euthanasia and assisted suicide

Defining terms

 

When we say "euthanasia," we are referring to the direct killing of a patient by a physician. This may be voluntary or involuntary.

 

When we say "assisted suicide," we are referring to situations in which a patient requests aid in dying, and a physician prescribes lethal medication for the patient to take on their own.

 

Some proponents of euthanasia and assisted suicide may use "medical aid in dying" as a euphemism for either.

Image by Ricardo IV Tamayo

Why do people seek assisted suicide?

 

Proponents of legal assisted suicide and euthanasia typically come from a place of compassion; they don't want people to suffer unbearable pain; that is understandable. No one wants that. 

 

However, statistics show that the concerns of patients requesting assisted suicide are primarily not issues of pain, but of disability. According to a study of the results of Oregon's 2013 Death with Dignity Act, 90% of patients cited being “less able to engage in activities” as one of the concerns that led to them requesting assisted suicide. 87% cited “loss of autonomy.” 72% cited “loss of dignity,” 59% cited becoming a “burden on family,” and 39% cited “losing control of bodily functions.”

 

Many of these reasons would be flagged as evidence of suicidal depression in healthy, young, able-bodied people. We should not simply accept that fears of disability are driving people to suicide. Everyone deserves suicide prevention care — including those who are ill or disabled. 

 

In the case of euthanasia, there is reason to doubt that consent is always possible or respected and whether doctors always have their patients’ wishes in mind. Research shows that .4% of deaths in the Netherlands do not have an “explicit request” from the patient—and explicit request can be difficult or impossible to get for many people with the advanced illnesses that people generally associate with euthanasia. In both Canada and the Netherlands, advanced dementia does not make a person ineligible for euthanasia, and in 2013, euthanasia was performed for “97 patients with dementia and 42 patients with psychiatric diseases” in the Netherlands. While this obviously disproportionately affects those of advanced age, Dutch legislation also allows euthanasia for infants who are born with serious disorders

 

With our current medical technology, pain can be managed. Suffering can be lessened. Steps can be taken to address a patient’s concerns, such as home care services to relieve feelings of burdening family. We should never accept direct killing as a solution to suicidal ideation or advanced illness.

The Philosophy

 

If someone’s losing their memory or independence, shouldn’t they be able to end their own life?

 

If we believe that value is intrinsic to human beings, then we know that extrinsic factors such as age, ability or dependence do not deprive an individual of value. 

 

Some argue that everyone has a right to “die with dignity,” and that euthanasia and assisted suicide dignify an otherwise degrading death. But dignity, like value, is intrinsic to being a human being; it cannot be taken away by disability or dependence. Ableist and ageist conceptions of dignity are predicated on health, ability, and independence. As our friends at Not Dead Yet write, “In a society that prizes physical ability and stigmatizes impairments, it’s no surprise that previously able-bodied people may tend to equate disability with loss of dignity. This reflects the prevalent but insulting societal judgment that people who deal with incontinence and other losses in bodily function are lacking dignity.” 

 

Euthanasia is often referred to as “mercy killing.” Euthanasia laws tend to apply to the terminally ill, at least at first, for this reason. In the cases of both assisted suicide and euthanasia, the implication is that death is preferable to the pain and suffering caused by the patient’s illness. We need to ask ourselves why we see it as merciful to assist in ending a disabled or dependent life while we build safety nets to stop others from ending theirs. What kinds of pain do we see as destroying dignity? Why is that so?

 

A major problem with euthanasia and assisted suicide legalization is that this implication, that it is better to die than to suffer, disproportionately affects the elderly and the disabled. As we saw in the statistics above, it creates a discriminatory double standard in which able-bodied people who say they want death are offered suicide prevention and people with illnesses or disabilities who say the same are offered suicide assistance.

 

Mercy that sees dependence as undignified is not mercy. Mercy that seeks to kill is not mercy. 

Image by Josh Appel

did you know?

Out of all the national disability rights organizations in the United States, every organization that has taken a stance on assisted suicide legalization opposes it.

Check out this Disability Rights Toolkit for Advocacy Against Legalization of Assisted Suicide from Not Dead Yet for more information.

FOOTNOTES AND FREQUENTLY ASKED QUESTIONS

What about intense pain?


Studies on the results of Oregon's 2013 Death with Dignity Act show that pain management is not one of the main concerns that motivate people to consider assisted suicide. When pain is a significant concern, palliative sedation is an option for pain management that does not involve the direct taking of life.




Can't a doctor tell if someone has no quality of life?


A growing body of evidence shows that people who have never experienced disability consistently misjudge the quality of life of people with disabilities, whose self-assessments are substantially higher. Many bioethicists refer to this phenomenon the “disability paradox.” Some studies show that non-disabled people who are not healthcare workers are better at assessing the quality of life of disabled people than non-disabled healthcare workers themselves. This seems to indicate that doctors cannot be trusted to assess quality of life in such grave cases as euthanasia and assisted suicide.




Other Resources


QUICK FACTS: Reasons for Requesting Assisted Suicide https://www.youtube.com/watch?v=XXEbWlVcI5Q QUICK FACTS: Assisted Suicide and Disability Rights https://www.youtube.com/watch?v=pEPBlBVSJhY A discussion with Rehumanize International board member Beth Fox Iabout ableism at the beginning and end of life: https://www.rehumanizeintl.org/podcast/episode/a2109c45/ableism-at-the-beginning-and-end-of-life-a-conversation-with-beth-fox





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