The Logical Inconsistencies of Physician-Assisted Suicide

Physician-assisted suicide (PAS) trades on several logical inconsistencies: that suicide is bad, except when you’re dying; that suicides don’t act responsibly, except when they’re facing death; that personal “autonomy” applies before a terminal diagnosis but not otherwise. 

Euthanasia may be coming to a state near you.  About ten states and the District of Columbia already allow doctors to prostitute their healing profession by providing patients with lethal drugs.  Right now, there is a concerted push in Michigan (alongside, paradoxically, commercial surrogacy) to bring what is euphemistically called “physician-assisted suicide” to the Great Lake State.  My Virginia delegate proudly announced that, with a Democrat majority in Richmond, he was reintroducing legislation that would “decriminalize” suicide. 

Has anybody ever asked about the logical contradictions in this movement?

Western society has traditionally banned suicide.  Perhaps at one time the law swung to an extreme, publicly reprobating suicides, e.g., by denying them public burial.  Modern psychology has made us aware of the layers of mental factors that color a person’s acts and, therefore, his responsibility.

That said, have we not swung to the other extreme?  Our psychologization of suicide may have reached the other extreme, where we deny human dignity by automatically assuming every suicide was “out of his mind” and, therefore, really “not responsible” for taking his life.

But, if that’s true, how then do we explain that we want to allow people facing extreme conditions -- a possibly terminal diagnosis or condition -- the “choice” of killing themselves?  Are they out of their minds or not?  Or, suddenly, only in the face of a potential death sentence, have they suddenly become mentally lucid?

That equivocation in what we think of suicide has consequences outside of end-of-life scenarios.  Apart from the coterie of people pushing death on the potentially dying, society as a whole does everything it can to deter suicide.  We’re not doing a good job of it, given declining life expectancies among some groups as well as the rise in both fast ends by suicide as well as slower dying by drugs and alcohol, what Dr. Stephen Doran calls “deaths of despair.”  Nor is it just old white guys; the rise in teenage suicide is alarming. 

But, our track record notwithstanding, we claim to be fighting suicide.  We have suicide hotlines.  We tell people they are “not alone.”  We do our best to discourage them.  We sometimes even institutionalize them “for their own good.”

Except in extremis, when they are facing death?

Why is suicide “bad” in all the other cases but “good” in the face of death?

The advocates of euthanasia might say, “it’s the person’s choice.”

Well, why is a terminal diagnosis – a diagnosis that can be wrong – a “magic moment” that suddenly creates a “choice” we would otherwise deny that person? 

Well, the advocates of euthanasia might argue, “the person’s dying.”

We’re all dying … every minute of every day.  Every day that we get up brings us one day closer to our personal appointment with our funeral.  So what makes one “dying” – a dying that can be mistaken – better than another?

Why does “dying” create some “autonomy” that otherwise doesn’t exist?  And why is that moment the one when the state should step aside when, if “autonomy” is real, it should never get in the way anyway?

Or, is the dirty little secret that we would simply like to give people the “right” to kill themselves anytime, anywhere, at any age… but don’t think we can sell that yet to the public?  And that admitting that dirty little secret might scuttle the whole long-term project?

The next time a politician tells you he’s for the “right to die,” ask:

  • Why is suicide at the end of life different from suicide at any other time of life? 
  • Why doesn’t “personal autonomy” or “privacy” cover suicide whenever, however, or by whatever means one wants?
  • Is a person who commits suicide mentally competent or not?  Don’t tell me “it depends?”  It “depends” on what – and what factors differentiate X from Y?

Michigan representative Mary Cavanagh is pushing assisted suicide in the lower house.  Her biography calls her a “vocal champion” for “our most vulnerable populations.” 

She’s a vocal champion for killing those most vulnerable populations, maybe “populations we don’t want too many of,” to quote a “great” Supreme Court justice.

The push for assisted suicide plays on fears and emotions: fears about suffering and emotions about wanting to “care for” or “help” those, particularly those close to us, who might be suffering.  What that push does not traffick very much in is logic, rational thought that recognizes the slippery slope it sets us on, standing on the edge of the grave with one foot on a banana peel.

It’s time to demand we cut the emotivism and address the facts.

Nobody “gets better” by dying.  Because death is not healthcare. 

Image: Picryl

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