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Right to Die

Among other troubling cases in medical ethics I have encountered this year is the proposition of a patient’s supposed “Right to Die”. Such a right would be exercised through either euthanasia or physician assisted suicide (passive euthanasia). Since I’m only examining the right itself – if it can even be called a right – I will not consider the more questionable varieties of euthanasia, nonvoluntary and involuntary, where the patient’s consent is either unobtainable or worse, overridden.

The statement itself seems nonsensical: a right to die, as if a law were needed to enforce the inevitable. Therefore, considering it to be a right to choose to die is more accurate. Regardless of semantics, the conflict remains; should one be allowed to choose to die? To me, suicide seems to be an intensely personal choice (both active and passive euthanasia are experienced as suicide by the affected patient) and there can be no justification for anyone to attempt to prevent such a choice.

Perhaps indicative of the independence of the decision is the relative futility of preventing suicide including the almost humorous threats of legal consequences (life imprisonment is a much weaker deterrent to the dead).

I do not want to be misunderstood, I am a strong advocate of suicide help-lines and other resources because they aid those who are not yet convinced and who could be persuaded to reconsider. However, the dying patient who could either live an additional week in crippling pain (therefore also causing pain to their loved ones) or could pass away peacefully should be able to choose their fate.

As with all controversial cases, slippery slopes abound, and all lead to terrible possibilities. It is not difficult to imagine that involuntary euthanasia could be pursued first as a means to alleviate a family’s suffering, then perhaps to alleviate society’s suffering; full-on genocide is not beyond imagination.
If you were caught in a situation where one avenue was euthanasia (either of yourself or of a loved one), would you pursue it?

Additional Reading: Death and Dignity: A Case of Individualized Decision Making

5 Comments

  1. Tarun

    Dec 12, 07:57

    Like you said, it is a personal choice.

    If I feel suicidal, I would really want to end the pain; even if it means I won’t be around to feel the relief.

    But if someone else is suicidal, I might go to any lengths to stop them.

    So there is really no generic answer to the question when one is not an outsider. Rationale is useless.

  2. Christopher

    Dec 12, 08:16

    The reading at the end helped me to understand the problems that society presents to someone who wants to die.

    There is, as you said, no reason we should have to enforce the right to pass into the inevitable. I see dying as a basic human right, something that every person has the option of choosing.

    As for the slippery slope argument, I think it’s a fallacious one. The right of a person to commit suicide, or of someone with a terminal condition to end their life prematurely, are basic ones. There is no obvious link, or enabling of a link, between those basic rights and involuntary euthanasia or genocide.

    Those two possibilities are neither inevitable nor likely. As long as a law is properly written so that doctors can assist without stepping into the realm of illegality, and it covers issues such as temporary depression or psychological disorders, then I see no reason to not allow such physician-assisted end-of-life plans.

    Public Agenda (http://www.publicagenda.org/issues/frontdoor.cfm?issue_type=right2die) has some interesting material on the issue. It seems to be one of those issues where someones public opinion is quite different than the choice they’d make if they were in the same situation.

  3. Thame

    Dec 12, 08:40

    Tarun:
    Good point. I don’t think I would be able to let go of a family member even if it is what they wanted.

    Writing about it is easy…

    Christopher:
    The slippery slope argument does always seem to be exaggerated (it is in it’s very nature), but in this case it seems at least partially true.

    I will try to find a link to a related article, but there have been cases in the Netherlands (where euthanasia is legal…kinda-sorta) involving children and people of ages far below what was understood to be the norm as well as a strikingly high number of involuntary euthanasia (which include cases where the patient expressly wrote that they did not want to be taken off life support).

    Perhaps suggesting that genocide was the next step was too much, but the slippery slope still exists and I think the future consequences of something like this should be taken seriously.

  4. Mrs Lifecruiser

    Dec 12, 11:27

    I found my way here from 9rules :-) Nice blog you you have and this post really is dynamite actually. Hot topic.

    It’s hard to know the true answer of mine on this, since I’m not in this situation myself right now, but I have an opinion anyway.

    Yes, I think that I would do it. If it was really really bad, to prevent more suffering.

    I think that the last thing that leaves us is the hope, therefor the dying patient him/herself might come to a conclusion about euthanasia a little bit too late, leaving this option only to the family in that case. This is a very hard decision for the family to take with a lot of difficulties to agree. Maybe with several doctors opinions and meetings it could be possible in some cases.

    I’ve seen a close relative – excuse me for being bold – literally rotten away of cancer and it was very inhumane. We would never let our pets suffer like that. When we KNOW the outcome already, it’s just a matter of time. This lady was tough, so she lived too long quite frankly. She should have been put to sleep long before she died.

    So I think that there is certain cases when it should be allowed. I know that there is difficulties to decide when it is necessary or not, but we should try to develop such routines. It’s the most humane thing to do.

    It would be interesting to know more about how The Netherlands get along with the euthanasia. I do think though, that if I got to know that I had cancer, I’d try to move there!

    I don’t believe in euthanasia when it comes to other cases though, such as for elderly. I have an old mother that has told us several times that she wants to go now and I understand her, her body is literally falling apart and she has no real life, but I don’t see that it’s our thing to decide that. Maybe I’ll change my mind about that if she gets worse and just laying there totally gone anyway. I really don’t know. The line is thin here….

  5. Nils

    Dec 12, 14:08

    Hi, first comment of mine here, I think. I guess it’s hard to say when you’re not currently involved in the dilemma, but yes, the right to choose to die is perhaps the one free choice we actually have in life (especially opposed to that of being born) and I think it should be safeguarded and remain an option at all times.

    I know that when my mom was in hospital, I would definitely have either supported her or gone with a doctor’s advice should such a choice have presented itself. Death was quicker though than any of us, so I was ‘excused’ of making any choices in the matter. Perhaps that was the only bit of ‘luck’ in there for all of us…

    One thing, though, although I am for (sounds strange, but a better word escapes me) both suicide and euthanasia, I do think we mustn’t confuse the two in any debate. Suicide, when someone contemplates it, is something I would try, like Tarun, to put a stop to whenever there was even the tiniest bit of a solution to whatever problem there was. Euthanasia, it seems almost, is a much ‘milder’ form that we associate with caring and compassion and ‘peacefully letting go’... In a way, of course.

    And as a last side-note (sorry for the length of this comment), if you can, and if the matter interests you more, watch the beautiful film Mar Adentro by Spanish director Alejandro Amenábar. An amazing document, a moving story and a great view of the euthanasia debate as it played out in Europe, especially in this case Spain.

    Well-written post. Thanks.

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