- Assisted suicide requires the assistance of some third party to carry out the act.
- Usually, "assisted suicide" connotes suicide by a person who is terminally ill.
I wish to challenge the accuracy and importance of the first distinction, and to examine how it interacts with the second distinction.
Assisted suicide, by definition, requires the assistance of another person. It conjures images of doctors injecting a lethal drug into a patient at the patient's request. But that is now how it often works in practice. Oregon's law is considered an "assisted suicide" law, but the "assistance" consists only in a physician writing a prescription for a lethal dose of Nembutal - not in helping to administer the drug. But is this really assistance?
The purported "assistance" going on in this type of "assisted suicide" is merely an artifact of our particular system of drug prohibition. We consider suicide by gunshot to be a suicide, rather than an assisted suicide; but why not call it an "assisted suicide," since the procedure for buying a gun requires the assistance of others? I think we would not call it an assisted suicide in the latter case. The distinction seems to be that, "assisted suicide" requires that the person providing assistance do so knowing the suicidal purpose of the person who is assisted. But the only reason the person wishing to commit suicide needs to let the doctor intrude on his personal life in this way is that he cannot obtain the drug in any other way. We too easily accept our drug prohibition as a given, when in fact it is a policy decision. There is not so much difference between "assisted suicide" and plain old suicide, except that in the former case, another person has been made privy to the suicidal person's private decision, often because the state requires the intrusion.
"Assisted suicide" in the form of a prescription is necessary, in most cases, merely because proper drugs are not available through other means. It is not "assisted suicide" any more than divorce with the help of a judge is "assisted divorce." But, in some cases, the physical inability to kill oneself is the circumstance that requires "assistance." This circumstance is especially likely in cases of people who are terminally ill. Here again, the "assistance" required may be for legal or practical reasons. If proper drugs are not available for legal reasons, the person who wishes to die may have to send a relative in place of himself overseas to seek out the necessary drugs. Or, the person who wishes to die may actually need physical assistance in dying, such as an injection, or assistance holding the cup if the drugs are taken by mouth.
I suspect that many people who oppose "assisted suicide" are concerned about the act of assisting someone to die in this latter sense. They fear that, rather than willingly choosing to die to end their own suffering, people may be put to death because they are disabled or inconvenient or expensive to provide for. To its credit, the Oregon law specifically requires a personal request, as well as an assessment of legal "capability" and many other safeguards, to prevent murders from disguising themselves as assisted suicides. I think the fears mentioned above should be taken seriously, and in this limited circumstance, I approve of the restrictions.
But these restrictions are not necessary when it comes to people who are fully competent and need no physical assistance in taking their own lives. The only comfortable sort of suicide - a suicide by overdose of fast-acting barbiturates - is only "assisted suicide" in that competent adults are generally prohibited from accessing the necessary drugs. Lift or even relax the barbiturate prohibition, and forced life becomes chosen life. There is no compassionate reason for forcing capable, suicidal adults to choose between shooting themselves in the head, cutting their arteries, hanging themselves, or living a life of unbearable misery and indefinite duration.