This House Believes that assisted suicide should be legalized
Assisted suicide is “Suicide accomplished with the aid of another person, especially a physician.”[1] It is sometimes used interchangeably with euthanasia “The act or practice of ending the life of an individual suffering from a terminal illness or an incurable condition, as by lethal injection or the suspension of extraordinary medical treatment.”[2] The important part is that it is assisted death rather than simply being allowed to die. Assisted suicide is an issue which causes world-wide conflict with various countries differing strongly on their legal stances towards assisted suicide. Currently there are only four places which openly and legally authorise assisted suicide; Oregon since 1997, Switzerland since 1941, Belgium since 2002 and the Netherlands since 2002. Equally, there are countries such as Russia, Hungary, Republic of Ireland and England and Wales that look upon assisted suicide as a criminal offence with harsh penalties. Between these two extremes there are also countries such as Germany, Denmark, Finland and Luxembourg where there is no specific law against assisted suicide but equally there is no legislation proclaiming it to be legal.[3]. Doctors themselves are divided upon whether it should be legalised. In September 1996 issue of the BMA News Review, the results of a survey of over 750 GPs and hospital doctors showed that 46% of doctors supported a change in the law to allow them to carry out the request of a terminally ill patient for voluntary euthanasia, 44% were against euthanasia and supported the present law and 37% said they would be willing to actively help end the life of a terminally ill patient who had asked for euthanasia and so assisting suicide, if the law allowed it.[4] This debate will examine both the propositional and oppositional arguments concerning whether assisted suicide should be legalised. This debate has received a lot of press recently due to the death of Jack Kevorkian, the man nicknamed 'Dr Death' since he claimed to have assisted more than 100 suicides. Throughout his life he waged a defiant campaign to help people end their lives, both sides of the debate would agree that he provoked a national discussion, and doctor-assisted suicide is now legal in three American states.[5]
[2] The American Heritage Medical Dictionary, ‘Euthanasia’, The Free Dictionary, 2007, (accessed 9/9/11)
[3] Derek Humphrey, 'Assisted Suicide laws around the world', assistedsuicide.org, 2 March 2005 (accessed 4/6/2011)
[4] Medical Opinion, religiouseducation.co.uk, (accessed on 4/6/2011)
Points For
Every human being has a right to life
Perhaps the most basic and fundamental of all our rights. However, with every right comes a choice. The right to speech does not remove the option to remain silent; the right to vote brings with it the right to abstain. In the same way, the right to choose to die is implicit in the right to life. The degree to which physical pain and psychological distress can be tolerated is different in all humans. Quality of life judgements are private and personal, thus only the sufferer can make relevant decisions.[1] This was particularly evident in the case of Daniel James.[2] After suffering a spinal dislocation as the result of a rugby accident he decided that he would live a second-rate existence if he continued with life and that it was not something he wanted to prolong. People are given a large degree of autonomy within their lives and since deciding to end your life does not physically harm anyone else, it should be within your rights to decide when you wish to die. While the act of suicide does remove option to choose life, most cases in which physician assisted suicide is reasonable, death is the inevitable and often imminent outcome for the patient regardless if by suicide or pathological process. The choice for the patient, therefore, is not to die, but to cease suffering and tto chose the time and manner of their death.
[1]Derek Humphrey, 'Liberty and Death: A manifesto concerning an individual's right to choose to die', assistedsuicide.org 1 March 2005, http://www.assistedsuicide.org/suicide_laws.html (accessed 4/6/2011)
[2]Elizabeth Stewart, 'Parents defend assisted suicide of paralysed rugby player', guardian.co.uk, 17 October 2008, http://www.guardian.co.uk/sport/2008/oct/17/rugbyunion (accessed 6/6/2011)
COUNTERPOINTThere is no comparison between the right to life and other rights. When you choose to remain silent, you may change your mind at a later date; when you choose to die, you have no such second chance. Arguments from pro-life groups suggest that nearly ninety-five percent of those who kill themselves have been shown to have a diagnosable psychiatric illness in the months preceding suicide. The majority suffer from depression that can be treated.[1] If they had been treated for depression as well as pain they may not have wanted to commit suicide. Participating in someone’s death is also to participate in depriving them of all choices they might make in the future, and is therefore immoral.
[1]Herbert Hendin, M.D., Seduced by Death: Doctors, Patients, and Assisted Suicide (New York: W.W. Norton, 1998): 34-35. http://www.usccb.org/prolife/issues/euthanas/roleofdepression.pdf (accessed 4/6/2011)
Those who are in the late stages of a terminal disease have a horrific future agead of them
The gradual decline of their body, the failure of their organs and the need for artificial support. In some cases, the illness will slowly destroy their minds, the essence of themselves; even if this is not the case, the huge amounts of medication required to ‘control’ their pain will often leave them in a delirious and incapable state. At least five percent of terminal pain cannot be controlled, even with the best care. Faced with this, it is surely more humane that those people be allowed to choose the manner of their own end, and have the assistance of a doctor to die with dignity. One particular account was of Sue Rodriguez who died slowly of Lou Gehrig's disease. She lived for several years with the knowledge that her muscles would, one by one, waste away until the day came when, fully conscious, she would choke to death. She begged the courts to reassure her that a doctor would be allowed to assist her in choosing the moment of death. They refused. Rodriguez did not accept the verdict and with the help of an anonymous physician committed suicide in February 1994.[1]
[1]Chris Docker, Cases in history, euthanasia.cc, 2000 http://www.euthanasia.cc/cases.html (accessed 6/6/2011)
COUNTERPOINTModern palliative care is immensely flexible and effective, and helps to preserve quality of life as far as is possible. There is no need for terminally ill patients ever to be in pain, even at the very end of the course of their illness. It is always wrong to give up on life. The future which lies ahead for the terminally ill is of course terrifying, but society’s role is to help them live their lives as well as they can. This can take place through counselling, helping patients to come to terms with their condition.
Suicide is a lonely, desperate act, carried out in secrecy and often as a cry for help
The impact on the family who remain can be catastrophic. Often because they were unaware of how their loved one was feeling. Suicide cases such as Megan Meier, an American teenager who committed suicide by hanging herself in 2006,[1] as the parents have to launch police investigations into why their child might have felt so desperate. By legalising assisted suicide, the process can be brought out into the open. In some cases, families might have been unaware of the true feelings of their loved one; being forced to confront the issue of their illness may do great good, perhaps even allowing them to persuade the patient not to end their life. In other cases, it makes them part of the process: they can understand the reasons behind their decision without feelings of guilt and recrimination, and the terminally ill patient can speak openly to them about their feelings before their death.
[1]Wikipedia, "Suicide of Megan Meier", en.wikipedia.org, http://en.wikipedia.org/wiki/Suicide_of_Megan_Meier (accessed 6/6/2011)
COUNTERPOINTDemanding that family take part in such a decision can be an unbearable burden: many may resent a loved one’s decision to die, and would be either emotionally scared or estranged by the prospect of being in any way involved with their death. Assisted suicide also introduces a new danger, that the terminally ill may be pressured into ending their lives by others who are not prepared to support them through their illness. Even the most well regulated system would have no real way to ensure that this did not happen.
Points Against
Every human being has a right to life
Perhaps the most basic and fundamental of all our rights. However, with every right comes a choice. The right to speech does not remove the option to remain silent; the right to vote brings with it the right to abstain. In the same way, the right to choose to die is implicit in the right to life. The degree to which physical pain and psychological distress can be tolerated is different in all humans. Quality of life judgements are private and personal, thus only the sufferer can make relevant decisions.[1] This was particularly evident in the case of Daniel James.[2] After suffering a spinal dislocation as the result of a rugby accident he decided that he would live a second-rate existence if he continued with life and that it was not something he wanted to prolong. People are given a large degree of autonomy within their lives and since deciding to end your life does not physically harm anyone else, it should be within your rights to decide when you wish to die. While the act of suicide does remove option to choose life, most cases in which physician assisted suicide is reasonable, death is the inevitable and often imminent outcome for the patient regardless if by suicide or pathological process. The choice for the patient, therefore, is not to die, but to cease suffering and tto chose the time and manner of their death.
[1]Derek Humphrey, 'Liberty and Death: A manifesto concerning an individual's right to choose to die', assistedsuicide.org 1 March 2005, http://www.assistedsuicide.org/suicide_laws.html (accessed 4/6/2011)
[2]Elizabeth Stewart, 'Parents defend assisted suicide of paralysed rugby player', guardian.co.uk, 17 October 2008, http://www.guardian.co.uk/sport/2008/oct/17/rugbyunion (accessed 6/6/2011)
COUNTERPOINTThere is no comparison between the right to life and other rights. When you choose to remain silent, you may change your mind at a later date; when you choose to die, you have no such second chance. Arguments from pro-life groups suggest that nearly ninety-five percent of those who kill themselves have been shown to have a diagnosable psychiatric illness in the months preceding suicide. The majority suffer from depression that can be treated.[1] If they had been treated for depression as well as pain they may not have wanted to commit suicide. Participating in someone’s death is also to participate in depriving them of all choices they might make in the future, and is therefore immoral.
[1]Herbert Hendin, M.D., Seduced by Death: Doctors, Patients, and Assisted Suicide (New York: W.W. Norton, 1998): 34-35. http://www.usccb.org/prolife/issues/euthanas/roleofdepression.pdf (accessed 4/6/2011)
Those who are in the late stages of a terminal disease have a horrific future agead of them
The gradual decline of their body, the failure of their organs and the need for artificial support. In some cases, the illness will slowly destroy their minds, the essence of themselves; even if this is not the case, the huge amounts of medication required to ‘control’ their pain will often leave them in a delirious and incapable state. At least five percent of terminal pain cannot be controlled, even with the best care. Faced with this, it is surely more humane that those people be allowed to choose the manner of their own end, and have the assistance of a doctor to die with dignity. One particular account was of Sue Rodriguez who died slowly of Lou Gehrig's disease. She lived for several years with the knowledge that her muscles would, one by one, waste away until the day came when, fully conscious, she would choke to death. She begged the courts to reassure her that a doctor would be allowed to assist her in choosing the moment of death. They refused. Rodriguez did not accept the verdict and with the help of an anonymous physician committed suicide in February 1994.[1]
[1]Chris Docker, Cases in history, euthanasia.cc, 2000 http://www.euthanasia.cc/cases.html (accessed 6/6/2011)
COUNTERPOINTModern palliative care is immensely flexible and effective, and helps to preserve quality of life as far as is possible. There is no need for terminally ill patients ever to be in pain, even at the very end of the course of their illness. It is always wrong to give up on life. The future which lies ahead for the terminally ill is of course terrifying, but society’s role is to help them live their lives as well as they can. This can take place through counselling, helping patients to come to terms with their condition.
Suicide is a lonely, desperate act, carried out in secrecy and often as a cry for help
The impact on the family who remain can be catastrophic. Often because they were unaware of how their loved one was feeling. Suicide cases such as Megan Meier, an American teenager who committed suicide by hanging herself in 2006,[1] as the parents have to launch police investigations into why their child might have felt so desperate. By legalising assisted suicide, the process can be brought out into the open. In some cases, families might have been unaware of the true feelings of their loved one; being forced to confront the issue of their illness may do great good, perhaps even allowing them to persuade the patient not to end their life. In other cases, it makes them part of the process: they can understand the reasons behind their decision without feelings of guilt and recrimination, and the terminally ill patient can speak openly to them about their feelings before their death.
[1]Wikipedia, "Suicide of Megan Meier", en.wikipedia.org, http://en.wikipedia.org/wiki/Suicide_of_Megan_Meier (accessed 6/6/2011)
COUNTERPOINTDemanding that family take part in such a decision can be an unbearable burden: many may resent a loved one’s decision to die, and would be either emotionally scared or estranged by the prospect of being in any way involved with their death. Assisted suicide also introduces a new danger, that the terminally ill may be pressured into ending their lives by others who are not prepared to support them through their illness. Even the most well regulated system would have no real way to ensure that this did not happen.
It is vital that a doctor's role not be confused
The guiding principle of medical ethics is to do no harm: a physician must not be involved in deliberately harming their patient. Without this principle, the medical profession would lose a great deal of trust; and admitting that killing is an acceptable part of a doctor’s role would likely increase the danger of involuntary euthanasia, not reduce it. Legalising assisted suicide also places an unreasonable burden on doctors. The daily decisions made in order to preserve life can be difficult enough; to require them to also carry the immense moral responsibility of deciding who can and cannot die, and the further responsibility of actually killing patients, is unacceptable. This is why the vast majority of medical professionals oppose the legalisation of assisted suicide: ending the life of a patient goes against all they stand for. The Hippocratic Oath that doctors use as a guide states 'I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect.'[1]
[1]Medical Opinion, religiouseducation.co.uk http://www.religiouseducation.co.uk/school/alevel/ethics/euthanasia/DpFS_MedOp.html (accessed on 4/6/2011)
COUNTERPOINTAt the moment, doctors are often put into an impossible position. A good doctor will form close bonds with their patients, and will want to give them the best quality of life they can; however, when a patient has lost or is losing their ability to live with dignity and expresses a strong desire to die, they are legally unable to help. To say that modern medicine can totally eradicate pain is a tragic over-simplification of suffering. While physical pain may be alleviated, the emotional pain of a slow and lingering death, of the loss of the ability to live a meaningful life, can be horrific. A doctor’s duty is to address his or her patient’s suffering, be it physical or emotional. As a result, doctors will in fact already help their patients to die – although it is not legal, assisted suicide does take place. Opinion polls suggest that fifteen percent of physicians already practise it on justifiable occasions. Numerous opinion polls indicate that half the the medical profession would like to see it made law.[1] It would be far better to recognise this, and bring the process into the open, where it can be regulated. True abuses of the doctor-patient relationship, and incidents of involuntary euthanasia, would then be far easier to limit. The current medical system allows doctors the right to with-hold treatment for patients. Though, this can be considered to be a more damaging practise than allowing assisted suicide.
[1]Derek Humphrey, Frequently asked questions, Finalexit.org http://www.finalexit.org/ergo_faq.html (accessed 4/6/2011)
If someone is threatening to kill themselves it is your moral duty to try to stop them
Those who commit suicide are not evil, and those who attempt to take their own lives are not prosecuted. However, it is your moral duty to try and prevent people from committing suicide. You would not, for example, simply ignore a man standing on a ledge and threatening to jump simply because it is his choice; and you would definitely not assist in his suicide by pushing him. In the same way, you should try to help a person with a terminal illness, not help them to die. With the exception of the libertarian position that each person has a right against others that they not interfere with her suicidal intentions. Little justification is necessary for actions that aim to prevent another's suicide but are non-coercive. Pleading with a suicidal individual, trying to convince her of the value of continued life, recommending counseling, etc. are morally unproblematic, since they do not interfere with the individual's conduct or plans except by engaging her rational capacities (Cosculluela 1994, 35; Cholbi 2002, 252).[1] The impulse toward suicide is often short-lived, ambivalent, and influenced by mental illnesses such as depression. While these facts together do not appear to justify intervening in others' suicidal intentions, they are indicators that the suicide may be undertaken with less than full rationality. Yet given the added fact that death is irreversible, when these factors are present, they justify intervention in others' suicidal plans on the grounds that suicide is not in the individual's interests as they would rationally conceive those interests. We might call this the ‘no regrets' or ‘err on the side of life’ approach to suicide intervention (Martin 1980; Pabst Battin 1996, 141; Cholbi 2002).[2]
[1] Cholbi, Michael, "Suicide", The Stanford Encyclopedia of Philosophy (Fall 2009 Edition), Edward N. Zalta (ed.), http://plato.stanford.edu/archives/fall2009/entries/suicide/#DutTowSui (accessed 7/6/2011)
[2] Cholbi, Michael, "Suicide", The Stanford Encyclopedia of Philosophy (Fall 2009 Edition), Edward N. Zalta (ed.), http://plato.stanford.edu/archives/fall2009/entries/suicide/#DutTowSui (accessed 7/6/2011)
COUNTERPOINTSociety recognises that suicide is unfortunate but acceptable in some circumstances – those who end their own lives are not seen as evil. It seems odd that it is a crime to assist a non-crime. The illegality of assisted suicide is therefore particularly cruel for those who are disabled by their disease, and are unable to die without assistance. For example, in March 1993 Anthony Bland had lain in persistent vegetative state for three years before a Court Order allowed his degradation and indignity to come to a merciful close.[1] It might cause unnecessary pain for people if they make an attempt at suicide themselves and subsequently fail. Rather than the pain-free methods that could be available through doctors and modern medicine.
[1] Chris Docker, Cases in history, euthanasia.cc, 2000 http://www.euthanasia.cc/cases.html (accessed 6/6/2011)
Only God can give and take away life
Life is Sacred so no one has the right to take a life, this includes ones own. As a result both suicide and assisted suicide are wrong. There are many passages within the bible that speak of the idea that God has appointed a time for all to die, 'Hebrews 9:27, “And as it is appointed unto men once to die, but after this the judgement:” Ecclesiastes 3:1-2, “To every thing there is a season, and a time to every purpose under the heaven: A time to be born, and a time to die; a time to plant, and a time to pluck up that which is planted;” Ecclesiastes 7:17, “Be not over much wicked, neither be thou foolish: why shouldest thou die before thy time?”[1] In addition to this, physicians are nowhere in Scripture given authority to take someone's life. Apart from the government in the case of capital punishment, all other human beings are given the commandment “Thou shalt not kill,” Exodus 20:13 and “Thou shalt do no murder,” Matthew 19:18.[2]
[1] Pastor Art Kohl, 'The Bible Speaks on Euthanasia', Political Science and the Bible, 2002 http://www.fbbc.com/messages/kohl_political_science_euthanasia.htm (accessed 6/6/2011)
[2] Pastor Art Kohl, 'The Bible Speaks on Euthanasia', Political Science and the Bible, 2002 http://www.fbbc.com/messages/kohl_political_science_euthanasia.htm (accessed 6/6/2011)
COUNTERPOINTWere the disposal of human life so much reserved as the peculiar province of the almighty, that it were an encroachment on his right for men to dispose of their own life, it would be equally criminal to act for the preservation of life as for its destruction'[1]. If we accept the proposition that only God can give and take away life then medicine should not be used at all. If only God has the power to give life then medicines and surgeries to prolong people's life should also be considered wrong. It seems hypocritical to suggest that medicine can be used to prolong life but it cannot be used to end someone's life.
[1]David Hume, Of Suicide, cited in Applied Ethics ed. Peter Singer (New York: Oxford University Press, 1986) p.23
It would have a damaging effect on society
Some people who do not agree with voluntary euthanasia argue that if it was legalised, it would damage the moral and social foundation of society by removing the traditional principle that man should not kill, and reduce the respect for human life. It might also be the case that once voluntary euthanasia has been legalised, this might lead to cases of involuntary euthanasia being carried out. With people deciding that someone else's life such as the elderly or the terminally ill is not worth living and therefore performing euthanasia without their consent.[1] A recent study discovered that some sufferers of locked-in syndrome – as many as three out of four of the main sample – were happy and did not want to die.[2]
[1]The case against, religiouseducation.co.uik http://www.religiouseducation.co.uk/school/alevel/ethics/euthanasia/DpFS_Agst.html (accessed 4/6/2011).
[2]Barbara Ellen, Who is to judge which lives are worth living?, guardian.co.uk, 17 April 2011 http://www.guardian.co.uk/commentisfree/2011/apr/17/barbara-ellen-assisted-death (accessed 6/6/2011)
COUNTERPOINTHowever, the idea that we should not kill is not absolute, even for those with religious beliefs — killing in war or self-defence is justified by most. We already let people die because they are allowed to refuse treatment which could save their life, and this has not damaged anyone's respect for the worth of human life. Concerning the notion that legalised voluntary euthanasia might lead to involuntary euthanasia being carried out, there is no evidence to suggest this. As Ronald Dworkin states, 'Of course doctors know the moral difference between helping people who beg to die and killing those who want to live.'[1]
[1]Ronald Dworkin, stated in The case against, available at http://www.religiouseducation.co.uk/school/alevel/ethics/euthanasia/DpFS_Agst.html (accessed 4/6/2011).
Bibliography
Jack Kevorkian: How he made controversial history', BBC News, 3 June 2011, (accessed 7/6/2011)
Docker, Chris, Cases in history, euthanasia.cc, 2000 (accessed 6/6/2011)
Ellen, Barbara, Who is to judge which lives are worth living?, guardian.co.uk, 17 April 2011 (accessed 6/6/2011)
Hume, David, Of Suicide, cited in Applied Ethics ed. Peter Singer (New York: Oxford University Press, 1986)
Humphrey, Derek, ‘Liberty and Death: A manifesto concerning an individual's right to choose to die’, assistedsuicide.org 1 March 2005, (accessed 4/6/2011)
Humphrey, Derek, ‘Frequently asked questions’, Finalexit.org (accessed 4/6/2011)
Medical Opinion, religiouseducation.co.uk (accessed on 4/6/2011)
The American Heritage Medical Dictionary, ‘Assisted Suicide’, The Free Dictionary, 2007, (accessed 9/9/11)
The American Heritage Medical Dictionary, ‘Euthanasia’, The Free Dictionary, 2007, (accessed 9/9/11)
The case against, religiouseducation.co.uik (accessed 4/6/2011).
Wikipedia, "Suicide of Megan Meier", en.wikipedia.org, (accessed 6/6/2011)
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