Assisted Suicide



A strong taboo cloaks the subject of suicide even though it is part of the human reality. The subject is complex and judgements on suicide cover the whole range from the judeo-christian position that it is a mortal sin worthy of eternal hell to the the limitless admiration of heroic acts of self sacrifice that are also a form of suicide (think of the Japanese kamikases in WWII and of today's islamic bomb bearers). Suicide is however generally condemned for it often reflects upon a society's inability to integrate all of its members into a harmonious whole.

Personnally, I hold the opinion that taboos and censorship generally serve the interests of manipulators and that we should feel free to explore all aspects of this question. Recent high visibility cases of assisted suicide, voluntary euthanasia and non-voluntary euthanasia have prompted the Humanist Foundation of Québec to set up a commitee to study this question. This page is a first attempt to clarify the matter of responsibility in suicide.


The medical machine

Dominated by the hypocratic oath, medical ethics impose the obligation to prolong life in all circumstances even when the quality of the life remaining is more important to the patient than its duration. The fragmentation of medecine into more and more narrow specialities tends to concentrate the attention of medical personnel on the struggle against the specific illness they are treating at the expense of the general well being of the patient. Finally, the progress of medical science now makes it possible to considerably prolong life by correcting many organic deficiencies that would have previously caused death.

We are all likely to survive medical incidents that would have carried us away a few decades ago. To prolong life constitutes a remarkable acheivement when the quality of life can be maintained at a high level but that is not allways the case.

Only the concerned individual can evaluate the bottom line between the prolongation of his life and the degradation of its quality. It is quite legitimate for a patient to prefer death to unbearable suffering in his prolonged life. It is perfectly reasonable for such an individual to choose a rational suicide when there is no hope of improvement in his condition. Such a liberation is his right and suicide is legal..

Generally however, the exercise of that right is legal only when the subject is capable of carrying it out by himself. Indeed, the laws of most countries prohibit a third party from helping someone to commit suicide. Exceptions are still few, Switzerland, the Netherlands, Belgium and Oregon, but the list is growing.

And yet, all public opinion polls, and there are many, reveal an overwhelming majority in favour of the availability of assisted suicide when requested by an agonising patient seeking to be freed from unbearable suffering in terminal phase. This contradiction between legislations and the will of the people reveals once more the failure of democraties exposed to the intervention of powerful private interests. In the case of assisted suicide, powerful religious organisations manage to impose their will on the majority in most countries even in those that claim to be secular.


Between suicide and murder

In real life, the specific circumstances of each case introduce a series of greys between the black and white of suicide and murder.  The following table seeks to distinguish some broad categories as to the responsibility shared between the concerned individual and the medical profession.

Nobody can be held responsible for a suicide carried out during a psychological crisis and especially not the subject that is not in full command of himself.
not applicable
The victim of a rationnal suicide is no doubt responsible for taking his life but that act is perfectly legal for it is considered a fundamental right of any individual.
not applicable
The classical medical protocol seeks to prolong life at all costs. These principles, that aim mostly to satisfy the Hypocrates oath of doctors, too often lead to therapeutic abuse would be a crime to impose on animals. The terror of facing the possibility of being forced to undergo such treatments is a reasonable justification for rationnal suicide,
not applicable
Moderate palliative care seeks to reduce the patient's pain and turmoil without doing anything that might shorten his life. They are also a convenient way for politicians to side track the prickly issue of assisted suicide even though the required resources are available for only a fraction of the patients that request that kind of treatment. The hypocrisy about this is huge.
not applicable
Extreme palliative care gives priority to the quality of the patient's life even if this can shorten its duration.  Palliative care , even extreme, remains a compromise between the legal liabilities of the medical personnel and the legitimate interest of the patient claiming the right to die with dignity and without pain. The difference between moderate and extreme palliative care resides in the courage of the medical personnel to come close to the borderline with assisted suicide or voluntary euthanasia.
not applicable

In assisted suicide, the medical personnel provides the patient with the means to end his life but they do not participate in the fatal act. Precautionary dispositions can easily garantee that the subject's will to end his life is authentic, persistent and free of any coercion. Experience with the permissive legislative framework of Oregon has shown that the availability of assisted suicide has often allowed the dying to live their agony to the end without using it.

not applicable

We are dealing with voluntary euthanasia when the medical personnel intervene actively to end the patient's life as per his wishes, previously clearly expressed, when he is no longer able to carry it out himself.



To let a patient die without intervening is acceptable when it happens as per the latter's previous instructions. This is where the biological will and the mandate in case of incompetence come into play.
Non-voluntary euthanasia occurs when an active intervention provides an "easy death" to end an agonising person's physical and moral suffering without specific instructions to that effect from the subject. The concensus is that this is murder but courts of justice will sometimes recognise attenuating circumstances when compassion is the sole motive. Letting a patient die without specific instructions from him to that effect can lead to a charge of abandonning a person in danger for his life.


Premature Suicide

Opponents of assisted suicide (religious groups), give themselves a good conscience by claiming that advanced "palliative care" can now reduce the physical and moral suffering of patients in terminal agony to a sufficient degree that it becomes acceptable to refuse the liberation they request.

These self righteous persons, who rush to deliver the "coup de grâce" to a severely wounded animal, do not find it cruel to prolong the agony of the dying because "suffering is good for the soul" or because "only GOD should choose the moment of death". What a monstrous hypocrisy it is that they impose their creed on everyone else in this manner!

Getting rid of the problem by mentionning "palliative care" is only a red herring because the resources necessary to offer such care efficiently are insufficient to meet the demand. The "palliative care" option will be credible only if it becomes a real alternative to assisted suicide, that is, when both will be equally available.

If at the critical moment, neither assisted suicide nor efficient palliative care are available, then you will become, like so many others, a "case" of a disease that the medical machine will combat to the end (yours), no matter what suffering that will cause you.

The only defense you will have against therapeutic abuse will be of having taken the precaution of signing a biological will before witnesses and distributing it widely enough that the medical machine cannot ignore it.

The thought that I will not be able to ask my doctors to help me put an end to my suffering makes me desperate. I am absolutely terrified by the perspective of being prisonner of a huge medical "machine" programmed to impose on me all kinds of treaments and procedures to prolong my life at all costs without regard for my wish to die.

If we try to imagine ourselves in the patient's shoes, we are forced to realise that forbidding assisted suicide is tantamount to an invitation to commit suicide prematurely to avoid being trapped by the medico-legal machine.

Bernard Cloutier
updated in July 2006



Exit International:
World Federation of Right to Die Societies:

Deusche Geselschaft fur Humanes Sterben (DGHS):

Voluntary Euthanasia Society of New South Wales:
Voluntary Euthanasia Society of Queensland:
Voluntary Euthanasia Society of Tasmania:
Voluntary Euthanasia Society of Victoria:

Association pour le Droit de Mourir dans la Dignité:

Choices in Dying:
Dying with Dignity:
Right to Die Society of Canada:

Fundación pro Derecho a Morir dignamente (D.M.D):

Derecho a Morir Dignamente (D.M.D):

Compassion & Choices:
Compassion in Dying of Oregon:
Death With Dignity National Center:
Euthanasia Research & Guidance Organisation (ERGO):
Final Exit Network:


Association pour le Droit de Mourir dans la Dignité:

United Kingdom:
Exit Scotland:
Friends at the End (FATE):
Voluntary Euthanasia Society:


Exit Italia:

Société japonaise pour mourir avec dignité:

New Zealand:
Voluntary Euthanasia Society of NZ :

Right to Die NL:

Exit/ADMD Suisse Romande:
EXIT/Vereinigung fur Humanes Sterben: http:/



Gervais Karen G. Redefining Death,- Yale University Press, ew Haven & London, 1986
Humphry Derek Final Exit, Random House, New York, 2002
"             "             The Good Euthanasia Guide,Norris Lane Press, Junction City, OR, 2005
Hillyard Daniel & Dombrink John Dying Right,Routledge, London 2001
Jamison Kay R Night Falls Fast, Random House, New York, 1999
Quill Timothy E.

Death and Dignity, Norton Co. New York, 1993

Weenolsen Patricia The Art of Dying


André Monjardet      Euthanasie et législation en France    
   "             "             Euthanasie et pouvoir médical



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