The Ethical Dilemma of Assisted Suicide and Euthanasia
Editor’s Note: This is the seventh and final article in a series reviewing the circumstances necessary to gain public compliance with criminal laws. Start the series here.
By Dr. Gary Deel, Faculty Director, School of Business, American Military University
Suicide often occurs under tragic circumstances. As a social phenomenon, suicide claims the lives of a staggering number of people. According to the American Foundation for Suicide Prevention (AFSP), in 2017, suicide was the 10th leading cause of death; 47,173 people took their own lives that year. That amounts to about 129 suicides every day, or five an hour. That sounds like an appalling number until we consider that 1.4 million people also attempted suicide that same year. With that information as context, we can find some solace in knowing that only about three percent of those attempts succeeded. Regardless, these numbers are nothing short of shocking.
Heartache and remorse aside, suicide actually costs the American people more the $70 billion each year, according to the AFSP. Suicide also disproportionately affects men, who are almost four times more likely to commit suicide than women. In terms of age, people in their 40s and 50s are most prone to suicide. And with respect to race, white Americans consistently outpace all other ethnic and racial groups in suicide rates.
How Laws Have Changed Regarding Suicide
Generations ago, the act of suicide was a felony in many jurisdictions. The government could seize the estate of the deceased to pay legal and court fees associated with the suicide. However, things have changed for the better.
Today, there are no federal laws that criminalize suicide, and most states have followed suit. Some states could still technically pursue attempted suicide as a common-law charge, similar to attempted murder, but these cases are rarely prosecuted. At most, a suicide survivor could be committed to a mental-health institution for monitoring and treatment.
However, what about assisted suicide and euthanasia? This is when a physician or healthcare professional helps facilitate death, usually by writing a prescription for a lethal dose of drugs. Today, most states prohibit assisted suicides, even by licensed physicians.
The Ethical Debate about Legalizing Assisted Suicide
Those who oppose assisted suicide usually argue that this would be akin to being complicit in a murder. The element of “consent” from the victim means nothing as suicidal people are generally deemed not to be of sound mind. And in most cases, that assessment would probably be correct. Studies have shown that 90 percent of suicides result from untreated depression. Obviously we don’t want to do anything to encourage these suicides. Instead, we want to try to find ways to save these people.
But what about the other 10 percent? Could we picture a scenario in which a rational person, with all of his or her mental faculties intact, might choose to take his own life? Certainly.
Imagine someone who has just been diagnosed with an incurable illness (e.g., Amyotrophic Lateral Sclerosis (ALS) or some types of muscular dystrophy) that becomes progressively more painful and more debilitating over time. Or perhaps a very old and sickly person who lives daily with crippling arthritis or dementia. Who among us could not empathize with the decision of such people to take control of their own fate and end their suffering on their own terms?
However, in the absence of assisted suicide, the choices available are generally unappealing. More than half of all suicides in the U.S. today are carried out with firearms. Another 25 percent are caused by suffocation. For individuals who are clinging to the last few threads of dignity, there is absolutely nothing dignified about shooting or hanging themselves.
So the morality undergirding the prohibition against assisted suicide is shaky at best because it depends largely on the circumstances of each individual case.
Why the Government Should Consider Legalizing Assisted Suicide
As for the methods, a flat ban on assisted suicide means that the topic isn’t even open for discussion. In other words, people who feel as if suicide might be the best choice for them don’t have an opportunity to make their case. The notion that they are capable of making their own competent decisions is simply not a possibility in the eyes of the law.
So what happens? The same thing that occurred with Prohibition, the war on drugs, and criminalized prostitution. People reject the law and take matters into their own hands. As a result, we probably lose more people to suicide than we otherwise would.
In a situation where assisted suicide would be legal, regulatory checks could ensure that those who wish to end their life are not victims of depression or some other emotional impairment skewing their judgment. If such individuals are found to be suffering from a psychological condition, the regulatory process could trigger support and treatment mechanisms to help them recover. But for those who are found to be sane and coherent, and who still wish to commit suicide, assisted suicide would allow for a peaceful and dignified death.
Assisted suicide should be facilitated only by trained physicians who have no personal ties to these patients or interests in their estates. We wouldn’t want to incentivize anyone to encourage suicides for the sake of inheritances or other benefits. A series of informed consents over time would serve to verify the wishes of the individual and document that he or she is not suffering from doubts or emotional instability.
In recent years, states have begun to recognize the wisdom in these policies. In 1994, Oregon became the first state to permit physician-assisted suicide. Since then, eight other states—California, Colorado, Washington, D.C., Hawaii, Maine, New Jersey, Vermont, and Washington—have all passed legislation to legalize euthanasia.
These states have a minimum age requirement, a requirement of doctor-diagnosed terminal illness with six or fewer months expected before death, and a requirement of several consents, both oral and written, over a span of more than two weeks.
Seven of these eight states passed their legislation in the past five years, so it appears that a trend is slowly building momentum in favor of compassion for individuals with extenuating circumstances and the capacity to make rational decisions about the continuity of their own lives.
Our criminal laws are still far from perfect. There is much work yet to be done. But if we remain committed to reviewing and revising our thinking on these topics, we can continue to make steady improvements in the years ahead.
About the Author: Dr. Gary Deel is a Faculty Director with the School of Business at American Military University. He holds a JD in Law and a Ph.D. in Hospitality/Business Management. He teaches human resources and employment law classes for American Military University, the University of Central Florida, Colorado State University and others. To contact the author, email IPSauthor@apus.edu. For more articles featuring insight from industry experts, subscribe to In Public Safety’s bi-monthly newsletter.