The ethics of suicide — assisted or not

Hippocrates of Kos, Wikipedia)

“A friend of mine decided, for no proper reason, to starve himself to death. I heard of this when he was already in that third day of his fast, and went and asked him what had happened. ‘I’ve decided to take this course,’ he said. Yes, but all the same, what was it that moved you to do so? If your decision is justified, look, here we are at your side and ready to help you on your way; but if your decision is unreasonable, you ought to change it. — ‘We ought to hold to our decisions.’ — What are you up to, man? Not to every decision, but to those that are justified.” (Epictetus, Discourses, II.15.4–7)

This passage from Epictetus encapsulates, I think, pretty much all there is to say about the ethics of suicide, assisted or not. I do not wish to oversimplify an issue that is keeping philosophers, politicians, doctors, and patients involved in endless discussions. An issue, moreover, that carries huge societal and personal implications. And yet there it is. Epictetus is saying three things in this brief excerpt from the Discourses: (i) suicide is admissible; (ii) it is a duty of one’s friends or caretakers to be of assistance to the person who has decided to commit suicide; but (iii) that person has a duty to carry out due diligence, specifically making sure — as far as it is humanly possible — that she has properly considered and evaluated the reasons for taking such an extraordinary step.

Of an entirely different opinion is Aaron Kheriaty, M.D., an associate professor of psychiatry and human behavior and director of the Medical Ethics Program at the University of California Irvine School of Medicine. He has recently penned a lengthy condemnation of the whole idea of physician assisted suicide in New Atlantis. He goes after individual doctors, medical organizations, and even countries (Canada, the Netherlands) who have supported the notion.