The Sanctity of Human Life

Chapter 3. PHYSICIAN-ASSISTED SUICIDE

C H A P T E R 3 PHYSICIAN-ASSISTED SUICIDE THEOLOGY, PHILOSOPHY, AND POLITICS Following the procedure of the preceding chapters, I deal with the question of physician-assisted suicide in three contexts: theological, philosophical, and political. In fact, the separation of these three contexts of the normative discussion of this question can be more precisely maintained here than in the preceding chapters because the theological discussion of this question need not be largely constructed anew, on the heels of the philosophical arguments, so to speak. The sources that are pertinent to the overall question of suicide and the question of agency that is so central to the question of appointing a physician to help a person commit suicide are very evident and extensive in the Jewish tradition. As such, for the most part they need representation rather than construction de novo. Conversely, the theological sources that are pertinent to a question such as universal health care and certainly to a question such as stem-cell research are much less evident and extensive in the Jewish tradition. In contrast to the two preceding chapters, we can make the transition from theology to philosophy and then to politics more easily in this chapter because we can more easily begin with theology. As a theologian, I begin with theology because my primary existential and intellectual commitment lies there. I can begin there with greater ease because I need not first confront the normative 111 question at hand in a philosophical context, as was the case with stem-cell research (because that question initially arose in a philosophical context). Similarly, I need not first confront the normative question at hand in a political context, as was the case with universal health care (because that question initially arose in a political context). In dealing with the normative questions of the two preceding chapters, I had to continually work backward into theology, either from the philosophical discussion or from the political discussion . Therefore, in those chapters, the logical sequence of the discussion often had to be different from its rhetorical sequence. In this chapter, however, the logical sequence of the discussion and the rhetorical sequence run together for the most part. WHO IS GUILTY IN PHYSICIAN-ASSISTED SUICIDE? The moral judgment about the act of physician-assisted suicide largely depends on how the act of suicide itself is judged. Physicianassisted suicide presupposes suicide, but suicide itself does not necessarily entail a physician’s assistance. In fact, most suicides are truly reflexive acts (the sui in suicide); they are committed without any outside assistance. So why would anyone want someone else’s assistance, whether that person is a physician or not, for an act that the person almost always can commit quite easily himself or herself? I return to this question later in this chapter when I examine what the motivation might be for seeking assistance in committing suicide. That motivation might be different from the motivation in seeking assistance in committing homicide—the act to which suicide most often is compared if not actually subsumed. One’s intention in committing suicide and seeking assistance in doing so is different, however— phenomenologically, if not legally—from one’s homicidal intention and one’s intention in seeking assistance from others in committing murder. To begin, however, I look at the legal connection in Judaism between suicide and a physician’s assistance in committing it. I then locate precisely the derivation of the prohibition of suicide—because suicide is not explicitly prohibited in scripture. Homicide, on 112 Physician-Assisted Suicide the other hand, is explicitly prohibited in the Decalogue: “Thou shalt not murder” (Exodus 20:13; Deuteronomy 5:17). Suicide and homicide obviously are closely related acts, yet there are some signi ficant differences between them.1 Both homicide and suicide are prohibited in the Jewish tradition . Legally, they differ only in terms of the punishment they entail as sins or crimes. Of course, if every suicide is judged after the fact to have been psychotic behavior—which most if not all Jewish jurists now take for granted—there is no punishment for what is regarded as behavior that was induced by forces that truly overwhelmed the self-destructive person himself or herself.2 Whether the suicide was really beyond the control of the now-deceased person who killed himself or herself, however, is left to the judgment of God in and for the...