An Australian philosopher argues that turning their requests down is discriminatory

Not waving but drowning / Ian Espinosa on Unsplash

A state of non compos mentis might seem like an excellent reason to remove people from the pool of those eligible for euthanasia. But what if they had signed an advance directive instructing their carers to have them euthanised if they became non compos mentis? What if they float in and out of dementia? What if they seem happy with their life?

This is one of euthanasia’s most sternly contested battlefields. In a recent article on the Journal of Medical Ethics website, Australian philosopher Joshua James Hatherley present three arguments in support of his belief that physician-assisted suicide is morally permissible for people with psychiatric conditions.

It is often argued that  “psychiatric conditions compromise a person’s decision-making capacity”. True enough, says Hatherley — but not all psychiatric conditions and not all persons. Excluding anyone with a psychiatric illness is discriminatory. They should be assessed in a more granular fashion to see if they can give their informed consent.

A person’s psychiatric condition may eventually be treatable. But why should they wait, asks Hatherley. If they have suffering for years, it is unlikely that relief is on its way “The certainty of relief that PAS [physician-assisted suicide] would bring, then, would be far preferable to the uncertainty of further dubious treatments.”

Many people fear that PAS for people with mental illness is simply too risky for society. It might decrease investment in mental health. It might also remove hope from the horizon of patients and make their suffering unbearable. However, Hatherley points out, this is also true for people with physical illness – and they are allowed to access PAS.

Hatherley’s ace is the notion of discrimination. He concludes:

“ … in jurisdictions wherein PAS is currently permitted for those suffering from somatic conditions, the exclusion of psychiatric patients on the basis of any of the three arguments addressed in this paper would constitute an instance of unjustifiable discrimination against those suffering from psychiatric conditions.”

Michael Cook is editor of BioEdge   

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Michael Cook

Michael Cook edits BioEdge, a bioethics newsletter, and MercatorNet, an on-line magazine whose focus is human dignity. He writes from Sydney, Australia.

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