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Making Sense of Bioethics: Column 113: Physician-Assisted Suicide and Confronting Our Fears

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The prospect of a very attrac­tive, recently-married young woman with a terminal illness facing excru­ciating pain and suffering as she dies is enough to move anyone. The life and death of 29 year old Brit­tany Maynard recently captured enormous media attention when she declared she was moving to Oregon to commit suicide after having been informed by her doc­tors that she had an aggressive form of brain cancer and likely had only six months to live. She brought her life to a close on Nov. 1st, a date she had selected ahead of time, by taking a lethal dose of barbiturates prescribed by her doctor.

In the public discussions that have ensued, some have ventured to argue that suicide under such desperate circumstances would, in fact, be justifiable. A recent on-line article from Time magazine ob­served that few fault those who were trapped on the top floors of the Twin Towers on 9/11 when they jumped to their deaths below as the flames surged around them. Similarly, the article suggests that those who face the prospect of a difficult, pain-racked death from a terminal disease should be able to take their own life through physi­cian-assisted suicide without fault or blame.

For those jumping out of the Twin Towers, however, we rec­ognize a horrific situation of des­peration, and even the possibility of a kind of mental breakdown in those final panic-stricken mo­ments. Their agonizing choice to hurl themselves out of the build­ing to their deaths below would be, objectively speaking, a suicidal act, and would not represent a morally good choice, but their moral culpability would almost certainly be diminished, if not eliminated, by the harrowing cir­cumstances in which they found themselves, driven by raw terror more than by anything else. Clearly, grave psychological dis­turbances, anguish, or grave fear of suffering can diminish the re­sponsibility of the one commit­ting suicide.

Yet in the face of a terminal medical diagnosis, it is not rea­sonable to let our fears dictate our choices; instead it behooves us to confront and resolve those fears without yielding to panic and without allowing unpleasant future scenarios to loom large in our imagination. 

Brittany Maynard not only greatly feared a difficult death for herself, but also argued that pro­tecting her family from pain and suffering was an important con­sideration in her decision to carry out physician-assisted suicide: “I probably would have suffered in hos­pice care for weeks or even months. And my family would have had to watch that. I did not want this night­mare scenario for my family.” Yet even with very noble intentions and a loving concern for our family, we can unwittingly become overzeal­ous in our desire to “protect” them from suffering. 

Brittany's desire to protect her family and friends from pain by committing suicide also led her to cross over critical moral boundaries such that she deprived her family and friends of the chance to love her through her sickness. Suicide in any form runs contrary to our duty to love - to love ourselves and to love our neighbor - because it unjustly breaks important ties of solidarity we have with family, friends and others to whom we continue to have obliga­tions. It is always a form of violence to eliminate suffering by eliminating the sufferer. We effectively give up on the Creator and all he has created. We refuse the help of our neighbor, the love of a family member, or even the beauty of another sun-drenched day to lighten our affliction.

Even as our lives wind down, we have a calling to be good stewards of the gift of life. Hospice and pallia­tive care, along with careful pain management, can lighten our burdens during the dying process. The mutual support of family and friends enables us, and them, to grow in unexpected ways. By respecting and working through the dying process, we can encounter deep and unanticipated graces. We may recognize the need to ask for and receive forgiveness from others and from God. We may be­come aware of God's presence and receive a strengthened faith. We gain peace in our dying days and hours by accepting our mortality and our situation, journeying down the road that still opens ahead of us, even as it becomes shorter, living it with the same tenacity and generosity we did when the road was yet longer.

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