‘To Thine Own Self Be True’: On the Loss of Integrity as a Kind of Suffering

Abstract

One of the requirements in the Dutch regulation for euthanasia and assisted suicide is that the doctor must be satisfied 'that the patient's suffering is unbearable, and that there is no prospect of improvement.' In the notorious Chabot case, a psychiatrist assisted a 50 year old woman in suicide, although she did not suffer from any somatic disease, nor strictly speaking from any psychiatric condition. In Seduced by Death, Herbert Hendin concluded that apparently the Dutch regulation now allows physicians to assist anyone in suicide simply because he or she is unhappy. In this paper, I reject Hendin's conclusion and in particular his description of Mrs Boomsma as someone who was 'simply unhappy.' After a detailed narration of her lifestory, I turn to the American philosopher Harry Frankfurt's account of volitional incapacity and love for a more accurate characterization of her suffering. Having been through what she had, she could only go on living as another person than the one she had been when she was a happy mother. That would have violated her integrity, and that she could not bring herself to do.

Treatment-resistant major depressive disorder and assisted dying: response to comments

“…It deserves a separate discussion and is outside the scope of our paper. The Chabot case was extraordinary because the patient had no wish to be cured from her depression because she felt depression to be an appropriate state to be in after the premature deaths of her two sons 4. This case also falls outside the scope of our paper.…”

Should We Extend Voluntary Euthanasia to Non-medical Cases? Solidarity and the Social Context of Elderly Suffering

“…The Netherlands allows euthanasia in psychiatric cases, whereas Canada, for example, does not. Of course, many other important questions arise (Griffiths 1995;Cowley 2013;Wijsbek 2012). For example, can doctors be confident enough to judge that a patient's mental illness will not get better in the future?…”

Las justificaciones de la muerte asistida

“…El supuesto de la preservación de la autonomía es crítico, porque ampliaría los casos en los que se podrían justificar las prácticas vinculadas a la muerte digna más allá del dolor físico intenso. De ahí que sus defensores hablen antes de sufrimiento que de dolor: el sufrimiento es un concepto más amplio que incluiría la pérdida de identidad y autonomía, tanto del moribundo como de sus allegados, conectando así con la noción de dignidad (Bayés, 2003;Cohen-Almagor, 2008;Wijsbek, 2012). Los filósofos australianos Peter Singer y Helga Kushe son los dos autores que más énfasis han puesto en esta vía de fundamentación del derecho a una muerte asistida, llegando a proponer una ética de la calidad de vida que sustituya a la tradicional noción de santidad de la vida (Kushe, 1995(Kushe, , 2001Singer, 1997).…”