The etymology of euthanasia, when translated from Greek, means “good death (1).” In our present debate on euthanasia in the United States, the public policy arena is currently predominated by assisted suicide, a form of euthanasia distinguished only by the fact that the person committing the ultimate act of killing is the victim (2). In spite of the presence of suicide prevention programs to talk the depressed out of harming themselves — and even involuntary commitment and suicide watch for those threatening their own lives — euthanasia by assisted suicide is slowly becoming sanctioned and commonplace (3). And therein lies the paradox: can a suicide, any suicide, ever be a good death?
Advocates of assisted suicide insist that there is a distinction that makes physician-assisted suicide somehow not suicide (and yet not homicide either) but merely “aid in dying” when employed by the terminally ill — even though it is the taking of one’s own life, which is the very definition of suicide (4). This insistence makes political sense: people recoil from the word “suicide” so much that polls on assisted suicide drop by twenty points at the mere mention of the word, which many associate with mental illness (5). Nevertheless, suicide (assisted or otherwise) is still suicide. The intent (to kill oneself) and the outcome (one’s own death) are identical when done by someone with a physical illness and someone with depression.
While those with physical afflictions may see an early self-imposed death as preferable to continuing to live a few more months — even if it is fewer than six months — with their illness, they could fail to see how those who suffer with mental illnesses may see death as preferable to living years with their affliction. Whether those taking their lives are suffering from physical or mental pain, in both cases, it is equally suicide.
Advocates of assisted suicide insist that the presence of a physical illness differentiates “aid in dying” from suicide, but these arguments are not compelling for one vital reason: the goal of assisted suicide is to take life, not to protect or preserve it (6). Even in the direst of circumstances, suicide is almost always a sign that something is very wrong — that there is some fate worse than death compelling a person to eschew all the basic instincts for survival in order to escape that fate. Suicide typically means someone was coerced by fear into killing himself or herself prematurely. And while it may be comfortable and even pain-free, does this make such self-destruction good?
Philosophically, what tends to make an action good or bad is a combination of the intent behind it and the outcome. Consider an individual with severe depression who plans to commit suicide and intends to destroy a human life, his own, and dies of self-induced carbon monoxide inhalation: the outcome
is exactly as he intended, the destruction of a human life. Compare this to a soldier who hurls his body on a live grenade to protect his brothers-in-arms. Both committed an act with the same outcome: the intentional destruction of their own lives. Yet to say the soldier on the battlefield committed suicide would be incredibly offensive and misleading given his intentions: to protect human life at the expense of his own.
Did the soldier die a good death? Well, it could certainly be said that a soldier who sacrificed his life for the lives his fellow soldiers did not commit suicide any more than someone who kills an attacker in self-defense committed homicide. The intent was to protect life against an imminent threat. Even though the outcomes for those who sacrifice themselves for the lives of others may be death, the intent is good: to preserve life. But in a suicide, the intent and the outcome are simply to destroy life.
Assisted suicide advocates compare their concept of “aid in dying” to the desperate acts of victims who fell to their deaths while fleeing the flames of the World Trade Center on 9/11— a famous photograph of one of these victims became known as “The Falling Man (7).” They exploit the tragedy of “The Falling Man” and insist that simply finding a less painful death when already condemned to die is not suicide. But they miss a key distinction: in the World Trade Center, the victim’s goal more than likely was not to die, but to seek survival. And in the attempt to find smoke-free air that they could breathe, and shelter from the encroaching flames, perhaps the only way to cling to life for a few more moments was to fall to their death.
The will to survive could have been manifest in their behavior, even if that behavior was purposefully stepping off a ledge to escape the imminent threat and succumb to death by gravity. This act presents itself as an instinctual attempt at survival and self-preservation, albeit short-lived. It does not necessarily mean that the action was a rational choice of a quicker, less painful death, as some suggest — as if remaining in smoke and the flames were possible. The goal could have been to breathe and to live, but the means brought death. If so, this would have been a tragedy, not a free choice.
People fleeing an imminent threat could absolutely jump from burning buildings, leap from moving vehicles, and otherwise do whatever it takes to survive, even when that action might also bring about their deaths. In that moment, there is no rational decision, just the instinct to flee a grave threat. Remaining in the World Trade Center as it burned was not a choice, so many were seen trying to get the air they required and sanctuary from the heat. Even those who deliberately chose to leap to escape the smoke and fire may have done so in order to breathe a bit longer.
Certainly, these deaths were not suicides, as those who died were just as likely not trying to end their lives but instead trying to preserve their lives from an imminent threat. While the outcome was that their actions resulted in death, the intent could have been to escape smoke and flames. In a suicide, attempted or otherwise, both the outcome and the intent of the act is the destruction of one’s own human life. A person does not intend death through assisted suicide as a means of self-preservation but self-destruction.
The excessive lengths assisted suicide advocates go to in order to rebrand assisted suicide as anything but suicide show just how much we recoil from self-killing. At its crux, the argument that assisted suicide is not truly suicide is both politically motivated marketing and also a deeply sanctimonious double standard when you consider that the brand of so-called compassion that prescribes death for those with physical suffering is not offered to those with mental illnesses.
It is disingenuous, however, to present what we know to be an act of desperate and unnecessary violence as something acceptable. But violence, even against oneself, can never be an acceptable solution for pain. For those in any pain, physical or emotional, a good death is one surrounded by those who care and who ease suffering through legitimate medical treatments and real compassion.
No suicide, whether called assisted suicide, euthanasia, or anything else, can ever be a good death.
1.) John D. Papadimitriou, Panayiotis Skiadas, Constantinos S. Mavrantonis, Vassilis Polimeropoulos, Dimitris J. Papadimitriou, and Kyriaki J. Papacostas, “Euthanasia and Suicide in Antiquity: Viewpoint of the Dramatists and Philosophers,” Journal of the Royal Society of Medicine 100, no. 1 (2007): 25, doi: 10.1258/jrsm.100.1.25.
2.) Rita L. Marker, “Euthanasia, Assisted Suicide & Health Care Decisions: Protecting Yourself & Your Family,” Patients Rights Council (website), updated December 2006, http://www.patientsrightscouncil.org/site/euthanasia-assisted-suicide-health-care-decisions/.
3.) Jacqueline Harvey, PhD, “Delaware Doublespeak: The Mixed Messages of Assisted Suicide,” Catholic Vote (website), accessed October 13, 2015, https://www.catholicvote.org/delaware-doublespeak-the-mixed-messages-of-assisted-suicide/.
4.) Jacqueline Harvey, “Euphemisms for Euthanasia and False Dilemmas: An Update on the Assisted Suicide Debate in the United States,” Witherspoon Institute (website), June 17, 2014, http://www.thepublicdiscourse. com/2014/06/13332/.
5.) Lydia Saad, “U.S. Support for Euthanasia Hinges on How It’s Described,” Gallup (website), May 29, 2013, http://www.gallup.com/poll/162815/support-euthanasia-hinges-described.aspx?utm_source=alert&utm_medium=email&utm_campaign=syndication&utm_content=morelink&utm_ term=Politics.
6.) Jacqueline C. Harvey, “California’s Assisted-Suicide Measure Would Mean Falsified Death Certificates,” National Review Online (website), May 20, 2015, http://www.nationalreview.com/article/418623/californias-assisted-suicide-measure-would-mean-falsified-death-certificates?target=author&tid=1488766.
7.) See, for example, Benjamin L. Corey, “Brittany Maynard Didn’t Commit Suicide (What We Can Learn from 9-11’s ‘Falling Man’),” Formerly Fundie (blog), November 4, 2014, http://www.patheos.com/blogs/formerlyfundie/ brittany-maynard-didnt-commit-suicide-what-we-can-learn-from-9-11sfalling-man/.