The ethics of assisted suicide

I haven't surveyed the vast literature on euthanasia, yet I'm guessing that proponents of euthanasia regard assisted suicide as an extension of mere suicide. But in this little post I will argue that assisted suicide raises ethical issues over and above mere suicide. 

i) Let's assume, for the sake of argument, that suicide is licit if you're diagnosed with terminal cancer, Alzheimer's, or some degenerative condition. Does it follow that assisted suicide would likewise be licit under those circumstances? No.

Take a comparison. I have a right to drive from Seattle to San Diego. That, however, doesn't mean I have a right to ask (much less compel) you to drive me from Seattle to San Diego. I'm not entitled to make the same demands on your time. Your time is your own. What you do with it is up to you. 

ii) Conversely, let's suppose suicide is illicit under those circumstances. If so, then assisted suicide is even worse. If it is wrong to kill myself, then I alone bear the guilt for my action. But assisted suicide makes a second party complicit in the same evil. A solicitation to evil. 

iii) Take a home euthanasia situation. If an ailing parent asked a grow child to euthanize the parent, that's an unfair request. A coercive request. That's a tremendous imposition on the son or daughter. That places the grown child in an emotional or psychological dilemma. 

On the one hand, the child looks into the pleading eyes of the parent. The child doesn't wish to refuse the desperate parent. 

Moreover, simply by making the request, the parent has now shifted the onus onto the child. If the parent continues to suffer, that's because the child refused to euthanize the parent at the parent's request. The child now feels directly responsible for the parent's suffering. It's his fault. Yet it's unjust to put the child in that position.

On the other hand, what if, quite understandably, the child can't bear to do that to his parent? For that matter, what if he can't do that to himself? For he will have to live with that decision. He will have to carry that around with him for the rest of his life. He may hate himself for complying with the request.

Sometimes it's wrong to even ask someone close to you to do something onerous. You are leveraging their feelings. In principle, they can refuse, but at a cost. 

iv) On a related note, the state permits suicide for the simple reason that the state can't prevent suicide. Even if suicide is technically illegal, that's unenforceable. The only way for the state to prevent suicide is to have a person involuntarily committed and kept on suicide watch indefinitely. And that's not practical on a large scale. Moreover, suicide is often unpredictable. Furthermore, involuntary commitment raises its own ethical issues.

By contrast, if euthanasia is legal, then the state will be directly involved in that process. It will regulate medical euthanasia as well as home euthanasia. The state is morally complicit in assisted suicide in contrast to mere suicide.  

v) Once euthanasia is legal, med schools will include that in their curriculum. And it won't be an elective. Every student will be required to learn how to euthanize a patient. 

vi) Moreover, once euthanasia is legal, it becomes a civil "right." Doctors will be required to euthanize a patient upon request, as long as the patient meets the criteria. In theory, there could be conscience clauses which permit a physician to opt-out, but in reality, liberals are intolerant of conscience clauses. This will be deemed a "medical procedure" (like abortion or a sex-change operation) which is the patient's right to demand. So even if it's voluntary for the patient, it's not voluntary for the physician. If he refuses, he can be fired, sued, and/or lose his license. That's how things will play out.

So, once again, a second party is implicated in the process. Even against his will.

vii) Furthermore, it's not hard to commit suicide. There are many time-tested methods. Why insist that someone else do it for you? Why wait around until you get to that point? If you really think life is not worth living under certain foreseeable conditions, why not do it yourself rather than making someone else do it under compulsion?

viii) Apropos (vii), perhaps an advocate of euthanasia would say assisted suicide is necessary because the patient has become too incapacitated to take his own life. If so, that raises questions. Incapacitated in what way? Mentally incompetent? If so, he's in no condition to give informed consent–absent advance directives. 

Physically incapacitated? If so, why did he wait until it was too late to carry out his own wishes? Does he now have the right to demand assisted suicide because he procrastinated to the point where he can't end his own life? 

An exception would be those who suffered a debilitating accident, like paralysis due to spinal chord trauma. But proponents of euthanasia don't confine the right to such narrow examples. 

viii) Finally, voluntary euthanasia inevitably leads to involuntary euthanasia. The patients who make the greatest demands on the healthcare system are generally the elderly and the disabled. They are a "drain" on the system. Once the state allows for voluntary euthanasia, it will justify involuntary euthanasia for the common good. The young and strong will euthanize the old and weak to keep healthcare available for the young and strong.