Some terminally ill patients are in intractable pain and/or experience an intolerably
poor quality of life. They would prefer to end their life rather than continue until their
body finally gives up. Does the state have a right to deny them their wish?
Suicide is a legal act that is theoretically available to all. But a person who is
terminally ill or who is in a hospital setting or is disabled may not be able to exercise
this option -- either because of mental or physical limitations. In effect, they are being
discriminated against because of their disability. Should they be given the same access to
the suicide option as able-bodied people have?
Many faith groups within Christian, Muslim, Jewish and other religions sincerely believe that God
gives life and therefore only God should take it away. Suicide would then be "considered
as a rejection of God's sovereignty and loving plan".1 They feel that individuals are all
stewards of their own lives, but that suicide should never be an option. This is an
important belief for members of these religious groups. They would probably
be extremely reluctant to
choose suicide (including physician assisted suicide) for themselves. But, for each deeply
religious individual in North America, there are many nominally religious or secular persons.
Substantial numbers of adults who have liberal religious beliefs treat euthanasia as a
morally desirable option in some cases. There are also many secularists, atheists,
agnostics etc. who actively disagree with religiously based arguments. Many of these
folks would like to retain suicide as an option in case they develop a terminal illness
and life becomes unbearable.
Do devout believers have the right to take their own personal
beliefs and force them on the entire population? Should religious liberals, Humanists, Atheists, Agnostics, etc. be denied their religious freedom to choose PAS?
Many faith groups believe that human suffering can have a positive value for the
terminally ill person and for caregivers. For them, suffering can be "a divinely
appointed opportunity for learning or purification". A Roman Catholic document
mentions that "some Christians prefer to moderate their use of painkillers, in
order to accept voluntarily at least a part of their sufferings and thus associate
themselves in a conscious way with the sufferings of Christ crucified". 2 These may
be meaningful suggestions to some Christian believers. However, can such arguments justify
denying PAS to persons who do not share those beliefs?
Many people argue that pain experienced by terminally ill people can be controlled to
tolerable levels through proper management. They conclude that there is no need for
PAS. However, tens of millions of individuals in North America do
not have access to adequate pain management. Tens of
millions are without healthcare coverage. Many doctors withhold adequate
levels of pain killers because they are concerned that their dying patient may
become addicted to the drugs.
By making PAS available, some people will be pressured
into accepting assistance in dying by their families. This pressure may sometimes occur in
very subtle forms. This is an important argument in favor of strict controls that would
confirm that a patient is not being influenced by others. Some feel that the potential for
interference is so serious that all assisted suicide should be banned.
Some people wish to die because they are suffering from clinical depression. This is
another argument in favor of strict controls to confirm that a patient requesting aid in
dying is "of sound mind".
In an age when total medical funding is restricted, is it
ethical to engage in extremely expensive treatment of terminally ill people in order to
extend their lives by a few weeks, if it is against their will? The money used in this way is not
available for pre-natal care, infant care, etc. where it would save lives, and
significantly improve the long-term quality of life for others.
Some people argue that patients would be frightened that their physicians might kill
them without permission. This is not a valid concern, since a patient would first have to
request assistance in dying. If they did not ask for suicide assistance, their doctor
would continue to preserve and extend their patients' lives.
There are two main arguments offered by Christians, and those of other faiths, that
advise against an individual seeking suicide, for whatever reason:
Life is a gift from God, and that "each individual [is] its steward." 3 Thus, only God can start a life, and only God should be allowed to
end one. An individual who commits suicide is committing sin.
God does not send us any experience that we cannot handle. God supports people in
suffering. To actively seek an end to one's life would represent a lack of trust in God's
Of course, there is a significant and growing percentage of Agnostics, Atheists,
Humanists, secularists, non-Christians and liberal Christians in North America who do not
accept these theologically based arguments. They might argue:
Each person has autonomy over their own life. Persons whose quality of life is
nonexistent should have the right to decide to commit suicide, and to seek assistance, if
necessary, to achieve this.
Sometimes a terminal illness is so painful that it causes life to be an unbearable
burden; death can represent a relief to the intolerable pain.
An active political question is whether individuals should be allowed to choose
suicide, or whether they should be forced to follow the theological beliefs of the
dominant religionz. This point is similar to that raised in discussions on choice in abortion and compulsory prayer in public