Assisted Suicide and the Notion of Autonomy

Volume 27, No 1
Gordon DuVal

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Objections to the criminal prohibition against euthanasia and assisted suicide are commonly framed in a number of ways, including the perceived threat to vulnerable persons (slippery slope), the sanctity of life, an affirmation of the proper role of the physician in the clinical relationship or the anomaly that is seen to be created by the legality of suicide and refusals of life-sustaining treatment. A different type of objection is proposed which focuses on the limits to autonomous decision-making which typically accompany suicidal intentions.

It is argued that a criminal prohibition against assisted suicide is justified by doubts about the state of the suicidal individual's understanding, freedom from coercive influences and ability to rationally evaluate his or her situation. While the law may not view one's own suicide as helpfully dealt with by the criminal law, the participation of another, in lending assistance to a suicide, is an appropriate object of criminal sanction. It is conceivable that one contemplating suicide could both make this decision in an adequately autonomous way and also require assistance. However, the difficulties inherent in determining whether a particular suicidal decision is sufficiently autonomous, coupled with its grave and irrevocable consequences, justify a general criminal ban on acts which promote the suicide of another. Decriminalizing such assistance would threaten to abandon suicidal persons to their own potentially inadequate capacity for self-determination at an especially vulnerable time, inviting tragic and irretrievable mistakes.

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