Debating Physician-Assisted Death (i.e.,Physician-Assisted Suicide)

Among the publications I can’t keep up with is the ASCO post, a tabloid-size, 100+ page newspaper that arrives in my mailbox monthly.  But I do peruse it.  December’s offering included a brief summary of a November 2014 debate regarding whether to “Legalize Assisted Suicide,” by the nonpartisan group Intelligence Squared US Debates.   That is the phrase the group used.  It is commonly pointed out that “suicide” is a pejorative here, in the eyes of advocates of physician-assisted death.  In any event, as regular readers of this blog will recall, whether one calls it “PAS” or “PAD,” I am agin’ it—that is, against active physician assistance, by action or prescription, to effect or intentionally provide the means for someone to terminate his or her own life.  I write here to point out the debate.  I have read the ASCO Post comments but have not had the opportunity to review the entire debate, a task which readers here may choose to do by following the link in this paragraph.

Arguing for PAS/PAD were Princeton’s Peter Singer and Columbia psychology professor Andrew Solomon.  Arguing against were Dr. Daniel Sulmasy (of the U. of Chicago and the Presidential Commission on the Study of Bioethical Issues) and Baroness Ilora Finlay, Professor of Palliative Medicine at the University School of Medicine in Wales, and President of the British Medical Association.

Just a brief couple of comments here, based on how the ASCO Post summarized some of the discussion:  First, Dr. Sulmasy appears to have argued that assisted suicide violates human dignity by making a live somebody into a nobody (a dead person), violating dignity intrinsically, and that to argue that autonomy and liberty underwrite the morality of PAS is somewhat self-contradictory, because death eliminates liberty and so purposefully ending life undermines the liberty that is supposed to support PAS to begin with.  It looks like Baroness Finlay argued for a proper sense of palliative care as caring for the whole person in the end of life. 

Professors Singer and Solomon appear to have relied on an autonomy argument; PAS supports human dignity by preserving an individual’s sense of control over his or her medical care, in a thought process that may be quite rational.  It seems to me that this is where all pro-PAS arguments have to finish if not start.  A couple of comments attributed to Prof. Solomon by the ASCO Post writer (one Jo Cavallo) struck me.  For one:  PAD is not suicide because suicide is a response to personal disintegration, whereas PAD is intended to prevent such disintegration.  That doesn’t seem right to me at all; it seems that a sufficiently despondent person could rationally want to be dead, and that the proper response would be to support that person’s life on the assumption that he or she has not “disintegrated.”  Second, the notion that palliative care can adequately deal with the end of every life is “arrogant,” and hospice can pose an “authoritarian, hard, paternalistic” view of dying.  That also seems to me untrue on its face, especially after reading Being Mortal, on which I commented in this space last month.

Space prevents me from carrying on further here, now.

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Barry Orvell, MD Recent comment authors
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Barry Orvell, MD
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Barry Orvell, MD

It strikes me that in the matter of PAS we each have a strong gut reaction to it first. Then we search for persuasive arguments to back up that quick response. And we never seem able to persuade the opposing view.
I am in favor of PAS. And I can give some good reasons. But so can the other side.
I wonder why that is. Why does this question of ultimate human importance resist the most vigorous effort to change a person’s mind. Personal experience? Religious beliefs? Fear of death?