Generally, euthanasia (the active but painless killing of another human to end their suffering) and assisted suicide are forbidden. But in some places, both practices are legal. ACSH’s Dr. Josh told us about one option legally available in Switzerland, which provides a peaceful, painless, and seemingly luxuriated version of asphyxiation by nitrogen. So, if painlessly killing another for noble purposes is lawful in one place but illegal in another, as it is in New York, can the perpetrator argue morality as a defense? Does nobility of motive ever expunge the crime?
In recent years, there has been a global liberalization in legal restrictions appended to suicide, either alone or with medical assistance. However, suicide remains illegal in 17 countries, and until recently, it was illegal in a few states (e.g., Virginia). For those who are successful, there’s not much you can do to punish them, so at first blush, the laws seem pointless, and the deterrence value is moot. Nevertheless, about 20 countries jail those poor souls who survive despite their attempts, and some states still consider attempted suicide illegal.
But imprisonment for failed suicide and ostracism by religion doesn’t seem to be much of a deterrent, as suicide rates appear to be increasing (although transiently dipping during the pandemic). There were 127,151 suicides reported by the National Crime Records Bureau in 2009, rising to 134,799 in 2013, with a 37% increase from 2000 to 2022. In 2022, nearly 49,000 people died by suicide, translating to one death every 11 minutes. Mostly, these were attributable to family problems and illness, but drug abuse/addiction, failed love affairs, financial ruin, and poverty are also contributory to the increased incidence, which has been facilitated in some cases when the “law” looks the other way.
RIP Doreen Brodhead:
Some months ago, an 85-year-old former doctor traveled to New York to help Doreen Broadhead kill herself. According to her daughter, the 59-year-old Ms. Broadhead had been plagued by pain for decades. But even in states allowing physician-assisted suicides (sometimes called MAiD, Medical Assistance in Dying), Ms. Broadhead wouldn’t have legally qualified for a truncated life: her chronic neck and back pain weren’t terminal. Nor did she have less than six months to live. Indeed, at 59, she had a two-decade of life-expectancy. But to die, she still wanted, at least per reports.
Unwilling to trust “taking her life” to chance, last November, Ms. Broadhead recruited former doctor Stephen. Miller (a member of Choice and Dignity, a right-to-die group based in Arizona), who had experience in assisting suicides using a pared-down version of the spa-like Swiss Nitrogen-Pod, i.e., asphyxiation via nitrogen. The attempt was a success.
Miller, the man who bought the nitrous oxide container found on Ms. Brodhead’s bed, was indicted for manslaughter and assault, as euthanasia in any form is illegal in New York. Miller’s lawyer claimed his client acted compassionately – and “morally did nothing wrong.” Perhaps law enforcement agreed, the 85-year-old pleaded guilty to the manslaughter charge, and the assault charges were dropped. He was sentenced to five years of probation, meaning he is free and available, possibly for remote assistance. At least for now, long-distance advice isn’t considered a crime.
However, Miller would not have been shielded from prosecution even in states that allowed MAiD. That law confers that option only to physicians, assuming that their fealty to the Hippocratic Oath might provide additional patient protection and that they are in the best position to determine the best medical course for the patient. Miller’s medical license was revoked years ago: the law considered him unfit to treat patients. Should he now be allowed to kill them, no matter how old he is?
And while some may find the lackadaisical approach of law enforcement reprehensible, turning a blind eye to this practice isn’t new. As Daniel Defoe reports in his quasi-fictional history of the Bubonic Plague epidemic [1] of 1665,
“Nurses, who attended infected People,…hastening their End, that is to say murthering [sic] of them. …. and I think two were sent to Prison for it,… and I have heard that three others …, were excused for Murthers of that kind,… but I must say, I believe nothing of its being so common a Crime, as some since have been pleas’d to say, … where the People were brought so low as not to be able to help themselves, for such seldom recovered, and there was not Temptation to commit a Murder, at least, none equal to the Fact where they were sure Persons would die in so short a Time, and could not live.”
Of course, Bubonic Plague would qualify for MAiD (i.e., imminent death via assistance of a medical professional). And surely relieving the horrific torment caused by that disease would, by any account, be considered compassionate.
The Law Sounds In
The quandary in Ms. Brodhead’s case is that she may have lived for decades had Miller not intervened, however questionable the quality of those years. Condemning another to live because one’s personal view is that any life is better than none, a refrain used by many courts, seems callous, if not narcissistic.
[CD1]I took this out because it was poorly constructed and I had no real way to revise it. I think the sentence stands on its on.
Nevertheless, relaxing an absolute sanctity afforded to human life (i.e., countenancing human killing if someone wishes it) generates a never-ending slippery slope; a lackadaisical approach to life might facilitate actual murder or allow law enforcement to turn a blind eye when investigating questionable cases. Indeed, death by nitrous oxide seems to be a favored vehicle for murder, at least in crime novels (1). On the other hand, in the Curzon case, the Supreme Court recognized that individuals enjoy a
"fundamental natural right ... to refuse or direct the withholding or withdrawal of artificial life-prolonging procedures when the person has no more cognitive brain function ... and there is no hope of further recovery."
The challenge presented to courts, if not the clergy, is protecting the living from nefarious motives masquerading as compassion. This might manifest in medical practitioners imposing their preferences on unfortunate patients or the temptation of a noble elderly or infirm parent to relieve their children from the moral “obligation” of caring for them by ending their lives early. Ascertaining certain, unequivocal, and unpressured intent remains critical.
Changing circumstances
But there is also the possibility that a change in circumstances might transform a life once considered not worth living into a life fulfilling a noble mission. Recall award-winning actor Christopher Reeves (aka Superman) thrown by his horse, leaving him paralyzed from the neck down and for a long time unable to breathe without a ventilator. Initially, he wanted to die, and only the urgings of his family changed his mind. It took two years of intense therapy and support before he finally was able to say he was glad to be alive, going on to live another seven productive years.
Isolated exceptions to a once-absolute philosophical framework?
Consider the case of Dr. Anna Pou, who was arrested for murder in the aftermath of Hurricane Katrina in 2005. The last physician remaining in the flooded, dysfunctional Memorial Hospital, without electricity, elevators, with temperatures reaching a humid 100 degrees, in fetid stench, Dr Pou diligently attended the patients who were evacuated last. And then there were the patients who couldn’t be evacuated at all. These were later found dead - with drugs in their system that experts contended were used to euthanize them. Dr. Pou claims she only wanted to relieve their pain and agitation. The Attorney General charged that she murdered them. (The DA refused to prosecute without a special grand jury indictment – which was not returned. She was still sued for civil liability).
In some cases, the law steps in to allow assisted death where the patient’s intent is clear. In Dr. Pou’s case, the patients were never asked if they wished to die. But perhaps not giving them that choice, not telling them their only alternative was to remain alone in the horrific conditions, was the compassionate act. Nevertheless, the law insists on clear expression of intent. At Memorial, the only manifestation of intent was the DNR directives of the dead patients. Their relatives claimed this meant “Do Not Resuscitate” -- not “Do Not Rescue.”
Assigning culpability for moral behavior remains the purview of religion. But respect for the law is the basis for society. While the legal-moral conflict plays out – patients suffer. It has been argued that the resources available to Chris Reeves are not available to most of us, minimizing his example. But perhaps the law might better allocate resources now used to curtail legitimate pain medications to relaxing their use and better relieve pain, giving patients more options and better lives. And perhaps instead of the groups focusing on enlarging the right to die with dignity, more resources might be spent on helping patients live with dignity.
[1] A Journal of the Plague Year by Daniel Defoe
