Mandy Phillips
A Utilitarian Take on Physician-Assisted Suicide
Death of any kind leaves lasting impacts on those affected by its inevitable nature. Some pass from this mortal life peacefully, some unexpectedly, and others in a long, arduous process due to a terminal illness. In those cases, many plead with their physicians for an escape via lethal drug. John Stuart Mill explains that “utility, or the Greatest Happiness Principle, holds that actions are right in proportion as they tend to promote happiness,” which would allow for this remedy to be acceptable. In the obvious way, a quick and painless death would minimize the unhappiness and the pain levels of a suffering patient. Utilitarianism aims to benefit not just the individual, but more particularly the most individuals possible within society, and its tenets are strong enough to maintain a firm resolution of the physician-assisted suicide moral problem by minimizing the emotional pain of those who ache as they watch their loved one die in such discomfort, maximizing the financial savings for both caregivers, family members, and the nation’s hospital expenses, and affording the individual the right to exercise their self-determination and autonomy. There are many objections and rebuttals to these arguments, but utilitarianism holds fast to its place in this predicament with its balance of cost vs. benefit.
By focusing on pleasing outcomes, utilitarianism helps resolve the ethically challenging question of whether physician-assisted suicide should be permissible. Since utilitarians aim to reduce the amount of pain and misery in the lives of as many people as possible, a terminally-ill patient’s pain-riddled last few weeks or months of life may stand in need of such an allowance. Suffering intensely from physical pain, as well as becoming largely dependent upon family and caregivers for assistance with their food and water intake and hygiene monitoring, would lessen the quality of one’s life immensely. There will inevitably be much physical and mental deterioration, including the frustrating experience of vision, hearing, and mobility loss. Family and friends having to witness a worsening, excruciating condition of their loved one would certainly cause them emotional pain as well. As a terminally-ill patient loses physical and mental function, and ultimately their independence by having to rely on others for care, they will subsequently lose their ability to enjoy life. Those who are against this method of expediting the imminent end would counter this argument by saying that while some family members may be relieved to see their loved one have an end to their torment as quickly and easily as possible, others may feel traumatized by this version of suicide. They may even feel immense guilt that perhaps there was more than could have been said or done to avoid the patient’s feeling so hopeless. Eternal knowledge would be requisite to understand the implications and future consequences of this assisted suicide on those involved. This opposing end result could lead to an equilibrium of cost v. benefit, to the point where the physician-assisted suicide is not the clearest choice entailing the most positive outcome. Since utilitarians strive to maintain the most good for the most amount of people, financial burden can also be taken into account within this equation. Medical care for the terminally-ill is highly expensive, for the nation and for those that are financially responsible for the patient. By cutting short the time period of in-hospital care, hundreds of millions of dollars would be saved annually. Dissenters would argue that this large sum of savings, divided by the number of patients, would be relatively minimal, in the $10,000 range per person, so it would not, to them, be worth the premature death because life is more valuable than that small amount. However, to the utilitarian, that feature is irrelevant because the overarching outcome is still a huge net savings that can go towards many other funds that can bring about more good in the world. In a pleasure vs. pain calculation according to the hedonistic formula developed by Jeremy Bentham and later perpetuated by John Stuart Mill, utilitarianism draws lines that ultimately would allow this medically-sanctioned taking of one’s own life to be an acceptable end with benefits for the individual and society at large.
In addition to easing the financial, emotional, and physical pain of suffering a terminal illness, physician-assisted suicide, under the utilitarian model, supports the benefit of maintaining a degree of autonomy for the affected individual. Having already lost much of their independence as mentioned previously, choosing the time and manner of death helps preserve the utilitarian moral code in that the individual is the keeper of his or her own best interests, as long as they are of coherent mind to do so. A common objection to this rationale is that many suffering patients are also dealing with depression disorders that alter their ways of thinking. However, these cases should not be considered, since it is necessary to be of sound mind in order to make a cogent, independent decision regarding one’s life and death.
A further objection to the utilitarian theory’s resolution of the physician-assisted suicide dilemma would be that rule utilitarians typically hold to the “do not kill” agreement. To deal with conflicting rules, utilitarianism “offers some sort of ranking system for placing rules in a hierarchy of priorities”. For example, self-defense is an acceptable reason to kill someone else. In this situation, a patient is desiring to defend themselves from a painful, uncomfortable, and undignified death. Because of the benefits of easing this physical pain as well as lessening the emotional and financial burden on loved ones, breaking the “no killing” rule would provide maximum utility for society as a whole. One would simply need to exercise caution in the sense that one’s personal goals and feelings cannot be given more weight in the equation than anyone else involved, since everything is equalized under utilitarianism.
Finally, a common dispute against this issue is that legalizing physician-assisted suicide has the potential to result in medical abuses as well as a rise in non-terminal patient suicides. It can be presumed that allowing physician-assisted suicide may lend itself to the violation of human rights. Those suffering from these illnesses that threaten inevitable death are in a vulnerable, delicate stage of their life. They look to their medical care providers for guidance and knowledge. A doctor’s authority can easily sway a susceptible patient’s opinion on what course of action to take. If a doctor increasingly sees cases where patients are taking their lives, they will begin to take the matter less seriously and then proceed to treat the issue with much less gravity with every subsequent patient, who, in turn, will more readily take these life-ending actions before really weighing it out in their minds. This can also lead to abuse because patients who are of lower income or a minority race might be more hastily nudged in the direction of suicide in order to spare their families and the country the financial trouble. All of this, in the long run, this could lead to the desensitization of the value of life and ultimately the widespread approval for any individual wishing to leave the mortal world at any given time to commit suicide. Utilitarians can respond to this horrific scenario, the “slippery slope” argument, with evidence-based research. According to a study done in the Netherlands, where physician assisted suicide is legal,
“There is no evidence to support the claim that laws against physician-assisted suicide or voluntary euthanasia prevent harm to vulnerable people. It is equally possible that legalising physician-assisted suicide or voluntary euthanasia will bring the issue out into the open, and thus make it easier to scrutinise what is actually happening, and to prevent harm to the vulnerable.”
Since there ultimately is no evidence to corroborate the fears of medical abuse resulting from physician-assisted suicide, the utilitarian position is able to maintain a strong position here.
From a utilitarian point of view, justifying physician-assisted suicide is a matter of showing that affording an individual the dignity of managing their own death at a time of their independent election, will bring them more happiness than the pain from their ailments, their loss of dignity, and the sorrow of waiting for a drawn-out, torturous demise. This means of ending personal suffering is functional for the individual, but utilitarianism deals with the overall happiness of society at large, not just that of the patient. Because of the positive outcomes shown regarding the easing of emotional distress and financial burden on both families and nations involved, the benefits outweigh the costs of physician-assisted suicide and utilitarianism still holds, and is a worthy resolution for this moral quandary.