Family-Supported Suicide and the Duty to Die

Original Article

In 1991, my friend Frances invited me to a “going away party.” She wasn’t moving or going on vacation. Frances wanted her closest friends to come to her home, to tell her how much she meant to us, and to hold her hand as she committed suicide.

We refused. Validating Frances’s suicide was unthinkable. We supported her life, not her death.

After an intervention, she called the suicide off. But Frances was in the thrall of the then–nascent “death with dignity” movement. A year later, having been diagnosed with treatable leukemia, she paid a cousin to accompany her to a hotel where she took a lethal overdose and placed a plastic bag over her head—following instructions published in the Hemlock Quarterly. (Frances’s suicide became the subject of my first anti-euthanasia column, published by Newsweek in 1993.)

Times have changed. It is increasingly common for friends and family to support—and even to attend—the suicides of their ill, disabled, or despairing loved ones. Brittany Maynard’s husband and mother, for instance, fully backed her assisted suicide and are now on the advocacy circuit promoting its legalization.

Maynard’s case is hardly unique. When English teenager Daniel James was paralyzed playing rugby, he became distraught and suicidal. In 2008, his parents flew him to a Swiss suicide clinic. They later defended their participation in his death as an act of love, telling the media that their son “was not prepared to live what he felt was a second-class existence.”

In Belgium, elderly couples have been euthanized together because they would rather die than face future widowhood. Astonishingly, these joint killings have been supported by family and friends. In one reported case, the death doctor was procured by the couple’s son—even though his folks were not ill. Similarly, the English conductor Sir Edward Downes died with his cancer-stricken wife Joan at a Swiss suicide clinic, a decision quickly endorsed in the media by their children.

Most recently, NPR-syndicated radio personality Diane Rehm very publicly supported her husband John’s suicide by self-starvation—a process known in euthanasia advocacy as (voluntary stopping eating and drinking). She told the New York Times that they had made a pact to help the other die if suffering seriously with a terminal illness. (John had Parkinson’s disease.) “There was no question but that I would support him and honor whatever choice he would make,”she said. “As painful as it was, it was his wish.” Rehm, like Maynard’s family, is now using her experience as an argument in favor of assisted-suicide legalization.

Is it right or wrong to support a loved one’s suicide? This seems to be one of those issues, increasingly prevalent in our society, about which debate is not possible: The answer depends on one’s overarching worldview. Some will believe that their duty is to support their family member’s choice, come what may. Others, including this writer, believe that supporting suicide is an abandonment that validates loved ones’ worst fears about themselves—that they are a burden, unworthy of love, or truly better off dead.

Either way, there is no question that family backing for suicide furthers the normalization of hastened death as a proper response to human suffering. Such normalization, over time, will put increasing pressure on those coping with the infirmities of age and with the debilitations of serious illnesses and disabilities to view their suicides as not only a suitable approach, but perhaps even as an obligation to those they love.

This is known in bioethics as the “duty to die” and has been debated for years in professional discourse. As described by John Hardwig in the Hastings Center Report:

A duty to die is more likely when continuing to live will impose significant burdens—emotional burdens, extensive caregiving, destruction of life plans, and, yes, financial hardship—on your family and loved ones. This is the fundamental insight underlying a duty to die.

One of Hardwig’s examples regards the elderly:

A duty to die becomes greater as you grow older. . . . To have reached the age of, say, seventy-five or eighty years without being ready to die is itself a moral failing, the sign of a life out of touch with life’s basic realities.

No, a day won’t come when the euthanasia police kick down doors and force unwanted lethal injections upon the sick and elderly. But legal compulsion isn’t the only way to push people out of the lifeboat. The more public support families and friends give their ill or debilitated loved ones’ suicides, the greater the prospect that a moral duty to die will become culturally legitimate.

Wesley J. Smith

Chair and Senior Fellow, Center on Human Exceptionalism
Wesley J. Smith is Chair and Senior Fellow at the Discovery Institute’s Center on Human Exceptionalism. Wesley is a contributor to National Review and is the author of 14 books, in recent years focusing on human dignity, liberty, and equality. Wesley has been recognized as one of America’s premier public intellectuals on bioethics by National Journal and has been honored by the Human Life Foundation as a “Great Defender of Life” for his work against suicide and euthanasia. Wesley’s most recent book is Culture of Death: The Age of “Do Harm” Medicine, a warning about the dangers to patients of the modern bioethics movement.