On October 29, the Philodemic Society gathered to debate whether or not physician-assisted suicide should be legalized in the United States. Mr. Josh Weiner of Illinois (COL ’16) gave the keynote on the affirmation and Ms. Janelle Spira of California (NHS ’18) gave the negation’s keynote.
Mr. Weiner opened the debate by defining physician-assisted suicide (PAS) as an act in which a doctor knowingly and willingly provides the means for a patient to commit suicide. Furthermore, only the patient would be the one to administer the drug. Mr. Weiner wanted the floor to understand that this debate was not meant to discuss the question of euthanasia, where doctors can kill a patient without their conscious and informed consent. As an example of this kind of PAS, Mr. Weiner pointed to Oregon’s “Death With Dignity Act” (1996). In order for an individual to receive lethal drugs in this world, a patient requires the approval of two doctors and a diagnosis of no more than six months to live. Mr. Weiner argued that PAS is a natural extension of the right to autonomy, and that it would prevent unnecessary pain for patients in the final stages of their lives.
Ms. Spira began her keynote with and excellent recitation of the lesser-known half of Hamlet’s famous soliloquy. Ms. Spira asked the floor to consider the doctor-patient relationship during the first half of her keynote. She argued that doctors must take the Hippocratic oath seriously and refuse to prescribe drugs solely for the purpose of individuals killing themselves. Breaking the Hippocratic oath would lead to patients being less willing to trust their doctors. The second half of Ms. Spira’s keynote focused on the necessity of limiting personal autonomy. She asked the floor to consider the economic incentives that would lead the medical system to suggest that chronically ill and destitute patients choose PAS instead of treatment. Furthermore, limitation of autonomy is necessary when it accomplishes making people equal before the law. Limiting access to PAS would ensure protecting poor patients from perverse incentives. Furthermore, Ms. Spira informed the society that there have been countries in which PAS was legalized that have since legalized other forms of euthanasia that do not require conscious consent. For this reason, legalizing PAS would open the door to legalizing euthanasia.
Mr. Hallisey opened the floor portion of the debate by requesting the floor to conceptualize the debate as one about life, not death. He then claimed that an effective life, one in which a person has the ability to choose the way they want to live, is the only type of life worth living. Mr. Schafer responded to Mr. Hallisey by reminding the society that there are many people who lack the ability to achieve their goals at all points of their lives because of physical or mental limitations. He argued that their lives are still worth living, and that there is meaning in the constant fight to overcome limitations and pain.
Mr. Ernst believed that the negation was confusing the floor with a slippery slope argument. He argued that while people should relish the opportunity to conquer pain at certain points in their lives, the end of one’s life is not a time to overcome pain. He claimed that he would rather die with dignity than be subject to unnecessary pain and suffering. Mr. Reid Kelley (COL ’13) rebutted Mr. Ernst by pointing out that a slippery slope is only illegitimate if the logical progression between each step is not clear. He then reasoned that if doctors are prescribing lethal pills, then they should be the ones to administer the medication.
Mr. Fletcher responded to Mr. Kelley by arguing that while PAS has progressed to euthanasia in other countries, it would not necessarily happen in the United States. Furthermore, concerns that people would make decisions based on cultural pressures are unfounded, as all people make their decisions based on rational thinking. Ms. Hernick answered Mr. Fletcher by pointing out that the principles of mercy and unlimited autonomy at their logical extremes support the practice of euthanasia. Ms. Hernick continued her speech by claiming that because statistics about Oregon’s PAS program rely on doctors self-reporting we cannot confidently claim that the system is not being abused.
Mr. Kleinman considered it extremely easy to stand on the affirmation. For him, if there was even one case in which PAS should be legal, then the practice should be legal. He then informed the society that NASA gave their astronauts cyanide so that they could kill themselves if there was ever a problem with their mission. The purpose of this story was to show that if someone were to face helplessly floating in the void of space until they ran out of oxygen, then PAS would appear to be justified. Chancellor Whelan rejected Mr. Kleinman’s notion of a law and substituted his own definition. He argued that a law should be morally permissible most of the time, and that if it does not meet that standard it should not be enacted. To end his speech, Chancellor Whelan asked the floor to cease discounting the intensity of mental pain in the context of the debate, and the possible ways it could contribute to an individual’s decision to pursue PAS.
Mr. Graff declared that Chancellor Whelan was attacking a straw man and that the society ought to ignore his argument. He continued by informing the society that it was none of their business how much pain a person is in, and that a suffering individual is qualified to judge that pain for his or her self. Mr. Graff conceded that the possibility of negative externalities was troubling, but that externalities could not outweigh the enormous utility of legalizing PAS. Mr. Marrow agreed that Chancellor Whelan was wrong, and instructed the society to consider the legitimate interest the state has in limiting the ability of its citizens to take their own lives.
With Healey Hall’s bells chiming, Ms. Julia Friedmann (SFS ’19) related a touching anecdote of her emotions when she realized her grandma was going to die. She told the society that even though her grandma had survived the Holocaust, she deserved the opportunity to decide whether or not she wanted to take advantage of PAS to die with dignity. Ms. Caroline Provost (COL ’19) argued that PAS did not need to be legalized because improving the effectiveness and affordability of hospice care would achieve the same goal as PAS.
Ms. Nina Young (SFS ’19) brought up the sensitive discussion of Alzheimer’s disease. She argued that living with Alzheimer’s is a life without purpose or meaning. She asked the society to consider whether they actually have the right to tell someone not to die when they’re faced with a meaningless life. In response, Mr. James Jennings (COL ’19) posited that the health care industry effectively puts a dollar value to maintaining human life, and that insurance providers have incentives to keep costs low. This incentive would lead to a sub-optimal outcome, as people would be pressured to take advantage of this option.
Mr. Ricardo Mondolfi (SFS ’19) utilized the writings of John Locke in his speech. He asserted that people’s bodies should be considered their property, and that people have a right to use their own property as they wish. Therefore, there would be no logical reason for someone to criticize a person’s decision to kill him or herself. Ms. Anneke Von Seeger (COL ’17) made the forceful point that PAS being illegal does not remove someone’s ability to kill him or her self. Her point was that PAS must add something to become legal, because otherwise legalizing PAS would mean the state is promoting suicide.
After non-members speaking time, Mr. Ellis instructed the floor to begin addressing the other side’s points instead of simply building up their own side. He then went on to say that if someone’s actions or beliefs don’t harm anyone, then it is acceptable for those beliefs and practices to be legal. He argued that we should not ascribe one set of values to everyone in a society. Ms. Thanki rebutted Mr. Ellis by claiming that this debate was not about ideals, but about implementing laws. She reminded the society that we don’t live in a perfect system, and that we could not know how well regulation would protect people from being pressured to use PAS.
Ms. Kurek explained to the society that she sees death as a beautiful part of life, and that a Judeo-Christian framework causes people to understand dying as a negative experience. She encouraged the society to move beyond this framework and to enact laws that are based on the values of autonomy and mercy. Mr. Tu posited that the debate was suffering from a classic epistemic barrier, meaning both sides suffered from being unable to know how much pain a person considering PAS is in. Mr. Tu argued that because of the unknowable amount of pain someone might be experiencing, the society should consider the possibility that people cannot make the decision to pursue PAS in a rational manner, which would justify keeping it illegal.
After commenting on how angry the debate had made him, Mr. Daniel Kendrick (COL ’15) began his speech by claiming that there are objectively desirable and undesirable states of life. Mr. Kendrick also put forward the belief that people ought to be able to determine if their lives are valuable or not without the state’s interference. He concluded by arguing that keeping PAS illegal is a form of state induced control worse than slavery, as slaves always had the ability to end their own lives. Mr. Perez-Reyes told Mr. Kendrick that he didn’t care if he thought PAS was ethical; he only cared about the consequences of legalization. If PAS incentivized cutting health care short, Mr. Perez-Reyes could not endorse its legalization.
Vice-President Willis countered Mr. Perez-Reyes by asserting that the problem Mr. Perez-Reyes proposed was a solvable regulatory problem. He also claimed that laws should reflect the values of a society, and that PAS is extraordinarily compatible with the American values of autonomy. Mr. Ma responded to Vice-President Willis by informing the society that only 23% of the people who committed PAS listed reasons of pain. The top self-reported reason people committed PAS was because of the loss of autonomy their disease would cause. He wanted the keynoters to convince him why autonomy was great enough that the thought of the loss of it would be enough to drive one to take advantage of PAS.
Ms. Hu gave the final floor speech of the evening. She said that PAS should be legal because the costs of extended care would be borne by the family of an individual. If an individual wanted to spare their family the costs of long-term health care, they should be afforded the opportunity of PAS. She also repeated the claim that life is not inherently meaningful, and that PAS grants people to find meaning in their death the same way they found it in their lives.
Ms. Spira took to the dais to convince the society that PAS is not the appropriate response to the loss of personal autonomy. She argued that this loss of autonomy contributes to a large amount of depression that causes people to act in irrational ways. She offered the example of Christopher Reeves continuing to live after becoming a paraplegic as an example of someone who overcame a extreme loss of personal freedom after a period of depression following their injury. She concluded her keynote by reminding the society that ideal regulation can never exist in the real world, and reiterating the ways a society can move from PAS to euthanasia.
Mr. Weiner closed out the debate by arguing that the support network people rely on for help making rational decisions in difficult times will not be destroyed if PAS is legal. He urged the floor to try to ignore the appeals to emotion on the floor and focus on the logic behind legalizing PAS. He responded to Mr. Ma by saying that he didn’t know whether he would choose PAS if he lost his own personal autonomy. However, Mr. Weiner exclaimed, everyone should have the ability to make that decision for themselves.
At the end of the night, the room decided to affirm this debate, with a vote of 28 affirming, 4 abstaining, and 22 negating.