Assisted suicide

Easing death

Terminally ill people should have the right to a gentle death, but that right should not be extended to others

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Readers' comments



I feel this should only apply to terminal aged people where there is no other recourse.Even then one needs to be very careful in handling the situation lest one does the wrong thing. I can see a litigation storm on the horison in Americas.

You are grossly wrong. Absolutely all genuine rights are liberties of choice. Just as the right to freedom of speech entails the right to be silent, the right to life entails the right to end one's life. No one else has signed his or her life away to you, so keep your vile hands off the lives of other people.


All those religious that say it's only God who gives life so only God can take it - every single one of them goes to the hospital when they are sick or diseased. What is this one step more? They don't suggest God will heal them except through a doctor's hands - what if God doesn't ease their suffering at the end, except by a doctor's hand?


Why physician-assisted suicide is not such a good idea

Having practiced medicine as a neurologist for more than 30 years I see the laws against assisted suicide not as a hindrance to easing death but rather as a protection to the public. To the layman it may seem that withholding a treatment that only prolongs agony or treating pain with analgesics that may shorten life equals assisted suicide. It does not. Very different is to provide an analgesic not to treat pain, but to shorten life. Physicians that cross this line become like tigers that have killed a human being: much more prone to doing it again. In an anonymous questionnaire to physicians in Washington State before assisted suicide was legalized, only one in nine physicians reported having received requests for assisted suicide, but those who did reported receiving up to 20 requests. No wonder that involuntary euthanasia has been documented to be on the rise in all sites where assisted suicide is allowed. Those sites also suffer deterioration in the quality of care for the terminally ill: why bother caring for them if they can be getting rid of. As an index of the strain placed in the terminally ill by the relaxation of assisted suicide laws, in 2011 it was reported from Washington State that one third of the terminally ill requesting suicide did so because they were concerned about being a burden on their family and friends.

Modern medicine has all the tools needed to alleviate suffering in the terminally ill without intending to kill them. Physicians can easily turn them into lethal weapons, to the disservice of their patients.

MadJerry in reply to masdeu

"Modern medicine has all the tools needed to alleviate suffering in the terminally ill without intending to kill them."

I wholly disagree with this statement.


"Suffering" includes the feeling of being a burden to loved ones.

mimomimo in reply to masdeu

You've obviously never known anyone with terminal cancer or you've watched too many films.

I watched my mum suffer for 6 months before she finally died when I was 15. My brother and sister were in the room when she actually died. My dad and I had popped out to get more morphine, they stayed with her. We had no idea she was so close. We didn't have a chance to say goodbye and that will never leave me. My brother and sister were brutally honest about how much pain she was in before she gasped her last breath and both ended up in counselling years down the line.

She was in pain and I know if she'd had the option to reduce that pain, she would have done. In her final month she was in so much pain she was constantly aggressive and angry despite being on morphine. She knew what was happening and was frustrated.

Lubumbashi in reply to masdeu

Neurology eh?

My experience with neurology is that very often it is more like science than medicine. The number of hugely expensive tests is burgeoning, EMG, CSF, TMS, MRI, PET, genetics, biopsy, but the number of effective treatments is not.

A man walks into a neurologists office, thinking he is a patient, expecting some answers, he walks out as an experimental test subject with a bankruptcy-inducing medical bill, either without a clear diagnosis, or a terminal one that can't be treated.

Neurologists think they understand pain, but they do not understand suffering.

Vetinarii in reply to masdeu

Patients asking to die because they fear being a burden on their relatives - is very sad, but isn't it a legitimate thing for them to worry about? If you find the tragedy of it unbearable, the solution is obvious - taxpayer-funded palliative care for patients nearing the end of their life, taking the burden off their families.

Needing constant care is bad, but knowing that you're condemning your family to constant work and penury must surely make it far worse.


It's a bit of a puzzle how we wish to keep humans alive regardless of pain experienced, but bring your pet to the vet and it's all too often "we should put him down, he might be in pain".

If a racehorse injures its leg, it's straight off to the butcher's. And of course we impose unspeakable pain and discomfort on animals that we eat before we kill them.

So criteria of pain, stress and quality of life seem pretty hypocritical since we can easily measure them in two different groups (P substance, stress hormones, an individual's disposition to being stuffed in a 1sqm cage with 22 of its peers) and yet come to completely different conclusions.


Every one should have the right to a gentle death if that is what they want.

Governments and the medical profession should make that possible instead of putting down conditions that will always be arbitrary. It is something one does to oneself and that freedom should never be curtailed.


"Take into the air my quiet breath"

Nice quote from Keats, and very apt. Let's not forget he was literally tortured in his last days in Rome by members of the medical profession, who sought to cure his tuberculosis by starving and bleeding him. They told him he was terminal but they (and his close friend John Severn) refused his desperate pleas for painkillers even as he daily coughed up blood. They were afraid he might commit suicide.


I ponder the thinking of those who do not approve of assisted suicide...especially for those in undeniable pain and/or suffering. How often are the use of transplants, antibiotics, etc. questioned?

Too often I hear the argument that we are interfering with the natural way of things by assisting those who want to die, yet how is this any different, or more immoral than man's ability to extend life beyond what is natural (ie. natural selection) or intended (ie. by a higher power)?

roadtriprich in reply to MadJerry

Agreed. I'm sure there would be plenty of circumstances in which the person who is suffering wouldn't be doing so had nature been allowed to take its course without human intervention in the first place.

If you ask me where we should draw the line, I'm not going to pretend I know the answer. As my father pointed out, I wouldn't exist if he hadn't been given the medication to manage his asthma when he was a child.

I'd simply point out that death (and aging) is a part of life, but as a species humans are having an increasingly hard time accepting this.

I don't think calling it "assisted suicide" helps either. Many in the medical profession like to hold on to life no matter what. I tend to think that pain and suffering is natures way of telling us it's time to let go. The word "suicide" infers we are giving them a push...we're not.

Lu Junhua

it's not in the same shoes with the terminally ill people for those who can still post comments here. the willingness to die should not be presumed from sympathic understandings by others who never experience fatal illness.
death should not be encouraged. suicide should not be pressed into the fragile minds.


Dear Sir,

It is good for everyone to think of the death that is one of life plan. Especially to think to what extent to get medical service when we are incapable to move or breath by ourselves is needed. Religious people must work to let many people think of them, not only to say no to assisted suicide.

Too many people have became terrible conditions suddenly and made their family members worried. If they write the memos that tell their needs to be cared and the last message for their family members and neighbors, better terminal care will be done. And by thinking of the death, we can start to think the better way to live now.


The Dutch, lead by the social liberal party D66, decided to legalize assisted suicide under very strict rules. One of the main reasons to do this is that they would have more control of what was happening. People will always find a way to get what they want, be it legal or not, if they are desperate. In the case of suicide, this can have horrible consequences, not only for the one who commits suicide. Has anyone considered what happens to a train driver after he is confronted with a suicide in front of his train? Plus, you will have a professional talking to the man or woman.

Furthermore, liberalising assisted suicide in a wise way, as was done in The Netherlands, would leave decisions on your life into your own hands instead of leaving it to bunches of wild 'religiots' with a 2000 year long reputation of genocide and child rape etc.


This topic presents an opportunity to choose between two undesirable outcomes.

1) If assisted suicide is not legal then some people who are incapable of committing suicide themselves (e.g. due to the advanced state of their illness) may have to suffer a painful and slow death.

2) If assisted suicide is legal then some vulnerable people may feel pressured to exercise this "choice" to die.

Which side do we want to risk erring on?


"Religious bodies tend to maintain that only God, who has given life, has the right to take it." Almost laughed out loud. I wait patiently for "religious bodies" in the United States to put up the same fight about capital punishment that they do about two consenting adults marrying each other. Where's the outrage from "religious bodies" about flying little remote planes over people then pushing a button to release weapons of mass destruction on a "target" with the knowledge there will be "collateral damage?"



Michael Watson in reply to semionato

Dear semionato, thank you for recommending the link to the New Yorker article. I cannot add to your own accurate description of the article. I would only say that such an article should be available (perhaps for practical reasons in an abbreviated form) in every family doctor's practise as well as in the appropriate departments of all hospitals.

Unqualified Critic

I think this, like abortions, is obviously a case by case notion. I generally believe there is solid justification for those, whose circumstances are completely unbearable and insurmountable, to find a dignified and justified way to end THEIR life. I think the article hit a proper moderate tone, especially towards showing a greater scrutiny toward depressed people. I also thought it showed good insight toward possible social stigmas of pressuring a loved one into this outcome because of their financial burden on the rest of the family. Touchy subject, but as with everything else, absolute answers are usually very dumb.

Nick Oliva

I appreciate your reasoning and largely agree with your conclusions. However, I do think there is room for employing society's existing tools in a more novel way, because terminal illness with proof of suffering is, as others have mentioned here, an inexact thing.

A person that wishes to die, for whatever reason, should be able apply to the state and have his day in court. Legal aid should be provided to the needy by the wealthy proponents of assisted suicide, e.g., Foundations, etc.

If you have proven to mental health experts and the court that you are choosing to end your life, you ought to be granted that ability. The courts should have a standard that ensures that you are not doing it under duress... as they already have for many, many other things that people do.

Nick Oliva in reply to Squiddies

I disagree with assuming the doctor, and with presuming that having terminal disease or proven pain is a requirement.

This should not be a "medical-ethical" question, it's a question of individual freedom. Who says doctors have more say regarding the ethical questions surrounding my death than I do?

If I choose to die, I should file some papers, consent to certain tests of "reasonable man" competence, pre-pay all the costs, and when I've met all the requirements, have a competent team of professionals come to my designated place of death, confirm my identity, and administer whatever will end my life peacefully.

roadtriprich in reply to Nick Oliva

Nick, I'm sorry but I simply cannot agree with you. Could you put yourself in the position of someone who is suffering and imagine having to go through the indignity of not only filling in forms to satisfy some bureaucrat, but to then testifying in front of an audience in order to justify why you want to die? I'd tell you to sod off (but probably in words that were somewhat more abrupt).

Nick Oliva in reply to roadtriprich

Actually, I can. When I came out of a coma three years ago, and off the ventilator, in ICU, I found they were much more interested in saving my life than in my levels of comfort...or suffering. I certainly did not complain about the necessities of due process.

Bureaucrats don't find form-filling particularly satisfying either, you know, but society recognizes that you need controls... fishermen recognize this when they get a fishing license.

I would tell you that having people sit with you to discuss your desire to terminate your life and ensure that you are in a suitable state of mind, financial situation, and are not under duress from others... is a reasonable, baseline requirement. I would have my doubts about the mental capacity of someone who would rather suffer than fill out forms.

There are certainly more "abrupt" ways to put my reply to you as well, and there are more abrupt ways to die, if you're of the "I won't stand in line" persuasion. I would hope if you really have decided to die that you are more at peace than you convey in your comment.

roadtriprich in reply to Nick Oliva

I empathise with your experience and have experiences of my own (which is why I am contributing), but I'm afraid I must maintain my position. I couldn't think of anything more humiliating and undignifying than having a court preside over my decision to live or die.

Nick Oliva in reply to roadtriprich

Perhaps you are envisioning some kind of TV courtroom drama? I acknowledge with regret that the religious right (in the US) is likely to try to make the process as undignified as possible, as they do with abortion, e.g., forcing women to watch ultrasound video of the fetus.

However, this is not necessarily the case. In the absence of contaminants such as "the religious right", I can't appreciate how the process I describe could possibly be more undignified than wanting to end your life, and not being able to do so.

Society has a need to ensure the truth of such requests.

From another angle, doctor's and lawyers so frequently confuse or forget the facts of your particular case as to be farcical (usually from overwork, not incompetence). I would rather have a team of independent experts "sign off" on my decision, than to have a doctor "proclaim" me terminally ill.

If you had the option to engage in the process I described or be condemned to continue the life you would prefer to end, I do think you would submit to the hurdles society demands of such decisions.

roadtriprich in reply to Nick Oliva

Perhaps I'm not Nick.

You're right...if I wanted to die and if I had a choice between your way or continuing to suffer, I'd chose your way. My original argument however was that I don't think your way is a very good/practical/dignified/caring solution. We both agree that assisted suicide should be lawful, but I think it best to agree to disagree how it be implemented.


Everybody else must die a terrible, rough and painful death, is that what The Economist is advocating lol? Iron Maidens and impaling for everyone!
Seriously though, why does a government bureaucrat has greater say in when and how I'm allowed to die than I do? Even if I'm depressed and make a mistake, the right to make a mistake should still be mine - that's what freedom is all about. Given that suicide is one of leading causes of death, this is not a trivial question.



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