On assisted suicide, and why it is important

Note: No, I will not take this down; if this topic makes you uncomfortable, that’s a you problem.

It’s important to talk about this, so let me start with the thesis: mental health is just as important if not more, than physical health, and assisted suicide should be legal in any country that claims to have a working healthcare system.

For convenience (and laziness), I’ll leave it to Wikipedia to define the relevant terms. For the purposes of this conversation, I’ll interchangably use the terms assisted suicide, physician-assisted suicide (PAS), and medical aid in dying (MAID). To be clear: this is different from euthanasia (which should also be legal, but that’s not this discussion). Assisted suicide is when an individual wants to die, and requests the help of a physician to do so in a dignified, painless manner.

The argument for assisted suicide is similar to the one for digital privacy, interestingly enough: similar to how digital privacy advocates like myself talk about the right to be forgotten (if you have data about me, I have the right to request its deletion), the right to die is a fundamental human right. Nobody asked to be born–it was entirely the decision of other people; people should at least have the right to end their life on their own terms. This is the principle of personal autonomy–people have rights over their own bodies. Contrary to the overoptimistic view that things will get better, for some people it just won’t (as an example: consider someone with an irremediable illness). Regardless, the reasoning for why someone wants to die is nobody’s business but their own–it’s not your right to coerce someone to continue living. Moreover, there’s the issue of caregiver burnout: people tasked with caring for others full-time often face burnout and stress; MAID relieves them of the responsibility.

MAID should not be limited to those with a forseeable end of life–psychiatric conditions such as depression or bipolar disorder can be crippling when severe; some medical conditions may make life unbearable while not immediately life-threatening. That said, people with any of these conditions should absolutely not be pressured to consider MAID–it should be entirely the individual’s decision. Bodily autonomy goes both ways: individuals should not be pressured to live or to die.

Let’s rebut some common arguments against PAS.

  • “It leads to a slippery slope”–do you know how slow government moves? Yes, it will open new (and necessary) conversations, but there won’t be changes overnight.
  • “It’s against the Hippocratic Oath”–so is abortion.
  • “You won’t feel this way forever”–see below.
  • “It’s selfish”–so is imposing your will to live on others.

To be very clear: I’m not suggesting a little shop where people sign in and are given lethal drugs–no PAS advocate is (probably). Of course there needs to be regulation, but what those regulations are a subject of debate even within PAS advocates. So what do I think should be the regulation? Canada has a decent start, but I think it need revisions. To summarize, my view is that for PAS, you need to:

  • be over 18
  • voluntarily request MAID, with no external pressure
  • either have a serious illness or disability, OR, if requesting for mental health reasons, first receive intensive psychiatric care, free of charge
  • over a period of 14 days, repeatedly express your wish to die, while a physician confirms that you are of sound mind, free of external pressure, and making decisions autonomously.
  • be allowed to withdraw consent for MAID at any time, including right before it is delivered, with no repercussions.

Notably, MAID should not be limited to people with a limited time left to live due to an illness–it’s overly restrictive and ignores important classes of people who deserve this right.

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