I certainly agree that some form of assisted suicide should be legal, but I also know that decisions about life and death are rarely simple or amenable to decision by the application of a general principle or rule.
As a vet, I euthanize animals alll the time, and I do agree that it is a vital humane service to individual patients who are suffering. However, I’ve been a doctor long enough to recognize the limits of my ability to predict the future. Some patients recovered that I would never believed had a chance, which makes me leary of strong statements about prognosis. And yet, people making euthanasia decisions want to know what will happen if they do or don’t treat in order to base their decision on that, and it’s hard for everyone when the reality is nobody knows for sure. So when is the “right time” is the first challenge, and while it can sometimes be very clear, it is more often quite muddy.
Quality of life is also not easy to assess, especially for patients who can’t give me their own opinion (though as Asanta pointed out, sometimes the patient’s wishes are influenced by depression or other factors which raise the question of whether they should be heeded). When does suffering reach a point where it justifies the decision to end life? And while one could argue it is no decision but the person whose life it is, I think that’s a bit naive. Very few of us live in a social vaccuum, and to imagine our choices aren’t going to affect others or that others don’t have legitimate reasons to want to help us even in ways we may not immediately want them to isn’t realistic. The balance between autonomy and one’s relationships with others is complex and cannot be easily codified.
And some people in my field appear to seek absolution from their vet for euthanasia when their reasons have less to do with the patient’s suffering than with the owner’s emotions, finances, or other interests which may differ from the patient’s. It is very challenging to balance my own conscience and beliefs, my ethical responsibility to the patient, and my responsibility to the client, who, in a legal sense at least, owns the patient, and who pays the bills and is the only one I can communicate directly with. Sometimes I feel pets should be euthanized when owners are unwilling, often for reasons I may not feel are legitimate even though I am ethically and legally obliged to respect (including religious belief and an inability to face the reality of the pet’s condition or the responsibility I think an owner has to act on their pet’s behalf even when it is painful). In other cases, people want to euthanize when I feel it isn’t appropriate, or they are forced to cease treatment because they can’t afford it even when the medical problem is fixable. The number of variables and permutations is enormous, and simple rules don’t help much in real-word situations.
So while I appreciate that reference to veterinary euthanasia is understandable as an example of why euthanasia in principle can be a good thing and should be available for humans, and I agree with this, being involved in veterinary euthanasia almost daily has given me a glimpse into the complexities and ambiguities associated with making decisions about ending life intentionally for compassionate reasons. I don’t envy the healthcare providers who will have to be a part of these decisions when this eventualy becomes an accepted practice for people.
