Mortality Study Should Raise Doubts About Assisted Suicide

In a strong overview of the grim new study showing sharply elevated rates of suicide and drug overdose among middle-aged white Americans without college degrees, the American Prospect‘s Paul Starr writes:

Case and Deaton’s analysis, published today in the Proceedings of the National Academy of Sciences, also shows increased rates of illness, chronic pain, and disability among middle-aged whites. The findings have important implications for American politics and public policy, particularly for debates about economic inequality, public health, drug policy, disability insurance, and retirement income. The data also suggest why much of American politics may be taking on an increasingly harsh and desperate quality.

Starr is right that evidence of a worsening crisis among a population increasingly disconnected from America’s core institutions ought to (but, sadly, probably won’t) have an impact on several areas of U.S. public policy. One area of policy that did not make Starr’s list but which also ought to be scrutinized in light of the new data: physician-assisted suicide, which is legally available to more than 50 million Americans across five states and gaining in popularity nationwide.

The U.S. states that have legalized assisted suicide only permit the practice in cases where doctors determine that a person is terminally ill. But assisted suicide opponents have long pointed out that whether or not a sick person chooses to kill himself has more to do with whether he feels depressed or unsupported (feelings more common among the poor and vulnerable) than the intensity of the pain he is experiencing. Moreover, assisted suicide programs tend, by their own internal logic, to gradually expand in scope. In several European countries, doctors may prescribe fatal drugs to people who disabled or experiencing chronic pain.The new analysis on mortality, in other words, paints a picture of a population with exactly the qualities—desperation, depression, deteriorating physical condition—that we should be worried about when it comes to physician-assisted suicide. This population is killing itself at faster and faster rates—either through clear-cut suicides or through drug overdoses (which are sometimes difficult to distinguish from suicides)—and seems likely to push the boundaries on assisted suicide that are currently in effect. Widespread legalization of assisted suicide could make it easier for lower-income Americans to kill themselves—and, by changing the official designation of some of those deaths from “suicide” to “treatment”—would help sweep their misery under the rug.