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Bioethics Watch
Suicide — Prevention or Assistance?

by Nancy Valko

Early this year people across the United States were shocked by the news that three Cornell University students committed suicide within the span of a few days. Many news stories searched for reasons for such sad and senseless deaths. What had gone wrong? Could these troubled students have been helped? How?

Coincidentally, at about the same time as the Cornell tragedies, news stories reported on the first anniversary of Washington State’s law legalizing physician-assisted suicide. The New York Times reported on March 4, 2010, that 36 people had died as a direct result of the new law.

Suicide is a death like no other. It complicates the grieving process for everyone involved and can even increase the risk of suicide for surviving family and friends. I know this both professionally as a nurse and personally as a mother. Last October, my much loved 30-year-old daughter, Marie, died by suicide using a “textbook Final Exit” technique, according to the medical examiner. However, Marie was not terminally ill or disabled but rather under treatment for substance abuse and mental health issues. Tragically, like so many young people, she was all too familiar with web sites supporting suicide and assisted suicide.

Suicide is a critical problem in our society and affects virtually every age group.  More than 33,000 people die by suicide in the US every year, and authorities estimate that there are hundreds of thousands of suicide attempts annually. The National Institute of Mental health cites “exposure to the suicidal behavior of others, such as family members, peers or media figures” as a risk factor for suicide.

If trying to prevent such deaths seems obvious to most of us, there are people want to assist in making it happen. Assisted suicide was first presented to the public in Oregon in the 1990s as a last resort for unrelieved pain in the terminally ill. Since then, however, Oregon’s yearly reports show that the 40 to 60 assisted suicide deaths reported each year are overwhelmingly motivated by a perceived loss in quality of life rather than pain.

Despite a unanimous 1997 US Supreme Court decision finding no constitutional right to assisted suicide, supporters continue to campaign relentlessly to legalize assisted suicide in every state. Unfortunately, such efforts have found support not only in state courts but also in the popular culture.

Now we have three states — Oregon, Washington and Montana — with legalized assisted suicide, and relentless efforts by groups like Compassion and Choices (formerly known as the Hemlock Society) to pass assisted suicide laws in other states. Assisted suicide is defended by these groups as a rational and even altruistic decision when a person is suffering and feels he or she no longer wants to live. Unfortunately, this message is also filtering down to the people in our society who are most at risk for suicide, like my daughter.

As a nurse with 40 years experience, I know how to control pain and other symptoms in dying people and I will do anything for any of my patients — except kill them or help them kill themselves.  I have also cared for suicidal people and I know the very real psychic and other pain that drives them to consider suicide. But I also know that suicide prevention and treatment does save lives.

Assisted suicide supporters may not want to admit it, but legalizing the participation of a medical professional or anyone else in suicide is not the admirable exercise of an alleged right but rather a dangerous demand for total control of death. Such control has terrible consequences not only for suicidal people and their families but also for the most basic medical ethics that protect all of us.

I would never have helped my daughter Marie kill herself under any circumstances. I would have continued fighting for her life. I wouldn’t have been holding her hand and supposedly respecting her decision to end her suffering as assisted suicide supporters suggest. That kind of so-called tolerance is really lethal despair and abandonment. “No” is a powerful and even lifesaving word. Marie, like everyone else, deserved a natural lifespan and the help to live it as well as possible until the end.

With so many suicide deaths and attempts yearly in the United States, we cannot recognize suicide as a tragedy to be prevented if possible while simultaneously glorifying assisted suicide as a courageous decision. Our most vulnerable people — young, old, dying, disabled, etc. — are listening and watching our response to the argument that some lives are not worth living.

We know of no Catholic suicide-prevention agencies as such, but many dioceses do have grief-support groups that might help people who may be considering ending their lives.

The Catechism of the Catholic Church, in its section on the Fifth Commandment, “You shall not kill”, addresses both suicide and euthanasia. As assisted suicide can be seen as a combination of both forms of killing, a review of the basic teaching of the Catholic Church on these life-and-death moral problems may help give direction. (See excerpts)

One thing is very clear: we must not discriminate as to who is worth saving when it comes to suicide prevention and treatment. We must oppose all forms of suicide promotion including assisted suicide.

Nancy Valko, a registered nurse from St. Louis, is president of Missouri Nurses for Life, a spokesperson for the National Association of Pro-Life Nurses and a Voices contributing editor.

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