Originally published September 1999

What’s wrong with assisted suicide?” my friends asked. “If people want to die, who are we to stop them?”

Over an appetizer, I reminded one of how quickly he had intervened when his daughter expressed suicidal desires.

“She was a teenager. She didn’t know what she wanted.”

“What makes you so sure that most people who commit suicide know what they want?”

“Look,” he said, “I know I don’t want to die in a hospital filled with tubes and needles and on a machine. I know I don’t want to die in a nursing home. I know I don’t what to die in a lot of pain.”

“Who does? Is killing them the best solution?”

“So you’re against assisted suicide.”

“It scares me,” I said. “I’m not sure it’s a genie we can put back in the bottle. And I think there are better ways to put people out of their misery than by killing them. It sounds like one of those wacko epitaphs from Vietnam — ‘We had to destroy the village to liberate it.’”

“Well, what’s your answer?” they all asked.

“Making it easier for people to off themselves implies that terminal illness or permanent disability are just inconveniences, something to be avoided or eliminated or aborted. What’s to stop us from eliminating defective humans? The Nazis did it.”

“The Hemlock Society wearing swastikas? Government death squads? HMOs using Jonestown cocktails for cost containment? Did you forget your anti-paranoia medication?”

They were crowing by the time the main course arrived, and I tried again.

“Assisted suicide without universal health care coverage is ludicrous. Do our choices have to be between death or pain, death or the nursing home, death or life support? Can’t we address the real-life problems instead of just pulling the plug?”

“You’re talking about a personal world that doesn’t exist,” one said. “We’re saying that when quality of life is gone, we should have the right to say ‘enough.’”

“How do you know what’s enough? I didn’t know for a couple of years after my injury what my quality of life could be. All I thought paralysis meant was burdensome and expensive and something I didn’t want. I still don’t want paralysis, but my quality of life’s not bad.”

They turned cynical: “You mean people should have to live in pain or isolation or without their dignity for years just to make sure they won’t — perhaps — come to like it? You sound like the Nazi now.”

“But it’s more complicated than that. What if your care is bankrupting your family, what if your pain isn’t treated or p