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The Hastings Center Report is probably the most prestigious bioethics journal in the world. Thus, when an opinion article appears in its pages, the ideas expressed are definitely in play among the bioethical elite. I bring this up because an article appeared in the May-June edition advocating assisted suicide for the mentally ill.

I have long maintained that the weight-bearing ideological pillars of assisted suicide advocacy—radical individualism that includes the right to choose the time, manner, and method of death, along with the view that killing is an acceptable answer to the problems of human suffering—preclude legalized assisted suicide from being limited to the terminally ill. The force of human logic—one of the most powerful forces in the universe—simply would not permit such a “restricted” approach, proved by the experiences of the Netherlands, Belgium, and Switzerland.

In “A Suicide Right for the Mentally Ill?” Brown University professor Jacob M. Appel echoes the above—with the exception that he approves of a broad assisted suicide license and I oppose all legalization. Subscription is required so I can’t link the whole article, but here are a few key quotes:

At the core of the argument supporting assisted suicide are the twin goals of maximizing individual autonomy and minimizing human suffering. Patients, advocates believe, should be able to control the decision of when to end their own lives, and they should be able to avoid unwanted distress, both physical and psychological.
Appel claims that assisted suicide would “empower” patients with mental illness:

Most likely, the taboo against assisted suicide for the mentally ill is a well-meaning yet misplaced response to the long history of mistreatment that those with psychiatric illness have endured in western societies. Psychiatrists and mental health advocates may fear that their patients will be coerced to “choose death” against their wishes, or that, once suicide is an acceptable option, the care for those who reject assisted suicide will be diminished. But as the plaintiff argued before the Swiss high court, in challenging “medical paternalism,” we are entering an era during which psychiatric patients do not need to be protected, but empowered. Our goal should be to maximize the options available to the mentally ill.
Of course, this was known all along, but political expediency (my term) prevented proponents from being, shall we say, candid with the people:
Since assisted suicide for the terminally ill was itself taboo fifteen years ago, it was unrealistic to expect that a mainstream debate would arise over the issue of suicide rights for psychiatric patients. Contemporary psychiatry aims to prevent suicide, yet the principles favoring legal assisted suicide lead logically to the extension of these rights to some mentally ill patients. But now that several Western nations and one U.S. state have liberalized their laws, it seems reasonable to question the policies that universally deny such basic opportunities to the mentally ill.
Ponder that last sentence; self destruction as a basic opportunity. Finally, the real agenda is coming into the open. Good. It is disrespectful of democracy to continue to play a game of hide the ball by pretending that assisted suicide would be permanently limited to the terminally ill for whom nothing else can be done to alleviate suffering.

So, let’s debate near death on demand. Let’s debate having euthanasia clinics widely available so the suicidal don’t have to kill themselves by jumping off bridges. Let’s have an open and honest debate about the limits, if any, that should be placed by society on destructive individual actions.

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