Medically enabled suicides

Medically enabled suicides occur when an individual (a) puts herself in a physiological condition requiring lifesaving medical care, and (b) the individual takes advantage of recognized treatment protocols (e.g., advance directives) requiring the withholding or withdrawal of care from competent patients to ensure that medical personnel enable her to die. Such suicides are likely to be attractive to those with chronic illnesses who either do not live in jurisdictions legally permitting assisted dying or who do not meet the legal requirements for assisted dying. Here I consider (and reject) two ethical objections to medical personnel refusing to participate in medically enabled suicides. The first alleges that medical care providers may not contribute to harming their patients, and so they may not contribute to their patients’ suicides. The second alleges that if care providers, as a matter of personal conscience, believe that suicide is wrong, then they may not be compelled to contribute to their patient’s acting wrongly by assenting to the wishes of a patient pursuing medically enabled suicide. Both dilemmas arise from the fact that while medical personnel are bound by widely accepted precepts of medical ethics to honor the competent wishes of their patients, medically enabled suicides entangle them in their patients’ suicidal plans in ways that result in their contributing to those suicides. I conclude that neither dilemma should be resolved in the direction of medical personnel having the right to refrain from involvement in medically enabled suicides. Thus, while we may find medically enabled suicide distasteful or exploitative, a strong case cannot be made that medical personnel refusing to involve themselves in such suicides is ethically permissible.