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Jocelyn Fitzgerald
8 min read

Choosing Compassion: Exploring the Deep Waters of Assisted Suicide

Picture a person who has been overwhelmed with the darkness of mental illness or the hardships of a severe injury or disease. Day after day after day going through the trials and tribulations of the battle that is their life. The struggle is often hard to imagine, how could someone want to end their suffering by ending their life? Imagine the struggle that is almost like an inescapable escape room. They are in a constant fight between their autonomy and their dignity, oftentimes a silent battle that others can’t see from the outside. Although it’s a touchy subject, to make a well-thought-out decision people have to understand what assisted suicide is, rather than its base definition. Which is, “suicide effected with the assistance of another person, especially the taking of lethal drugs provided by a doctor for the purpose by a patient with a terminal illness or incurable condition.” according to the dictionary. However in order to fully grasp this definition, everyone has to understand the research and reasoning behind the legalities of AS. Everyone who fits the decision-making criteria should be entitled to assisted suicide because they could be facing a problem that has no cure, or no further treatment, leaving them with the decision to assisted suicide


Many may know or recognize the term euthanasia, which is less commonly used due to the negative connotation that it has received. One of the reasons for this negative connotation is because of its association with former Nazis and other historical practices. According to an article titled Euthanasia and assisted suicide: An in-depth review of relevant historical aspects “The term euthanasia was misused during this period; approximately 275,000 subjects (as reported at the Nuremberg International Military Tribunal 1945–1946), who had some degree of physical or mental disability, were killed during Adolf Hitler's Euthanasia program” This negative history impacted the” definition that is used, therefore leaving people with the new term “assisted suicide”. The “new term” assisted suicide implies that the client or patient has a choice in the decision, rather than the decision being forced on them. The history of how it became legal, especially in the United States is a fundamental part of understanding the practice. In an article by J.D canidate Morgan Schultz it states “In Washington v. Glucksberg, the Supreme Court of the United States ("the Court") examined whether Washington's ("the State") prohibition against "caus[ing]" or aid[ing]" a suicide offended the Fourteenth Amendment to the United States Constitution”(Schultz). The decision was made that assisted suicide does not offend the fourteenth amendment right which is, “No State shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws.” Therefore making it a state and physician's choice to administer the practice, without fear of punishment.


Decision-making criteria is a vital criteria for people contemplating going through with assisted suicide. Decision-making criteria as stated in the article "Suffering is Not Enough “determines whether or not someone can make a decision for themselves, especially when it comes to healthcare decisions'' (Trachsel and Jox). This determination is very important when making a big decision, such as the AS procedure, especially when it comes to physicians' ability to go through with the procedure. The choice varies from case to case and person to person, whether they have a severe injury, mental illness, or want to escape the hardships in their life. Although autonomy remains important regardless of the circumstances,“The principle of respect for autonomy tells us that we should not prevent patients who can make autonomous decisions from accessing assisted suicide if they wish to do so. Similarly, the principle of non‐maleficence indicates that we should not inflict harm upon patients who are mentally competent by insisting that they remain alive and suffering” (Trachsel and Jox). Navigating the complex nature of assisted suicide emphasizes the balance between respecting a patients autonomy and avoiding unnecessary suffering. Just as a skilled sailor must know how to navigate through turbulent waters, physicians must also grapple with the moral and ethical dilemmas surrounding this issue. As society grapples with the complex nature of this subject, they must also pave the way for people who are suffering to be allowed to go out by choice and with dignity.


Mental illness is more so recognized in today's society than almost any time before. More diagnoses are being made and treatments are being administered day after day. Mental health and illnesses play a large part in the topic of Assisted suicide. According to the psychoanalytic understanding of suicide, Suicidal Thoughts often come from internal conflict, which is the distortion of one's reality. Many people struggling with suicidal thoughts are also coping with something such as depression, anxiety, or other mental or physical pain. According to an aritcle written by Nathalie and Pautex “Up to 60% of people requesting assisted suicide were diagnosed with depression”(Nathalie Dieudonné Rahm and Pautex). Previous attempts are also a large factor in eligibility and are very common among people with a mental illness. As mentioned before suicidal thoughts often come from some kind of self-conflict. A decent percentage of adults have made previous attempts, as represented in the aritcle Determinants of Suicidal History before Assisted versus Self-Initiated Suicide “A total of 26 of 497( 5.2%) and 20 of 149( 13.4%) older adults have made previous attempts before assisted and self-initiated suicide.”(Nathalie Dieudonné Rahm and Pautex). This is important to factor in when thinking about the population of people who may be asking for this procedure.


Another important population to think about is those suffering from a severe injury that leaves them incapable of doing daily tasks. An example of this is ALS which means Amyotrophic Lateral sclerosis, which is a neurological disease that affects motor neurons, is currently untreatable/has no cure, and has no direct timeline. People with ALS have difficulty with everyday tasks, including swallowing, walking, speaking, driving, and so much more. Sometimes part(s) of the body can even be completely paralyzed. This relates to assisted suicide because patients may have the right to a lethal injection of potassium chloride or another lethal drug to end their suffering. Although they must be written and oral and receive an OK from the physician for the “treatment” to proceed.


AS is legal in 10 states in the United States of America, and 28 countries. The policies only vary slightly from country to country, although they mostly have the same policy. Over the countries of the Netherlands, Luxembourg, Spain, Belgium, Canada, and Switzerland the policy remains along the lines of Spain's Policy which perfectly sums it up. According to Matteo Scopetti, Spain's Policy is “have a grievous and irremediable medical condition that meets all of the following criteria: have a serious illness, mental illness, disease or disability; be in an advanced state of decline that cannot be reversed; experience unbearable physical or mental suffering from the illness, disease, disability, or state of decline, unrelievable under conditions acceptable to the person” This sums up all of the countries policy in one, in simple terms saying that as long as a patient is deemed to fit the Decision Making Criteria by suffering a mental or serious illness, they are allowed to request and go through the procedure.


There have been some cases in which people who have asked for AS and have self-initiated suicide have been regretful. These patients were also deemed ineligible for the treatment to be administered by a physician. The following are two cases in which people have been regretful of their decision but luckily were saved. The first case was a case of an 88-year-old widowed male with hypertension, hypothyroidism, essential tremor, and “well-controlled bipolar disorder”, who seems to be in pretty decent health. One of his reasons for wanting assisted suicide was to take charge of when he died, after seeing his sister not be able to. his psychiatric history showed two suicide attempts and psychiatric hospitalization around his forties. After being decidedly ineligible for assisted suicide, he attempted suicide by overdose. it was noted that he” now regretted his decision” according to Elie Isenberg-Grzeda. The second case was an 80-year-old female with controlled hypertension, bladder cancer, and major depressive disorders, which resulted after postpartum. She attempted suicide after her eligibility for assisted suicide was turned down. she explained how she attempted suicide by overdosing because she “wanted the suffering to end”, although later noting that she was “regretful”. Regretful decisions are a key point to factor in because once the drug or other treatment is administered there is no turning back, which could leave others wary. These cases serve as cautionary tales, but also as a beacon of light overtaking the darkness illuminating the need for careful thought and consideration.


It is important to know where pushback may occur and in what situations people would or wouldn’t agree with assisted suicide. Some percentages from a questionnaire in Attitudes about Withholding or Withdrawing Life-Prolonging Treatment are “(38.1%) think that people who are dying and who are experiencing extreme and unbearable suffering should have their wish to die granted, and no treatment procedures should be initiated that could extend their life.” “(77%) agreed with the statement that withholding treatment and "allowing" a patient to die should be regulated by law to avoid abuse.” “37.1% of the respondents agreed and 38.2% disagreed with the statement that procedures performed by a physician to directly kill a person should be absolutely prohibited by law” These are important statistics to know how society may feel about making assisted suicide legal. Many people believe that others who are suffering should have access to the procedure as shown before. Knowing these could help people make a decision about the cause, hopefully swaying the decision towards it being legal for everyone deemed fit. 


Although there are many factors in who is allowed to have assisted suicide, everyone should be able to make their own life decision as long as they are within the decision-making criteria.


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