The question of whether assisted suicide should be legal is nothing new.
In fact, one of the key arguments in support of this sort of suicide — deliberate, planned and rational — dates back over 260 years. Scottish philosopher David Hume, a canonical figure in Western thought, wrote in 1750: "I believe no man ever threw away a life while it was worth keeping.”
Of course, Hume's argument that our "natural horror of death" is so great that any suicide would have to be valid to be committed, is flawed. Many suicides are impulsive and unconsidered and lack the rationality Hume presumes.
But if the philosopher had only been talking about assisted suicide, he would have been right. In these cases, life is never discarded, but valued enough to be given a dignified end.
It should not have taken over two centuries for the good sense of Hume's argument to begin to be accepted into law, but here we are. Last Friday, Canada's Supreme Court ruled the country’s ban on physician-assisted death to be unconstitutional. The ruling was not so much a decision about the morality of suicide, but the practicalities of grave illness: If an able-bodied person can freely take their own life, why shouldn’t a person who physically cannot be prevented from doing so, and why should a physician be punished for aiding them?
The story of 29-year-old Brittany Maynard's physician-assisted suicide in Oregon last year also highlighted the value that a doctor's assistance can bring to an individual who has decided to die. Unassisted suicide can be messy, protracted and botched. Deaths like Maynard's, with a lethal dose of barbiturates, with loved ones nearby, exemplifies why we call this death with dignity.
Telegenic and articulate, Maynard took to YouTube before her scheduled death to explain her choice and advocate for others. She was given six months to live, diagnosed with terminal brain cancer. Instead of painful mental and physical degeneration, she moved from California to Oregon, where physician-assisted death is legal, alongside Washington State, Vermont, Montana and New Mexico. In other states, doctors can still be prosecuted for assisting a patient in death. Where the ban is lifted in the US, candidates for suicide aid must be terminally ill and judged to be sound of mind.
Given the inexorable swiftness with which Maynard would decline and die, her decision was hard to question (for anyone without, say, a religious conviction against such an act). And her story — and her making it public — did important campaigning work for the issue. Her death stands as an important reminder to us all that assisted suicide is not only an issue applicable to the elderly; the question of how to die, and whether we can do it with dignity, could face any of us at any time, should tragedy strike.
Not all cases are as clear cut as Maynard's, however. There are other instances where a patient may be incurably suffering, but not terminally ill. Or there are cases where the candidate's soundness of mind is in question. Assisted suicide laws around the world take different approaches to addressing these issues, in an attempt to fortify against the abuse of vulnerable individuals.
The Canadian ruling is broad, but more conservative than the policies in some European countries. The court stated that a "permissive regime" with "properly designed and administered safeguards" will allow doctors to assist individuals with incurable conditions entailing "enduring and intolerable suffering." While lawmakers have a year to hammer out the details of the ruling's actual application, it seems clear that it is not limited to terminal patients (incurable conditions don't necessarily cause death), and that mental as well as physical anguish could be covered.
The Canadian court's ruling states: "there will be risks, for sure." There's no corner of life and law where this is not true. In this instance, we must weigh whether the small risk of abuse – the risk of murder — outweighs the certainty that many individuals will be saved from intolerable suffering. I think it does.
There's no convincing those who argue from a religious standpoint that any sort of suicide is inherently immoral. But those arguments shouldn’t derail progressive, sensible legislation. There is a reasonable concern, however, which must be addressed by even the most lenient system, about who gets to be greenlit as a rational, autonomous actor seeking suicidal aid. This consideration helps avoid unnecessary tragedy, recognizes that some tragedies are unavoidable, and protects ethical doctors themselves from remorse and prosecution.
Essentially, we want Hume's point to be true: that no life is thrown away that is worth maintaining. It is up to the bearer of that life to decide if it is worth living; suicide is no crime. Safeguards demanding clarity of mind in assisted cases serve to protect the consciences of assisters as much as anything.
Parties opposing Canada's Supreme Court decision see an inevitable mission creep from defensible suicide to murder. As with so many loaded arguments, the opponents cry "but think of the children." In Belgium, a 2002 amendment allowed assisted-suicide laws to apply to children in very specific immediately terminal cases. As with adults, the child must be able to request euthanasia and recognize that they understand the choice.
From a standpoint that rightly insists that children, especially young children, cannot be held responsible for, or legally consent to, all their decisions, the extension of assisted-suicide here is troubling. But considering that only children very close to death can be candidates, the Belgian law recognizes that the options available to the young patient at this point are final days with suffering, or, with assisted suicide and fewer painful last days. Such a law thus supports actual dying children, laudably ignoring non-specific cultural fears about abstracted suicidal kids.
Following the Canadian ruling, an anti-abortion news site published a fear-mongering piece reporting that Robert Latimer had praised the decision. Latimer is a Canadian farmer who is in prison for second-degree murder after putting his 12-year-old daughter Tracy in his truck, connecting a hose from the exhaust to the cab, and leaving her to die of asphyxiation. Tracy had cerebral palsy, which caused severe mental and physical disabilities. An ethical quagmire surrounds Latimer's act: did he mercifully end his child's incurable pain, or did he indefensibly decide that her disabled life was not worth living? There's no easy resolution here. But no assisted-suicide laws in the world, not in Belgium or Switzerland – which has the most liberal laws on the issue — would have made Latimer's actions legal.
We should close our ears to bad arguments. Other governments, statewide and national, should echo Canada's court ruling. To uphold bans against assisted-suicide at best protects against unlikely risk, and at worst imports a religious moralism into laws that apply to everyone. It's a moralism that denies agency and, in so doing, condemns those in pain and anguish to more suffering. People who reject a right to die assert and privilege their own right to exact unnecessary suffering on others. Which is an immoral position indeed.