(Cross) Examining Assisted Suicide

I recently had the opportunity to come on the Cross Examined Life podcast to defend the position that physician-assisted suicide should be illegal. It’s a really great new podcast, with a premise that resonates with me- improving the way we disagree. I enjoyed the conversation, and I hope you’ll check it out. You’ll have to give it a listen to get the full argument, but I had a couple of thoughts after we spoke.

First off, I wish I’d emphasized more that my position is primarily concerned with protecting the rights of vulnerable people. That’s why I hold it, and that’s why it’s important. It’s easy to wander off into abstract ideas and lose the thread of why the ideas and principles matter–in this case, they matter to the people who will be harmed if this principle is discarded. A common argument is that assisted suicide ends an individual’s suffering, and it’s simply nobody’s business how someone chooses to deal with their suffering. So I want to strongly reinforce this point: this is emphatically NOT about “morality” in terms of “I think it’s distasteful, so YOU shouldn’t do it.” Rather, it’s about morality in terms of not harming or abandoning vulnerable people in their time of need.

Looking back, I would have organized my case a little bit differently. Instead of presenting separate arguments, I realize that I might rather have presented all the later points as evidence of what goes wrong when you violate the first one. That would have reflected my thinking more clearly, and would have kept me from getting tied up like I did in questioning whether someone is competent to make this or that decision. Rather than debating whether freedom from coercion and pressure is itself a reason to make assisted suicide illegal, I should have made clear from the start that the problem of coercion is something which emerges from the violation of the fundamental principle; that is, that we shouldn’t be killing people anyway.

I also would have tried to more clearly express the argument that life has intrinsic value, because that’s what’s underneath the whole thing. If the basic principle that “life is worth defending” is itself in question, then none of the rest matters. I think that might have sparked a bit of productive discussion. Why is life worth defending? Why do we all generally accept that we shouldn’t kill people, or that suicide is sad? These questions need to be answered before we can really explore whether or when exceptions ought to be made (e.g., we shouldn’t kill people, except in circumstances X and Y when rule Z takes priority, etc.).

At the end, I said that the conversation gave me some things to ponder further. What I had in mind was one of Chris’s very first questions, asking about the role of autonomy. As someone with a tendency towards libertarian thinking, this gave me pause. In the conversation, I stayed mostly grounded in the argument that virtually everyone agrees that matters of life and death are an appropriate place for government regulation. One can make “personal autonomy” a high priority and still believe there’s a place for laws addressing whether or not it’s ok for us to kill each other.

Upon further reflection, I think I’d flesh out an additional point. I briefly touched on this, then moved on quickly. But the question on the table isn’t actually about autonomy; that is, about someone’s individual actions and choices. We weren’t talking about whether suicide is ok or should be legal; I’d give a different answer to that question. We were considering assisted suicide- should it be legal for a doctor to give someone, in a moment of despair, a way to harm themselves. “Should an individual be able to do what he wants?” is a different question than, “should we call ‘causing death’ a form of medical care?” The principle of autonomy applies to the first, but not as strongly to the second, I would argue.

One last thing. I should have done a better job of acknowledging how blurry the line between “allowing death” and “causing death” can look, that’s absolutely fair criticism. If I could go back, I’d grant that the two things don’t always appear all that distinct on the surface. That said, I would still push back on the point. Here’s why: I think people everywhere, in all cultures, widely recognize this distinction. If someone holds that there is not really an important difference between a disease taking someone’s life, versus a person taking it, then that’s the view that requires defending.

Please give the podcast a listen and a share, and let me know what you think!

To go deeper into this topic, many disability-rights and elder-abuse prevention organizations have great resources. These types of groups are almost unanimously opposed to legalizing assisted suicide, which should carry some weight in itself.

Disability Rights Education and Defense Fund

Patients Rights Council

American Association of People with Disabilities