Ageism and elective death

Opting to die in hopeless medical circumstances is gaining acceptance, as is evident in the legalization of assisted suicide in some jurisdictions. I maintain that choosing to die in hopeless medical circumstances can be a rational option not only when continuing to live results in great suffering but especially when doing so diminishes the individual as a person. We are self-reflective entities and our intellectual and emotional consciousness is the essence of our personhood. Significant diminishment of our ability to think coherently and feel effectually by physical maladies, by accompanying continuous suffering, and by the effects of medication intended to relieve our pain, erodes our personhood. It is rational to choose to die as oneself rather than survive as a lessened entity. In support of my contention, I offer a criterion for rationally choosing to die. I also maintain that the issue of whether choosing to die is rational precedes questions about its morality, whether the questions are about violation of ethical or religious codes or practical ones about the effects of choosing to die on family and friends. If choosing to die is irrational, then the moral question does not even arise, for there can be no possibility of an act being both irrational and moral. My position and arguments have prompted two major negative responses. One response is basically dismissal by bioethicists who consider my contention about the rationality of choosing to die too abstract and irrelevant to the practical business of dealing with individuals considering the option to end their blighted lives. Against this, I maintain that bioethicists require a common abstract basis on which to ground their assessments and decisions and that the alternative is a dangerously chaotic situation where advice given to those considering elective death varies from professional to professional and support of families and friends diverges depending on the professional involved. The other negative response is the charge by bioethicists and others that my position is ageist in nature and that my claims encourage diminished concern about the elderly on the part of the medical profession and families. The gist of the charge is that leniency shown regarding elective death in advanced age is a step onto a “slippery slope” to facile acceptance of death among the elderly and hence reduced care and concern about them. My answer is to stress the highly selective nature of my criterion for rationally choosing to die and to point out that ageist implications are due to critics’ generalizations rather than to anything inherent in my position or criterion.