Is there some obligation to life? Ethical aspects of discussions about assisted suicide

Martin M. Lintner

Highschool of Philosophy and Theology of Brixen/Bressanone

Abstract

In the context of intensive discussion on the different legal regulations of assisted suicide, the underlying understanding of patient autonomy, plays an important role, but often this is not made the subject of discussion. The first understanding views autonomy not only as respect for the free will of a patient, but relates it to the principles of beneficence and nonmaleficence. A physician sees himself obliged to the principle salus aegroti suprema lex. In contrast to this today often we can find an understanding of patient autonomy in the sense of voluntas aegroti suprema lex, according to which the will of a patient obliges that of a doctor. The patient’s autonomy is not seen any more as the right to refuse medical interventions, but becomes a right to claim something. From the point of view of the latter the first concept is often criticized as paternalism. The author deals critically with both concepts of patient autonomy and tries to outline an understanding according to which autonomy and the need of care do not present a contrasting pair. He asks critically whether or under what conditions a voluntary request to be killed can really be understood as an expression of true autonomy. Further, he shows the social-ethical implications of the debate insofar the legal permission of assisted suicide can create a social climate of acceptance of suicidal acts. Finally, the author puts the question if hastened death by voluntary self-denial of food and drink can present a medical and ethical acceptable alternative to assisted suicide.

 

Keywords:

voluntary euthanasia, killing on request, assisted suicide, patient autonomy, care, voluntarily stopping eating and drinking