Neither heroes nor villains inhabit a world where physician-assisted suicide is a compassionate choice. In “Assisted or not, suicide can be contagious” (Nov. 24), Aaron Kheriaty makes the case that individual actions affect the lives of those socially connected to a person who acts on their ultimate desires.

Recognition of the Werther effect (publicity produces so called “copycat” suicides) and the countervailing Papageno effect (suicidal ideas that are overcome by coping with adversity) does not answer our ethical questions so much as illustrate the vital connections that sustain individuals in every social network. The ways that the overall behavior of social groups affects the health of individuals is well-documented. Cultures of overeating lead to obesity, cultures of abuse lead to violence and cultures of desperation lead to suicide bombings in the service of tyrannical ideology.

But what else can we do besides empower individuals to make their own choices? I knew a woman who recently passed away following a self-imposed period of fasting. She was diagnosed last year with colon cancer and had refused surgical and chemical interventions, fearing the potentially painful ordeal. She had witnessed a parent’s death under similar circumstances and was determined to create a different outcome. She had recently experienced a decline, and with the care and support of her spouse and close social network, she prepared and carried out her end-of-life wishes.

Would we define this as a “suicide”? A zealous prosecutor might find that these actions fit the definition, while a compassionate human being might demure considering age, medical condition and high emotional intelligence. Are we devastated? Of course, but this is why we gather to heal the tear in our social network created by her departure. Could a heroic medical intervention have saved her? It is possible that an interval of additional time might have been made available to her, but in her own calculation, the costs outweighed the benefits.

It’s one of those damned trade-offs, a Hobson’s choice, a bird-in-the-hand, a point-of-view that we cannot measure lest we affect the result.

In a culture of compassion, we recognize that, as Jim Morrison put it “ … no one here gets out alive.” We seek the path of enlightenment, even at the cost of our own lives. Maybe we experience little or no support, and despair overtakes us. Maybe we have connections that allow us to cope with monumental adversity and find a way to continue.

In a culture of compassion, we enable and encourage physicians to use their skills to participate in end-of-life care without fear of laws that mandate false heroics in the service of tyrannical ideology.

In a culture of compassion, we recognize the inherent worth and dignity of every person and accord them the respect to make difficult choices. In a culture of compassion, we put aside our own biased judgments and ask what is best for the ones we love.

In a culture of compassion, we listen hard for the quiet voice. In a culture of compassion, we face these mysteries together and are kind to one another.


George Hutchinson lives in Minneapolis.