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Your Right to Die Isn’t Enough

The ethics and morality of assisted suicide

AFP/Getty Images

On July 7, a California bill to legalize assisted suicide died in committee before it could advance to a vote in the State Assembly. The bill's supporters could not overcome politicians’ concerns that legal assisted suicide would enable unscrupulous agents to coerce the poor into ending their lives prematurely. In its failure, the bill joins similar measures in other states, including Maine, Connecticut, Maryland, Delaware, and Nevada.

Some opponents of assisted suicide legislation are concerned that, with assisted suicide on the table, exhausted doctors and cash-strapped families might coerce ill family members into taking this cheap, quick way out rather than suffering through further treatments and payments for terminal illness. Others worry that legal assisted suicide will transform culture in such a way that the option to die will eventually be interpreted as an obligation to do so after a certain point, creating a slippery slope from legal to de-facto compulsory. Still others fear that euthanasia advocates don’t appropriately take into account the possibility of spontaneous remission, and worry that readiness to end the lives of terminally ill patients would foreclose the possibility of recovery for those with the potential for it, however slim.

There is little evidence that legal euthanasia contributes to the coercion of the poor, and numbers on spontaneous remission can usually be adduced for any given terminal disease, which helps prevent the what-if objection from gaining much traction. Yet there is reason to worry about a slippery slope forming between the legal but rare option of euthanasia for the terminally ill and the haphazard elective suicide of persons with no real physical illness. At this moment, for example, a 24-year-old Belgian woman is awaiting assisted suicide for no reason other than her unhappiness. She won’t be the first: a friend of hers who also suffered from depression was euthanized for that condition less than two years ago, following in the footsteps of numerous people with sad life experiences or momentary shocks who, thanks to Belgian law, sought death instead of treatment.

Euthanasia became legal in Belgium in 2002, and despite over a decade of availability, the elective suicidal impulse appears to keep increasing. In the last year alone, assisted suicides in Belgium increased by 27 percent; meanwhile, in February of 2014, Belgium’s parliament passed an ordinance allowing for children to be euthanized. Belgium’s willingness to permit the assisted suicide of children is premised on both the child’s wishes and the parents’ consent, but the country does not permit minors convicted of serious crimes to be imprisoned for life: The weight assigned to the decisions of minors, it seems, varies widely in Belgian law.

The discrepancy makes sense in the frame of rights: If a person has, as euthanasia advocates typically claim, a right to decide when and how to die as a matter of personal liberty, then children are naturally owed such options. (And minors should never be long imprisoned or, worse, subject to capital punishment, as both are terrible infringements upon most conventions of human rights.) So if the extension of euthanasia to children concerns you (as it did some 160 Belgian pediatricians, those closest to the sick children in question) but you agree that criminal minors should not be executed or imprisoned for life based on beliefs about their human rights, perhaps it is a sign that something in the euthanasia advocacy equation is out of joint.

Human rights, as commonly invoked, tend to signal dues or liberties which are so important as to be unquestionable. If a person is understood to have certain human rights, and his or her community and government protects the free exercise of these rights, then we have achieved an optimal community and governmental arrangement. Yet, this view of governance, which is not entirely misplaced, can lead to the somewhat dangerous notion that providing for the free exercise of rights is sufficient to produce goodness or justice. It is not.

A rights-based ethical framework measures whether or not actions are acceptable by whether or not a person has a right to do them: If a person has a right to choose when to die, then when a child or healthy person elects to undergo assisted suicide, they have done nothing wrong. This would appear to be the Belgian analysis. But there is clearly a level of moral analysis missing from these cases, most notably because the valuation of human life itself precedes all rights. (If human life doesn’t matter, why are we obligated to respect human rights?) People have a right to live, but they have more than that as well. There is an inherent value to living that is difficult to describe in terms of rights.

And there is an inherent wrong in snuffing out life due to nothing more than impulse or unhappiness or spite, which is also difficult to formulate in terms of rights. It makes sense to avoid the lifelong imprisonment or execution of minors (or anyone, for that matter) in terms of rights because living life with some reasonable quality is an inherently valuable thing; on the other hand, it doesn’t seem to make so much sense to declare death the kind of right that life is, because death does not share the same inherent value as life, and because the death of a person has an impact on other persons that can’t be fully fleshed out in the language of rights.

If, for instance, the ever-increasing and ever-expanding use of euthanasia contributes to a medical culture that views elected death as an acceptable treatment for anything from childhood sickness to general disappointment with existence, then the value of human life will be somewhat diminished. Lowering the perceived value of life itself is troubling on its own, but it also goes a long way toward undermining rights-based reasoning about ethics and politics, insofar as respect for human rights is premised on special respect for human life. A rights-based approach alone, therefore, doesn't seem capable of handling the full ethical weight of euthanasia. Especially when it comes to assisted suicide, there must be another layer of moral reasoning, one that asks: Should this person’s life be ending?