REPLACING LAWS AGAINST 'ASSISTING SUICIDE'

What help-in-dying is permitted?
What help-in-dying in prohibited?
Laws against 'assisting suicide' give no guidance.


(1) Preamble for Minnesota:

    The state of Minnesota, in north-central United States,
has already revised its law concerning assisted suicide
so that a doctor's end-of-life medical recommendations
are explicitly excluded from being considered any form of 'assisting suicide'.
A doctor may increase the pain-medication and/or withdraw life-supports
without any worry that such life-ending medical behavior
might be charged as the crime of 'assisting a suicide'.

    But what help can non-doctors provide?


(2) Preamble for Canada:

    In February 2015, the Supreme Court of Canada
overturned Canada's law against 'assisting suicide'.
And this court postponed the effective date of this ruling by one year,
thereby giving the national Parliament of Canada
12 months to enact a new national criminal law
to replace the defective old law against 'assisting suicide'.
(In January 2016, extended by four months, to June 6, 2016.)

    The old law violated Canada's Charter of Rights and Freedoms.
Like almost all similar laws,
it did not separate helping someone to commit an irrational suicide
—which all civilizations want to discourage—
from making wise end-of-life medical decisions.
The police and the public prosecutors
should never visit Canada's hospitals
to prevent terminal-care doctors from 'assisting suicides'.

    In June 2016, the national Parliament of Canada
enacted a new law permitting "medical assistance in dying".
This right-to-die law takes the form of creating
a new exception to the law prohibiting 'assisting suicide'.
Doctors and nurse practitioners are authorized
to prescribe and/or provide gentle poison for dying patients.
If they fulfill all 12 safeguards embodied in the law,
they will not be charged with culpable homicide,
aiding suicide, or administering a noxious thing.
And this immunity from prosecution extends to all others
who cooperate in the authorized medical assistance in dying.

    The province of Quebec had already enacted a new law (2014),
which authorizes three approved medical methods of managing dying:
(1) withdrawing or withholding medical treatments and life-supports,
(2) continuous palliative sedation—keeping the patient asleep until death,
(3) medical aid in dying—giving the patient gentle poison to cause death.
This new end-of-life medical care act for Quebec
came into effect in December 2015.
It was reviewed by the Supreme Court of Canada and allowed to stand,
even tho it did not use exactly the same language as the Carter decision.

(3) Preamble for readers anywhere on the Earth:

    Vague and imprecise laws give rise to endless debates in court
about what was intended by the lawmakers when they wrote certain laws.
Thousands of pages of testimony are created
trying to apply specific words in the laws
to very particular end-of-life medical decisions.
When this happens, such laws should be discarded as useless:
They do not tell the ordinary citizen or the practicing physician
whether or not a particular end-of-life plan might be charged as a crime.

    Laws that give no guidance about behavior
should be repealed and/or replaced by new laws
that tell everyone exactly what is permitted and what is prohibited.


        WHAT IS "ASSISTING SUICIDE"?


by James Leonard Park



    Many years ago, various states and countries
enacted laws against 'assisting suicide'.
In those days everyone knew what a suicide was
and it did not stretch the imagination much
to know what 'assisting a suicide' might be.

    Here are three stories of people throwing their lives away
—with the help of others—
which should still be considered irrational suicide
and assisting an irrational suicide:

    (1) When a businessman loses everything on a risky gamble,
he might want to benefit his family by killing himself
so that his family will have at least his life-insurance.
A 'friend' buys a disposable used car
and directs the bankrupt businessman to a cliff,
which he can conveniently drive off,
resulting in his 'accidental' death.
If the friend's role is uncovered,
he might be tried for the crime of 'assisting a suicide'.

    (2) When a teen-age girl plunges into despair
because she was disappointed by 'love',
she might want to kill herself to end her misery.
Anyone who procures a gun or pills
so that she can solve her heartbreak by suicide
is guilty of 'assisting a suicide'.

    (3) A cult leader tells his followers
that they can all move to a distant planet
by buying new shoes and drinking poison.
If this leader survives the suicides of his followers,
he should be tried and convicted of 'assisting suicides'.

    (See several additional examples of assisting irrational suicides.)

    The behavior of these 'helpers' should remain criminal offenses,
even where irrational suicide itself is no longer a crime.
(Suicide was decriminalized not because we want people to kill themselves
but because we want to help them
rather than put them in jail if their suicide-attempts fail.)

    And here are three end-of-life medical situations
in which the patient on the death-bed is not committing suicide
and all of the family members and medical helpers are not 'assisting suicide':
Helping a dying patient to choose the best pathway towards death
should never be considered 'assisting or encouraging suicide':

    (1) Grandmother has been maintained in a nursing home
for a number of years with ever-deepening dementia.
She has even forgotten how to eat normally.
And a feeding-tube has been implanted into her stomach
so she can receive the food and fluids to keep her 'alive'.
Her loving family decides to authorize discontinuing the tube-feeding
so that grandmother can have a peaceful death.
Are these family members helping with a suicide?

    (2) A middle-aged man is suffering incurable cancer.
He has decided that ending his life now
is better than more days of meaningless suffering,
followed by dying later.
Everyone close to him agrees with his life-ending decision.
And his doctor orders terminal sedation,
which will keep the patient permanently asleep
until the process of dying completes itself.
Is the doctor or anyone in the family guilty of 'assisting a suicide'?

    (3) A patient with a failing heart
has been given only a few months to live
if a transplantable heart is not found for him. 
With the support of his family and his doctors,
he removes himself from the pool of patients waiting for hearts.
He will receive comfort-care until his natural death.
Should anyone who cooperated in this life-ending decision
be charged with 'assisting a suicide'?

    (See several additional examples of
helping patients to make wise end-of-life medical decisions.)

    Because all of the traditional laws against 'assisting suicide'
are so brief and broad,
they should be replaced by more careful laws
that define which behaviors are permitted
and which behaviors are prohibited.

    Modern medicine has created many end-of-life situations
in which decisions must be made
that will either extend the life of the patient
or bring that life to a close.

    We want to continue to prohibit assisting irrational suicide.
But we also want to authorize reasonable end-of-life medical decisions.

    The replacement law to accomplish both goals
might be called "causing premature death".
This new law would define and describe 'premature death'.
And it would specify what would be a 'timely death'.

    Briefly, premature deaths have these four characteristics:
(1) harmful, (2) irrational, (3) capricious, & (4) regrettable.
And timely deaths have four opposite characteristics:
(1) helpful, (2) rational, (3) well-planned, & (4) admirable.

    And workable safeguards would be included in the law
to separate dying too soon from dying at the right time.

    Here are the 10 most likely safeguards to include:

1. Advance Directive for Medical Care.
2. Informed consent from the patient.
3. Psychological consultant reviews everything.
4. Doctor's summary of condition and prognosis.
5. Independent physician confirms the medical facts.
6. Hospital or hospice care.
7. Family members agree with the life-ending decision.
8. Ethics committee reviews the plans for death.
9. Legal review by a lawyer or the public prosecutor.
10. Waiting periods to re-evaluate all life-ending decisions.

    Many more safeguards might be included,
all of which could be used to defend against
the charge of causing a premature death.
When several safeguards have been carefully fulfilled,
assuring that the end-of-life decisions were reasonable,
why would any further investigation be needed?

    A draft of such a new law to replace the vague and overly-broad
laws against 'assisting suicide' will be found on the Internet
by searching for "Causing Premature Death".

    And several advantages of a new definition
of what is permitted and what is prohibited
will be found with this search-term:
"Advantages of the Premature-Death Approach to the Right-to-Die".

JAMES LEONARD PARK is the founder of Right-to-Die Minnesota.

Created February 26, 2015; Revised 3-3-2015; 3-4-2015; 3-19-2015; 4-7-2015; 4-21-2015; 4-25-2015;
5-8-2015; 5-12-2015; 5-13-2015; 5-14-2015; 6-22-2015; 8-28-2015; 10-31-2015; 11-30-2015;
1-28-2016; 5-25-2016; 6-8-2016; 7-7-2016; 7-8-2016; 1-25-2018; 6-17-2019; 1-14-2020; 


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    See several additional examples of assisting irrational suicides.

    See several additional examples of
helping patients to make wise end-of-life medical decisions.



    Related essays and chapters on the Internet:


Interpreting Laws Against 'Assisting Suicide'

Fifteen Safeguards for Life-Ending Decisions

Will this Death be an "Irrational Suicide" or a "Voluntary Death"?

Four Medical Methods of Managing Dying

Comfort-Care Only:
Easing the Passage into Death

Induced Terminal Coma:
Dying in Your Sleep---Guaranteed

Pulling the Plug:
A Paradigm for Life-Ending Decisions

VDD:
Why Giving Up Water is Better than other Means of Voluntary Death

Gentle Poison: The Demand for Quick Death

Draft model law against Causing Premature Death

Advantages of the Premature-Death Approach to the Right-to-Die



    If you have appreciated this op-ed piece,
here are four more concerning the right-to-die:

Should Minnesota Clarify End-of-Life Choices?

Do We Need a New Method of Dying?

Right-to-Die Hospice

Five Medical Methods of Managing Dying



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