Saturday, December 17, 2005

Swiss suicide

The university hospital in Lausanne has decided to allow assisted suicide on its premises.

I wrote a Criminal Law paper in 2002 on the relationship between euthanasia and patients in persistent vegatative state (PVS). Assisted suicide is a different beast, but all part of the same argument, really.

It would seem that this practise is only going to become more prevalent around the world. It is already legal in some jurisdictions, to assist terminally ill patients to suicide, in, theoretically, strictly controlled conditions. Usually, these laws require (1) terminal illness, (2) doctors certifying the patient will not recover, (3) competence on the part of the patient, and (4) no practitioner involvement in the act which constitutes suicide, apart from the ability to provide a lethal concoction of drugs. This method of assisted suicide is legal in, for example, The Netherlands and Switzerland, as well as Oregon. There is a huge case being decided in the Supreme Court of the US on the constitutionality of the statute in Oregon.

The ethical concerns surrounding these practices are many. Of course, there is the issue of 'competence' and when a patient is actually competent to make a decision. A patient can be perfectly mentally aware but clinically depressed, or can be competent but feeling either direct pressure from children or the indirect feeling that they are becoming a 'burden'. Regulating improper influence is incredibly difficult.

I posted once about the 'sperm ship' and this is another example of what could be called 'regulatory arbitrage'. Basically, the ability of persons to seek out a jurisdiction which suits their agenda means there is a race to the bottom in terms of regulation. In Victoria, I cannot receive assistance to die, so I join the new 'death tourism' phenomenon and go somewhere I can.

The solution is not immediately obvious. Whilst generally in favour of removing life support for PVS patients, assisted suicide is an entirely different proposition. What are people's views?


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