March 21, 2022
We discuss personal autonomy in many cases; liberty, freedom, and all that. However, one blind spot we - we as in society, America, etc. - seem to have is autonomy regarding the right to die. In the past thirty years, there have been prominent cases - Brittany Maynard, Ramon Sampedro, Dax Cowart - which involved this right, stoking condemnation from those who believe that voluntary euthanasia should not be legal, especially for disabled people who choose to end their own lives.
However, the opinion that people should not be able to end their own lives is profoundly disgusting, especially in the case of disabled patients. One goal of medicine is to be restorative; to provide people as much function and autonomy as they are able to after an injury. And able-bodied people are free to kill themselves in any number of ways. If we are truly meaning to restore autonomy to disabled patients, that includes a right to die. To say otherwise is to say that disabled people deserve less autonomy than their able-bodied counterparts.
There is always the question of pressure - what if legalizing euthanasia leads to more people using it, especially due to doctor/family pressure? For the first component of the question, we already have a test group. Suicide is effectively legal for those able to do it; and yet everyone does not commit suicide. To say that disabled people would choose euthanasia at higher numbers approaching 100% ignores reality, and further stigmatizes disability more than optional euthanasia does. Even if the rates among both populations are different overall, the circumstances are different, and we should not expect similar rates. Finally, the Netherlands has had assisted euthanasia for quite some time, and the rates of taking this option have levelled off in recent years at 4% of deaths or so.
The question of pressure is more of a policy question - it may be necessary to require testimony to an independent approver of euthanasia, though this limits personal autonomy to an extent. Another way to reduce pressure - though I doubt this is much of an issue, as most people do not want to kill others either - is to give patients prescriptions for the euthanasia agent that they can choose to take in isolation, unless unable to administer the medication themselves. That being said, we should consider pressure in any policy solution, as possible incentives for people’s deaths for unethical third parties do exist (inheritances and the like).
To nix euthanasia altogether for disabled patients is to violate their inherent right to personal autonomy, claiming that they deserve less than the able-bodied population. This is a repugnant conclusion, and we ought to allow assisted euthanasia for those who request it if we are to truly equalize autonomy for everyone.
On February 27, 2022, I thought it would be a great idea to create some sort of content - writing, art, coding, etc. - every day of the next month. Luckily, the alliteration worked out. This should be the twenty-first post in the series.