Can Subjective Pain Be Objectively Assessed? The Problem of Unbearable Suffering in Psychiatric Requests for Physician-Assisted Dying

Laura Maria Nowak

Faculty of Humanities and Social Sciences, University of Rijeka, Croatia

Physician aid-in-dying (PAD), consisting of euthanasia or assisted suicide, is a medical procedure of terminating one’s life due to their health conditions, which make life arduous. The first laws legalizing PAD appeared almost two decades ago, and recent changes enabled seeking it not only for ‘regular’ (i.e., suffering from physical conditions) patients but also for psychiatric ones. Although there are many problems with the general issue of life-or-death decisions, the justification of PAD seems particularly complicated and challenging.

In this paper, I will investigate whether or not unbearable suffering, which constitutes the main criterion of PAD eligibility, can be met by psychiatric patients wishing to access the PAD procedure. Connected to the change of perspective in terms of perceiving mental illnesses and normalizing seeking psychological help, there is no doubt that people with mental illnesses do suffer. However, the question is whether that psychological pain can be objectively identified as unbearable by a professional, and what kinds of suffering should be taken into consideration in this context.

In the first part, I shall provide the necessary framework, such as the definition of suffering and a short reconstruction of the parity argument, which justifies access to PAD in cases of mental illnesses.

In the second part, I will highlight different kinds of suffering, such as physical and, more importantly, psychological and social. I will discuss whether all of these phenomena provide legitimate grounds for seeking PAD. For this purpose, I will outline legal regulations on this matter and consider how they differentiate between different causes of suffering, especially when the solution is not clear (e.g., fatigue of life as an invalid reason for PAD).

In the conclusion, I will demonstrate how non-physical suffering can be classified as unbearable by a professional in the same way as it is for patients seeking PAD due to somatic disorders.

Chair: Paulina Oppermann

Time: 05 September, 10:40 – 11:10

Location: SR 1.004