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Suicide vs Assisted Dying

 

Suicide vs Assisted Dying

 
‘Assisted Dying’ is one of many euphemisms for assisted suicide, along with “aid-in-dying”, “end of life choice”, “dying with dignity” and “right to die”. The euphemisms are used to receive higher public poll results and to get around insurance policies that refuse to pay out on suicide.

 

Essentially the only difference between suicide and assisted suicide is the number of people involved.

 
Suicide is a person ending his or her own life without help, for whichever reason.

Assisted suicide is a person ending his or her own life with help, for whatever reason.
 

The letter below was published in the NZ Herald on 31 December 2015:

A screenshot of a letter published in the NZ Herald. It's main point is that the only difference between suicide and assisted suicide is the number of people involved.

Assisted suicide as ‘rational suicide’

 
Assisted suicide advocates argue that suicide is different from ‘assisted dying’, and that ‘assisted dying’ is ‘rational suicide’.

The idea of rational suicide is highly disputed. Dr Sandy MacLeod, a psychiatrist from the Canterbury District Health Board, said:

“…Psychiatry does not have the expertise … to ‘select’ those whose wish for a premature death is rational, humane and ‘healthy’.”1

Let’s examine the arguments by pro-assisted suicide advocates to see whether they hold up to scrutiny.
 
Here is an excerpt from an article published in Policy Quarterly (August 2015) arguing that there is a difference between “irrational suicide” (suicide) and “rational suicide” (assisted dying”):

“Irrational suicide is impulsive, often violent, and causes extreme distress to family and friends. Almost always the mental condition which leads to the act is treatable and hence reversible. Physician-assisted suicide is a type of physician assisted dying where, at the request of the patient, the physician prescribes a drug and the patient takes it to end their life. This is called ‘rational suicide’ and has the same ethical characteristics as described above. Irrational suicide is completely different from physician-assisted dying, yet again the criminal law on abetting suicide regards them as the same and needs changing.”

 
The “ethical characteristics” referred to are:

“From an ethical point of view the act of assistance under the carefully prescribed conditions can be considered beneficial to the patient, a compassionate act and respectful of their autonomy, and allows them to say a conscious farewell to their family and friends.”

 
Let’s look at these assertions point by point.
 
 
1. Advocates claim that “Suicide is impulsive”
 
Suicide is not necessarily impulsive. A person could think about and plan their suicide for some time.

The desire for assisted suicide or euthanasia can be impulsive also. Simona de Moor said that five minutes after hearing that her daughter had died from a heart attack, she knew she wanted euthanasia.
 
 
2. Advocates claim that “Suicide is often violent”
 
Suicide is not necessarily violent. There are many different suicide methods.

Our society doesn’t discourage people from certain “violent” suicide methods in favour of others. We discourage people from suicide full stop. The problem with suicide is not the method, but the fact that a person dies prematurely.

It could be argued that a lethal injection,  the most common euthanasia method, is also violent. There are calls to replace lethal injections with a firing squad or electric chair as “more humane” methods of execution.

Assisted suicide and euthanasia can involve distressing complications such as uncontrollable vomiting, epileptic fits, choking, anxiety and regaining consciousness.
 
 3. Advocates claim that “Suicide causes extreme distress to family and friends”
 
Assisted suicide and euthanasia can also cause extreme distress for family and friends. For example, in 2012 Tom Mortier’s mother received a lethal injection from a Belgian oncologist for her depression. Tom found out about it when the hospital called him to collect his mother’s body. Three years later he is still extremely distressed about it.

A Swiss study found that people who observe the assisted suicide of a loved one has a 20% risk of contracting Post-Traumatic Stress Syndrome a year or later after the event.
 
 
4. Advocates claim that “Almost always the mental condition which leads to the act is treatable and hence reversible.”
 
The desire for assisted suicide or euthanasia is ALSO mainly a mental condition that is treatable and reversible. A UK study found that 98-99% of people who wanted to die changed their minds after they received treatment for depression.
 
 
5. Advocates claim that ‘assisted dying’ is “beneficial to the patient, a compassionate act and respectful of their autonomy”
 
If assisted suicide is to be regarded a “benefit to the patient” then so should suicide. The consequence of both suicide and assisted suicide is death. People who desire suicide and those who desire assisted suicide could both feel they are suffering unbearably and hopelessly, and that death may be a relief. Suffering is subjective. By that reasoning it would be compassionate and respectful of their autonomy to allow a person to commit suicide instead of trying to stop them from doing so.
 
 
Essentially assisted suicide is proposed as a more socially-acceptable suicide method.
 
In a documentary aired on Seven Sharp, Diana Schipp said she wanted assisted suicide to be legalised because she wants to die “now”. She is capable of ending her own life, but prefers having a doctor do it for her. She said, “Why should I slit my wrists if I can get a pill from a doctor?”
“From an ethical point of view the act of assistance under the carefully prescribed conditions can be considered beneficial to the patient, a compassionate act and respectful of their autonomy, and allows them to say a conscious farewell to their family and friends.”
 
A person who commits suicide could also say a conscious farewell to family and friends. (Isn’t that what suicide notes aim to do?)
 

Conclusion

 

The only difference between suicide and assisted suicide is the number of people involved. The implication is that people who are concerned about suicide prevention should also be concerned about keeping assisted suicide illegal.

Because more than one person is involved in bringing assisted suicide about, it is not merely a personal choice and an individual action. It is not ethically equivalent to suicide.

  1. Playing the ferryman: Psychiatry’s role in end-of-life decision-making, ResearchGate www.researchgate.net/pub. Accessed Sep 17, 2015