One last go at this for now.
Most of those that argue against assisted suicide do so on the grounds that it will be difficult or impossible to distinguish between cases of genuine assisting of suicide and cases in which the "assistance" actually involves some sort of pressure to commit suicide - that is to say, that there will be more deaths that are not actual suicides.
My objection is different. I believe that the key problem with assisting suicide is that there will be more actual suicides.
As matters stand at present, if you saw a girl running towards a cliff edge whom you believed intended to throw herself over, you would feel both a moral and a civic duty to attempt to prevent her. You might call out. If you were large and strong enough you might rugby tackle and subdue her (provided that such physical intervention did not place you at material danger of being dragged over the cliff with her). This civic duty is considered as justifying state intervention. If you were a doctor you might sedate her. If you were a mental health nurse you might place her in restraints.
We do not consider that such a girl has a human right to die, which we violate with rugby tackles, our drugs and our restraints. On the contrary, we believe that we have a duty to prevent her death if we can. Furthermore, her family and friends are unlikely to be so clinical as most of you in thinking about her proposed act. They are likely to be upset by the idea that she might kill herself; angry with her (“angry”...what does that say? Might they perhaps think she was considering doing something wrong?); pleased that you intervened. You might be hailed as a hero, not condemned as a human rights violator.
People in the UK are regularly sectioned on the grounds that they are suicidal. We do not typically require that someone also believes herself to be a poached egg or the Archbishop of Canterbury. We have developed an idea of the rational suicidal person, whom we do not section, but let’s stick with the standard case for now. Just being miserable and wanting to kill oneself is normally sufficient.
Do you want that to end? Do you want us to have no civic duty to do what is reasonable and safe that might prevent a suicide? Do you want it to be improper for doctors to restrain or sedate those that might kill themselves? Do you want there to be a right to die? Do you want it to be legally fine to see a depressed person seeking to end her life and offer her a sharp knife or open the high-rise window and help her out onto the ledge?
For that is what you have argued for, in the discussions about doctor-assisted suicide. Perhaps you want to tell me that only terminally sick people have the right to die? Why should that be? If it is my human right, an integral part of the right to life and the right to privacy over my body (as many have argued recently), then it must also be a human right for the well. It cannot logically be restricted to the terminally ill. And of course, in practice, when there is doctor-assisted suicide, it is not restricted merely to the terminally ill. Dignitas assisted the suicide of a paralyzed young man recently, and an elderly man who, though rather deaf, was not terminally ill, but simply did not wish to live without his wife. In the Netherlands, a woman was recently granted the right to doctor-assisted suicide on the grounds that she did not want to live after her children died.
Why should these cases shock you? Was it not the right of these people to commit suicide, and if it was their right, why shouldn’t others help them in claiming their rights? The reality is that if you legalise the assisting of suicide, then people will assist suicides instead of feeling a civic duty to prevent them, and more suicides will occur.
Perhaps you will modify your position, and say something like: “Okay. I see now that there cannot be a general human right to suicide. Such a right applies only in cases where life is so unpleasant as to be not worth living. We should restrict the right to suicide (i.e. the right not to have other people intervene to prevent suicide) to such cases and also permit assistance with suicide in just those cases.”
Does this idea attract you? Do you want the state to set out that certain lives are so unpleasant as to be not worth living? Do you not think this might have implications for healthcare funding and research into medicines? Do you not think that, automatically, once the state officially deems certain lives not worth living, then people in such circumstances will be more likely to commit suicide? Does that make you uncomfortable? I suspect it does. But why? For don’t you really believe that such lives are so unpleasant as to be not worth living? Aren’t the people in those circumstances merely liberated to claim their rights by the government’s statement?
Here is the reality. I do not believe that the vast majority of you want, any more than I do, to change the fundamentals of the law in respect of suicide. You do not want to make those that prevent suicides, by physical intervention or sedation or restraint, into human rights violators. You do not really believe that there is any right to suicide. If a friend or relative of yours became unhappy and killed herself you would not see her as a noble expresser of her life and privacy. You would feel betrayed, abandoned, let down, angry. In the privacy of your heart, as well as pitying her, you would condemn her – and curse yourself for doing so. You don't doubt, any more than I do, that most suicides are seriously immoral acts that should be prevented by any public-spirited person that observes one underway.
I understand the desire to end suffering. But if the tool we use to try to end that suffering – creating a right to suicide and destroying the civic duty to prevent suicide – leads to more suicides of the standard depressed-well-person sort, we have got the tool wrong.
Here are two other tools that I don’t necessarily recommend, but place before you for your consideration. First, looking the other way. We may think that assisting someone to commit suicide needs to be a crime, but we do not always have to convict everyone that does it, any more than we convict everyone guilty of a theft. That has been the approach in assisted suicide these past nearly fifty years. Second, we could convict but then impose no punishment beyond the fact of conviction. This has tended to be the approach in cases where spouses pity-murder their terminally ill or otherwise-suffering partners.
As I say, I do not necessarily recommend one or other or both of these. I merely place them before you as alternatives to the creation of a right to die or the state declaring officially that certain lives are not worth living.
