Primer: Physician-Assisted Suicide
Physician-assisted suicide, also referred to as medical aid in dying, is the practice in which a medical professional provides a patient with the means to end their own life, at the patient’s request. The process usually involves prescribing a lethal dose of medication that the patient must self-administer, distinguishing it from the broader term of euthanasia, in which the life-ending act is directly carried out by another party, such as a physician.
Jurisdictions that permit physician-assisted suicide typically require strict safeguards: the patient must be an adult of sound mind, demonstrate repeated and informed consent, and suffer from a serious, incurable, or terminal medical condition that causes an intolerable suffering. In some countries, this eligibility is attached to the terminality of an illness, one with a short prognosis; in others, however, it may extend to cases of chronic or more psychological suffering.
Legal acceptance for physician-assisted suicide, both across the country and the world, is growing. In the United States, so-called “death with dignity” laws exist in ten states, including Oregon, Washington, California, and New Jersey, as well as the District of Columbia, all of which limit eligibility to those with a terminal illness and a life expectancy of six months or less. In Canada, medical assistance in dying was legalized nationwide in 2016 and expanded in 2021, no longer requiring that death be imminent but that the patient have a "grievous and irremediable medical condition.”
Several European countries, such as the Netherlands, Belgium, and Spain, allow broader access, sometimes extending to cases of psychological suffering — for those “unbearably without hope.” Switzerland is notable for permitting assisted suicide without requiring terminal illness, provided the decision is made competently and without selfish motives by third parties. Meanwhile, countries like Germany, Portugal, and New Zealand have also recognized or legislated some form of assisted dying under strict regulation.
Proponents of legislation legalizing physician-assisted suicide argue that it offers terminally ill patients a humane and dignified way to end a life that has reached the point of unbearable suffering. The right to live, after all, is not very different from the right to die. They emphasize that these laws can be structured with strict safeguards, including residency requirements, multiple physician confirmations, waiting periods, and mental health evaluations, to prevent the wanton abuse that might otherwise occur. They might also appeal to other analogous but less controversial practices, such as withdrawal of life-sustaining treatment or palliative sedation, and contend that physician-assisted suicide is only another process of that kind, reducing needless physical and psychological pain for patients and families alike.
On the other hand, opponents might appeal to the fundamental, moral risk of physician-assisted suicide. For example, the Hippocratic Oath, the basis of our medical ethics, commands “First do no harm,” a principle surely incompatible with physician-assisted suicide. The prevailing moral sensibilities, moreover, in a time when mental health awareness and suicide prevention have been accorded such worth also seem to conflict with the prospect of government condoning a form of suicide. For example, critics of euthanasia in Switzerland label their law “suicide tourism,” since such a policy might actually invite people from around the world into Switzerland for the sake of suicide. And those skeptical of the practice might see a worrying trend and the trajectory of relaxing eligibility requirements seen in countries like Canada. They also might wonder whether adequate safeguards can truly prevent abuse or exploitation of the elderly, disabled, and economically challenged, some of society’s most vulnerable people.
Please come join us Monday night at 7pm in Scott Hall 201!
"Euthanasia" by Alberto Biscalchin is licensed under CC BY-NC-ND 2.0.