Physician-Assisted Dying

The current debate over physician-assisted suicide would benefit from a change in terminology--whereby we substitute instead, physician-assisted dying. Classifying all cases of taking one's own life as "suicide" runs too great a risk of failing to make an important moral distinction.

In cases of taking someone's else's life, we usually make several moral and/or legal distinctions--murder in the first degree, murder in the second degree, manslaughter, justified homicide, killing in self-defense, killing in war, capital punishment, mercy killing. By making these distinctions, we take account of varying degrees of responsibility and justification. Even when controversy arises regarding their application, most people do not deny the appropriateness of the moral or legal distinctions themselves. (I grant that some people deny the moral significance of the distinctions; and I grant that each one requires justification; yet these denials are not my concern here. I am asserting, rather, that the large number of persons willing to make these distinctions with respect to taking someone else's life should also grant the appropriateness of making moral distinctions with respect to taking one's own life.)

Instead of moral and legal distinctions with respect to taking one's own life, we seem to have images--for example, ritualistic suicide in Japan, an elderly Native American of the nineteenth century going off in the winter cold to die, or a person in reasonably good physical health taking one's own life for psychological or evaluative reasons.

The last image is the most powerful one in U.S. society: It is what we ordinarily mean by the term "suicide"; and it is usually regarded as morally unacceptable or condemnable. Our moral qualms about this last image are well-founded. First, we should be morally concerned that a person in a temporary state of depression may take the momentous, irreversible step of taking one's own life. Secondly, we value human life highly, and we see rejection of living based upon psychological or evaluative reasons as a reversible situation--since numerous people have contemplated suicide or tried it unsuccessfully and later have gone on to live valued, satisfying lives.

The situation of persons in irreversible states of severe physical deterioration though does not fit this ordinary image of suicide very well. The severe physical deterioration in terminal patients, unlike psychological or evaluative states, is irreversible. Furthermore, the psychological or evaluative states calling for an end to one's life now become a reasonable assessment of life circumstances in the judgment of a large number of rational people. (That is why, faced with the death of a suffering or comatose terminally ill patient, so many people console each other by saying, "It happened for the best." This consolation concedes that an end to the person's life makes better sense than continuation of life in the terminally ill state.)

Although they both may express weariness with life and a desire to end it, a dying person's judgment is different from that of a person with a temporary psychological or non-terminal physical affliction. It usually is the difference between a reasonable assessment and a rationally questionable one. We need a moral distinction that recognizes this difference.

By referring to a physician's participation in taking one's own life in the dying person's situation as physician-assisted dying rather than physician-assisted suicide, we lay the groundwork for that important moral distinction.

Comments? yezzi@mankato.msus.edu

(Note: For years I've maintained a policy of not listening to anonymous telephone callers and of not reading anonymous letters addressed to me. Before reading an e-mail message offering comments, I first satisfy myself that I know the identity of the sender and I then test to make sure that I can send a reply. So if you want me to do more than admire the ingenuity of your e-mail name, be sure to identify yourself and to make a dialogue possible.)

Return to Home Page

Last updated 12/3/95