Do people have the right to end their own lives? This question gets right to the core of whether the case brought by Fu Da-jen (傅達仁) is worth getting behind.
If one believes that people do, indeed, have the right to end their own lives, then the question of whether assisted suicide should be legalized depends on whether the regulatory framework required for the proper implementation of this right would be feasible and whether the social cost would be within the bounds of what society can tolerate.
We could perhaps approach the question from the experience of Switzerland, Belgium, the Netherlands and Luxembourg, where cases in which the right to die has been abused — for example, where a patient who had chosen assisted suicide was not fully in command of their mental faculties at the time, had not prepared advance directives requesting assisted death on behalf of their future self, or whose condition was still potentially curable — are few and far between, and the social costs are low.
Given that, if we determine that people should have the right to assisted suicide, the legalization of euthanasia is certainly something that we in Taiwan should give some thought to.
Generally, mainstream, established religions take a rather dim view of assisted suicide. The individual, within the cosmological view of these mainstream religions, has a very low status.
If the teachings espoused by these religions are correct, then people do not actually have this right and, this being the case, they cannot give permission to others to end their own life and there is no path to the legalization of assisted suicide.
That said, in the secular world, within free, democratic societies, where of course the religious faith of individuals must be respected on the level of constitutional government, an unavoidable question for citizens remains: Do people truly — independent of religious teachings — not have the right to end their own lives?
A landmark ruling handed down by the Supreme Court of Canada in 2015 said that an individual has the right to make use of a third party’s help in dying.
The reasoning the court gave was as follows: To deny this right might lead to people prematurely taking their own life, “often by violent or dangerous means,” as they might be worried that their condition would deteriorate to such a degree that one day they might be unable to end their own life and that a third party, too, would be powerless to give them the assistance they needed to end their own life.
In this case, they may be “condemned to a life of severe and intolerable suffering” until such time as they die from natural causes.
In the eyes of the Supreme Court judges, palliative care at a hospice, even when administered properly, could not fully prevent such circumstances from arising and palliative care has its own inherent limitations.
In this theoretical scenario, the Supreme Court of Canada was essentially asserting that the right to death derives from the right to life: If the law results in a situation in which people are forced to resort to “violent and dangerous means” to end their own lives prematurely, then it is in itself in violation of the right to life.
Irrespective of whether one agrees with this theoretical scenario, Taiwan actually does accept that an individual has the right to have a third party assist them in ending their own life.
The Hospice Palliative Care Act (安寧緩和醫療條例), as well as the new Patient Right to Autonomy Act (病人自主權利法), which is slated for implementation in 2019, would both give terminally ill patients the right to refuse treatment and give consent to medical personnel to facilitate the ending of their life by disconnecting them from life-support equipment.
Regrettably, these rights do not go far enough. Even with these, Taiwan will still not accord the individual the right to consent to a physician ending their life through lethal injection.
This position of limiting the rights of people desiring assisted suicide is difficult to defend. In terms of the outcome, disconnecting terminally ill patients from life-support equipment and administering a lethal injection both lead to death; in terms of process, medical personnel are involved in the death of the patient in both methods; and in terms of motivation, medical personnel would have no reason to be put off by the procedures because their actions will lead to the death of the patient.
It is possible to distinguish between the two methods: The act of disconnecting life-support equipment means that a medical professional is essentially just letting nature take its course, allowing a patient who will die either way to pass away without actually speeding up the death, but administering a lethal injection means expediting death.
However, this distinction might be splitting hairs, because once a patient is connected to life-support equipment, subsequently disconnecting this equipment still expedites the time of their death.
Fully acknowledging the right of the individual to give others consent to end their life does not in any way imply that medical personnel should have a duty to carry out this process.
If medical professionals’ religious beliefs prohibit them from assisting patients in this way, the government should respect their choice. However, the government should make it legal for those who are willing to give this kind of assistance to do so.
Shei Ser-min is a professor of philosophy at National Chung Cheng University.
Translated by Paul Cooper
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