Dr. Kevorkian, an ostracized radical for his time, had many morally questionable ideas, from “terminal human experimentation” on death row inmates to transfusing corpse blood to a living body. Yet despite his eccentric tendencies, one of his major hallmark beliefs is still being debated and beginning to gain traction as a morally acceptable and humane practice: physician assisted suicide (and active euthanasia). Physician assisted suicide (PAS) consists of providing a means of death to a patient, while euthanasia involves the doctor actively administering lethal drugs to the patient. These practices (in varying combination) are now legal in six states and 8 additional countries to the U.S. While most laws regard terminal illnesses such as cancer, as if the topic isn’t already an ethical minefield, in Belgium and the Netherlands, PAS is also made available to those solely suffering from psychiatric illness. Yet after researching specific cases, such as that of Adam Maier-Clayton, petitioning for PAS for mental illness, I question whether my use of “solely” in the past sentence is not only morally, but also logically incorrect.
While the notion of mental illness being in every way the equal of physical illness despite its lack of visible symptoms, the lack of deep scientific understanding, along with ‘palpable’ proof has held the public back from truly accepting this notion. Adam’s case is the perfect mode of evidence to quell this dissonance; He suffers from a mental illness which manifests in the form of crippling physical pain. While this pain is not as visible as some diseases, it’s the fact that his pain is physical rather than emotional that will ‘win’ some people over. So then comes the question of why not assist every suicidal person, not responding to treatment, in their endeavors if mental and physical illness are equals? And that lies in the simple fact, as of now, that we will never be able to say with certainty that someone with a mental illness is ‘beyond the hopes of recovering,’ or should we call it… terminal. The main point to keep in mind when considering this is that many people granted PAS actually don’t use it—especially with mental illness, often jus the power to be able to take their own life alone is very cathartic. I also imagine that the fact that friends and family would be present when the euthanasia takes place forces those considering suicide for mental illness to genuinely be drawn out of their misery enough to see how their decision would affect those they loved. It’s notable that of these mental illness sufferers, those who didn’t go through with PAS often continues to live, i.e. didn’t go on to commit suicide at a later date.
A psychological and political writer, Andrew Solomon, claims that, “our society is very confused about liberty. I don’t think it makes sense to force women to carry children they don’t want, and I don’t think it makes sense to prevent people who wish to die from doing so. I feel there should be notice boards reminding everyone that the right to physician aid in dying is not a spreading infection that will afflict those who deplore it.” Yet others retort that the constitution provides no such “right to die,” but rather only considers freedom about life choices. Aside from these points, my only clear and strong opinion on the whole PAS debate is that if someone so wishes to die, absolutely NOTHING is stopping them from doing so. There are plenty of painless ways to carry out D.I.Y. suicides, such as falling asleep in a garage willing with carbon monoxide or carefully overdosing on sleeping pills. If someone is so sure that either they wish to die before becoming perpetually plagued by incipient pain from a terminal bodily disease or are in fact so miserable, and have been such that they know it is never-ending, then I am completely sure that that person can and will take their own life. I believe that PAS only affords 2 potentially arguable benefits over traditional suicide—being able to die with one’s family without them being considered accomplices in murder and ‘protection from judgement by one’s own peers since an authority has convened and agreed with your actions. And I do truly believe these are not nearly strong enough reasons to propone PAS. The judgement argument seems transparent to me: if someone is that concerned with what people of this world think of them they probably aren’t consumed by enough pain that they’re ready for the next world. The family and friends being able to die with you argument is much more compelling, yet I still believe it isn’t enough to condone PAS; I believe the issue here has to do with legality of the situation. People such as Adam work around it, letting their loved ones know they will go soon, yet don’t let them know exactly when they will such that their loved ones can’t be considered “involved” in the death. In fact if this issue IS such a big one, I still don’t think PAS is the answer—I think the law ought to be changed such that a psychiatrist can assess the situation and allow or disallow the suicide, such as that the person can do so at home with their loved ones without their loved ones getting in legal trouble. I agree with Dr. Byock, who claims that, “From its very inception, the profession of medicine has formally prohibited its members from using their special knowledge to cause death or harm to others. This was – and is – a necessary protection so that the power of medicine is not used against vulnerable people.” There is no compelling argument, in my opinion, for PAS being implemented and very much less so PAS actually involving administration by a physician whatsoever.