What’s the number one reason for people to opt for a physician assisted suicide?
The issue of physician assisted suicide (PAS) has come to the news this week. Brittany Maynard is a 29 year old woman with terminal brain cancer. She plans on ending her life on November 1. As a Christian, I have theological reasons as to why I disagree with PAS, but I know that there are those who don’t share my worldview. Going back to my college days as a philosophy student, I always found arguments pertaining to PAS unclear and felt that they easily became bogged down in defining terms.
For many, this is seen as being her choice. America is a nation that focuses much on the individual and values people’s rights and liberties. If someone is going to die anyway, and they’re of sound mind, than why shouldn’t it be up to the person? Whose business is it what they do?
It can be difficult to oppose euthanasia. It’s an emotionally charged discussion to have.
In the United States, PAS is legal in five states (Washington, Oregon, Vermont, Montana, and Wyoming).
Yet in the places where it’s legal, it is still rarely practiced. In places where PAS is legal, the vast majority of people who are facing an inoperable medical condition choose not to pursue PAS. In 2013, 71 people in Oregon and 173 people in Washington state took their own lives through PAS (according to those state’s reports). To give some perspective, the total number of cancer deaths from those two states in 2013 was more than 20,000 people. Keep in mind that cancer is not the only reason why people opt for PAS. ALS, COPD, and other illnesses are also recognized in these states. Oregon was the first American state to legalize physician assisted suicide, and in its first 16 years, 752 (47 per year) people have ended their lives.
The arguments for terminally ill patients ending their lives often times revolve around the terrible pain that people endure as the consequence of these various illnesses.
So I return to the question from the beginning of this post: what’s the number one reason for people to opt for a physician assisted suicide?
Fear of pain? Oregon and Washington both survey people who have chosen to end their lives. Both states allow people to list more than one reason. “Inadequate pain control or concern about it” is not one of the top five reasons in either state. In Oregon, less than 25% of participants have cited that as a reason.
In Oregon and Washington’s 2013 surveys, the top 5 reasons are:
- Losing autonomy (93% in Oregon, 91% in Washington)
- Less able to engage in activities making life enjoyable (88.7% in Oregon, 89% in Washington)
- Loss of dignity (73.2% in Oregon, 79% in Washington)
- Burden on family, friends/caregivers (49.3% in Oregon, 61% in Washington)
- Losing control of bodily functions (36.6% in Oregon, 52% in Washington)
(keep in mind that people were allowed to list more than one reason)
Again, consider that a very small number of eligible people actually choose to end their lives due to a terminal illness. Even where it’s available, people die every day from terminal illnesses rather than ending their own lives before their health fails them.
And considering that concerns about inadequate pain control is rarely the reason, are all people who have lost autonomy, dignity, the ability to engage in enjoyable activities, have become a burden, etc. have a right to end their lives?
Let me ask you a question: who has the highest suicide rate in America? Teenagers?
No. Elderly white males. The rate of suicides among men 65 and older is higher than it is for people aged 15-24. You might think: “well that’s covering more years if it’s 65+.” But the suicide rate of men 65-74, and 75-84, and 85 and older are all individually higher than the rate of suicide in males aged 15-24.
An elderly person who has lost various capacities might not be terminally ill of a specific condition, but is still someone who isn’t going to get better and regain that which was lost. And since pain avoidance is not the reason in most cases of PAS, wouldn’t an elderly person have an equally legitimate reason?
In the Netherlands, dementia is a legally recognized reason for PAS.
How do we decide when it is or isn’t acceptable for a person to end their life?
To quote philosopher Daniel Callahan from “a case against euthanasia:”
“It is bad public policy to abandon long-standing legal prohibitions, with important reasons and traditions behind them, for the sake of a very small minority, and particularly when the consequences open the way for abuse and a fundamental change in medial values. The fact, for so it seems, that the small minority reflects not some general human response to pain and suffering but a personal, and generally idiosyncratic, view of suffering is all the more reason to hesitate before legally blessing euthanasia. Human beings, in their lives, and in their deaths, have long been able to see their lives come to an end without feeling some special necessity to have it ended for them, directly by euthanasia or self-inflicted by physician-assisted suicide.”
In every influential ethical system, every society, and in every religion, suicide has been considered immoral. It goes against long established medical ethics in the western world. Suffering and horrible diseases are not new to humanity. And neither are means of ending life, and yet, through thousands of years of the human experience, the idea of intentionally ending life to avoid suffering has been nearly universally rejected. As Callahan argues, should we be so quick to cast off this almost universal value?
If PAS is about individual liberty, why should the reason even matter? If a person has a desire to end his or her life, why can’t anyone go to the doctor and get prescribed the necessary medication that would end his or her life? What makes one person’s suicide unacceptable and a terminally ill patient’s suicide moral?
- Suicide statistics from suicide.org
- Oregon statistics on physician assisted suicide as well as annual reports and survey results are through Death with Dignity National Center
- Washington statistics on physician assisted suicide as well as annual reports, and survey results are through the Washington State Department of Health
- Cancer statistics through cancer.org