Renzo Bruni

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What stands in the way of allowing assisted suicide in first world countries?

The Netherlands and three states in the US (Oregon, Montana and Washington) have decriminalized assisted suicide, and this was done with co-operation of their local medical (professional) communities. China, in fact, announced a plan to prosecute monks who allowed a fellow monk to immolate himself in protest. Why is this so confusing: does not the right to life imply a right to self termination?
Why is this considered ethically wrong in secular Western democracies? Is it because of political expediency? Are the populations afraid to allow it? Is it morality or fear that maintains the prohibition?
I am definitively NOT addressing the (many) cases of teens, depressed and deranged persons whose impulse to suicide can be made better by therapy or medications. I too deplore these needless deaths and all the suffering that leads up to it.

  • Aug 30 2011: In the US it is more complicated than just ethics. Much of it is because there is a fear of blurred lines. I believe that there is a fear with the whole concept of dying.

    I believe many medical professionals, especially holistic minded professionals, would say that dignity in death is just as important as dignity in life.There are steps we could take before suggesting assisted suicide.

    What if we talk about DNR (do not resusitate) orders that are not upheld due to the POA making an emotional decision to sustain life artificially. I read an article in AMSN Journal and the very end of the article described changing the terminology to AND [Allow Natural Death].I could go on forever about my thoughts about talking to patients and their families in EOL (end of life) decision making.

    I think it is important to convey what a DNR order is in terms of allowing natural death not withholding life sustaining measures.I think AND [allow natural death] focus's the families in the direction of the preserving dignity for the patient in dying while leaving the caregivers without regret.What do you think about this?
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      Aug 30 2011: Interesting and topical points, thank you.
      I was not aware of the new move to add "Allow Natural Death" to the DNR orders, but I think it is appropriate and timely for this concept to be opted into common practice. PsOA should not be allowed to change the DNR orders after patients-of-a-certain age(say sixty or seventy) have made it clear what their wishes are. PERHAPS emotions (which are illogical but expected in situations of anticipatory grief and death of loved ones) should be dealt with as emotions, not reasoned assessment of facts in a medical situation. This might be easier in a society where doctors and nurses did not fear lawsuits for "bad" outcomes AND where people had realistic notions about medical interventions (in other words, there is a limit, not only to what is possible, but also what is seemly).
      I have witnessed horrible deaths and peaceful deaths; peaceful is much better, I am sure (in spite of not having been through it myself/personally).
      • Aug 30 2011: I woudn't say there is a move to add "allow natural death" to the DNR orders, but I wish it were a movement. It was just a concept mentioned at the end of an article. There is a need for timely intervention in having the discussion with the physician because you are right. A great question is what is considered a good outcome to the patient vs. only knowing the survival probability for that particular person in the event of arrest. A family should be aware that the decision was made by the patient because it is likely the patient, if revived may only be able to breathe on a ventillator ect. ect.

        If you have not seen it, check out the movie Don't Know Jack
  • Aug 30 2011: The idea of "sanctity of life" and people forcing their beliefs on others is another reason why. Although thinking about it, it could be greed - killing yourself saves you from a long stay in hospital with a terminal illness, which earns people money. To be honest, I'm really not sure why this is considered illegal. We put down animals when they have medical conditions that make life unbearable for them.
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      Aug 30 2011: @ Llewelyn - fascinating viewpoint.... I am surprised to see the issue turned around this way, but I actually think you might be RIGHT, at least about one of the primary advertising themes - and who benefits from it. Compelling observation, thank you.
      I actually am faced with the impending demise of a cherished dog I whelped and raised (with some help from her dam). She has seen me through a long illness, sleeping at my side with a paw on my arm to be sure she would wake when I did during the night. Her lymphoma will hack relentlessly at her health until I realize in a sudden dam-bursting moment that "it is time" to let her go. I have done it several times before and I find it wrenchingly sad, but very decent and appropriate.

      Like you, I fail to see why it is not as decent and appropriate for humans that we love also.
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    Aug 30 2011: While I have been made aware of two familial end of life choices, I still have reasons why I would want it to be approached with great caution.
    My biggest fear is that sick and demoralized people can have very short term perspectives. I would really want to ensure that a person was in fact terminal. The case that makes me most frightened is one I read about from Holland years ago where a young anorexic decided with medical approval to end her life. That scares me.

    The other and perhaps more significant fear is that with an aging population, old people are becoming expendible and they are already being labeled as a drain on the system (read profit drain for American healthcare companies). No one should be shamed into ending their life for the benefit of their heirs' financial picture. Each Life is and always will be an utterly unique and precious thing in this universe of ours and it should never be extinguished for money.
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      Aug 30 2011: @ Debra -- excellent points!!! I had not heard about the anorexic in Holland, but I am sure the story is complex (whether fully explained by the media or not), and there are folks around whose mental/emotional/psych problems are something in the neighborhood of terminal in the sense at leas that they will never improve and will be the cause of death (directly or indirectly).
      I think the two doctor rule in Netherlands is careful, but perhaps in some cases not enough.
      The depression that accompanies all kinds of serious physical illness is difficult to sort out.
      But most of all, I agree with your analysis of the old folks who might feel pressure to "die now" for their families. But if we had single payor we would not have to confiscate the entire wealth of an oldster when they moved into final care facilities. Then pressure from families would be lessened. There will never be a solution for families who don't care, however.
  • Aug 30 2011: religion?
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    Aug 30 2011: @ Tim -- I am confused. I would think that insurance companies would like to have the expense of hospitalization finished and over with as soon as possible. Did you think this through (and can you explain it to me) or are you just blaming them for everything?
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    Aug 30 2011: insurance companys
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      Aug 30 2011: @ Birdia - I am a bit confused. Do you mean civil lawsuit judgments, or criminal prosecution judgments? Or do you mean that people reject it as inconsistent with their personal morality?
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          Aug 30 2011: Funny (???) story about Huxley's deathbed request. I never heard that one before, and from long ago (very limited) experience with LSD, I must say I would not choose that drug to "go out on". Personally, I no longer think being outside of my own mind is desirable and I mostly don't understand the impulse to use LSD anymore.
    • Aug 30 2011: fear driven judgements.