February 02, 2007

Art Caplan on Switzerland's Decision that the Mentally Ill May Be Helped to Take Their Own Lives?

This is an incredibly momentous and controversial court decision by the highest court of Switzerland:
Switzerland already allows physician-assisted suicide for terminally ill patients under certain circumstances. The Federal Tribunal’s decision puts mental illnesses on the same level as physical ones.

“It must be recognized that an incurable, permanent, serious mental disorder can cause similar suffering as a physical (disorder), making life appear unbearable to the patient in the long term,” the ruling said.

Assisted suicide has always been linked to the challenge of allowing the terminally ill a choice in managing their inevitable death. That is the policy in the state of Oregon which has had legalized assisted suicide for the terminally ill for many years.

Linking the right to assistance in dying from physicians to the quality of someone's life or their suffering is an enormous and, in my view, very dangerous shift in thinking about assisted suicide.

IF this policy were to be put into place in Switzerland or elsewhere it would put physicians in the position of trying to distinguish 'competent' requests from persons with mental illness alleging emotional despair from 'incompetent' or 'temporarily desperate' persons with mental illness alleging emotional despair --something psychiatry and psychology are not always adept at doing.

Moreover, this policy opens the door to anyone who says they have unbearable psychological or emotional suffering to request help in dying--people with terrible burns, those who are severely disfigured, those who are emotionally bereft at the loss of a child, partner or loved one and even those suffering from career setbacks and failures.

I think the policy is both difficult to enforce and dangerous to apply since it is hard to see how it will not lead to a very slippery slope. Once assisted suicide is extended to those who claim or state that their quality of life is not worth living it puts medical professionals in the very difficult role of trying to figure out if such a claim is valid. It then puts them in the even more difficult role of trying to decide why it is their responsibility to alleviate the suffering, even the most miserable suffering, that people may face through the prescription of lethal doses of drugs.
-Art Caplan

Labels: , ,

View blog reactions

| More