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Suicide by Physician

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Male medical worker regulate the intravenous drip system at the patient bed in the critical care unit

Full-Bore Death on Demand Arrives in the West

The 1973 dystopian film Soylent Green featured several shocking moments, including overpopulation riots and men calling women “the furniture” required for sex. But the most disturbing scene showed Edward G. Robinson entering a euthanasia clinic, choosing to be put down rather than live with his existential anguish. What was once fiction is becoming reality. Assisted suicide, unthinkable then, is popular now. Since the movie was released, many have come to view human existence as a relative, rather than absolute, good. The sanctity of life ethic has been replaced by the drive to eliminate suffering, even if this requires eliminating the sufferer. And the raw power of this logic has led directly to suicide clinics and a right to death on demand—since no one can judge what another person considers to be unbearable torment. Assisted suicide activists insist that euthanasia is only for the seriously ill, and offer vacuous promises of strict guidelines to protect the vulnerable. Such bromides have never made sense to me. If there is indeed a “right to die,” if the most important good is “choice” rather than “life,” how can the right to commit suicide remain limited to the seriously ill? After all, many people suffer more intensely and for a longer time than the sick. Once one accepts the moral propriety of euthanasia, the logic eventually leads to death on demand for anyone who desires to die. Still, even I never expected full-bore death on demand to arrive in the West for another decade. I was too optimistic. A recent ruling from Germany’s highest court has cast right-to-die incrementalism aside and conjured a fundamental right both to commit suicide and to receive assistance in doing it. Moreover, the decision has explicitly rejected limiting the right to people diagnosed with illnesses or disabilities. As a matter of protecting “the right of personality,” the court decreed that “self-determined death” is a virtually unlimited fundamental liberty that the government must guarantee to protect “autonomy.” In other words, the German people now have the right to kill themselves at any time and for any reason. From the decision (published English version, my emphasis):  The right to a self-determined death is not limited to situations defined by external causes like serious or incurable illnesses, nor does it only apply in certain stages of life or illness. Rather, this right is guaranteed in all stages of a person’s existence. . . . The individual’s decision to end their own life, based on how they personally define quality of life and a meaningful existence, eludes any evaluation on the basis of general values, religious dogmas, societal norms for dealing with life and death, or consideration of objective rationality. It is thus not incumbent upon the individual to further explain or justify their decision; rather their decision must, in principle, be respected by state and society as an act of self-determination. The court wasn’t done. The right to suicide also includes a right to assist suicide: The right to take one’s own life also encompasses the freedom to seek and, if offered, utilize assistance provided by third parties for this purpose. . . . Therefore, the constitutional guarantee of the right to suicide corresponds to equally far-reaching constitutional protection extended to the acts carried out by persons rendering suicide assistance. The court also opined that Germany’s drug laws might have to be changed to facilitate the absolute right to die that “the state must guarantee”: Sufficient space must remain in practice for the individual to exercise the right to depart this life and, based on their free will and with the support of third parties, to carry out this decision on their own terms. This not only requires legislative coherence in the design of the legal framework applicable to the medical profession and pharmacists but potentially also requires adjustments of the law on controlled substances. This is stunning and appalling: In Germany, autonomous people now have the absolute right to commit suicide and receive assistance in doing so for any reason or no identifiable reason at all. The court’s ruling is so encompassing that it seems to apply even to children capable of making autonomous decisions, since being underage is a “stage of existence.” While the court stated that minor restrictions such as waiting periods might pass legal muster—the government may also prohibit “particularly dangerous forms of suicide assistance” (whatever that means)—the German constitution now requires, literally, death on demand. That will not be the end of it, either. One radical court ruling leads to another. The right to commit suicide could soon become a right to be killed outright. After all, everyone isn’t physically or emotionally capable of committing suicide, and homicide can achieve death more swiftly and with less discomfort than a do-it-yourself demise. Since Germany’s absolute right to assist in suicide is open-ended and not limited to doctors, why not permit friends to kill friends? The ruling also opens the gates to social anarchy. How can the state now restrict the taking and selling of addicting drugs? Drugs may be harmful, but if an autonomous person chooses to spend their days high, how can the state gainsay that decision or inhibit the commercial providers who supply the fixes? How can the state restrict any surgical or chemical sex changes? And on what basis can the state prohibit people who identify as “transabled” (people who have body identity integrity disorder) from amputating their healthy limbs or severing their healthy spinal cords? If suicide is no longer a harm the state has a duty to prevent, how can the state thwart a person’s desire to destroy his bodily functions? Indeed, how can the state restrain any personal behavior or vice, so long as the desired autonomous act does not directly harm an unwilling other? I am reminded of Canadian journalist Andrew Coyne’s prophetic words more than twenty years ago. Reacting to his country’s strong public support for a father who murdered his disabled daughter as a supposed act of compassion, he wrote: “A society that believes in nothing can offer no argument even against death. A culture that has lost its faith Read More ›

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Germany’s Highest Court Creates Right to ‘Self-Determined Death’

The logic of euthanasia/assisted suicide has always pointed towards a right to death-on-demand. Assisted-suicide activists deny it for reasons of expediency. But the logic is irrefutable. If there is a “right to die,” how can it be limited to restricting categories? Well, the Federal Constitutional Court, Germany’s highest judicial body, has gone there and without equivocation. In overturning a legal ban on “professional assisted suicide,” i.e., by doctors, the court ruled that there is virtually an unlimited right “to a self-determined death” — and to also receive help from others in achieving that end. From the AFP story (my emphasis): Judge Andreas Vosskuhle at the Federal Constitutional Court in Karlsruhe said the right to a self-determined death included “the freedom to take one’s life and seek help doing so”. The court also surprised observers by explicitly stating that the right to assisted suicide services should not be limited to the seriously or incurably ill. The freedom to choose one’s death “is guaranteed in all stages of a person’s existence”, the verdict read. This right to receive help dying wouldn’t be limited do doctor-assisted suicide, by the way. I write more on this at National Review, but suffice it to say that this is “death on demand” come true.

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In Canada, No Need to be ‘End of Life’ in Order to End Life

The Canadian government wants legal homicide to be available for generally healthy, non-terminal persons. Canada wants a future where a physician will be expected to hand over a fatal overdose or perhaps even authorize a lethal injection for, literally, children. Read More ›
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Suicide Prevention Means Rejecting Suicide Assistance

A friend calls you up to let you know that she’s thinking of ending her life. What do you tell her? She’s getting older and has experienced a life-threatening (but not terminal) condition for many years. She feels beaten down, alone, and like she’s too great a burden for those who were once closest to her, but who’ve generally stopped visiting in recent years. She’s looking to you for good counsel. If you’re like most, you wouldn’t respond by affirming her hopelessness. If you’re like most, you wouldn’t respond by enthusiastically affirming her “right to die” or by encouraging her to pursue a means of suicide. Instead, you would recognize her vulnerability. Instead, you would strive to stand alongside her in solidarity and love. Instead, you would become a better witness to her than you have been, showing her how important she is in your life and in the world. Instead, you would ensure she was afforded every ounce of suicide prevention available. You would do these things because you love her. Affirmation and solidarity, strangely, are increasingly ridiculed and outright litigated against by “right to die” activists who are more concerned with easier access to suicide than with better treatment and care. Kirsten Powers diagnosed the problem with “right to die” activism a few years ago when she pointed out that pro-suicide activists “take advantage of human vulnerability” to “obfuscate [the] reality of assisted suicide”. What these activists are doing in states where suicide is now lawful is to “sweep some of society’s most vulnerable—the elderly, the terminally ill and disabled—prematurely into the hereafter.” Courtney Hempton of the Monash Bioethics Centre offers a case study in pro-suicide activism dressed up as medical ethics in writing on Australia’s embrace of suicide in the form of “voluntary assisted dying”: Eight months after voluntary assisted dying became an option for the terminally ill in Victoria, three bioethicists have raised concerns about a unique ‘gag clause’ preventing doctors from raising the subject with patients. Section 8 of the Voluntary Assisted Dying Act 2017 (Vic) prevents a registered health practitioner from initiating discussion about voluntary assisted dying, or suggesting it as a possibility. Monash PhD candidate Courtney Hempton describes the gag clause as “unwarranted, unprecedented and ethically-problematic”. Breaching section 8 may result in the Australian Health Practitioner Regulation Agency revoking a health practitioners’ licence for “unprofessional conduct”. When the Act became law on 19 June, 2019, the Victorian Government described it as the world’s safest and most conservative regime for the terminally ill, with ‘68 safeguards’ designed to protect the rights of vulnerable patients. Let’s set aside the fact that “terminal” no longer necessarily means “near death” or even “dying” in certain jurisdictions, but can mean simply that a person has a chronic or otherwise unwelcome disability or condition. Amazing how quickly a common sense patient protection provision comes under attack—Victoria’s “Voluntary Assisted Dying Act of 2017” only came into force this past June. No doubt that this suicide-indifferent Act won passage at least in part precisely because it was seen as “the world’s safest and most conservative” approach to lawful suicide. Now, some eight months later, it is precisely those “safeguards” designed “to protect the rights of vulnerable patients” that will be viciously attacked by those who want physicians to be able to pro-actively recommend suicide to their patients. As Wesley J. Smith routinely documents, this is how pro-suicide activists operate: When pitching legalization, they solemnly promise that they have written, oh so “protective guidelines” into the legislation to prevent abuse. Then, once the law is safely in place, advocates grouse that the guidelines they touted are “obstacles” or “barriers” that unjustly prevent suffering people from accessing assisted suicide. Eventually, political agitation begins to amend the law to make things, shall we say, more flexible. … The emphasized items, now called “barriers,” were lauded as protections in the campaign to convince voters to legalize assisted suicide. We can have a culture that either pursues suicide as if it were a positive good or we can have a culture where we strive to prevent suicide because we recognize that it is a threat to public health and human flourishing. Choose your path. Be honest and clear-eyed about what you’re striving for. We can’t do both at the same time.