Is Assisted Suicide a Slippery Slope? Cont'd

Editor’s Note: This article previously appeared in a different format as part of The Atlantic’s Notes section, retired in 2021.

From a reader in Portland, Oregon:

Your reader says the situation in Belgium is “frightening.” I wonder, in what sense is it frightening? The only people who are dying there have chosen to die. Perhaps some of their cases don’t fit the reader’s criteria, but how is that his or her business? Either we own our lives or we don’t. If we do, then the choice of how and when to terminate that life is one of the most essential rights we have. Does the reader feel “frightened” by other choices adults make for themselves: to have or not have kids, to use various drugs, to jump from airplanes? If not, in what sense is a sovereign adult’s end-of-life decision “frightening?”

This reader, on the other hand, says “the idea of assisted suicide terrifies me”:

For most of her life, my grandmother struggled with chronic depression. It runs in my family, including myself, so I understood the struggle she went through, the dark hole that exists within, even though my depression has so far never run as deep.

When my mother was young, my grandmother’s depression was severe—severe enough that only her immense strength and faith brought her through it, with the aid of new antidepressants. While I was growing up, my grandmother’s depression was mostly handled through those drugs, though it took awhile to find the right ones. Even with them, she struggled.

As she aged, the drugs stopped working as well and she starting falling to the dark pit again. My grandmother tried everything to run from that dark hole again, including ECT treatments, new drugs, moving to a different state, different doctors, different therapists, different pastors.

Still, despite all of that, my grandmother committed suicide.
It was devastating for the whole family. We knew she suffered, we knew she was in pain, we knew her pain, because many of us feel it ourselves. And even though we knew her pain had ended, we still grieved for her, and we still feel guilty that we could not do more. But we were also incredibly glad for all the years we did have with her, that she got through her early depression and became the woman we all loved.

And personally, knowing what my grandmother went through, knowing what I’ve gone through, the idea of assisted suicide terrifies me. What happens when someone like my grandmother goes to a physician for an assisted suicide? What happens when that dark hole takes hold and some white coat decides that the pain may as well be considered “terminal”? That dark hole takes your sanity; you cannot make a rational decision when it pulls at you. What happens to me, my family, when it pulls and suicide is available, considered a good thing, a relief?

What happens is the devastation my grandmother’s suicide caused, because it was too easy to let the dark hole win.

Another reader looks to a simpler solution:

I own my body; the state does not. Assisted suicide is the use of language to make something simple complex. The state prevents me from killing myself humanely by creating a monopoly on drugs that would do this easily. Until then, long live the 2nd Amendment.

Another points to a much slower and more painful means:

You can kill yourself anytime you like by refusing water and food. You will die after three or four uncomfortable days but it will be your death, your timing, and your action. Choosing your time to die may be your right, but requiring that someone assist you is not. Even those who choose to assist may not be unaffected.

Another reader shifts the debate:

Whatever anyone thinks about the ethics or rights around assisted suicide, it drives me insane that PAS [physician-assisted suicide] drives so much of the discussion of death and dying. We’re in a country where hundreds of millions of people haven’t had basic conversations over advance care planning. Palliative care is only beginning to take off, physical pain is poorly managed, psychological and spiritual pain are practically neglected, storage and retrieval of advance directives in medical records is chaotic, etc.—and you all want to talk about assisted suicide? The most controversial policy that would help the fewest people gets to be the priority?

We can help thousands of people die better every day by doing basic things that everyone agrees on. Twenty years from now, if there are still people suffering despite the best medicine can provide, we can have ourselves a PAS debate. Until then, spare me. It’s an insult to all of us doing the real work on the ground.