide is in the patient’s best interest, and this interest can include the financial situation of a patient’s relatives. Competent terminal patients can easily see the sorrow and grief that their families undergo while they wait for death to take their dying loved ones away. The choice of assisted suicide would allow these terminally ill patients to end the sorrow and griefof their families as well as their own misery. The choice would also put a halt to the financial worries of these families. It is in the patient’s interest that the families that they leave will be subject to the smallest amount of grief and worry possible.This is not a mere “duty to die.” It is a caring way for the dying to say, “Yes, I am going to die. It is all right, please do not worry anymore.” Further, legalization of assisted suicide will also help to regulate the practice of it. “Legalization, with medical record documentation and reporting requirements, will enable authorities to regulate the practice and guard against abuses, while punishing real offenders”(Smith 409).
There are still some, however, who argue that the right to assisted suicide is not a right that can be given to anyone at all. This claim is countered by a judge by the name of Stephen Reinhardt. According to an article in the Houston Chronicle, Judge Reinhardt ruled on this issue by saying that “a competent, terminally-ill adult, having lived nearly the full measure of his life, has a strong liberty interest in choosing a dignified and humane death rather than being reduced at the end of his existence to a childlike state of helplessness, diapered, sedated, incompetent” ( qtd. in Beck 36). This ruling is the strongest defense for the right to assisted suicide. It is an inherent right. No man or woman should ever suffer because he or she is denied the right. The terminally ill also have rights like normal, healthy citizens do and they cannot be denied the right not to suffer.
The right to assisted suicide must be freely bestowed upon those who are terminally ill. This right would allow them to leave this earth with dignity, save their families from financial ruin, and relieve them of insufferable pain. To give competent, terminally-ill adults this necessary right is to give them the autonomy to close the book on a life well-lived.
Barnard, Christaan. Good Life/Good Death. Englewood Cliffs: Prentice, 1980.
Beck, Joan. “Answers to Right-to-Die Questions Hard.”Houston Chronicle 16 Mar. 1996, late ed.: 36.
Cotton, Paul. “Medicine’s Position Is Both Pivotal And Precarious In Assisted Suicide Debate." The
Journal of the American Association 1 Feb. 1995: 363-64.
Dworkin, Ronald. Life’s Dominion. New York: Knopf, 1993.
Smith, Cheryl. “Should Active Euthanasia Be Legalized: Yes.” American Bar Association Journal April 1993. Rpt. in CQ
Researcher 5.1 (1995): 409.
--Esther B. De La Torre
In recent months, heartbreaking stories of Americans such as Brittany Maynard struggling with devastating diagnoses have captured our empathy—and launched a national conversation about physician-assisted suicide (PAS). In response, activists are using these stories to advance legislation that has otherwise been rejected by the people.
At least 18 states across the country are considering whether to allow physician-assisted suicide. But legalizing physician-assisted suicide would be a grave mistake.
The merciful thing would be to expect doctors to do no harm and ease the pain of those who suffer and support families and ministries in providing that care.
Keep up with this story and more by subscribing now
Indeed, that was the message of Senator Ted Kennedy’s widow as she campaigned against physician-assisted suicide in Massachusetts in 2012. Victoria Reggie Kennedy pointed out that most people wish for a good death “surrounded by loved ones, perhaps with a doctor and/or clergyman at our bedside.” But with physician-assisted suicide, “what you get instead is a prescription for up to 100 capsules, dispensed by a pharmacist, taken without medical supervision, followed by death, perhaps alone. That seems harsh and extreme to me.”
Indeed it is.
The Hippocratic Oath proclaims: “I will keep [the sick] from harm and injustice. I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect.” This is an essential precept for a flourishing civil society. No one, especially a doctor, should be permitted to kill intentionally, or assist in killing intentionally, an innocent neighbor.
Human life doesn’t need to be extended by every medical means possible, but a person should never be intentionally killed. Doctors may help their patients to die a dignified death from natural causes, but they should not kill their patients or help them to kill themselves. This is the reality that such euphemisms as “death with dignity” and “aid in dying” seek to conceal.
Legalizing physician-assisted suicide, however, would be a grave mistake, as explained in a new Heritage Foundation report. It would:
Endanger the weak and vulnerable,
Corrupt the practice of medicine and the doctor–patient relationship,
Compromise the family and the relationships between family generations and
Betray human dignity and equality before the law.
To understand the problems with physician-assisted, one must understand what it entails and where it leads.
What Is Physician-Assisted Suicide?
With physician-assisted suicide, a doctor prescribes the deadly drug, but the patient must take the drug himself. While most activists in the United States publicly call only for physician-assisted suicide, they have historically advocated not only physician-assisted suicide, but also euthanasia: the intentional killing of the patient by a doctor.
This is not surprising: The arguments for physician-assisted suicide are equally arguments for euthanasia. Neil Gorsuch, currently a federal judge, points out that some contemporary activists fault the movement for not being honest about where its arguments lead. He notes that legal theorist and New York University School of Law professor Richard Epstein “has charged his fellow assisted suicide advocates who fail to endorse the legalization of euthanasia openly and explicitly with a ‘certain lack of courage.’”
The logic of assisted suicide leads to euthanasia because if “compassion” demands that some patients be helped to kill themselves, it makes little sense to claim that only those who are capable of self-administering the deadly drugs be given this option. Should not those who are too disabled to kill themselves have their suffering ended by a lethal injection?
And what of those who are too disabled to request that their suffering be ended, such as infants or the demented? Why should they be denied the “benefit” of a hastened death? Does not “compassion” provide an even more compelling reason for a doctor to provide this release from suffering and indignity?
Although the Supreme Court has ruled in two unanimous decisions that there is no constitutional right to physician-assisted suicide, three states permit it by statute: Oregon, Washington and Vermont.
Four Problems with Physician-Assisted Suicide
As explained in The Heritage Foundation Backgrounder “Always Care, Never Kill,” physician-assisted suicide is bad policy for four reasons:
1. Physician-assisted suicide endangers the weak and marginalized in society. Where it has been allowed, safeguards purporting to minimize this risk have proved to be inadequate and have often been watered down or eliminated over time.
Physician-assisted suicide and euthanasia are allowed in three European countries—the Netherlands, Belgium and Luxembourg—and Switzerland allows assisted suicide.
The evidence from these jurisdictions, particularly the Netherlands, which has over 30 years of experience, suggests that safeguards to ensure effective control have proved inadequate. In the Netherlands, several official, government-sponsored surveys have disclosed both that in thousands of cases doctors have intentionally administered lethal injections to patients without a request and that in thousands of cases they have failed to report cases to the authorities.
People who deserve society’s assistance are instead offered accelerated death.
2. Physician-assisted suicide changes the culture in which medicine is practiced. It corrupts the profession of medicine by permitting the tools of healing to be used as techniques for killing. By the same token, physician-assisted suicide threatens to fundamentally distort the doctor–patient relationship because it reduces patients’ trust of doctors and doctors’ undivided commitment to the life and health of their patients.
Moreover, the option of physician-assisted suicide would provide perverse incentives for insurance providers and the public and private financing of health care. Physician-assisted suicide offers a cheap, quick fix in a world of increasingly scarce health care resources.
3. Physician-assisted suicide would harm our entire culture, especially our family and intergenerational obligations. The temptation to view elderly or disabled family members as burdens will increase, as will the temptation for those family members to internalize this attitude and view themselves as burdens. Physician-assisted suicide undermines social solidarity and true compassion.
4. Physician-assisted suicide’s most profound injustice is that it violates human dignity and denies equality before the law. Every human being has intrinsic dignity and immeasurable worth. For our legal system to be coherent and just, the law must respect this dignity in everyone. It does so by taking all reasonable steps to prevent the innocent, of any age or condition, from being devalued and killed.
Classifying a subgroup of people as legally eligible to be killed violates our nation’s commitment to equality before the law—showing profound disrespect for and callousness to those who will be judged to have lives no longer “worth living,” not least the frail elderly, the demented and the disabled. No natural right to physician-assisted suicide exists, and arguments for such a right are incoherent: A legal system that allows assisted suicide abandons the natural right to life of all its citizens.
The Alternative: True Compassion and Care
Instead of embracing physician-assisted suicide, we should respond to suffering with true compassion and solidarity. People seeking physician-assisted suicide typically suffer from depression or other mental illnesses, as well as simply from loneliness. Instead of helping them to kill themselves, we should offer them appropriate medical care and human presence.
For those in physical pain, pain management and other palliative medicine can manage their symptoms effectively. For those for whom death is imminent, hospice care and fellowship can accompany them in their last days. Anything less falls short of what human dignity requires. The real challenge facing society is to make quality end-of-life care available to all.
Doctors should help their patients to die a dignified death of natural causes, not assist in killing. Physicians are always to care, never to kill. They properly seek to alleviate suffering, and it is reasonable to withhold or withdraw medical interventions that are not worthwhile. However, to judge that a patient’s life is not worthwhile and deliberately hasten his or her end is another thing altogether.
Victoria Reggie Kennedy has said it best:
My late husband Sen. Edward Kennedy called quality, affordable health care for all the cause of his life. [PAS] turns his vision of health care for all on its head by asking us to endorse patient suicide—not patient care—as our public policy for dealing with pain and the financial burdens of care at the end of life. We’re better than that. We should expand palliative care, pain management, nursing care and hospice, not trade the dignity and life of a human being for the bottom line.
Palliative care focuses on improving a patient’s quality of life by alleviating pain and other distressing symptoms of a serious illness. Palliative care is an option for people of any age at any stage in illness, whether that illness is curable, chronic or life-threatening.
Citizens and policymakers need to resist the push by pressure groups, academic elites, and the media to sanction physician-assisted suicide. For more on this, read “Always Care, Never Kill.”
Ryan T. Anderson researches and writes about marriage and religious liberty as the William E. Simon Fellow at The Heritage Foundation. This article first appeared on The Daily Signal.