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On Assisted Suicide

by John Walker
Libertarians for Life
Copyright 1998, 2000

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In addressing "assisted suicide," there are two separate areas of discussion. In principle, is there a right to suicide? If so, do you have a right to ask someone else to help you? Do you have the right to have any others perform the task entirely? Most libertarians answer yes to such questions.

The second area is another matter entirely: In practice, how do we distinguish between whether a death has been an assisted suicide and whether it has been, instead, killing someone without their assent? How do we determine whether the "assisted" person voluntarily requested or assented to the "suicide"?

Many opponents of assisted suicide also believe that suicide per se should be restricted by law. Many who advance the principle of suicide and assisted suicide also act as if problems of practice are trivial or nonexistent. Nonetheless, principle and practice are separate. It is most important that we constantly and explicitly distinguish these two areas. Moreover, particularly if one's defense of assisted suicide is founded on individual rights, then many proposals in support of assisted suicide must be viewed with profound suspicion.

The people most often offered as candidates for "needing" assistance in suicide include those in severe pain, those with diminished mental capacity, and those needing long-term or expensive medical care. The greatest threat to individual rights arises from the simple fact that it is too easy to make their "consent" a charade. These people are less likely to be able to give genuine consent, and are all disproportionally subject to the control of others.

Although couched in the language of individual rights, the danger to individual rights is obvious: Assisted-suicide laws will simply deprive the vulnerable of legal protection against being killed.

Paradoxically, some supporters of assisted suicide have sought to circumvent this real threat by insisting upon another charade — "substituted judgment." Under this doctrine, we establish a legal fiction whereby others (whether family, physicians, special committees, or the courts or other agencies of government) are deemed to make the judgment "as if" the individual had made it. Some of these proposals at least make some deference to individual rights by calling for preceding mechanisms such as living wills and durable powers of attorney. Some proponents of assisted suicide, however, are clearly willing to have decisions take place on the basis of what they think people "ought" to want. The decisions of "professionals" are frequently advanced as the preferred mechanism for deciding who is killed (by passive or active means) and who isn't. In an age of government-funded and government-controlled healthcare, the threat to the individual is obvious.

The situation in Holland is already well known. Even when patients have explicitly insisted that they be kept alive, and even when their own physicians have supported that decision, people have been put to death because others knew "better" — or wanted to open up bed space more quickly.

In Oregon, the Health Services Commission decided in 1998 that lethal doses of prescription drugs should be provided as a welfare benefit for the poor. Government, which outlaws easy access to pain killers, does not want to be "uncompassionate" by denying tax money to end the lives of those in pain. Libertarians object both to the principle of welfare and to its still-increasing cost. Let us hope few libertarians believe in capital punishment for welfare recipients. Government is not apt to be so compassionate when it wishes to cut costs.

Strangely, the Libertarian Party itself adopted in 1996 a position perhaps even more dismissive of individual rights than government has yet dared. The 1996 Libertarian Party platform, while rejecting the authority of "experts," offered in its place one of the most sweeping doctrines of substituted judgment possible:

"In the absence of [living wills and durable medical powers of attorney] and the ability for the individual to choose (e.g., coma) the matter should be decided by such person or persons as the individual may have clearly preferred, with whatever guidance they may desire." ("Health Care" Plank)

Discussion of assisted suicide was dropped in 1998 when the plank was trimmed in size; the current Platform merely objects to laws restricting the right to commit suicide. Nonetheless, the 1996 wording shows how far even Libertarians can go: If you were the one at risk, then all that others would need to determine is whether there were some other individual whom you may have "clearly preferred." Once that determination were made, that other individual would have absolute power of life and death over you. Period.

The platform's language would have avoided the threat of government committees. Moreover, libertarians can argue, it is dramatically less likely that family and friends will kill us for convenience than will government or "professionals." But the plank gave us a strange case — one where many Americans would conclude that the LP simply threw out all concern for individual rights. The power to be granted was so absolute in principle that it was more apt to frighten than to reassure.

Regardless of arguments for or against particular forms of substituted judgment, however, it should be obvious to libertarians that assisted suicide is a slippery slope. Government control over medicine is growing, not lessening. Picture yourself weak and helpless in the hospital with an admirer of Dr. Kevorkian looking at you saying, "I'm from the government, and I'm here to assist you."

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