TOP 2020-04-11

The Right to Die

Everyone should have the right to die. It is just as important as the right to life, as only when we have the right to die can we even begin to make up for the injustice of having been forced into life in the first place.

At the time of writing people commonly support the right to die for people who have terminal illnesses, and this is legal in a number of jurisdictions. But if people with terminal illnesses are allowed to take control of their own life and death, then why not everyone? Who should be allowed to tell you what kind of suffering you may escape, and what kind you must simply endure?

Of course people must be made aware of their choices so that they are able to make an informed decision. Everyone should have support networks as well as access to care, treatment, therapy and advice. These must always be voluntary, and the right to die cannot be contingent on having first exhausted these options (as is currently the case in Belgium) - rather, the right to die must be available to everyone without discrimination on any basis.

It is not enough to be allowed to commit suicide. Certainly not in the world we live in, where barbiturates - which can be used for peaceful euthanasia - are controlled substances, unavailable to most people. Without access to substances like pentobarbital, most suicide methods are difficult, dangerous, and cause pain. Hanging, jumping and even shooting yourself carry a risk - no matter how small - that instead of dead you will merely end up with severe and permanent brain damage. Nobody commits suicide thinking that this is an attractive possibility.

In their desperation, people kill themselves by jumping in front of trains and cars, hence putting other people’s lives at risk. So we end up with a situation where the restriction on access to a ‘peaceful pill’ actually endangers lives, and causes extreme suffering, all in the name of saving the lives of people who do not want to be saved.

All individuals must have the right to give their informed consent to die, in conditions they choose. To make death safe and accessible to all who want it, there should be assisted dying clinics, assisted suicide should be decriminalised, and it should be legal to sell barbiturates for suicide.

Depression

People will argue - can people with depression really make an informed choice? Do they really have the mental and legal capacity to make such a decision? The reality is that people considered mentally ill have been discriminated against for a long time. Once locked away in institutions and denied the freedom to make any decisions at all, practically all societies today still cannot break free of the idea that the ‘mentally ill’ should be controlled and oppressed, and that we should withhold from them some of the rights that others have. People who have made suicide attempts are routinely institutionalised - that is, imprisoned - and therefore prevented from having full control over their own body.

Instead we should take seriously the United Nations Convention on the Rights of Persons with Disabilities (CRPD), which states that all people, regardless of disability or mental health status, have legal capacity. Rather than making other people’s decisions for them, we can look to a model of supported decision-making, where a person can choose one or more supporters who help them to make difficult decisions.

Even so, nobody should be forced to make use of supported decision-making if they are already convinced of what they want to do. And while this does entail a risk that somebody will make a drastic decision based on a false belief, this is no more serious than what is already routinely the case. People make decisions based on false beliefs all the time, believing for example that they have to do or not do something because a god has told them so, even though no such god exists. Many of these decisions may, in practice, be irreversible. Yet since we do not police all of these decisions, let alone prevent them, we cannot argue that we should do so only when the person has a mental health condition. That is textbook discrimination.

Rash decisions

People may also be concerned that if pentobarbital could be bought over the counter, then people may kill themselves too rashly, such as immediately after a painful break-up, even though they might have recovered easily from the sadness in time. Of course it would be perfectly possible to regulate the system to prevent occurrences like this. For example, people might be asked to fill in a form and then reassert their wish to die, in writing, a month later.

While this sounds sensible at first glance, it still raises an ethical dilemma - why do we think we have the right to force someone else to carry on suffering for another month, if they have already made up their mind? Moreover, a person who is desperate might still kill themselves. They might jump in front of a bus, endangering other people’s safety, or they might try to overdose on something that only gives them even worse problems but not kill them. Why leave these possibilities open, but restrict the one option that is known to be safe and effective?

What is better than introducing arbitrary restrictions like this, is to improve the state of education about this topic. Information about suicide should be openly accessible and it should not be taboo to talk about it. We should understand on the one hand that while suicide is a valid option, there are many other things that may be able to help us. We should make it common knowledge that it’s perfectly normal and OK to feel suicidal at times, and that most of the time, these feelings will pass on their own. At present, people will bottle up their feelings - they need to hide any thoughts they are having about suicide, because they don’t want to be locked up in a mental institution; they don’t want people to over-react and start trying to control their life. And this inhibits honest conversations, and means that people don’t always get the help that is most suitable for them.

And sometimes we need to admit that the help most suitable for someone is indeed the help they need to end their life. Death is a powerful remedy, as not only does it stop the suffering that someone is experiencing right now, it also permanently prevents all future suffering regardless of cause. It is really no wonder that so many people are attracted to this option.

Loss

People may also be concerned about other people’s pain when someone they know or love kills themself. In fact, many people consider it to be ‘selfish’ to commit suicide, as it ends your suffering but makes others suffer instead. They do not stop to think about how selfish it is to force other people to remain in a situation they find unbearable just because you personally prefer them to be there.

In fact, few people think like this with any other life decision. If your good friend at college decides to quit college and move states, you will likely be disappointed, perhaps very upset. But could you really claim that it is “selfish” for them to do what they want to do, what they believe is right for them, just because it spoils your own experience? Or if your child decides to marry someone who is poor and unskilled, perhaps it will make you unhappy in the long run, perhaps it will cause you many problems, but can you claim that it is “selfish” for them to do such a thing? Would it ever be justified in cases like these to go as far as to prevent them from making these decisions just because you don’t like them? Would it be justified to make it illegal to make such decisions?

My assumption is that few people would answer yes to all of these statements. It makes no sense to apply this standard anywhere, including the decision of whether to live or die.

It is actually our own choice to get sad because of someone else’s life decisions. How we react is up to us. If somebody commits suicide because they genuinely believed that it was the right decision for them, then it should be just as easy for us to be happy for them as it is to be sad. While it may seem natural to be sad when someone decides to die, to end their suffering, the other side of the coin is that you were happy when they were suffering. It is actually more malicious to derive pleasure from someone’s suffering than it is to be happy about their death.

Conclusion

It is ironic that pentobarbital is used to administer lethal injections for the death penalty, hence granting these criminals a much more peaceful death than most people will get naturally, albeit a non-consensual one. And yet such a peaceful death is denied even to those who do give their consent. Similarly, non-human animals are routinely euthanised painlessly with the same chemical, and yet there are few jurisdictions that allow the active euthanasia of humans even when they are in unbearable pain. “It was the kindest thing to do,” we say to ourselves of a sick dog or cat that the vet has just put down. And yet humans apparently do not deserve such kindness even when they cry out for it (which your dog or your cat would never do). Society has its priorities totally backwards, enforcing death on those who don’t want it, while denying it to those who do. Death without consent is murder; life without consent is torture.

One cannot be sad about positive experiences that are potentially foregone, any more than you can lament the unlived lives of the never born. Since death ends and prevents all suffering regardless of cause, it should never be considered a ‘waste’ and it should not be considered a ‘last resort’. If a person’s body is not to be the property of other people, then other people including family, friends and society at large have no right to force someone to keep living against their will. It is no more acceptable to force someone to live as it is to force someone to die.