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Suicide - the Practical Debate
By Anonymous and EverDawn
In [1], we covered theoretical pro-life arguments claiming that suicide is immoral or irrational. However, there is a different class of arguments which oppose legitimizing suicide. These arguments while implicitly accepting that suicide is not necessarily wrong, claim that, in practice, legitimizing suicide will not work. If the right to suicide is accepted, then it may be abused in numerous ways, and this alone is reason enough to oppose this right.
Note that currently, penal codes in most civilized countries do not punish suicide attempts, but this does not imply that people have the right to exit. There are great efforts to prevent suicide by involuntary hospitalization, by laws against assisting someone else in suicide, and by the outlawing of reliable means (such as lethal drugs) needed to succeed in suicide. Suicide is far from being acknowledged as a legitimate option.
Before we discuss arguments for the impracticality of the right to suicide, we will first provide a rough outline of how this right might be implemented. This description, of what laws about the issue might be like, also explains why most of the possible abuse can be avoided.
2) The Right to Exit : in Practice
In implementing the right to exit we need to address two issues: first, who has a right to exit, and second, how does exiting take place.
In general, everybody has the right to exit. However, the right to exit involves two values in conflict: individual liberty and the value of life. If one cannot exercise individual liberty then the right to exit is not relevant. According to this criteria we will exclude people to whom the right to exit should not be given.
One suggestion for determining whether the right to exit should not be given, is that suicide must first be approved by a committee (at least one of the members being a mental health professional) much in the same way as it is done for Euthanasia in the Netherlands.
One might argue that even experts in a committee do not have access to objective truth. But we have to face reality. Do politicians always make the right decisions? Do judges always make the correct ruling? Do doctors always manage to cure their patients? No. Yet even though the decisions of such people may cost lives, we still use their services, because there is simply no better way.
Note that the job of the committee is not to judge whether the suicide is justifiable. Rather, their goal is only to determine whether the person, who wants to exit, can exercise individual liberty. For example, we want to exclude somebody who wants to die in order to meet his dead cat and bring it back to Earth. The committee should determine whether the person is in touch with reality, is capable of rational thought, and is not delusional.
The right to exit is not to be granted to minors or to people who are mentally incompetent. Again, some might object to using an arbitrary age to exclude people from the right to exit. What is the difference between an 18 year old and somebody who is only 17 and half? Is it not possible that a 15 year old could be more mature than somebody twice the age? Indeed, it is arbitrary, and far from perfect, but such arbitrary criteria are in common use, and they are simple and practical.
There are cases of individuals who enter a sudden crisis such as the death of someone close, or separation from a significant other. Grief from such crisis usually subsides after some time, thus such situations do not necessarily justify suicide. To prevent such exits, the request to exit must be made several times, and each such request should be made only after some time has passed.
There are many borderline cases, for example what about people who committed crimes and want to exit in order to escape responsibility? What about a minor who has a terminal disease? What if somebody wants to die in order to speed up reincarnation? These cases are difficult to decide. Perhaps more detailed guidelines could be developed, but at the end, the reason for having a committee is that it make these decisions according to the specific circumstances of each case.
Suicide does not take place at home, but in some kind of center, under supervision of professionals. One comes to the center and communicates the desire to exit. This is done in order to make it impossible for an exit to be mistaken as a murder. Also, if exiting means where given to individuals, they might be used for homicide.
See [2] for much greater detail on how such an exit center might be like.
Abuse is always possible. Abuse can occur from either breaking the law, or doing something that the law did not anticipate, but we still consider wrong.
Abuse as a result of breaking the law happens all the time. For example, many car accidents occur because of breaking traffic laws. But do we stop using cars? We do not stop using cars because we acknowledge that transportation is good. To prevent abuse by breaking the law, police find violators and punish them.
Abuse which is not covered by law is eliminated by amending the law when required.
In short, abuse can be minimized, by introducing laws which eliminate possibilities of abuse, by enforcing the law, and by incremental improvement of the law when loopholes are found.
Doctors are sworn to abide to specific ethical behavior which requires them to save lives. Some argue that for this reason doctors cannot help people to commit suicide. However, accepting the right to exit might include changing these ethics, so this technical problem would be eliminated. The Hippocratic oath, which is widely used as a covenant and as an ethical code for doctors, has been modified many times over the centuries to reflect the moral climate of successive societies.
Furthermore, doctors are not only sworn to save lives. An equally important duty of their's is to ease suffering. When these two values come into conflict, they should act according to the patient's wishes.
However, the entire issue can be avoided, since, in principle, the right to commit suicide does not require others to assist. This of course depends on how the law is defined.
A right for an individual implies a corresponding obligation from others. But several levels of such obligation are possible. For example, rather than demanding that doctors are obligated to help somebody to commit suicide, we could only ask that society is obliged not to interfere in the process of a (legitimate) suicide.
This way, no doctor is forced to assist suicide, but if somebody else is willing to assist in suicide, then the doctor is obligated not to intervene.
Note that to assist in suicide one does not even have to be a doctor, since administering most suicide methods does not require much expertise. People could undergo special training to be qualified to assist an exit.
5) It Would Make Money a Factor
One concern related to the practical implementation of pro-choice legislation is that people facing a decision to exit may face considerations involving money.
For example, consider a person who is not terminally ill yet is indefinitely bound to a hospital bed due to a debilitating illness. The hospital bills are very expensive, dwindling his financial resources. This has a great impact on his family. Not only can he not help support his family, but the hospital bills put an additional burden upon them. Is this a valid consideration to take into account when deliberating whether to commit suicide?
It is sad to admit, but committing suicide may be a rational decision in such a situation. This could be avoided by having the state finance the hospital bills. However, not all countries provide such service. Such a country would be actively contributing to the introduction of money as a factor to be taken into consideration by the deliberating individual.
Of course, every country would like to be able to fund these hospital bills. However, since the amount of money a country can spend is limited, it has to make a choice, allocating funds to areas which the country deems as most important, and not allocating funds to other areas, such as hospital care for people with a debilitating and costly disease.
If a country has freedom in determining that there are issues which are more important than supporting such people, then why should individuals not be allowed the same freedom? A mentally competent individual may decide that the future of his family is more important than preserving his life which has little quality. The patient should be allowed to act according to such a decision. It may be true that such a decision is rational only given a bad social framework, but this does not delegitimize the decision itself.
Of course, there are cases where considerations involving money may indeed lead to abuse. If the family is supposed to inherit property, they might blackmail, or coerce somebody to exit. Again, such abuse can be blocked by asking for the reasons why the person wants to commit suicide.
[1] ASH FAQ part 4/4: The Debate std.html
[2] Jo Roman, "Exit House, Choosing suicide as an alternative".
