The sticking point, of course, is what constitutes a justifiable reason to kill yourself—or have a doctor do so for you.
Today, February 20, marks the tenth anniversary of Hunter S. Thompson killing himself with a .45-caliber handgun in his home in Woody Creek, Colorado. Since his suicide, the right-to-die movement has gained a stronger foothold in American consciousness—even if the country is just as divided as ever on whether doctors should be assisting patients in ending their own lives.
“Poling has always shown a majority of people believing that someone has a moral right to commit suicide under some circumstances, but that majority has been increasing over time,” says Matthew Wynia, Director of Center for Bioethics and Humanities at the University of Colorado Anschutz Medical Campus. Wynia believes a chief factor in that change has been “more and more people say they’ve given a good deal of thought on this issue. And the more people tend to give thought to this issue, the more likely they are to say they are in favor of people having a moral right to commit suicide, under certain circumstances.”
The sticking point is what constitutes a justifiable reason to kill yourself or have a doctor do so for you. In Thompson’s case, he was suffering from intense physical discomfort due to a back injury, broken leg, hip replacement surgery, and a lung infection. But his widow, Anita, says that while the injuries were significant, they did not justify his suicide.
“His pain was unbearable at times, but was by no means terminal,” Anita tells me via email. “That is the rub. If it were a terminal illness, the horrible aftermath would have been different for me and his loved ones. None of us minded caring for him.”
A mix of popular culture and legislative initiatives have shifted the terrain since then. When Thompson made his big exit in 2005, Jack Kevorkian was still incarcerated for helping his patients shuffle off their mortal coil. He was released in 2007, and shortly before his death a few years later, HBO chronicled his struggles to change public opinion of physician-assisted suicide in the film You Don’t Know Jack, starring Al Pacino.
Last year, suicide seemed to cross a threshold of legitimacy in America. When terminally ill 29-year-old Brittany Maynard appeared on the cover of People magazine next to the headline, “My Decision to Die,” the issue was thrust into the faces of every supermarket shopper in the US. Earlier in the year, the season finale of Girls closed with one of the main characters agreeing to help her geriatric employer end her life, only to have the woman back out after swallowing a fistfull of pills, shouting, “I don’t want to die!”
After the self-inflicted death of Robin Williams last summer, those with strong moral opposition to suicide used the tragedy as an illustration of how much taking your life hurts those around you. “I simply cannot understand how any parent could kill themselves,” Henry Rollins wrote in an editorial for LA Weekly. “I don’t care how well adjusted your kid might be—choosing to kill yourself, rather than to be there for that child, is every shade of awful, traumatic and confusing. I think as soon as you have children, you waive your right to take your own life… I no longer take this person seriously. Their life wasn’t cut short—it was purposely abandoned.”
A decade earlier, Rollins’s comments might have gone unnoticed. As might have Fox News’ Shepard Smith when he referred to Williams as “such a coward” for abandoning his children. Of course, both received a good lashing in the court of public opinion for being so dismissive toward someone suffering from depression. “To the core of my being, I regret it,” Smith apologized in a statement. Rollins followed suit, saying, “I should have known better, but I obviously did not.”
A 2013 Pew Research Poll found that 38 percent of Americans believed that a person has a moral right to commit suicide if “living has become a burden.” But if the person is described as “suffering great pain and have no hope of improvement,” the number increased to 62 percent, a seven-point jump from the way Americans felt about the issue in 1990.
Still, only 47 percent of Americans in a Pew poll last October said that a doctor should be allowed to facilitate a suicide, barely different from numbers at the time of Thompson’s death. Wynia believes an enduring factor here this is the public’s fear that assisted suicide will be applied as a cost-cutting measure to an already overburdened healthcare system.
“There is worry that insurance companies will cover medication to end your life, but they won’t cover treatments that allow you to extend your life,” he says. “And then the family is stuck with either ponying up the money to extend that person’s life, or they could commit suicide. That puts a lot of pressure on both the family and the individual. Also, there is the issue of the doctor being seen as a double agent who isn’t solely looking out for their best interest.”
As with abortion before Roe v. Wade, when determined citizens are denied medical assistance and left to their own devices, the results can sometimes be disastrous. “There are people who try and fail at suicide, and sometimes they end up in much worse positions than they started,” Wynia adds. “I’ve cared for someone who tried to commit suicide by drinking Drano; that’s a good way to burn out your entire esophagus, and if you survive it, you’re in very bad shape afterward.”
A 2014 Gallup poll showed considerably more support for doctors’ involvement in ending a patient’s life. When asked if physicians should be allowed to “legally end a patient’s life by some painless means,” 69 percent of Americans said they were in favor of such a procedure. But when the question is whether physicians should be able to “assist the patient to commit suicide,” support dropped to 58 percent. This has lead many advocacy groups to adopt the term “aid in dying” as opposed to “assisted suicide.”
A statement on the Compassion and Choices website states: “It is wrong to equate ‘suicide,’ which about 30,000 Americans, suffering from mental illness, tragically resort to each year, with the death-with-dignity option utilized by only 160 terminally ill, but mentally competent, patients in Oregon and Washington last year.”
According to Oregon’s Death With Dignity Act—which permitted Brittany Maynard to be prescribed a lethal dose of drugs from her physician—a patient must be over 18 years old, of sound mind, and diagnosed with a terminal illness with less than six months to live in order to be given life-ending care. Currently, four other states have bills similar to Oregon’s, while 39 states have laws banning physician-assisted suicide. Earlier this month, legislators in Colorado attempted to pass their own version of an assisted suicide bill, but it failed in committee.
In 1995, Australia’s Northern Territory briefly legalized euthanasia through the Rights of the Terminally Ill Act. Dr. Philip Nitschke was the first doctor to administer a voluntary lethal injection to a patient, followed by three more before the law was overturned by the Australian Parliament in 1997. Nitschke retired from medicine that year and began working to educate the public on how to administer their own life-ending procedure without medical supervision or assistance. Last summer, the Australian Medical Board suspended his medical registration, a decision which he is appealing.
Nitschke says two states in Australia currently offer life in prison as a penalty for anyone assisting in another’s suicide, and that he’s been contacted by the British police, who say he may be in violation of the United Kingdom’s assisted suicide laws for hosting workshops educating Brits on how to kill themselves. Unlike more moderate groups like Compassion and Choices, Nitschke’s Exit Intern