Who Will Decide You Should Die?

Article excerpt

Writing in Free Inquiry on assisted suicide and later on the contentious end of Terri Schiavo's life, my fellow secularist Tom Flynn (I'm in the atheist division) has said, "If we trust our fellow human beings to choose their occupations, their significant others, their political persuasions, and their stances on religion, we should also defend their right to dispose of their most valuable possessions-their liveseven if disposing of life is precisely the choice they make" ("The Final Freedom," FI, Spring 2003).

Any competent person in this nation does indeed have the right, in law and by Tom Flynn's logic (up to a point) to commit suicide. But the practice of assisted suicide (lawful in Oregon and being proposed in other states), along with certain other aids proposed by death-with-dignity advocates, complicates the issue.

As Tom Flynn has also written, "Advocates who rail about 'the culture of death' [including this writer] overlook the fact that all too often ours is a culture of life coerced ... In my view, our culture systematically forces life and suffering on countless individuals who would rationally, gratefully let go of life if they could. If death-with-dignity measures carry the risk of abuse, let us acknowledge the risk and seek to curb abuses . . ." ("Life: Right or Commodity?: Introduction," FI, August/September 2005).

It would be useful if Flynn in a future article would explore those possible abuses and suggest how to deal with them. In an effort to be helpful, I will go first.

The impelling desire to commit suicide often attends clinical depression. I speak from personal experience. Years ago, when that blackness occurred, I spent a lot of time trying to figure out how to kill myself with the least pain. But, then, a doctor put me on lithium, so here I am writing for Free Inquiry and still causing trouble elsewhere.

In Oregon, of the thirty-eight persons who in 2005 were assisted in committing suicide, only two had been referred for psychiatric evaluation. How many were suffering from clinical depression? How many doctors involved in assisted suicide are skilled in diagnosing clinical depression? As I can attest from my own consultation with physicians when I was in a depressed state, many are not. I know of other patients who have had similar experiences.

Increasingly, unlike Flynn, some of the most influential champions of the right to dispose of our most valuable possession are willing to downplay "the risk of abuse" and ignore safeguards. Ludwig Minelli, the founder of Dignitas, an organization based in Switzerland that assists suicide, is planning to establish a chain of centers to help people such as the terminally ill who choose to die as well as "people with illnesses and mental conditions such as chronic depression." According to Mr. Minelli, "We never say no."

Dr. Phillip Nitschke, an Australian who travels widely to lobby for legal assisted suicide, described in the 2001 National Review Online an egalitarian basis for providing life-ending resources "to anyone who wants [them], including the depressed, the elderly bereaved, and the troubled teen." Inclusion of that last category could mean a significant reduction in the world's population.

Even the preparation of advance directives may not guarantee protection from possible abuses. Many Americans were motivated by the Terri Schiavo case to prepare specific advance directives, detailing precisely the conditions under which they would not want-or want-to continue living. Yet, increasingly, hospital ethics committees and individual doctors are permitted to disregard advance directives that do not agree with these ethicists' and caregivers' appraisals of certain patients' "quality of life. …