Regarding assisted suicide, the realistic alternative in the case of the 28 year old would not be that she would live unhappily ever after. The alternative is an an unilateral suicide attempt by her.
Unilateral suicide attempts impose additional costs on society. The patient can rarely communicate their decision to anyone close to them beforehand because any confidant might have them locked up in psychiatry instead. The lack of ability to talk about any particulars with someone who knows her real identity[1], especially their therapist, will in turn mean that plenty of patients who could be dissuaded will not be dissuaded.
There is a direct cost of suicide attempts to society. Methods vary by ease of access, lethality, painfulness and impact on bystanders. Given that society defects against them by refusing to respect their choices regarding their continued existence, some patients will reciprocate and not optimize for a lack of traumatization of bystanders. Imagine being a conductor of any kind of train spotting someone lying on the tracks and knowing that you will never stop the train in time. For their loved ones, losing someone to suicide without advance warning also is a bad outcome.
I would argue that every unilateral suicide attempt normalizes further such attempts.[2] While I believe that suicide is part of a fundamental right, I also think that not pushing that idea to vulnerable populations (like lovesick teenagers) is probably a good thing. Reading that a 28yo was medically killed at the end of a long medical intervention process will probably normalize suicide in the mind of a teenager than reading that she jumped from a tall building somewhere.
Of course, medically assisted suicide for psychiatric conditions could also be a carrot to dangle in front of patients to incentivize them to participate in mental health interventions. Given that these interventions are somewhat effective, death would not have to be the default outcome. And working with patients who are there out of their free will is probably more effective than working with whatever fraction of patients survived their previous attempt and got committed for a week or a month. (Of course, I think it is important to communicate the outcome odds clearly beforehand: “after one year of interventions, two out of five patients no longer wanted to die, one only wanted to die some of the time and was denied, one dropped out of treatment and was denied and one was assisted in their suicide.” People need that info to make an informed choice!)
Realistically, I would not even bet on being able to have a frank discussion with a suicide hotline. Given that they are medical professionals, they may be required by law to try their best to prevent suicides up to and including alerting law enforcement, and phone calls are not very anonymous per default.
Assisted suicides would not necessarily legitimize unilateral suicide attempts. People can be willing to accept a thing when regulated by the state and still be against it otherwise. States collecting taxes does not legitimize protection rackets.
Regarding assisted suicide, the realistic alternative in the case of the 28 year old would not be that she would live unhappily ever after. The alternative is an an unilateral suicide attempt by her.
Unilateral suicide attempts impose additional costs on society. The patient can rarely communicate their decision to anyone close to them beforehand because any confidant might have them locked up in psychiatry instead. The lack of ability to talk about any particulars with someone who knows her real identity[1], especially their therapist, will in turn mean that plenty of patients who could be dissuaded will not be dissuaded.
There is a direct cost of suicide attempts to society. Methods vary by ease of access, lethality, painfulness and impact on bystanders. Given that society defects against them by refusing to respect their choices regarding their continued existence, some patients will reciprocate and not optimize for a lack of traumatization of bystanders. Imagine being a conductor of any kind of train spotting someone lying on the tracks and knowing that you will never stop the train in time. For their loved ones, losing someone to suicide without advance warning also is a bad outcome.
I would argue that every unilateral suicide attempt normalizes further such attempts.[2] While I believe that suicide is part of a fundamental right, I also think that not pushing that idea to vulnerable populations (like lovesick teenagers) is probably a good thing. Reading that a 28yo was medically killed at the end of a long medical intervention process will probably normalize suicide in the mind of a teenager than reading that she jumped from a tall building somewhere.
Of course, medically assisted suicide for psychiatric conditions could also be a carrot to dangle in front of patients to incentivize them to participate in mental health interventions. Given that these interventions are somewhat effective, death would not have to be the default outcome. And working with patients who are there out of their free will is probably more effective than working with whatever fraction of patients survived their previous attempt and got committed for a week or a month. (Of course, I think it is important to communicate the outcome odds clearly beforehand: “after one year of interventions, two out of five patients no longer wanted to die, one only wanted to die some of the time and was denied, one dropped out of treatment and was denied and one was assisted in their suicide.” People need that info to make an informed choice!)
Realistically, I would not even bet on being able to have a frank discussion with a suicide hotline. Given that they are medical professionals, they may be required by law to try their best to prevent suicides up to and including alerting law enforcement, and phone calls are not very anonymous per default.
Assisted suicides would not necessarily legitimize unilateral suicide attempts. People can be willing to accept a thing when regulated by the state and still be against it otherwise. States collecting taxes does not legitimize protection rackets.