Dr. Kevorkian’s Victims

If we allow that the right to die exists, the arguments for confining it to the dying seem arbitrary at best.

Comments: 125

  1. Ross, probably hundreds of doctor-assisted suicides occur every day in the U.S. People like me who have living wills volunteer to let medical professionals let us go.

    I have personally witnessed two such decisions within my own family. The doctors were not only aware of what was going on, they helped both the dying patient & the family through the wrenching ordeal. No, the doctors didn't -- as far as I know -- administer any drugs to shorten the patients' lives. But they honored the patients' wishes to go when they were ready. These were rational decisions made by fearless people who were fortunate to have brave, caring doctors.

    Most people have heard some version of, "I don't know how she did it, but Granny stayed alive till Uncle Fred could get here." Or "After Paula died, Jim just didn't want to go on." We don't have much control over when we die, but in the normal course of dying, we do have some. People who don't want medical personnel messing up that normal course or do want doctors to help that course along should indeed have the option.

    Perhaps when you are older you'll better understand the process of dying. It's a bit flip to write, "We're all dying every day." Most people your age have no idea what that means. And I'm glad of that.

    The Constant Weader at www.RealityChex.com

  2. Have you ever noticed that conservatives and some religions are only concerned with people during their nine months in the womb and then again when they are drawing their last breaths? Those trying to deny health care to poor people in our current nihilistic political climate have no right to criticize assisted suicide when they themselves are indirectly contributing to assisted homicide through enforced medical neglect. Fifty million Americans currently lack health insurance, and with the burgeoning unemployment crisis, that number will only grow.

    Ross Douthat seems to think anybody feeling the slightest physical or emotional pain will run to the suicide clinics should they ever become legalized. He sure doesn't seem to have much confidence in the resilience of human beings. To compare a terminally ill person with a bereaved person is just plain silly. Some grieving people kill themselves, but most do not. They know life goes on. For the terminally ill, life does not go on.

    Maybe if we had universal health coverage, more people would stay alive and not want to kill themselves due to a disease that was never treated due to lack of money. How about it, Russ? Sounds like a humane plan to me.


  3. If someone wants to die, and there is a gentle way to help them, it is that person's right of autonomy. If you don't want the service, don't participate.
    Just as you have the right to choose to undergo medical procedures that allow you to go on living, another person has the right to make the decision to undergo medical procedures to die.

  4. This issue is far more complex than you suggest, Mr. Douthat. The issue is not a black and white choice between forbidding all assisted suicide versus allowing anyone to demand help offing themselves whenever they want. Instead, it is a question of where should we draw the line between our societal desire to promote and preserve life, and our societal desire to avoid unnecessary suffering and to allow people free will.

    Right now, with a few exceptions like Oregon and Washington State, we draw that line at an extreme, disallowing any sort of assisted suicide. As a result, we end up with significant unnecessary suffering, as people whose bodies and minds are riddled with the often unbearable pain of end-stage cancer, ALS, Alzheimers, and other diseases are unable to find any relief from their suffering. Such situation subjects not only the individual to unnecessary pain, but is also deleterious to their family and friends who have to watch them suffer for days, months, and even years on end with no chance of relief.

    The opposite end could also be highly troublesome. If we allowed assisted suicide whenever anyone wanted it, people may kill themselves when they are going through a relatively short rough patch in life, and may find themselves pressured toward suicide if, for example, they face an illness and don't have health insurance to pay for treatment.

    What we need to do is find a middle ground, where people with terminal illnesses can seek assisted suicide, but only through a highly regulated and regimented system. For example, require any such suicide to occur either in an established hospital or in the care of specially accredited doctors who work at such a hospital. In addition, require multiple doctors to sign off on a requested assisted suicide, and have an independent board review the requests.

    No system if perfect, and any system is going to lead to some unnecessary pain and heartache. But the current system is simply unbearable for far too many people facing terminal illness. Rather than fearmongering about slippery slopes towards rampant assisted suicide for anyone, let's work to develop a system that allows for terminally ill patients to end their lives in dignity and that includes the checks and balances necessary to help ensure that such system is not abused.



  5. Helping someone commit suicide who is terminally ill and suffering unbearably and wants to die seems to me to involve more factors than a simple "right to suicide." If in fact the clients of assisted suicide don't actually present with all the avowed factors, that's an issue of fact, not an issue of the theory (except insofar as it shows a weakness in the theory, namely that it can be misused too easily).

  6. It would help if Douthat actually explained his objection to assisted suicide rather than simply painting it as some dark immorality. I would like to know why it is such a bad thing if a person wants to die and does so through a portal of hospice like medical care rather than the myriad agonies of solo, desperate suicide. Can we not take control of our lives? Why must dying be OK only when it happens through uncontrolled or uncontrollable forces like disease, accident, murder, etc., rather than when a person consciously decides it. Must it remain a mystery and an invisible accident rather than a freely chosen act?

    The real problem in so many spheres is that we have mechanisms to control events that when they ere acts of nature had no moral or troublesome reverberations. Providing the option of conscious control makes "natural" acts or vents problematic. that is one of the deepest ethical challenges we face today.

  7. I am an old geezer. The Lord put me here and he knows when he wants me back. That's my lhope and prayer.

  8. What is it about "freedom loving" conservatives that they feel compelled to meddle in the basic aspects of biological life, and to enforce their views on others. Particularly when it is about women or sex, but here as Mr Douthat is inclined, about the other end of the spectrum. Does one not have a right to die, on one's own terms, so long as it is not imposed on others? Thankfully this right exists, whether a government wants to impose laws or not. What is curious is that a "conservative" like Mr Douthat (a Catholic, we note, a religion which proscribes against suicide, birth control, abortion etc. while in its name it has dispatched many a soul by bonfire, etc.) feel compelled to enforce his views in these areas, by the tool of the state, while at the same time he will loudly yell the state should stay firmly out of other matters - say like economic choices, or the making of regulations for the communal good and welfare, like environmental restrictions or requiring manufacturers to not poison the air, etc.

    I frankly don't comprehend how these political types can twist these things in their mind unless, perhaps, they are simply a form of schizophrenic who lives in two different opposing worlds at the same time.

    I have always been against the "Golden Rule." It is ego-centric. A proper golden rule would be "Do unto others what they want done unto them."


  9. I understand you have a word limit, but could you flesh out your objection to the "right" to relinquish life? Is it to do with friends and family being stakeholders? Would the slight against these stakeholders justify punitive action against an individual who attempted suicide?

  10. Mr. Douthat, you have it wrong. You say, "The difference, of course, is that Kevorkian’s clients asked for it. That free choice is what separates assisted suicide from murder, his defenders would insist.
    But this means that the moral case for assisted suicide depends much more on our respect for people’s own desire to die than on our sympathy for their devastating medical conditions."
    It is an over simplification to say that people's own desire leaves out their condition, as your assumption wishes, in order to make your point.
    The rest of your piece becomes nonsense as a result.

  11. People have a right to end their lives. Period.

  12. I've never understood the warped justifications for inflicting needless suffering by a person who wants the right to choose escape that otherwise inescapable pain and misery.

    No Bible quotes, Mr. Douthat? Your argument, such as it is, cannnot be based on reason or compassion. Do you also approve the stoning of adulterers and homosexuals?

  13. Mr. Douthat,stay out of my home or hospital room. I am not a child. I will decide if I would like to take certain measures to ease my suffering. I will make this difficult choice. I don't need you or some politician to decide this for me.

  14. I find the inability to separate the clear and morally unambiguous human right to control our own lives from the grayer areas where mental illness may require society to intervene against the wishes of the individual to be intellectually insincere.

    If I am physically able I hope to hike into the mountains and spend my last hours with god's sunshine and wind in my face and my toes in the warm soil before months of dementia or pain takes away the essence of my being. If I physically can't perform this task I would hope that I would have options that could make my last moments meaningful rather than criminal, tranquil rather than traumatic.

    To not be able to clearly define the line where one's decision to leave a life is reasonable rather than a sign of mental illness is no shame. Undoubtedly there will be cases where that line will be indistinct and there should be passionate debate as to the nuances of an individual case, but there is no doubt that there are times where a person's life is best to end kindly rather than to force a bitter end.

  15. I refuse to cede my right to die by my own hand if I so choose (to be clear, I have no plans to do so). It's my right to end my own life if I choose, as long as I do no harm to others while doing it (I frankly don't care what the law says re: any technical illegality of suicide). Mr. Douthat's attempt to turn this into an exercise reminiscent of a session in Philosophy and Morality 101 class does little to add to the debate in my opinion. It sounds more like an exercise in arguing counterpoint to a position, than an attempt to actually contribute to the discussion about an issue with significant implications for individual rights. I understand where he is trying to go with this, but he oversimplifies the debate and in doing so does nothing for the argument against assisted suicide.

  16. Dear Ross, You seem to assume the reader will be against assisted suicide of the non-terminally ill. I think that if a person wants to kill him or herself, the community should intervene to make sure the person is competent to make that decision. If so, the 'right' to suicide should be respected. Assistance should not be sought or given unless the person is unable due to illness or disability to manage a painless suicide. In those cases assistance should be legally available.

  17. I don't think we should mix up suicidal people with terminally ill patients and treat them all the same. While assisting suicidal people to commit suicide may be unethical and illegal, helping terminally ill patients in severe pain to end their life is same as ending the life of
    a lethally wounded animal with no hope of recovery. How many of us want to suffer pain as long as possible before we die ? Not to mention the tremendous and futile expenses of end-of-life intensive care would incur.

  18. "The difference, of course, is that Kevorkian’s clients asked for it. That free choice is what separates assisted suicide from murder, his defenders would insist."

    You have failed to refute this. Instead, your arguent rests entirely on a (literally) textbook example of circular reasoning--it's wrong because it's illegal.

    Which means that miscegenation and freeing slaves would also both had to have been when they were illegal. And certain sexual acts are wrong in the states in which they are still illegal.

    Very disappointing.

  19. "Death is everyone's pre-existing condition" was a phrase that caught my attention several years ago. But we try and pretend that death is not for us, for our family, for our friends. This will always be proved wrong. But what about our attitudes towards dying and death? A very mixed bag.

    To our soldiers, first responders, and other men and women who serve the country, our praise and adulation for their deaths is unbounded. We far too often lose the youngest and dearest as we continually, it seems, send them to war and domestic conflicts far and near.

    To the unborn, we ascribe the virtues and characteristics of the best and brightest of our society, not knowing how their lives might play out and whether they might enter this world unloved and unwanted, and worse.

    To a loved one, we cannot bear to let them die even if they are no longer the person we loved, having lost their mental abilities or are unaware of the world and those who love them. Or they endure pain, procedures, and conditions that are torturous because we decide to keep them at all costs.

    Why is it heroic to die in battle, or defending the cities and towns we live in, but atrocious to die peacefully when the alternatives are dismal? Why do we clamor for every fetus to emerge and then leave them to their own devices? Why are we selfish in clinging to having those we love around when they may not love it so much?

    Every sermon I have ever heard has conveyed the message that the most glorious part of our existence will be to die and enjoy eternal life in heavenly bliss. Yet the resistance of most devoutly religious people I know, and hear express similar views, is to avoid death at all costs.

    And it is that at all costs a principal part of our health care problem. The vast sums spent on sustaining life - I believe about 25% of annual costs go to the last 6 weeks of life - when there are alternatives is beyond comprehension.

    Suicide is not the only answer. Hospice care over hospital care is another, but that doesn't generate revenue (no burden on health expenditures).

    Hospice care aside, early exits by suicide should not be off the table. The safeguards are plenty and readily identifiable: competence, compelling diagnosis, self administered, watchdog boards, etc. Can something fall through the cracks? It is possible. But statistically, it will (because of the scrutiny) far less likely than an accidental medical procedure taking a life.

  20. Dear Sir,

    I am neither particularly sick nor overly depressive, thus have no practical interest in the issue beyond the philosophical aspects. However, I could not disagree with you more strongly on the notion that assisted suicide is a crime for which someone should be incarcerated. I am not celebrating Dr. Kervorkian or anyone else who assists a terminally ill patient, or indeed someone who has decided that life in his/her condition is not worth living. I am only focused on who is entitled to make the choice on one's own life or death. If it is not the right of the individual to decide his/her own life, by what notion should it be anyone else's, but the individual? If someone is deterred by his/her religious beliefs that is fine, but those beliefs are not universal. While it should be the task of the state to protect the weak, it is not to protect people from their own choices, especially this most fundamental one, a choice that is hardly made lightly, or if it is, then it speaks to the suffering on the other side of the ledger that makes it an easy choice.



  21. I share with other posters the criticisms of this article. Suicide is a choice one can rationally make even if not terminally ill. I, for one, can envision many medical conditions which would make life unworthy to live, despite the possibility of hanging on for years. My demented mother, whom I visit in a nearby city weekly, did not want to live as she does, nor would I wish her life to extend in this condition; however, this is her lot and my siblings and I do everything we can to care for her and elicit some occasional smile or a kiss. We will continue to do this until she dies a natural death, but we despise the cultural criticism of assisted suicide and hope we never have the horror of living past the ability to make our own choice, unhindered by laws or the opinion of others.

  22. I feel the same way about assisted suicide as I feel about abortion: If you don't like it, don't do it - but don't you dare tell me what I can (or can't) do with *my* body! If I had the horrible misfortune to have a terminal illness and I was unwilling to continue suffering needlessly, I just hope I'd have the ability to decide when I'd had enough. I also find it quite ironic that right-wingers are only too eager to tell the rest of us what we should or shouldn't do - in myriad aspects of our lives - and yet otherwise they have a totally hands-off attitude when it comes to things we desperately need (like taxes to pay for pesky little things such as police officers, firefighters, teachers, healthcare and a whole host of other critical things that are part of a First World society).

  23. I agree with your sentiments. I am a longtime resident of the Detroi area, where Kevorkian lived, or should I say "creeped"?
    There is of course hospice care, which allows the terminally ill to die with dignity.
    BTW, I believe the segment on "60 Minutes" where he iced someone is what precipitated his prosecution. I was aghast when Mike Wallace greeted him on his release from prison like he was a hero.

  24. You write:

    "But this means that the moral case for assisted suicide depends much more on our respect for people’s own desire to die than on our sympathy for their devastating medical conditions. If participating in a suicide is legally and ethically acceptable, in other words, it can’t just be because cancer is brutal and dementia is dehumanizing. It can only be because there’s a right to suicide."

    I can't claim to understand your logic. Firstly, couldn't it be said to depend on both. Putting forward the slippery slope argument that allowing some people to choose to die means that we have to give all people the same right is simplistic. Just because it's hard to draw a line doesn't mean it's impossible. We draw lines everyday. And then we adjust them. A cancer patient who is terminally ill deserves the choice. A depressed person in need of medical assistance likely does not. Your argument is shallow because it doesn't probe the differences that exist between the cases that tug at our heartstrings and the ones that make us cringe. Certainly there is a difference, and a reason why we react one way to particular cases and in the opposite way to others. Adopting a black and white solution to this very complex problem is ridiculous. If a person has five days left to live, and if they're living in pain that cannot be alleviated, and if they are of sound mind, do you really maintain that we should force them to live out their remaining days? What if you or one of your loved ones were in their position? Medical advances have allowed us to keep dying people alive longer. What is the difference between refusing treatment and pulling the plug? Patients have the legal right to refuse treatment. Is the difference between refusing treatment and allowing a terminally ill person to die with dignity so great indeed?

    Instead of engaging with the above questions, you have chosen instead to attack Kevorkian's character. Perhaps he wasn't the saint HBO popularized him to be. But does his character have any real bearing on the above questions? I look forward to a better article that treats this issue with the seriousness it deserves.

  25. It seems that "conservatives" have a problem of the consistency of their logic: they seem to care about everyone's beginning and end of life, but not about all the years in between. They seem to care about how you act even if it bothers no one else, but they don't care if you are unable to obtain an education, healthcare, or a job. They want the president to increase the job opportunities, but they want to do all manufacturing overseas. They want the increase of population at all costs, but don't want to deal with the cost of problems associated with overpopulation. They care about the welfare of themselves and their immediate family, but don't care abut the welfare of anyone else - which may include their own grandchildren and subsequent generations - or the welfare of the environment or any other species of animal. Humans are a special species above all other species they say, except for all other human adults (they can fend for themselves), until they are about to die and then we should send in the military to guard them against a comfortable exit of their own choosing from their meager existence.

  26. Isn't it ironic that the "Humane" Society (emphasis mine) makes sure that animals are treated (and euthanized) by a much higher law than the law of the jungle; by the highest form of civilized behavior in the animal world--i.e. that of human beings. Stories abound like my friend who held her sick, frail old cat in her arms while the vet administered the lethal dose, and how the burial in her back yard was so respectful of the life she had had with her gentle and amusing pet. The brutality of removing Terri Shaivo's feeding tube and letting her die a "natural" death by starvation reveals the moral bankruptcy of a society that cllaims to be "civilized" and "humane" but is in fact afraid and unable to make the hard decisions that define what it means to be a genuinely great human being. We hold people to a high standard of responsibility to end a life; would that we held them to the same level of scrutiny before they began it.

  27. How interesting I saw "Arsenic and Old Lace" the same weekend Jack Kevorkian died. It seems "Dr. Death's" rationale, to aid the suffering, was not so different from the well-intentioned Brewster sisters.

  28. When I worked for hospice, it was common for family members to help friends and family members end their life with a little help from a friend in a hypodermic needle. Mr. Douthat you really are clueless about how much assisted suicide goes on already.

  29. Your "we are all dying, day by day" is about as silly an application of the slippery slope argument as I've ever heard. We're not all terminally ill, period. Furthermore, it shouldn't be surprising that an investigation found that 60% of Kevorkian's patients were not in fact terminal, given that he was acting with blatant disregard for the law to begin with. People who are terminally ill have a right to avoid unnecessary pain, suffering, and expense.

  30. Mr. Douthat, you wrote, "We are all dying, day by day: do the terminally ill really occupy a completely different moral category from the rest?"
    Does that mean people who smoke or drink and hence accelerate the process of dying should also be tried? To borrow your logic, why should smokers and drinkers occupy a completely different moral category?
    I agree with the comment that you have no idea or understanding about how people feel when they are old, terminally ill, and also suffering from excruciating pain on an hourly basis. It is a complicated issue and needs to be addressed with compassion without compromising ethical standards. You started by castigating Dr. Kevorkian as a criminal (this part does not bother me at all) but you have also belittled every terminally ill patient who has contemplated on consciously choosing death (however momentarily)!

  31. dredge up one of the "free markets" enthusiasts in your camp now, ross, and have them explain to you why this may be none of your 'business' - but possibly some of theirs....

  32. Ah, right-wingers are so libertarian! Except when people choose to conduct their personal lives (and deaths) in ways right-wingers don't like. Then they're so ... authoritarian, isn't that the word?

  33. Mr. Douthat is no different than most when it comes to the issue of assisted suicide; namely, he has strong personal feelings that frame his views and shape his comments. Unfortunately, while we now know some of what he rejects, we know virtually nothing about what he affirms and why.

  34. The prohibition of suicide is part of some ethical traditions and not of others. Requiring us to conform to it violates the separation of Church and state if the tradition is defended on theological grounds. Any cancer survivor who accepted treatment rejected God's decision that his or her time was up.

    Since the choice of suicide can also be a product of mental illness, the state has the right and the duty to confirm that the person is competent to decide and has given the decision the deliberation such an irreversible decision deserves. but in a free country the state's legitimate power stops there.

  35. Conservatives insist that we come into the world, even if we're to be born unwanted into a dysfunctional home. Now they insist that we stay, even if we're in unbearable physical or psychological pain. I can't understand why conservatives should be the arbiters of life and death. Douthat is clearly appalled by the idea of assisted suicide, and calls those who would provide such assistance murderers.

    But conservatives are not shy about causing death. They certainly support the death penalty, with both George W. and Jeb Bush enthusiastically signing many death warrants. Conservatives are also fond of marching soldiers off to war, even if those wars are based on lies, or drag on for years, while soldiers and civilians alike are killed for far less reason that someone in the terminal stages of a painful disease. Of course, conservatives are not shy about causing pain, either, as torture was one of the strings of Bush's strategic bow.

    So it seems that conservatives aren't really opposed to ending lives, they're just opposed to ending lives if it's to be used for humane purposes.

    In fact, it's probably a little more complicated than that. There's a study that found that religious conservatives are more likely to ask doctors to take heroic measures to extend their lives, while the non-religious are more likely to sign an order to "allow natural death." It is likely that conservatives are more afraid to die, and the invention of an afterlife is an expression of this fear. They have less trouble killing, because causing death creates the illusion that one has power over it. But watching others commit suicide reminds them that death is inevitable, and brings it too close to home.

    In the final analysis, I suppose that I don't want my life to end in prolonged misery just because conservatives are afraid to face the reality of their own demise.

  36. What happened to the freedom loving conservative? Hypocrite.

  37. You over think the situation too much, Mr. Douthat. It's really quite simple. While I had no say in being born, I do have a say in how I want to die. Put Frank Sinatra on, give me the magic potion, hold my hand gently and bid me a fond adieu. Lights out!

  38. Shortly after I was diagnosed with multiple sclerosis, another person who had lived with MS for many years shared with me the following bit of dark humor: On the day you are told that you have MS, the doctor says “I have good news and I have bad news. The good news is that it won’t kill you. The bad news is that it won’t kill you.” Having lived with MS for more than fifteen years now, I have a better understanding of that awful joke. Everyday of my life is filled with struggles that once would have been unimaginable. Still, my life remains filled with love, friendships, laughter, and many other joys. I would not want to give up my life despite its challenges. That, however, is my choice. The choice should belong to me and not to the State.

  39. Mr. Douthat correctly notes that Dr. Kevorkian often participated in the deaths of people who were depressed or perhaps who suffered from a somatizing disorder. What he doesn't note is that the ideological nature of then-Oakland County (MI) Prosecutor Richard Thompson's cases against Kevorkian led to repeated acquittals. Instead of concentrating on the facts & the law, Thompson, now head of the Thomas More Law Center in Ann Arbor, tried to push his religious views down the throats of jurors.

    I am ambivalent about physician assisted suicide, but I thought Kevorkian & Thompson (against whom I was delighted to vote) were both appalling in their own ways. The Ingham County prosecutor who finally convicted Kevorkian wasn't a magician, but he wasn't on a crusade, either. He just did his job. Had Thompson been equally serious about the law, Kevorkian could have been stopped long before he was.

    Nowadays, Thompson is busy treating Muslims like boogeymen, but the occasion of Kevorkian's death would do well to remind social conservatives of how often their overreaching backfires.

  40. "If participating in a suicide is legally and ethically acceptable, in other words, it can’t just be because cancer is brutal and dementia is dehumanizing. It can only be because there’s a right to suicide."

    But not necessarily a universal right at all times, Ross. Society can prescribe when assisted suicide, or suicide itself is deemed to be a rightful act. You certainly wouldn't argue that the societal acceptance of a killing of another person by way of self defense expressly mandates a general right to kill, would you?

  41. Such a shame in this ultra partisan United States that we have to place everyone in their corner. But it certainly seems Mr. Douthat is reverting to type here in his curious concern for those among us who might want to at some point decide their own fate when it comes to a time to die.

    It seems a typically Republic trait to attempt to levy a God like command when it comes to matters of a woman's right to abortion, or the right of states to exercise capital punishment or as in this case, the personal right to choose suicide.

    These seemingly profound concerns for the sanctity of Life do not jive with other Republican traits. In mind are the lack of concern for the rights of innocent citizens whose equally precious Lives evaporated in the executions of "shock and awe" in Iraq, and the seemingly non-ending Nato raids in Afghanistan that obliterate innocents almost daily.

    Mr. Douthat, where is your concern for these losses of Life?

  42. I personally do not recognize ANY abstract ideological arguments for or against assisted suicide. From purely practical reasons it is one of the situations when hundreds or perhaps thousands of doctors do it (I think my father died that way after his cancer metastized into his bones and his pain became ubearable - I never made a slightest attempt to find out, though) but it is virtually impossible for them to admit it.

    'Moral absolutists' (basically religious fanatics like Douithat) pretend to be appalled. If their parents reached the point as my father did some 40 years ago, they may (or may not - depending on the degree of their fanaticism) reconsider.

    Actually, there is no PRACTICAL difference betwen Mr. Duithat, the moral absolutist and myself, 100% pragmatist. We both agree that it may not serve society well to ADMIT the practice and to try to set rules for it.

    True, they may be some 'innocent' victims but, at this time, they are much many more victims of absolutists like Duithat - he and his 'ilk' can be quite effective in intimidation of good doctors and legislators. Something like Palin's 'death panels'. It works...

  43. Here is a challenge for you and your readers. Take a paper-filled clipboard with you and begin knocking on doors. Analyze the results.

    Question One:
    What is your general religion?

    Question Two:
    What is your specific religious orientation?

    Question Three:
    Are you not a member of a religious philosophy?

    Question Four
    If you were asked by a loved one to end her or his pain-filled life with no legal repercussions would you? If “Yes,” why? If “No,” why not?

    Question Five:
    If you had a pet you loved that was in pain and could not be cured, would you ask her Vet to end her life? If “Yes,” why? If “No,” why not?

    Question Six:
    If you were in a pain-filled life with absolutely no expectation of living even remotely free of pain for the rest of your few remaining days would you ask a loved one, a dear friend, or even a trustworthy stranger, to end your life if you could somehow guarantee no legal repercussions would you? If “Yes,” why? If “No,” why not?

    Morality flows from religious beliefs. Ethics flow from an awareness of what can benefit us while causing as little harm to others as possible. One causes nations and religions to kill others sanctimoniously. The other doesn’t.

    What Dr. Kevorkian sought was the end of life with dignity for those who requested it. I have seen people die in peace and those who were just in pain and whose dignity had left long before. Spare me sententious prattle. If I am in a position to choose, I choose peace and freedom from pain. If any of you want to die in pain, I hope you are granted your wish, generously. Keep out of my life. Keep out of my death.

  44. Just a couple of decades ago, medical science couldn't keep sick people alive past certain terminal points, but now lives can be extended for many years past the point where some sick people wish to let go. My father died of Alzheimer's at 86, and my sister was with him when the nurse told her that he could either be allowed to die or be moved to a hospital and attached to machines. Fortunately she shares my feelings (and his, we both knew), and allowed him to go peacefully. While that isn't exactly "assisted suicide," by Douthat's reasoning it would probably be a slippery slope. I know I don't want to live to be mindless and machine-run in a hospital bed, and I hope there are doctors who will allow me to die rather than use their handy-dandy new techniques to keep my heart beating.

  45. Many commenters seem to miss a key point in the column -- if there exists a right to end one's own life, would we ever try to stop someone from committing suicide? Would we even perhaps be obliged to assist people in exercising this right? If a right to end one's own life exists, how and where would a line be drawn on who could do it? A 60 year-old with cancer who has 2 years to live? A 40 year old depressed man in a dead-end job? If your otherwise healthy 20 year-old daughter wanted to kill herself, what would you do?? If you truly believe that people have a right to end their lives, you'd have to hand her the hemlock. These are not unreasonable comparisons, these are real situations if one believes a right to suicide exists.

  46. I think we should have have end-of-life care for fetuses because that is the next most "logical" step in abortion and I am a typical moronic liberal.

  47. Agree with Mr Douthat that the ethics of assisted suicide is complex.

    I believe that people who praise Dr Kevorkian have in mind a patient who has terminal cancer and who is in great pain and wants to pass away in a dignified manner. It seems hard to argue that such a person should not avail themselves of assisted suicide if they desire to do so. And it is not obvious that this is a slippery slope and would allow all sorts of people to commit suicide. Society handles other similar ethically complex issues -- pain killers for instance -- that are illegal for the majority of the population, but prescribed for certain patients by doctors.

    Regardless of who Dr Kerkovian might have helped die, and regardless of what his real motives were, people will continue to admire him for taking a stand for the hypothetical dying cancer patient, and going to jail for it.

  48. Contrary to your assertion, your argument IS largely hypothetical. Even if Dr. Kevorkian was guilty of the malpractice you allege, that doesn't mean legalized euthanasia can't or hasn't been implemented in a way that minimizes both suffering and risk. Pretty much anything we do carries some risk whether it's vaccinating infants or fluoridating drinking water. The well worn tactic of depriving people of real options for real problems to save them from some abstract potential risk (in this case your dystopian scenario where life is cheapened) will convince no one who hasn't already made up his mind on the subject. Perhaps circumstances will one day give you direct insight into the plight of those terminally ill people living in sheer agony. Them maybe you wouldn't be so quick to callously limit their control over their own bodies in the name of protecting them for themselves.

  49. Ross: One man’s poison is another man’s release!. The point is that that your molrals or mine are not the prfoper judge(s). Moral decisions, riven as they are by conflicting beliefs, must be made according to the mlorals of the effected. That should clear things up. It is important to note that I do not know what the right thing to do is. How do I get to be as sure as you are.

  50. Ross, you state that Kevorkian "pined for a day when both assisted suicides and executions could be accompanied by vivisection." I hope you weren't referring to the facts reported in this paper's obituary: "As a student at the University of Michigan Medical School, from which he graduated in 1952, and later as a resident at the University of Michigan Medical Center, Dr. Kevorkian proposed giving murderers condemned to die the option of being executed with anesthesia in order to subject their bodies to medical experimentation and allow the harvesting of their healthy organs. He delivered a paper on the subject to a meeting of the American Association for the Advancement of Science in 1958."

    Why inject a lethal dose of intellectual dishonesty into the argument? Does all complexity have to be terminated with omissions and distortions?

  51. There's the Ross I know! The libertarian pushing for individual's rights, telling government to let people simply be.

    Oh wait.

  52. "And once we allow that such a right exists, the arguments for confining it to the dying seem arbitrary at best." Correct. What's the problem with that?

  53. All rights exist on a slippery slope, whether it's yelling into a crowded theater (Speech), the death penalty (Life) or taxation (Property). The rights to be worried about are the ones that people claim usurp all other rights.

  54. This is one of those sui generis issues where it is hard to say how personal morality and common law are supposed to relate. It's easy to say that my right to swing my fist ends where another person's nose begins, but there is nothing more intimate to one's self than one's life, and nothing more personal than the will to live or the will to die. This is simply not a legal question like any other. Haughtiness on either side is a sign that something is being over-simplified, or that compassion in all its unpolitical depth is not being expressed to the fullest.

    It's hard to analyze this as a legal issue without taking time to analyze the *existential* situation of someone compelled to take his or her own life. But the problem cuts both ways. Most commentators so far have taken issue with Mr. Douthat for basing his logic on a humanist instinct that's murky at best. Yet from an existential point of view, the simplistic appeals to personal freedom that have been expressed so far -- boiling down to "I can kill myself if I want to, because it's my life" -- are equally unconvincing. From a legal point of view, personal freedom may be the sacred cow. But we do a disservice to our humanity if we try (cf. Comment #11) to limit the discussion, curtly, to rights under the law. We cannot address this issue without asking the meaning of our life, the meaning of suffering itself, a point on which the pro-choice argument is often silent...perhaps because it often boils down to a souped up form of nihilism.

    The best we pro-lifers can do in a political debate is to point out that every individual's decision to kill him/herself contributes to a culture of death. In the liberal-permissive Netherlands, one hospital killed despairing sick people with such frequency that it started making mistakes, prompting some patients to wear "do not kill me" bracelets on their wrists. The slope got slipperier, as parents started euthanizing children who, it is safe to say, could hardly decide for themselves whether they wanted to shuffle off the mortal coil. And doubtless, people who might otherwise have imagined they could bear their suffering looked around at how eager society was to get rid of them, and started having second thoughts. The right, I should say, to kill myself ends where another person's bodily integrity begins.

    Of course, this still leaves us with people who suffer, seemingly unbearably; what can be said to them? That they must endure, just so as not to sink people's spirits? It's an almost intractable issue. The Catholic Church strikes a middle ground by honoring the "kill / let die" distinction, which seems sage and humane to me. (Not many people know that most of our secular vocabulary for end-of-life issues was coined by the Catholic Church.)

    I don't know the next move in a legal discussion. I can contribute one thought to the necessary existential dimension of the debate. A Vatican bioethicist named Gonzalo Miranda described the culture of death as follows:

    “It is not saying that our society is thirsty for blood and death; this is not so. Rather, it is a culture in which death is seen as a solution to problems that we do not know how to handle in another way – problems that we do not know how to handle because we have lost generosity, the ability to support the one who suffers.”

    And this is a serious problem, indeed.

  55. "And not every unbearable agony is medical: if a man losing a battle with Parkinson’s disease can claim the relief of physician-assisted suicide, then why not a devastated widower, or a parent who has lost her only child? "
    Why shouldn't these also be reasons for wanting to die? I simply don't understand the obsession with prolonging life at any cost. The world can be unbearable. Most people do their best to get by but there are limits. What is the Christian obsession with suffering? Theses days we have an elite who is making it difficult for many people to live. Meanwhile, there is a Catholic Church with private schools around the globe catering to the very wealthy while simultaneously discouraging suicide. The elite offspring who will graduate from such schools will ultimately take up posts like Lloyd Blankfein's and Newt Gingrich's who are designing our brave, new, difficult world. I just don't understand the aversion to suicide.

  56. I have a hard time understanding this column. I get that Douthat is saying that assisted suicide -- or maybe suicide itself? hard to tell -- is wrong.

    But why, exactly? What's the argument? It's not in this column, that's for sure.

  57. There's a problem with your argument here, Ross. I think it comes from this statement here:

    "But this means that the moral case for assisted suicide depends *much more* on our respect for people’s own desire to die than on our sympathy for their devastating medical conditions." [emphasis mine]

    You seem to take an unwarranted leap in your logic here by assuming that the argument in favour of assisted suicide is based primarily upon the right of every individual to commit suicide. This is false. Rather, I would argue it is exactly because of our sympathy for people who have devastating medical conditions that it is possible to make a moral case for assisting these individuals with committing suicide, if they so choose. In other words, the moral argument depends on both our sympathy for people with devasting medical conditions and our respect for allowing these people a right to end their lives well. This is different from the argument which you are attempting to defame.

    And the reasoning behind this argument is clearcut. In our society, we believe that suicide is wrong because life is something to be cherished; because as terrible as many people may feel at certain times in their lives, there is always the possibility that one's life will improve. But what happens when life becomes a terrible and torturous ordeal, one with no respite, no hope of remedy or happiness? In such a case, can it truly be argued that life must be preserved? This is not an argument which supports allowing suicide in all cases; rather, it is an argument which attacks the legitimacy of our society's belief that life ought to be extended at all costs. Seeing as we live in a secular society, I think it is well past time we start questioning the religious basis for this flawed belief.

  58. You mean people DON'T have the right to commit suicide? That's news to me.

  59. Whether what Dr. Kevorkian did was right is indeed a tricky moral question: there is a tricky balance between an adult's right to do whatever they want with their body with the interest of society in improving the mental health of its members.

    Mr. Douthat ignores this balance entirely, saying that such a right to die doesn't exist because the courts haven't said it does. As for why it _shouldn't_ exist, Douthat merely gives a weak "slippery slope" argument, providing no secular moral reasoning even at the very bottom of his slippery slope.

    Instead of explaining why elderly adults of sound mind should be denied a right to die, Mr. Douthat moves on to a cute "human experimentation" ad hominem attack against the late Dr. Kevorkian along with some whining about the good treatment he (and other doctors abroad) received from people who recognize that what he did, for good or ill, was certainly not exactly murder.

    This article almost feels like a parody of a standard "conservative editorial on social issue" template, right up to the "people who disagree with me are unpatriotic" conclusion.

  60. Where the major difficulty exists with this discussion is the lack of familiarity most people (99% apparently) seem to have with the term "suicide" and what it means legally and psychologically. A suicide is an unnatural death. From a standard and well established medical/psychiatric perspective, it is an act of aggression-- a homicide turned inward. And every case is evaluated as such -- with a psychological autopsy. Where these evaluations are done, 87-98% of the psychological autopsies done on suicide victims reveal a prior psychiatric history.

    Suicide therefore is evidence of mental illness. NOT a wish to end suffering.

    Most anyone who is aware of the advances in hospice and palliative care understands well that the treatments that are now available are VERY VERY effective in keeping patients in a comfortable condition until they naturally succumb to illness. Refusal of treatment, and DNR are available to anyone who wishes to hasten their departure --- and no one is refused the right to talk a long walk in the snow either.

    What this debate boils down to is the individual wishing to push off personal responsibility for something that is so terrifying to them spiritually and psychologically -- and shift that burden onto another entity that they see as more formidable and more capable, who will then do for them what they haven't the courage to face themselves.

    Suicide is an act of aggression. And it is evidence of mental illness. It is not a wish to end suffering. It is a homicide on the self.

    My warning is to be suspicious of anyone who says they are trying to "help" others die.

  61. In ancient Rome suicide was considered to be an honorable end for an unbearable life, but it was strictly prohibited for slaves, who would be tortured if caught in the act, or if they did not succeed in dying. Mr. Douthat I think that tells it all.

  62. >> do the terminally ill really occupy a completely different moral category from the rest?

    Good Lord, is this a real question? If not them, who?

  63. Why is it that so many people like Mr. Douthat won't allow us even the right to die with dignity?

    If we choose to die, it won't hurt him or cost him money (might even save him some money by reducing tax costs to him). Why does he want to take away another of our remaining freedoms. Here in the Land of the Free and the Home of the Brave?

  64. Thank you Dr. Kervorkian - you started the revolution.

  65. I beleieve not only the terminally ill have a right to die, normally healthy people do too. Isn't that the essence of free will? What is more important in exercising this free will than makiing the decision of life and death? I am not talking about those who, on an impulse, decide to end his or her own life. I am talking about those who are healthy, and mentally stable, however it is defined, and who decide to end their own lives for what they consider as rational choices. One may require that they go through counciling sessions, go through psychological evaluations, or whatever. But their right to terminate their own lives should not be denied.

    Yes I also admit that such a right could be exploited. But everything in this world could be exploited too. Do we ban money lending because it could be and is being exploited everyday, or selling whatever, etc.? One cannot make the assumption the desire to live on, however low the "quality of life" may be, is a rational decision but the right not to live on is not.

    I think most of us do not want to be a burden to our loved ones. And one does not have to become a burden only when he or she is termianlly ill, or become demented.

  66. Just last week, my old sick cat Jeremy gave us all a lesson in death with dignity. He knew that his time had come, as his once beautiful orange fur was matted and uncared for, and he was no longer the big, strong tom but an emaciated and weak old man, but he walked off (it was a horrible struggle) to his favorite woods and chose the place where he wanted to die. We brought him a water bowl and I went to visit him at sundown, but we respected his will and let him end his life as he wanted it. He was gone the next morning.
    I hope that when my time comes, that I know when it is time to head off to the forest, and I sincerely hope that there is no Ross Douthat around to impose some sort of conservative/Christian doctrine on me!

  67. As someone who has recovered from suicidal bipolar disorder completely, I'd argue that the moral difference between the suicide of a cancer patient and the suicide of a depressed person is the possibility of recovery. I would go further and say that this is a very real moral difference. If it had been accurate that depression was terminal and untreatable--and it certainly is neither--then suicide would have been the ideal choice for me as well. If a cancer patient cannot avoid a lengthy period of suffering leading irrevocably to death, and wishes, ahead of time and with counseling and multiple second opinions, to end his or her life, who are we to stop them? I look at Hunter S. Thompson as a prime example of the consequences of making assisted suicide illegal.

  68. A lot of ordinary people, I'd say a decisive number as far as influencing legislation, have common sense viewpoints on issues, and they get there without logical syllogisms and statistics.

    I live in Italy, where the Vatican plays ball with home team advantage, but ordinary people say, either out loud or confidentially, that they can't see why the plug can't be pulled on accident victim patients who have been vegetating for years on life support, and judged by doctors to have zero chance of recovery.

    This means that ordinary people, Roman Catholics, see a case for letting people die, and don't need spinach to mount a challenge to perfect Papal teaching.

    Then again, we don't have the death penalty in Europe. The USA does. And they have it because of the same common sense thinking of masses of ordinary people. Personally, I'm against it, but to get there, I followed the debate, logged statistics, reflected, and groomed my decision.

    But have another look. Ordinary people in the USA have started to change their minds about the death penalty. They don't care about DNA testing; they just don't like the idea that innocent people were executed by mistake, so they're ready go against their own previously held belief.

  69. I greatly respected my father, who said that a competent physician should ensure that everyone dies without any pain. He did not accept assisted suicide, but did think that all terminally ill patients should be given enough narcotic painkillers that they were pain-free but lucid, and he insisted that a competent physician could titrate the painkillers to achieve this.

    Of course, he said, this level of painkillers does depress respiration and so shortens life somewhat, but is still below the immediately lethal dosage of assisted suicide, and is given to preserve dignity, not to hasten death.

    But, of course, my father's prescribed regime for the terminally ill is now illegal in most US jurisdictions, where patients are expected to accept all the suffering destined for them without the analgesic relief that might interfere in that destiny.

  70. This is simply the argument of the Catholic Church, not a rational one. Douthat has always been a supporter of all Catholic doctrine, although he purports to take a rational view.

  71. Those who are suffering and have no future have a right to suicide. Denying the rights of the suffering is not a form of compassion.

  72. You're whole argument revolves around a distinction between the terminally ill and those who are not. For you, only the terminally ill seem to have a case for assisted suicide, a case that supposedly will lead to a slippery moral slope. However, why does it matter if someone is ill or not when one wants to die? If one wants to die - and is deemed lucid by mental health professionals - then one should be allowed to take his or her life with clinical assistance. Don't you conservatives always rave about the sacred rights of your socially constructed concept of the individual? It would seem that those rights would include the right to die by choice.

  73. Some smug kid making comments about "dying every day". I'm sure he'd have a different opinion if each day of his life meant experiencing excruciating pain, complete loss of mobility, spending every moment hooked up to machines or quickly losing all mental capacity.

  74. Douthat comments smugly that the US has not done as Switzerland does in legalizing assisted end-of-life actions. Switzerland is not alone in its moral superiority over the US, perhaps because it is not burdened with a large contingent of religious extremists. With other countries, it consistently ranks higher than the US in various measures of happiness, general health, teenage childbirth, infant mortality, and other such indices. Perhaps smugness is not the appropriate response.

  75. This is the most articulate and intelligent number of responses I think I have ever read following a controversial subject like Mr. Douthat has chosen to write about. If this were an Olympic event I'd say the judges gave the readers comments a 10 and Mr. Douthat a zero.

  76. Mr. Douthat,
    If a high percentage of assisted suicides are not for terminally ill individuals, then to whom? It could well be that they are all for people suffering with unbearable and intractable pain that sucks all remaining pleasure out of life. If so, what's the point of living?

    Your use of statistics are so obviously incomplete, and your condemnations are so self-righteous, that I suspect you of hiding something.

  77. There are many good comments here. I will just add that Ross illustrates the classical sadistic puritan ethic: "I will feel better for forcing you to continue living, even though you will suffer more."

  78. We treat the suffering of the terminally ill worse than we do our dying pets. Much beloved pets are routinely euthenizied and it's very, very difficult for us and our families to say good-bye at the vet's office before our pets depart this earth. But for a human loved one; well, that's another thing entirely. They must suffer even when they, unlike our mute pets, beg to end their pain and suffering.
    No one questions when we put our pets down; it's understandable, rational, we get lots of sympathy and share stories with others who have gone through the enevitable... but humans?
    Well, why? Why shouldn't humans have this right to die too?
    No, they must suffer because...?

  79. Assisted suicide is not illegal in Switzerland. And while we have a media feeding frenzy every time some 'foreigner' decides to come here to die in peace, the process is not abused.

    This is morally right, and I wish all global citizens had access to the same care in the final stage of their life.

  80. I would contest the concept of "If we allow these rights to exist" statement.

    Where does the government express the right to determine what rights its citizens have?

    Yeah, you might want to think about the Bill of Rights, but no, you'd be wrong. The Bill of Rights doesn't "give" rights to the people, it expresses what the government cannot do to the people.

    You have to go do the Declaration of Independence and wonder whether the clause "inalienable rights" extends all rights to the people and the Constitution only grants certain rights to the act of governing, of which the Bill of Rights then curtails how the government may treat the people.

    So if the people determine in good faith that their inalienable rights include the right to assisted death then the government really doesn't have the wherewithal to disavow the action.

    The point of a living will also is the enactment of a personal right in terms of one specifying that they be allowed to die rather than have extraordinary methods to maintain life.

    If I specify that I don't want extraordinary methods to maintain my life and my wife agrees to pull the plug under those circumstances, then is she assisting in my death?

    The problem is that the press and the conservative Right always try to redefine situations so that they might have more power to wield. We're not talking about assisted suicide. We are talking about assisted death, and for Mr. Douthat to suggest different is the continuation of an effort to redefine the meaning of life in his terms.

    In actuality no one should be expected to continue their own life if they do not so desire. And yet that desire is determined to be illegal, and rather than allow a person to commit suicide the state takes away their rights and commits them to mental institutions for assessment and "adjustment". Now that sounds like government interfering with the rights of the individual, if you ask me.

    Or you simply put up with the destructive attitude of the individual to slowly kill themselves by such methods as drug and/or alcohol addiction and the additional costs to the taxpayer in trying to prevent such actions.

    What it comes down to is compassion and whether a compassionate act is tantamount to an illegal act. Mr. Douthat seems to suggest that such is the case, which means there are a lot of people out there committing crimes against the state when they pull the plug on a loved one.

    You really cannot distinguish between the two. If a person is actually able to ask for assisted death, or they are beyond asking except in a living will, then the circumstances for both is exactly the same and one cannot be legal whilst the other is illegal.

    If a person's life is to be honored, one cannot do so without honoring the person's own wishes.

    Roger W. Norman

  81. Dear Mr. Douthat,

    Why must being terminally ill be a prerequsist for suicide, assisted or not? My wife choose suicide two months ago after nearly three years of agony brought on by psychosomatic pain - pain for which the doctors can find no physical cause and which is NOT a terminal disease.

    According to your line of argument, such people should be made to live in their agony until your good Lord finally shows His mercy. Fat chance.

    A study in The Journal of Medical Ethics suggested that 21 percent of the people whom Dignitas helps to commit suicide are not terminally ill.

  82. Both you and your objectors seem to assume that legal right and wrong should always be perfectly congruent with moral right and wrong. But the truth may be that positive human law ought never to condone mercy killing but there are circumstances in which there is a moral duty to break that law.
    The bedrock disagreement between you and your objectors seems to be over the metaphysical question of whether our lives are our own property or not.
    Incidentally, calling mercy killing "euthanasia" (good death) rather begs the question. The moral questions it raises are hard enough to deal with without having to approach them through a cloud of canting euphemism.

  83. All 'rights' and and other circumstances whose control come under the government has to be monitored and modified to some degree. This one is no different - we would have to make sure it was not misused like all our rights. If there is no 'right' to die then is it illegal? If it is illegal how are we going to punish those who do it? Charge them with murder? I know people personally who unsuccessfully ‘attempted’ suicide. Are they guilty of crime?

    It seems that we are only talking about the ‘right’ to assist in suicide without considering the right to die itself. We would have to create a criterion when the right to assist in suicide is illegal and when it is not – just as we do with murder itself – we speak of homicide, justifiable homicide and self defense. The issue of abortion is similar. We may need to define when a termination of pregnancy is permissible and when it is not. These are issues with which civilized societies must come to grips.

    Your argument rests on the religious concepts of ‘god’s will’ as opposed to ‘human will’ – and that augment is no longer relevant.

  84. It takes rather a lot of nerve to claim that I cannot and should not have the freedom to choose how and when I die. It it time for ideologues to shut their pie holes and worry about their own lives. Your meddling in mine is unwanted, and increasing it is stoking my hostility.

  85. Seems that conservatives are always railing about how the government tries to boss us around except for when it comes to the bedroom, that is where they are more than happy to have the government boss us around. Whether it be the consummate bed or death bed, somehow there is always room for further federal regulation preventing people from using their own bodies in a manner they see fit.

  86. Ross, your arguments fit nicely under the definitions of sophistry and speciousness, meaning that they sound reasonable but are flawed and misleading. One glaring example is to identify Dr. Kevorkian as a murderer. This is untrue which anyone can determine by looking up the definition of murder.

    Allow me to digress long enough to point out the unspoken roots for your position. Based on your religious affiliation and sectarian brainwashing, suicide—whether assisted or unassisted—is a sin because it is said that only God has the right to take a life. Where is the logic in allowing this supernatural being the power to visit a prolonged painful death on many while delivering a gentle exit into that long night to others regardless of how they may have lived their lives? Indeed, what kind of deity would permit its only son to die an excruciating death through torture while arranging that Joseph Stalin die quietly in bed?

    While one might disagree about Dr. Kevorkian's in-your-face style of calling attention to the cruel way American society treats terminally ill patients, his approach brought the issue out of the dark in which it hid and led to open discussion of humane alternatives. I'm guessing that you must have at least scanned the Comments section following the Times' article announcing Kevorkian's death. Assuming this is so, you must have noted that the overwhelming majority of those comments were supportive of Dr. Kevorkian's mission. I'm guessing that your column today is your effort to dilute that support, a goal that will fail as more people face the cruel fate being brought to them by the Republican Party's malign attack on decent health care.

    Returning to the general concept of suicide, a freethinking individual capable of rational thought should have the right to determine his/her own departure from this vale of tears as long as it does not result in the taking of other lives in the process (e.g., suicide bombers). The reasoning may be to end unbearable physical or psychological pain, but as long as the death isn't coerced or forced, the human should be a free agent unfettered by inhumane religious mythologies. Where the candidate is unconscious or in a vegetative state, an independent panel of medical personnel should be allowed to make the end-of-life decision. As the natural world is less than perfect, there will be lives tragically ended too early by unrequited love or grief over departed loved ones, but this unavoidable "collateral damage" should not stand in the way of a rational and humane policy allowing assisted suicide. To prevent irrationally derived suicides by those people suffering from depression, decent and readily-abvailable mental health counseling should be made widely available. If the nation had its priorities in order and was governed by thoughtful and compassionate lawmakers, proper health care would take precedence over a bloated military and tax breaks for the rich.

  87. Ross, I respect your your position. if, when you are dying, you choose to endure unending suffering rather than the option of a dignified and self-chosen death, I wish you all the best. But please, do not impose your beliefs on me and so many others like me. Everyone dies in his/her own way. With all respect, I don't care to die by your precepts, but rather by my own.

  88. I can't imagine the cruelty suggested in the column that people in pain, people who are struggling to breathe should not have the option to terminate their lives. That should be a decision for a patient and a doctor. Mr. Douthat's certainty that helping the terminally ill die with dignity will spread throughout the non-terminally ill seems illogical at best.

  89. This is a troubling piece not only because of the author's inability to take seriously the condition of the dying, but because of what seems very much like intellectual dishonesty. By this I mean that the right's insistence on a so-called "culture of life" is not a moral position but a financial and social one. Nowhere was this clearer than in their opposition to reimbursement for end-of-life conversations between doctors and patients, for which they coined the nasty and misleading neologism "death panel." What frightened them into taking this extreme measure was the possibility that terminally ill patients would learn that receiving hospital treatment until the end is often physically brutal for them and traumatic for their families, and that they would thus eschew those last desperate procedures that make so much money for the medical industry in favor of a humane program like hospice. Moreover, a culture in which we relinquish our identities as entitled consumers and instead imagine other values, in this case comfort, is odious to neoliberals like Douthat. It is bad enough that they could be so inhumane, but far worse that they hide it in obfuscatory language that implies that they care.

    Can the left please re-assert itself as the faction of family and moral values? We have the higher ground, here and elsewhere.

  90. Speaking as a physician, I agree with Mr. Douthat that physicians should not be in the business of assisting suicide. Often in the course of a terminal illness, the benefits of life-prolinging treatment wane, and the burdens grow. At some point, it often becomes in the patient's best interest for their physicians to focus their efforts on reducing suffering. The goal of care at this point is maximizing comfort, with the understanding that lifespan might be shortened. The intent is never to kill. As a profession, we lose our moral way, and the trust of our patients, if killing is on our menu of offered services. If assisted suicide were legal, physicians should not involve themselves.

  91. Mr. Douthat's position on making assisted suicide a crime represnts an ill-formed faith based example of absolute morality that has no place in an educated democracy. On the one hand he and the right wing denies potential life universal health care to the uninsured. On the other thye think its find to prolong a panful exodus for those with terminal illness who might choose to expedite their departure from this planet. There is no slippery slope here. A team of educated medical and mental health providers, family, and social workers, could be put into place to help confirm that there was no abuse of the system in instances of hospice care/assisted death choices. Decisions about terminated care, living wills, choices of who can and who cannot receive an organ transpant are made very day. These are not crimes but the appropriate administration of medical care, in a caring way.

  92. Mr. Douthat,

    I encourage you to re-read the 1st comment (by Marie Burns). Those that have worked in medicine recognize that Dr. Kevorkian was revolutionary only in that he brought attention to what regularly occurs out of compassion, duty and necessity across this country every day.

    You do a dis-service to the issue, the dying and the clinicians who deal with this issue in real-time by attempting to over simplify the dynamics in your essay. Extrapolating that one "asks for it" is to ignore all issues that are situational and require context. And issues, particularly for the sick, are often situational and contextual. It is this context that has clinicians assist with diagnosis, treatment and outcome. Even if that outcome may be a final one.

  93. right. and why not punish people who commit suicide (or attempt to commit suicide) too? maybe with the death penalty?

  94. Douthat has apparently never witnessed the torture of a terminally ill loved one, whose hair had turned white overnight, whose arms were tied to the bedside, whose every breath was an agony, who was effectively being waterboarded for days and weeks, not because of any crime, but because society feared having its virtue impugned.

  95. To paraphrase the British historian and author Robert Graves, "It's but a short step to take, from making someone sleep for one night, to making him sleep forever." It's but a short step to take from advocating right-to-die according to someone's skewed political correctness, to embracing a fascist euthanasia program. To whom, pray tell, would we extend the "right" to die? Those who cost too many health-care dollars?

  96. There are two distinct issues here. Have we the right to commit suicide? Have we the right to assist someone else in committing suicide? The first question is unproblematic as a moral question – if it is our life, we may do with it as we choose. That of course is different from the question whether we may be blamed for our choice, criticized for the wreckage that suicide sometimes leave behind, or even for cowardly behavior. But being subject to moral criticism is not the same as not having the right to act in the manner subject to criticism. Recently a woman left several hundred thousand dollars to the church organization that predicted the end of the world. Her family lost all that money, and criticized her for it. She did not lose that right to be foolish or credulous. It was her money! Not her family’s money. Nor is the fact that the United States Constitution does not contain a right to die relevant to the moral question whether there is such a right. Legal and moral rights are not equivalent.
    If Ralph has the right to commit suicide, does Jack have the right to assist him in doing it? The right in question here is ambiguous. It was the legal right that did not exist for Jack Kavorkian – and only the legal right. Whether it was morally right in any particular instance to give such assistance is, like all moral questions, heavily dependent on the facts and circumstances of that situation. And to collapse the question of moral justification to the question of terminal illness, or mental status, or any other single talisman, as though we could substitute a fact of some sort for a moral decision fails to understand the nature of moral questions. There can be no global moral answer – always yes or always no – the whether we should help another person in their own enterprise. Would it be morally right to help the lady to disinherit her family? It certainly would be legally permissible to do so. It was legally permissible for the ministry to keep her money.
    Profound questions of morality, of personal rights, of the integrity of each human person cannot be reduced to a formula.

  97. Douthat, whether he admits it or not, is arguing from a Roman Catholic dogmatic perspective, and wants to enforce his views on the rest of us. He's welcome to his theology.... the rub comes when he (and the Right) force their theology on the rest of us.
    He has not made the case (or even argued for it!) that suicide--for whatever reason--ought to be illegal.

  98. I believe most of us have no idea what prompted Mr. Douthat to write this opinion piece, other than Dr. Kervorkian's recent passing.
    Douthat presents an opinion based on nothing other than a personal moral belief, one that evolves in every one of us as we age and as we see others struggle to cope with debilitating diseases and/or lifelong accidental physical trauma. I trust, as Mr. Douthat experiences more of life, he will understand the personal decisions of others.

  99. It is natural to be afraid of suffering and of being dependent on others when we begin to lose our health and faculties. These moments give us a chance to appreciate more the help others give us in sickness and old age. Dr. Diane E. Meier, a palliative care specialist in New York, says it is more the "worried well" who advocate assisted suicide: she finds that the sick and elderly want to cling to life even as it gets harder. Palliative care - helping terminally ill patients to be comfortable and helping their families to help them - is only advancing in those places where assisted suicide is prohibited. Otherwise, when there's a difficult case, well, that's the end of it! Having been at the bedside of more than one of my family members in their painful, last moments, I have learned how important those moments are for our growth as persons, for both the "well" and the "sick" - for our souls. If we try to avoid this suffering at all costs, we are actually trying to evade part of our human condition, and in a sense, short-cutting it. We cannot give ourselves life, and we don't have the right to take it away from ourselves or others. To be near a dying person has made me feel closer to heaven, and has affected the way I live my life.

  100. What more basic human right can there be than the right to choose whether to be or not to be. I wonder what your feelings on the subject would be if we you were to trade places with a person who is in severe pain daily, lost the control of both bowel and bladder and mental faculties are fading. Whose daily existence is one of pain and humiliation with no hope of improvement and to put the icing on the cake whose daily cost of care is depleting their families lifetime savings making their legacy one of poverty and perhaps homelessness for the loved ones they leave behind.

  101. Yes, very disappointing.
    What started out looking as if it might be an interesting weighing of the pros and cons suddenly took a swing to the only side you had really considered.

    How do you propose we help the victims of failed and merely "attempted" suicides?
    Dr Kevorkian's option provides a sure, clean exit for those who really desire it, while those who use an attempt at suicide to gain sympathy or attention will not choose Dr Kevorkian's certain termination.

    This might help avoid the awful problem of failed suicides. Many would-be suicides are left in a worse condition than before deciding to take their own life. So are their families, who are obliged to support their now-disabled relatives for the rest of their "natural span".

    Sorry, Mt Douthat, but I'm sure you've got it wrong.

  102. Yes, we should be proud that we are a country that does not allow the likes of "Dr. Death" to operate here, helping people who actually ARE suffering, along with the fact that we enjoy the privilege of state(s) sponsors executions of sometimes dubiously guilty - or just plain innocent - people, women and teens included.

  103. Simply another example of opinionated, slanted thinking. Hopefully, rational others will proceed toward humane, informed laws which will free all of us from control exerted by zealots of any type.

  104. It is ironic to me that we have no moral qualms about euthanizing the family dog or cat when their quality of life is no longer worth living, but helping a terminally ill person reach the terminal point? HA! What is the difference, really? We all eat, sleep, mate and defend, animated by a common life-force, or soul, if you will. We humans have this unfortunate "superiority" complex about ourselves that sees ourselves disconnected from both nature and the natural order of life. This has only become more exacerbated in modern times with mass urbanization, cities that never sleep, and a greater and greater sense of disconnectedness. That alone is reason enough for suicide for some.

    Dr. Jack Kavorkian was a pioneer in allowing the right of the individual to be individual, to allow people to make that final decision for themselves with dignity and grace. He was no pariah, but a saint in disguise. God bless him and may we find someone else of similar moral fortitude to take up his cross and continue the Journey of removing the stigma of suicide so that it becomes another option to make one's exit, if necessary.

  105. Why do Republicans have such a difficult time with the concept 'freedom' when it comes to our own bodies.

  106. Regulate society and de-regulate commerce. This is the word of The Conservatives.

  107. What you refer to as suicide, even at the 'victims' request, is unacceptable.

    Is however, sending an eighteen year old to, on the one hand kill and maim or on the other be killed or maimed in a military incursion of some 'wiser' person's doing, albeit a bit more of a crap shoot, OK in your book?

    Don't, if you have a response, give it any more thought than is contained in your article.

  108. Get government out of my personal life!

  109. Better they should hang on and drain Medicare?
    Better they should drive Social Security to the brink?
    This must have been a hard article for you to write, Russ. I'm sure you were torn between morality and the bottom line. Sometimes the Republican ideology is maddening isn't it?
    Kinda' like defunding Planned Parenthood, which denies contraception for poor women, which then results in more unwanted pregnancies, which then triggers more abortions, which then...OW! MY BRAIN HURTS!

  110. I am a liberal democrat that cared for the terminally ill for over 20 years. I totally agree with Ross on this one. The slope is extremely slippery. I found, when patients were receiving excellent palliative care they almost never request assisted suicide. I've had patients over the years whose sudden deaths led me to suspect they took an overdose of pain medication. I understood and didn't judge but was glad they didn't try to involve me in the plan. Patients and families know what they can do. I think its wrong to shift responsibility to health care professionals .

  111. "The Supreme Court, in a unanimous 1997 decision, declined to invent a constitutional right to die."

    Yes, and the Supreme Court, in a momentous 1973 decision, Roe v Wade, did invent a right to kill.

    So much for common sense and humanity. Keep alive by force those who die. Kill the innocent ones in the name of choice.

    How shameful!

  112. I am very confused. My understanding was that conservatives are in favor of individual liberties. Maybe that's true--except for the right to determine the end of one's own life, the right for a woman to control her own body, the right to avoid intrusive drug tests without cause, the right to privacy, the right to free association....

    I think it's clear now: conservatives are in favor of liberty for large corporations. The rest of us are on our own.

  113. This column is a decree, not an argument. And people who want to commit suicide will find a way to do so, whether or not the laws and Ross Douthat think it's OK. Remember that when abortions were illegal, people still had them; but they were much more dangerous.

  114. If your life truly belongs to you, then yes, you are allowed to have someone else kill you if that is your wish. If, Mr. Douthat, you say the Roman Catholic Church does not allow such a thing, then we would need a Constitutional amendment to say that the Catholic Church has jurisdiction over the life of an individual. Good luck with getting that amendment ratified.

  115. Where the major difficulty exists with this discussion is the lack of familiarity most people (99% apparently) seem to have with the term "suicide" and what it means legally and psychologically. A suicide is an unnatural death. From a standard and well established medical/psychiatric perspective, it is an act of aggression-- a homicide turned inward. And every case is evaluated as such -- with a psychological autopsy. Where these evaluations are done, 87-98% of the psychological autopsies done on suicide victims reveal a prior psychiatric history.

    Suicide therefore is evidence of mental illness. NOT a wish to end suffering.

    Most anyone who is aware of the advances in hospice and palliative care understands well that the treatments that are now available are VERY VERY effective in keeping patients in a comfortable condition until they naturally succumb to illness. Refusal of treatment, and DNR are available to anyone who wishes to hasten their departure --- and no one is refused the right to talk a long walk in the snow either.

    What this debate boils down to is the individual wishing to push off personal responsibility for something that is so terrifying to them spiritually and psychologically -- and shift that burden onto another entity that they see as more formidable and more capable, who will then do for them what they haven't the courage to face themselves.

    Suicide is an act of aggression. And it is evidence of mental illness. It is not a wish to end suffering. It is a homicide on the self.

    My warning is to be suspicious of anyone who says they are trying to "help" others die.

  116. I do not see how it is in the interest of any government or society in general to prohibit assisted suicide for the terminally ill. The terminally ill generally (perhaps an exaggeration) can not commit suicide by themselves. Those that can will generally do it by themselves or try. So then what we are basically saying is:
    If you can commit suicide by yourself then we really can not practically stop you although we would prefer that you did not and we will try to stop you depending on circumstances but if you can not do it then suffer. I submit that that is a ridiculous position. What would GOD think?

  117. Were assisted suicide not to carry a prison term in most states, how long before we would hear of the frail, the aged, and the in pain(emotionally or physically) being 'helped' out of this world by those who's motives might be suspect? Just so they won't be 'burden'anymore.
    I have for awhile now sensed that a faction of this country would have not one problem with usering folks they feel 'cost too much', or are 'in the way' into the hereafter-especially if it meant there might be something in it for them or if there were no familiy members to stop it.
    For those at life's end by virtue of age or final stage illness, there is Hospice(a chance to leave this world in a secure setting, often in their own homes and surrounded by caring and compassionate people who ease their pain as much as is possible), and doctors almost everywhere, in a hospital setting will refrain from doing more than making a terminal patient comfortable if they have a DNR on them.
    But to go beyond that opens doors not meant to be open. It's playing God, sometimes for Devilish reasons.
    And right now, with all this talk of cutting costs no matter what, sacrificing whatever it takes..I don't want to see the 'whatever it takes' be people.

  118. I live in a state (Alaska) that has one of the highest rates of suicide per capita in the United States. Many of those who take their lives are young Native Alaskans living in rural communities (although suicide is common enough in larger towns and cities in our state too.) In a village of 800 people only forty miles from my home, there were recently five suicides in less than a year -- all but one were young people in their teens and early twenties. I know from personal experience the devastating impact each suicide has had on that small community. Although each of those five people I'm sure thought that they had a compelling reason to commit suicide and that their decision to take their own lives was theirs' alone, their suicides had a much wider and harmful effect on others than I'm sure they realized.

    What I think that Mr.Douthat's column was trying to address were some of the ways that Dr.Kevorkian's advocacy of assisted suicide and a legal right to take one's own life, work against the common good. I can only imagine how difficult it would be to make the case against suicide, especially to our young people, if assisted suicide was legally permitted in my state, where incidence of suicide is epidemic.

  119. Not many individuals were demonized as vociferously and consistently during their lifetime as Jack Kevorkian.
    But although his dogged efforts to legitimatize and legalize the right to choose how and when to die resulted in his being labeled “Dr. Death” and far worse by opponents of the nascent “Death with Dignity” movement, Kevorkian never backed off from his beliefs.
    In retrospect, Kevorkian’s harshest and most persistent critics may have unwittingly aided his efforts to gain acceptance for assisted suicide; their relentless attacks on him kept his cause in the public eye. He undoubtedly knew the price he’d pay for his views was shrill, endless, and at times nearly universal vilification from a large and intractable segment of the population equally as ardent about their point of view as Kevorkian was about his. But his uncompromising commitment and dedication to what he believed in required far more courage than heaping abuse upon him did from his detractors. Kevorkian risked imprisonment for the actions he took in order to further his beliefs; how many of his antagonists were willing to pay that price?
    The reaction Kevorkian received in response to his determined and deliberately provocative challenges to social taboos was consistent with treatment past social reformers have gotten. People have resisted change for as long as human beings have banded together to form societies, even on those occasions when the proposed modification(s) would benefit nearly everyone involved. Throughout history those suggesting alterations to accepted sociological, technological, biological and religious norms have been laughed off, dismissed, derided, undermined, demonized, assaulted, and in extreme cases eliminated by those who for a variety of reasons were unable or unwilling to let go of what they knew to be right and/or true because, well, they just knew it was right and/or the truth.
    Elizabeth Cady Stanton and Susan B. Anthony were initially ignored when they formed the American Equal Rights Association in 1866 in order to promote universal suffrage. But later when it began to appear their efforts might indeed bear fruit, they and their allies were vilified by the establishment of their day with a ferocity similar to that which Dr. Kevorkian was treated to more than a century later.
    Early proponents of automobiles got the same derision, which grew more intense as the possibility of their vision becoming a reality became more likely. And much of the resistance to their proposed innovations came from horse breeders, wagon builders, and others who stood to lose out if the inventors looking to change society were successful. For similar reasons those proposing sociological changes have always faced the same obstacles technological groundbreakers have, and from the same kinds of sources. Many religious leaders denounced Charles Darwin’s evolutionary theories as heresy in the mid-19th century. Their successors just as predictably vilified Margaret Sanger and other proponents of reproductive rights nearly 100 years later when the birth control pill was introduced.
    But as Darwin pointed out, human beings evolve, and so do societies. Few presidents were as bitterly criticized while in office as Abraham Lincoln was; today he is one of American history’s few deities. Half a century ago Martin Luther King, Jr. was seen by much of America as a disrespectful, uppity rabble-rouser; today America rightly marks the anniversary of his birth with a national holiday.
    Jack Kevorkian’s courage resulted in the growth of hospice care in the United States, and in an increased willingness by society in general and doctors in particular to reconsider their thoughts about palliative care.
    If America continues to progress there’s little doubt history will view Jack Kevorkian as a courageous reformer sooner rather than later. Two decades after he became the only U.S. president to resign in disgrace Richard Nixon was memorialized on a postage stamp. If the United States Postal Service still exists twenty years from now America’s boldest pioneer in the field of end-of-life protocol ought to be on one as well.

  120. Mr. Douthat,

    Please refute Dr. Kevorkian's actions and the idea that assited suicide is wrong and should be illegal on some factual evidence or at least gather your thoughts and ideas before you attempt to refute something on soley moral grounds. I believe that keeping a terminally ill person clinging to aggonizing last breaths is simply subhuman and at most torture.
    It is comparable to a hostage situation, in which because of your moral, religious, or your squirmishnes about death you keep someone in a deplorable physical condition AGAINST their will in this physical world. If they want/NEED out, let them out.
    My right to live or die, should be mine and mine only!

  121. Over the years I have assisted in many memorial services. There is never an "easy" funeral. Some people die unexpectedly. Others die after a long struggle. I believe that every human death is a tragedy, whoever you are, whatever you have done. I do not think that assisted suicide should be legal.

    However, I think there is a glaring omission in this brief article and in most of the comments I have read here so far. Is the choice to die simply a matter of personal autonomy? What about those who mourn? What about those whose lives are changed, maybe even for the better, by caring for someone over the long haul in the most difficult of circumstances?

    If our conversations around beginning-and-end-of-life ethics continue to focus on nothing more than "me" then our conversations around the everything-that-happens-between-birth-and-death ethics will also be "me" focused.

    This conversation is ingrown.

  122. Ross - your slippery slope from a clearly ailing individual to a grieving parent is a serious theoretical stretch. But the slippery slope of limiting individual freedoms on the basis of some "moral" ideals is most certainly not. I suggest you check your history books - a great many things now legal (abortion, alcohol, inter-racial marriage, homosexuality...) were outlawed at some point or other.

    You should look on the other side of the hill - the slope is not only more slippery there, it's steeper too!

  123. None of us asked to get on this bus, so we ought to be allowed to get off at any stop we choose. That's the autonomy argument. In the case of the terminally, painfully ill, it is hard not to accept it, not least because many of the inflictions on the terminally ill assist (if not motivated by) hospital bottom lines.

    But suicide among those who are not terminally ill does have a moral component -- the effect on those left behind. In terms of pure autonomy, I have a right to kill myself. But what of my obligations to my family? Have they no rights? A friend who killed herself a few years ago left a note, I'm told, acknowledging that her suicide was a selfish act. That moral question has to come into the discussion.

    Separately, one has to consider the right to die among the terminally ill and the way we pay for medical care. How slippery is the slope between a right and an obligation, or at least a push? We pay for medical care with insurance, largely. Does the insurer not have a right to say that, for example, a 6-month life expectancy is no worthwhile expectancy and put into the contract that it will not pay for treatment that, on average, will provide only another 6 months of life? It's the insurer's money, after all. These issues need to be addressed in the discussion.

  124. And are you equally as passionate in supporting a reformed health care system that will not permit millions to die before their time for the simple inability to pay the obscene, unconscionable cost of health care in this country? Apparently, they can die. No problem with murder-by-system.

    For you to dare preach "morality" with a right wing bias that flies in the face of everything Jesus ever taught, or considered teaching, would be a joke if it weren't so very sad and dangerous.

  125. Unfortunately for those who dissent to this argument, you can really only be for life or for death. There is plenty of room for parsing on either side of that line, but the line exists and is a bright one.

    Suicide does not become legitimized with pain of the body any more than it should be the final refuge of distress from the mind. And one needs only consider the tragedy that ensues when a gay teenager takes his life to understand that moral absolutes are absolute because the shading brings us right back to the debating table.

    Baseball is America's game because we all agree on the numbers of balls, strikes, outs, and innings. It is my hope that we can evolve a game with all rules determined by the players at the time of the game and based on their own interests. The resulting game would look a lot like where 21st Century America is heading.