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A Death of One’s Own

PRINCETON – Dudley Clendinen, a writer and journalist, has amyotrophic lateral sclerosis (ALS), a terminal degenerative illness. In The New York Times earlier this year, he wrote movingly both of his current enjoyment of his life, and of his plan to end it when, as he put it, “the music stops – when I can’t tie my bow tie, tell a funny story, walk my dog, talk with Whitney, kiss someone special, or tap out lines like this.”

A friend told Clendinen that he needed to buy a gun. In the United States, you can buy a gun and put a bullet through your brain without breaking any laws. But if you are a law-abiding person who is already too ill to buy a gun, or to use one, or if shooting yourself doesn’t strike you as a peaceful and dignified way to end your life, or if you just don’t want to leave a mess for others to clean up, what are you to do? You can’t ask someone else to shoot you, and, in most countries, if you tell your doctor that you have had enough, and that you would like his or her assistance in dying, you are asking your doctor to commit a crime.

Last month, an expert panel of the Royal Society of Canada, chaired by Udo Schüklenk, a professor of bioethics at Queens University, released a report on decision-making at the end of life. The report provides a strong argument for allowing doctors to help their patients to die, provided that the patients are competent and freely request such assistance.

The ethical basis of the panel’s argument is not so much the avoidance of unnecessary suffering in terminally ill patients, but rather the core value of individual autonomy or self-determination. “The manner of our dying,” the panel concludes, “reflects our sense of what is important just as much as do the other central decisions in our lives.” In a state that protects individual rights, therefore, deciding how to die ought to be recognized as such a right.