Thursday, January 12, 2012

Peter Singer on suicide

Suicide, and doctor-assisted suicide, remains a subject of (repugnant transaction) controversy. Here's Princeton's Peter Singer: A Death of One's Own

"A friend told Clendinen that he needed to buy a gun. In the United States, you can buy a gun and put a bullet through your brain without breaking any laws. But if you are a law-abiding person who is already too ill to buy a gun, or to use one, or if shooting yourself doesn’t strike you as a peaceful and dignified way to end your life, or if you just don’t want to leave a mess for others to clean up, what are you to do? You can’t ask someone else to shoot you, and, in most countries, if you tell your doctor that you have had enough, and that you would like his or her assistance in dying, you are asking your doctor to commit a crime.

"Last month, an expert panel of the Royal Society of Canada, chaired by Udo Sch√ľklenk, a professor of bioethics at Queens University, released a report on decision-making at the end of life. The report provides a strong argument for allowing doctors to help their patients to die, provided that the patients are competent and freely request such assistance.

"The ethical basis of the panel’s argument is not so much the avoidance of unnecessary suffering in terminally ill patients, but rather the core value of individual autonomy or self-determination. “The manner of our dying,” the panel concludes, “reflects our sense of what is important just as much as do the other central decisions in our lives.” In a state that protects individual rights, therefore, deciding how to die ought to be recognized as such a right.

"The report also offers an up-to-date review of how assistance by physicians in ending life is working in the “living laboratories” – the jurisdictions where it is legal. In Switzerland, as well as in the US states of Oregon, Washington, and Montana, the law now permits physicians, on request, to supply a terminally ill patient with a prescription for a drug that will bring about a peaceful death. In The Netherlands, Belgium, and Luxembourg, doctors have the additional option of responding to the patient’s request by giving the patient a lethal injection.

"The panel examined reports from each of these jurisdictions, with the exception of Montana (where legalization of assistance in dying occurred only in 2009, and reliable data are not yet available). In The Netherlands, voluntary euthanasia accounted for 1.7% of all deaths in 2005 – exactly the same level as in 1990. Moreover, the frequency of ending a patient’s life without an explicit request from the patient fell by half during the same period, from 0.8% to 0.4%."

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