Begging to Die

The curiously circumscribed suicide right recognized by Canada's Supreme Court.

According to the U.S. Supreme Court, people do not have a fundamental right to kill themselves. The Supreme Court of Canada used to agree, but in February it changed its mind.

Both courts still agree, however, that the government has the authority to determine when and how you may take your life. The curiously circumscribed right recognized by the Canadian Supreme Court reflects a willingness to surrender our most basic liberty—to be or not to be—in exchange for an official stamp of approval that free people should not need.

The Canadian Supreme Court concluded that criminal penalties for assisting suicide "unjustifiably infringe" on "the right to life, liberty and security of the person," but only "to the extent that they prohibit physician-assisted death for a competent adult person who (1) clearly consents to the termination of life and (2) has a grievous and irremediable medical condition that causes enduring suffering that is intolerable to the individual." Oregon, Washington, and Vermont, which have statutes that allow physicians to help patients kill themselves, likewise strictly define the circumstances in which suicide is acceptable.

It is not hard to see why judges, voters, and legislators would be sympathetic to people in the situation described by the Canadian Supreme Court. If I had a grievous and irremediable medical condition that caused intolerable suffering, they think, I would like to have the option of dying painlessly at a time of my own choosing, and I might need other people's help to do that.

One of the plaintiffs in the Canadian case provided compelling testimony to that effect. "I live in apprehension that my death will be slow, difficult, unpleasant, painful, undignified, and inconsistent with the values and principles I have tried to live by," said Gloria Taylor, who died from amyotrophic lateral sclerosis (a.k.a. Lou Gehrig's disease) in 2012. "What I fear is a death that negates, as opposed to concludes, my life. I do not want to die slowly, piece by piece. I do not want to waste away unconscious in a hospital bed. I do not want to die wracked with pain."

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It truly is outrageous that the state would try to prevent someone in Taylor's position from ending her own life on her own terms. But why is strictly regulated "physician-assisted death" the only alternative that any government sees fit to allow?

The state has a legitimate role in distinguishing between assisted suicide and murder, which requires some sort of verifiable agreement and perhaps proof of mental competence if there is any serious question about that. But why must the process be overseen by physicians, state-appointed gatekeepers who certify that each supplicant has what the government recognizes as a good reason to kill himself?

One reason is practical: Doctors have special access to the drugs that are most suitable for suicide. As the late psychiatric gadfly Thomas Szasz observed, drug prohibition goes a long way toward explaining the clamor for physician-assisted suicide.

As Szasz also pointed out, mandating the involvement of physicians serves a psychological function by disguising a moral judgment as a medical one. That impulse is apparent from two decades of polling on this issue.

Since 1997, the Gallup Poll has found most Americans support physician-assisted suicide. But support is substantially higher when respondents are asked whether a doctor should be allowed to "end the patient's life by some painless means" than when they are asked whether a doctor should be allowed to "assist the patient to commit suicide."

That gap, which has ranged from 10 to 19 percentage points, suggests that many Americans would rather not take responsibility for their own deaths. They prefer to trust the experts. But doctors have no special knowledge or training that enables them to say when a life should end, and the law should not pretend that they do.