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Simon Binner killed himself on camera at a Swiss suicide clinic last October. His death aired last week as part of a BBC documentary on dying. Once we tried to stop people from committing suicide. Now we watch.
Advocates say it is “compassionate” to prescribe death-inducing chemicals to the terminally ill, thereby giving them a choice to end their lives “on their own terms.” They speak of dignity as if it were a condition of the body, rather than a quality of the soul.
I know how brutal dying can be. I’m a hospice volunteer, and I helped care for my own dad as he wasted away from terminal cancer. The fear of helplessness or suffering and the desire to end a person’s suffering is only human.
Enabling suicide, however, is not humane. In the five U.S. states and as many western countries that have legalized physician-assisted suicide, such laws have opened a Pandora’s Box of unintended consequences that are anything but compassionate or liberating.
From Personal Choice to Imposed Death Sentence
Physician-assisted suicide is legal in Belgium, Canada, Luxembourg, the Netherlands, and Switzerland. Five American states—California, Montana, Oregon, Washington, and Vermont—have legalized physician-assisted suicide, and advocates are pursuing legalization in a dozen more. In my own state of Colorado, the House of Representatives is advancing a doctor-assisted suicide bill, and voters may see a ballot initiative this November.
Hopefully Coloradans will not be deceived. What begins as a legal framework for doctor-assisted suicide for consenting terminally ill patients ends in a far darker place. In addition to the thousands of Dutch and Belgian adults who choose to commit suicide each year with doctor support, an untold number of disabled newborns, sick children, comatose patients, and patients with dementia are killed without their consent.
The rate of physician-assisted suicide has tripled since 2002 in Holland, where it accounts for one in 28 deaths. Mobile clinics now make house calls. Patients need not be terminally ill to request death. They need only convince two physicians that they are experiencing “unbearable” suffering. Patients with chronic conditions like multiple sclerosis, depression, autism, and blindness have committed suicide with the help of their doctors.
When doctor-assisted suicide elevates suicide as a solution, it necessarily weakens the obligation of friends and family to make life more livable for the sufferer and renders the virtues of courage and endurance meaningless. With this option, the human spirit cannot transcend suffering. It does not endure with loved ones’ help. Instead, suffering gains complete victory over the sufferer, crushing the spirit before taking the body. C.S. Lewis once discerned, “Man’s conquest of Nature turns out, in the moment of its consummation, to be Nature’s conquest of Man,” When we think we have conquered suffering and death, it has conquered us.
A Particular Threat to Disabled People
The disabled are particularly vulnerable. For this reason, advocates for the disabled like Coloradan Carrie Ann Lucas oppose assisted-suicide legislation. A mother of four and attorney, Lucas has a progressive neuromuscular disease similar to ALS (sometimes called Lou Gehrig’s disease).
She warns that the legislation in the Colorado House of Representatives “threatens me, my family and my community… If I were to become depressed — either situational depression or major depression — and this bill passes, I could go to my doctor and ask for a lethal prescription. Because I have a disability, and because physicians are terrible at evaluating quality of life of people with disabilities, I would likely be given that lethal prescription, rather than be referred for mental health treatment.”
People with disabilities, chronic conditions, or terminal diagnoses are not the only people at risk. Such laws threaten all of us. Without social stigma, even healthy people are vulnerable to suicide’s deadly beckon when life seems unbearable.
After Washington and Oregon legalized assisted suicide, they experienced a 6.3 percent increase in the number of total suicides. Suicides among the elderly rose by 14.5 percent. If suicide is considered a legitimate solution to suffering for those with six months to live, why not for those with more than six months to live? Why not prescribe suicide for anyone with a painful chronic illness, persistent depression, or unshakeable addiction?
Death Is Cheaper than Life
This is what Dutch doctors are increasingly doing in their role as suicide enablers. Physician-aided suicide has a poisonous effect on the practice of medicine. There’s a reason why Hippocrates wrote in his famous oath: “I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect.” How committed to treatment are doctors once they have become bringers of death?
Even good doctors make incorrect prognoses. My dad lived two and a half years beyond what his prognosis predicted, and my aunt lived 14 years beyond hers. Both had stage four cancers. The trouble with a suicide “treatment” is that it cannot be undone.
Government agencies and private insurance companies also face pernicious incentives. Ending a patient’s life is cheaper than providing care, after all. There was some publicity and public outrage, now forgotten, when the Oregon Health Plan denied a patient cancer treatment but offered to cover suicide pills. No one hears when Americans like Carrie Ann Lucas have to struggle to keep a do-not-resuscitate order out of their medical file or fight Medicare for life-sustaining medical equipment. It’s more common than the able-bodied could ever know.
Family members also face pressure to support suicide. In studies, 7.6 to 10 percent of seniors reported abuse or neglect, usually at the hands of children, spouses, or partners. Another 4 percent of seniors reported major financial exploitation. It is not hard to imagine a greedy relative who wishes to hasten the insurance payout pressuring a vulnerable relative to take a simple pill.
Even loving family members face extraordinary pressure. A spouse who is profoundly anguished by his beloved’s suffering may understandably support her wish to end life.
How to Help People Instead of Killing Them
Both caretakers and patients need support, but not the lethal kind. Life-affirming support is available for patients and their families through hospice. Hospice offers palliative care, pain management, counseling, and equipment like an oxygen machine, wheelchair, or hospital bed for patients who remain at home. Many hospices operate facilities for patients who cannot or do not wish to remain at home.
The hospice that cared for my dad and family (and where I now volunteer) has volunteers to provide respite for caretakers and company for patients. The idea that dying patients have two choices—linger in a hospital where doctors needlessly prolong life, or commit suicide—is false. There are other choices.
Assisted-suicide advocates, however, want the law to sanction the choice to die at a time of their choosing. “I feel that it’s a basic human right to be in charge of your own destiny, if you will. The situation now is that you and I are not in control of what happens at the end of our lives,” says Lance Wright, who is promoting an amendment to the Colorado constitution to legalize assisted-suicide.
He is wrong. Death is not a right. If it were, it would be illegal to stop someone from killing himself, because it is his right to take his life. There would be no suicide hotlines for the depressed, suicide watches for the incarcerated, psychiatric holds for the suicidal, or 2 a.m. phone conversations with hopeless friends.
The idea that a person should be able to do anything with his body so long as it doesn’t directly injure another person disregards the interconnectedness of human lives. There is a reason that an American cannot legally sell his kidney on the market, break quarantine with a virulent disease, sell methamphetamine, or walk naked down the street. These actions ultimately hurt other people. In the same way, physician-assisted suicide has a disastrous impact on society and particularly the most vulnerable within it. It undermines the integrity of the medical profession, the dignity of the sick, and the compassion of the well.
Terminally or chronically ill patients, the disabled, the depressed, and the suffering deserve compassion, care, and concern—not a poison pill.