Death on Demand

The Swiss Supreme Court has ruled that people with mental illnesses can be legally assisted in suicide. The case came about when a member of Dignitas, an organization that, for a fee, provides a safe house for, and assistance with, suicide, brought a lawsuit seeking the right to have his death facilitated. The man does not have cancer, AIDS, or another physical illness, as that term is popularly understood. Rather, he is depressed from bipolar disease. But this does not mean that he does not have a right to die. According to the International Herald Tribune , the Swiss high court ruled, "It must be recognized that an incurable, permanent, serious mental disorder can cause similar suffering as a physical (disorder), making life appear unbearable to the patient in the long term."

No one should be surprised by the Swiss ruling. The two weight-bearing ideological pillars of euthanasia/assisted suicide advocacy—a radical individualistic notion of “self-ownership" and the deemed propriety of killing as an acceptable answer to the problem of human suffering—virtually compel this result. After all, many people suffer more intensely and for far longer than people who are dying. And, if choice is the be all and end all of personal freedom, then who can gainsay a suffering person’s decision to die? Hence, rather than being a radical extension of assisted suicide ideology, the Swiss court decision is simply its logical outcome.

Indeed, the Swiss court is not the first to issue such a ruling. More than ten years ago, the Dutch Supreme Court reached a strikingly similar conclusion in a decision interpreting the parameters of the Netherlands’ euthanasia program.

The case involved the 1991 assisted suicide of a depressed woman named Hilly Bosscher. After Bosscher’s two sons died, she became obsessed about being buried between them. She approached the Dutch psychiatrist Boudewijn Chabot, an assisted-suicide advocate, seeking his help in killing herself. Chabot met with her on four occasions but did not attempt treatment. Instead, believing that she would never improve, he assisted Bosscher’s suicide. The Dutch Supreme Court subsequently approved, finding, like the Swiss court after it, that the law cannot distinguish between suffering caused by physical illness and that caused by mental anguish.

These European cases are consistent with ongoing advocacy among some American mental-health professionals for the recognition of what is called "rational suicide" or "permitted suicide." Under this view, if a patient is deemed by a psychiatrist or psychologist to suffer from a "hopeless illness," and if the patient has a sustained desire to die, the mental-health professional is not duty-bound to engage in suicide prevention and indeed may even be permitted to facilitate a patient’s demise.

This begs the question: What is a hopeless illness? The term has been defined broadly in mental-health literature as “including but limited to people with terminal illnesses, [maladies causing] severe physical and/or psychological pain, physically or mentally debilitating and/or deteriorating conditions, and circumstances where [the] quality of life [is] no longer acceptable to the individual.”

We can thus see that rational-suicide advocates seek to implement a policy of suicide permissiveness. After all, "severe physical or psychological pain" could include almost any sustained illness, injury, or emotional malady—from multiple sclerosis to chronic migraine headache, from clinical depression to schizophrenia, from rheumatoid arthritis to cancer. Indeed, hopeless illness could even be reasonably interpreted to apply to almost anyone with more than a transitory desire to die, since, by definition, a suicidal person believes that his or her life is “no longer acceptable."

For political reasons, savvy euthanasia advocates, aided and abetted by the media, continue to pretend that "the right to die" is about last resort "escape valves" for the dying few (which would be wrong in any event). A few may even believe it. But the evidence demonstrates that "death with dignity" leads inevitably to "death on demand."

Wesley J. Smith is a senior fellow at the Discovery Institute and a special consultant to the Center for Bioethics and Culture. He is currently researching a book on the animal-liberation movement.