David Albert Jones, director of the Anscombe Bioethics Centre, Oxford (England), recently published an article on euthanasia, assisted suicide and suicide rates in Europe in the Journal of Ethics in Mental Health (JEMH). After compiling a record of non-assisted suicide rates, the professor of bioethics concluded that these acts increase markedly in countries where assisted suicide has been legalized.

Countries where assisted suicide is already approved claimed prior to its legalization that approval would reduce the number of non-assisted suicides, arguing that “[i]f people had the security of knowing that these were options then they might not take their lives prematurely”. However, as the author of the aforementioned paper explains, the available evidence refutes this.

The total number of suicides (assisted or non-assisted) in countries where euthanasia or assisted suicide are permitted has increased considerably since their introduction, compared with neighboring countries. Data from Europe and the US also show that “it is women who have most been placed at risk of avoidable premature death”. As the paper states, “the legalisation of assisted suicide might also have the effect of normalising suicide (whether assisted or non-assisted) and hence might lead to an increase in non-assisted suicides”. It is ridiculous to think that the solution to preventing suicides is to say “yes” to suicide.

Dr. John Maher, a psychiatrist specializing in serious mental illness and editor-in-chief of JEMH, stated in an article published in 2020, that “We can’t have it both ways: suicide prevention and suicide facilitation are fundamentally incompatible moral and pragmatic positions”. “[…] a gross moral transgression is masquerading as a civil right, [I] shout out to my fellow citizens to please pause, pay attention, weigh what you are doing, and help relieve the suffering of people living with mental illness, not by killing them but by treating their illnesses”.

Maher tells the story of a patient with a treatable mental illness, who asked him to kill her. She told him that, “A doctor killing me is not suicide, it is totally different”. He recalled that “Her distraught parents came to the appointment with her because they were afraid that I might support her request and that they would be helpless to do anything about it”. We have reached the extreme of having to worry about going to the psychiatrist because we may be killed, when we could opt for other treatments that would end the person’s suffering.

It is logical that the number of suicides should increase in places where your own country says that “[y]ou deserve to have the right to get your doctor to kill you […] Unfortunately, you do not seem to deserve the right to have the treatment or support that decades of evidence shows can help”.

Bioethical assessment

As we previously discussed, legalizing suicide fosters the slippery slope phenomenon, which ends up encouraging the practice of more suicides, each time with less restrictive criteria, or even practiced on patients who have not requested it. Legitimizing an attack against human life and dignity also causes certain sectors of the population to confuse what is legal with what is ethical, shifting to tolerant positions towards practices that they previously rejected, as also occurs with abortion. Unjust laws violate moral rectitude, rights and dignity, and must be rejected from well-founded ethical positions, not dependent on the status of legality or illegality that the different majorities eventually dictate.

Bioethical training, from solid anthropological foundations, based on respect for human life and dignity, directed not only to healthcare staff but to the entire population, may prevent the moral manipulation that the vagaries in the legal regulation of certain homicidal practices may spread to the population, promoting the acceptance of harmful acts against the physical and moral integrity of individuals.

Julio Tudela and Paloma Aznar

Bioethics Observatory – Institute of Life Sciences

Catholic University of Valencia

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