Assisted suicide under the microscope

I’m a lot different than Jerry, a former co-worker.   About twelve years ago, Jerry told me that he had a collection of guns and ammunition for when times got bad.  He foresaw that all decent society might collapse someday.  At that point, large numbers of people would become violent, running around in every neighborhood breaking into each others’ houses and shooting each other in order to steal each others’ stuff.  If this ever happened, he assumed that he would be spending considerable time sitting on his front porch defending his family with his guns.

Image of book cover:  Erich Vieth
Image of book cover: Erich Vieth

Jerry asked me what I would do if that day happened.   I told him that I had already purchased a copy of a book called “Final Exit.”  If society got that bad–so bad that I’d need to sit on my front porch shooting my neighbors in order to survive–I’d rather check out.   Jerry, a conservative and religious man, had never heard of Final Exit.  I explained that it is a book written by the founder of the group formerly known as the Hemlock Society.  The book explains a relatively painless method of killing one’s self.   The author was largely motivated by the fact that so many people in great and unrelenting physical pain longer wanted to live, yet they had no socially acceptable way of ending their lives.

After I explained this, Jerry was aghast.  You’d kill yourself?   At that time I had no children.  I figured that it was my wife’s choice whether she wanted to sit on the porch and shoot the neighbors.     Now that I do have children, the decision of what to do, assuming society-wide pandemonium from which there is no physical escape, would be all the more wrenching.   I don’t know what I’d do.  It would depend on how bad things actually got.  I am utterly repulsed by the thought of shooting my neighbors.

My conversation with Jerry recurred to me as I read “Death Watch: Final Exit’s clandestine ways have put the assisted-suicide network on life support,” by Aimee Levitt, published 4/8/09 by the Riverfront Times, a free alternative newspaper in St. Louis.  Levitt dug deeply into the facts, carefully considering the divergent perspectives on the moral/emotional/legal issues generated by the actions of a group that calls itself, “Final Exit,”  a group that assist its “clients” to commit suicide.

The right to kill one’s self always seems to be a simple issue in my mind, at least at first glance:  My body, my choice.  But upon analysis, the topic unravels precipitously.  Much like the issue of abortion, no aspect of it seems to be resolvable among those who disagree.  But I keep coming back to My body, my choice.  Does that sound selfish?  Certainly, in the case of a person whose body is riddled by cancer, I keep thinking:  Their body, their choice.  Why should we involve the law enforcement system to force people to keep living lives that they, after careful consideration, don’t want to live?

Levitt spends quite a bit of her time on the legal ramifications of assisted suicide and she does a thorough job.   As you can imagine, assisting another person to commit suicide can get one in all kinds of legal trouble.   Those who engage in this work are careful to cover their tracks, as Levitt points out.   These efforts include how to disguise the suicide:

In the 1992 edition of his best-selling Final Exit: The Practicalities of Self-Deliverance and Assisted Suicide for the Dying, Derek Humphry recommended prescription drugs — specifically barbiturates, preferably Nembutal — ground up in Jell-O or swallowed with a stiff drink. He also suggested that patients tie plastic bags over their heads, just in case the pills didn’t do the trick.  Deadly cocktails of this sort, though, often made patients dependent on their doctors and pharmacists. Humphry decided to bypass the medical profession altogether and, in the 2002 edition of Final Exit, unveiled a new method of painless suicide: inert gases, especially helium, which is easy to obtain.

I realize that suicide is a distasteful topic for many people.    I admire Levitt and the RFT for discussing these issues.  You would never see such an important topic covered in-depth in the St. Louis mainstream media.  It’s too much of a downer topic; it won’t sell the kinds of ads that get people out to the mall.   You can laugh at the kinds of advertisements you’ll find in the back of the RFT, but that revenue is what keeps big sponsors (those who run ads in the daily newspaper) from controlling news content.  That’s my opinion based on various conversations with those in a positions to know.   Alternative newspapers don’t attempt to be cheerleaders for the powers that be–they are often-enough driven to publish the kinds of engaging stories that need to be discussed.   You know, the kinds of stories that inspire people to become journalists in the first place.  Levitt has written other first-rate articles, including this one on high school drop-outs.

Should we talk about suicide?  Should it be taboo to discuss whether thoughtful people should be allowed access to methods for ending their lives even after they’ve carefully considered the issue?    Let me end with some statistics:  In 2006, 32,000 people killed themselves.   That’s more than 600 people killing themselves each week. The group most at risk includes elderly caucasian males.   Also consider that in 2006, almost 600,000 people were treated at hospital emergency rooms by trying to kill themselves.  I didn’t find statistics regarding the number of terminally ill people who, having considered the issue carefully, like to kill themselves if only such assistance were available.   I suspect that that number is immense.

Yes, assisted suicide is a compelling issue that needs to be discussed.   Our failure to discuss this issue might needlessly be extending the deep constant pain borne by thousands of of desperately sick people who are afraid to even raise the topic.

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Erich Vieth

Erich Vieth is an attorney focusing on civil rights (including First Amendment), consumer law litigation and appellate practice. At this website often writes about censorship, corporate news media corruption and cognitive science. He is also a working musician, artist and a writer, having founded Dangerous Intersection in 2006. Erich lives in St. Louis, Missouri with his two daughters.

This Post Has 9 Comments

  1. Avatar of Tony Coyle
    Tony Coyle

    I think the issue in the States (and in some other places) is the conflation of death and punishment.

    The US is quite happy (it seems) to assist others to die – but only if they are 'bad'. Capital punishment may not be meted out with the same gleeful abandon as in years past, but it is still part of the American mindset.

    Your former co-worker simply extends that mindset to scenarios where he, knowing himself to be 'sane' and 'lawful', protects himself and his family by meting capital punishment upon those who are bad.

    As discussed on other threads, this makes it extremely difficult for those of a strongly conservative or right-wing mindset to embrace any view of 'assisted death' that does not include punishment.

    In their ideology, suicide is simply wrong. Post-hoc justifications for why it is wrong are simply that – justifications. They will not change their minds, despite the glaring contradiction of their stance.

    Personally, I want the choice to check out when I feel ready – if I'm in extreme pain, if the prognosis is extremely poor. By that point, I think I'd rather resources were used to improve health outcomes for younger people still able to make significant contributions, instead of being wasted upon another few days or weeks for me.

    I understand the fiscal and legal challenges my family would face if I took such a course. They would receive no insurance benefits, so I better make sure my mortgage is paid off, and there are sufficient investments to ensure their comfort. I had also better make sure there is nothing to indicate that my death is assisted – otherwise someone could be tried for murder, or manslaughter.

    If I commit suicide – if I check out – I want it to be me, myself, and I. No other involvement. No collateral damage. Planned and understood beforehand, so that my family and friends are ready for the change. And I'd like it to be legal.

    (I think I'd like to have my wake before I die – then simply go to bed and not wake up)

    1. Avatar of Erich Vieth
      Erich Vieth

      Tony: Good point. Death is always bad, at least viscerally. It's always bad even though, to many religious believers, death can be the gateway to eternal happiness.

    2. Avatar of Danny
      Danny

      I read the RFT article and it really got me thinking, and I appreciate your particular take on it, Erich.

      Suicide is not illegal (according to wikipedia, but Erich, you may want to vouch for that being a lawyer). I know police can put you in protective custody, but you can't get prosecuted for attempted or successful suicide. However, are we talking about how the surviving family could be denied life insurance? If that's the case, then that is the business policy of private companies and not a legal issue. If it were legislated that insurance must be provided to suicide victims, then premiums would likely become too high for most to afford. I suppose if legislation clearly outlined the necessary conditions for suicide then insurance companies could just create revised actuary tables. Do people really foresee life insurance being a sustaining business with this in place?

      Here I go playing counterpoint again, but the thing I can't reconcile is, though "my body, my choice" sounds like a flawless statement, I'm trying to reconcile that with, "no man/woman lives unto themselves."

      Bottom line, people commit suicide because they find life not worth living. They believe it is because of pain or the horror of exiting unexpectedly, but really the issue is that they find their present suffering to be unredeemable and meaningless. If it were legal (i.e., legislation required inheritance and insurance payouts), it seems like the necessary legal condition should not be health related, but "does the individual find life worth living," for isn't this the only reason people choose it?

    3. Avatar of Erich Vieth
      Erich Vieth

      Danny:

      Life insurance contracts are are generally written so that they don't pay in case of suicide. Some policies used to have exceptions that they did pay if the suicide was the result of insanity (I handled one of those cases a long time ago). My understanding is that many policies now cover suicide if it occurs more than two years after the inception of the policy.

      It is also my understanding (though I haven't done much looking) that suicide is not a crime in most states, though assisting a suicide is. If anyone has a good link on this topics it would be appreciated.

  2. Avatar of Erika Price
    Erika Price

    "He who does not accept and respect those who want to reject life does not truly accept and respect life itself." – Thomas Szasz, one of my favorite psychologist/armchair philosophers. Or perhaps this quote is better: "Suicide is a fundamental human right. This does not mean that it is morally desirable. It only means that society does not have the moral right to interfere."

    In my mind, true liberty must necessarily involve the right to make even bad decisions. Not that suicide is necessarily always a bad decision. I especially think that we should look at treatment-resistant depression as very similar to a debilitating medical condition where suicide is often a more tolerable response.

    Does incurable mental anquish differ much from endless physical suffering? Or, should that difference concern noninvolved parties? I think that the choice should always lie with individuals.

    As for the end-of-the-world, shooting-your-neighbor situation, I think I'd stay for the party. I'm inclined to find a hellish (but very interesting) situation far more compelling than a non-existence of nothing at all.

    I always say this when given the scenario of a meteor heading straight for the earth, as well- I'd rather live and see the painful fireworks than die and face oblivion just a pinch sooner. But I respect those who'd like to opt out.

    1. Avatar of Erich Vieth
      Erich Vieth

      OK, OK. Erika. I'll stay around long enough to shoot at my neighbor whenever he tries to steals the bags of grain I have stashed in my garage, but I'm definitely NOT going to stick around long enough to shoot at his children for lurking near my garden!

      I don't really agree with Jerry's prediction regarding the future. I think we can all learn to steal in non-violent ways. Our financial institutions are doing a pretty good job of it already, come to think of it.

    2. Avatar of Erika Price
      Erika Price

      Erich: part of the reason I'd want to stay around is that I don't think the "end of the world" would be as chaotic and horrible as your acquaintance suggests. No doubt a lawless society would result in some pretty nasty situations, but I'd venture we all have plenty of social and reasons to not go around slaying everybody.

      But I suppose I'm very off-topic. I'll just take a moment to echo your recognition of alternative papers. Sure, much of the content amounts sleazy escort ads and stoner send-ups, but the freedom of the format sometimes allows for interesting unconventional work. My favorite is Seattle's The Stranger, which regularly posts decent, biting little articles of wide variety (their featured articles are here).

  3. Avatar of Erich Vieth
    Erich Vieth

    Here are some relatively recent (up to 2005) stats regarding American suicides, in graphed form so you can see the trends at a glance.

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