As human beings, we often think about death and what it entails. Whether one believes in the afterlife or in reincarnation, you know you can only experience death once, which can be scary. As frightening and sad death can be, it also provides a sense of peace to the person who experiences it. Death is arguably poetic, as poets would say. There’s nothing quite like living a fulfilled life and ultimately being at peace with the idea of death, as you know you did everything you have wished to. There’s a worldwide attraction to books and movies in which the main character sacrifices themselves for the person they love most.
Emily Dickinson wrote a poem about death, in which she describes the way in which the world remains the same after one’s departure. The birds, the bees, the noon, the daisies, and the trades do not stay still, they keep on living just as they had done before.
“If I should die,
And you should live— And
time should gurgle on—
And morn should beam—
And noon should burn—
As it has usual done—
If Birds should build as early
And Bees as bustling go— One might depart at option From enterprise below!
‘Tis sweet to know that stocks will stand
When we with Daisies lie— That
Commerce will continue—
And Trades as briskly fly— It
makes the parting tranquil
And keeps the soul serene—
That gentlemen so sprightly
Conduct the pleasing scene!”
While death is inevitable, some people experience it prematurely due to tragic causes. It goes without saying that the right to your life is a given, but the longtime debate is about assisted suicide. Not to be confused with euthanasia, assisted suicide is, according to NHS, “the act of deliberately assisting another person to kill themselves”. Euthanasia can be regarded as manslaughter or murder. Euthanasia can be voluntary (currently legal in Australia, Belgium, Canada, Colombia, Luxembourg, The Netherlands, Spain, Switzerland, and New Zealand), where a person “makes a conscious decision to die and asks for help to do so” and it can also be involuntary, when another person makes a life-or-death decision in the case that the individual is unable to give consent (e.g.: a coma).
According to The Guardian, assisted suicide is currently legal in Canada, The Netherlands, Switzerland, eleven states in the US, in certain parts of Australia (it remains illegal in Northern Territory and the Australian Capital Territory), and Belgium. Each country mentioned defines a set of conditions in order to be administrated a lethal dose of drugs (medication). Canada allows assisted suicide when it comes to people who go through “grievous and irremediable medical conditions”, the same applies to the Netherlands, but the individual has to be at least 12 years old and has to be granted approval from the parents if they are under 17. Belgium legalized assisted dying 21 years ago and it does not prohibit euthanasia for people without a terminal illness either. Citizens diagnosed with psychiatric disorders or dementia can request a medical professional to perform euthanasia. France, for example, has not legalized assisted suicide, but it allows doctors to keep a patient close to death under permanent sedation, as long as the dose is not lethal.
Lydia Dugdale, Barron Lerner, and Daniel Callahan wrote a study on the pros and cons of assisted suicide. On the one hand, people in favor of this procedure argue that it is one’s right to choose when it comes to their own autonomy, as long as they are informed and are aware of the risks. “This logic, it is argued, naturally extends to AID (aid in dying); patients accustomed to making their own health care decisions throughout life should also be permitted to control the circumstances of their deaths”. Relief of suffering should also be taken into consideration. Those in favor of assisted dying argue that relief in suffering is “humane” and “compassionate”. It is important to also ask the question of how justified the criteria for assisted suicide should be and who could benefit from, as well as why merely certain illnesses. If terminally ill patients are considered a safe category for assisted suicide, should those with schizophrenia, bipolar disorder, depression, or borderline personality disorder not be as well? The aforementioned mental illnesses can be deadly too. According to VeryWellMind, “49,449 people died by suicide in 2022, a 2.6% increase over the previous year” in the US alone. Mohsen Khosravi and Fahimeh Hassani state for BMC Psychiatry that BPD (borderline personality disorder) has a “high suicidality rate between 40% and 85%”, according to their study done on 110 BPD diagnosed people and 110 without it. As seen on Healthline, people who are diagnosed with bipolar disorder have a high risk of suicide of 20% and around 20% to 60% make at least an attempt at it during their lifetime.
While assisted suicide is considered a safe medical practice by some, the criteria should not therefore discriminate between severe chronic illnesses. If we look at it this way, the mortality rate would increase significantly, but it would bring peace to a patient. Should assisted suicide be then legalized worldwide for all patients that fit the criteria? That would include doctors having to kill dozens or hundreds of patients. Where would a line be drawn? On the other hand, as painful as mental illnesses are, based on the suicide rates and the number of people who struggle with severe symptoms, half of them could end up requesting to be given a deadly dose of medication during an episode. Assisted suicide is painless, safe, and fast, while simply the act of killing oneself is not. Being able to ask for a lethal dose might impact other patients negatively too. They would see that there is no hope, so dying is the only option they have.
A counterargument for the legalization of assisted suicide is suicide contagion. According to Mary Anne Walling, “direct and indirect exposure to suicidal behavior has been shown to precede an increase in suicidal behavior in persons at risk for suicide, especially in adolescents and young adults”. She states the following factors as those who have a significant impact on somebody’s health: psychiatric disorders, previous suicide attempts, sexual abuse, and family history of suicidal behavior, as well as the loss of a parent to suicide in early childhood.
Terminally ill patients should not be excluded from the category of mentally ill individuals either, as studies show that cancer can cause depressive symptoms. According to Donald Rosenstein, “dying patients can experience a broad spectrum of depressive symptoms, ranging from transient sadness to psychotic depression”. According to Rosenstein’s research showed that while terminal cancer patients can experience intense depressive symptoms, such as fatigue, pain, lack of energy, weakness, and appetite loss, 5% to 20% will meet various diagnostic criteria for major depressive disorder.
Physicists who oppose assisted suicide provide ethics as an argument, as deliberately helping a patient kill themselves would be against their professional role as a healer. As stated above, the legalization of assisted dying would imply thousands of deaths caused by doctors who would not be able to deny a patient’s request due to their profession. But then again, is a doctor not supposed to respect the decision of a patient?
There are numerous pros and cons to how we should view assisted suicide, as well as for whom it should apply, what is ethical and what isn’t, whether a doctor is able to fully make sure the patient is eligible and aware of what the procedure would mean, whether society would benefit from this, or quite the contrary, there would be an extreme risk. Ultimately, you cannot stop a person from dying and even though suicide rates are currently high as it is, the legalization of assisted suicide would inevitably cause a lot more deaths. There are indeed many factors to be taken into consideration when it comes to this subject. The legalization would not only cause more deaths, but it would be seen as a valid option of stopping the pain forever.
