PAAGE: Discussion Piece # 2 – Right To Die

In the United States our supposed inalienable human rights include, among others, freedom from torture, slavery, freedom of speech, religion, and the right to life. But what of death? If we possess the right to life, do we not also have the right then to choose how and when to dispossess that life? This question of the “right to die” has recently re-entered public debate and policy discussion via a controversial lawsuit against the state of New York aiming to secure the right to doctor-assisted suicide. But the legalization of doctor-assisted suicide must overcome two very cogent social stigmas: suicide and murder. Suicide, since the time of Durkheim if not earlier, has been classified as a sign of pathology – a social, and increasingly, individual pathology. The logic follows that an individual who chooses to commit suicide must not be in his or her right mind and be in need of psychological treatment, medication, and other more invasive forms of care. Similarly, the taking of another’s life is murder. It is the violation of another’s basic human right to life. Doctor-assisted suicide is situated somewhere in the gray territory between these two, engendering explosive criticism and rejection.

But, putting aside reactionary responses, many who have (had) a beloved family member or friend facing chronic and terminal conditions such Alzheimer’s disease and cancer are often sympathetic towards the idea of allowing one to choose how and when they will die. Several states in the U.S., including Oregon, Washington, and Vermont, have legalized assisted suicide for terminal patients, and have built legal frameworks to ensure the process is an ethical one. A common trend emerging from states in the U.S and other nations where assisted suicide has been legalized is that many whom express interest do not actually go through with it. Medical Anthropologist Frances Norwood, from the Columbian College of Arts and Sciences, draws a distinction between “euthanasia talk” and the actual act of euthanasia in her book on assisted-suicide in the Netherlands, The Maintenance of Life: Preventing Social Death through Euthanasia Talk and End-of-Life Care – Lessons from the Netherland (2009). This is an important distinction, as the ability to choose death for terminally ill patients opens space for discussion with trained professionals, family members, and loved ones about death. The option to choose how to die additionally preserves the dignity of the individual in question, as they exert a final measure of control over their life.

The question of physician-assisted suicide is particularly salient for anthropologists of aging and gerontologists. With life-extending medical treatments and technologies, seniors with once-terminal conditions now find their lives being extended by years, percutaneous endoscopic gastrostomy (PEG) feeding tubes being a prominent example. But what is their quality of life? Or perhaps I should say, their quality of death? If there was a legal system in place that allowed them to choose to end their life, would they? How can the debate around physician-assisted suicide be conceptually reframed to distance it from already marked concepts like suicide, murder, and death? What are other cultural and historical perspectives on euthanasia that might offer lessons to the still nascent debates underway in the U.S.?

Ender Ricart

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