Is it one’s duty to live?

During a public hearing by the German ethics committee on euthanasia, Prof. Gethmann presented two ethical questions outlining the topic:[1] First, ‘Is suicide morally permissible?’ Second, ‘Is coercion to continue to live morally permissible?’ In the exploration that followed, Prof. Gethmann provided two conceivable paths that the ethics committee, and more importantly each individual, can take in answering these difficult questions. One is straightforward: If my answer to the first question is yes, then the answer to the second must be no. If, however, my answer to the first question is no, then how do I respond to the second? Is it one’s duty to live?

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Impressions from a closed psychiatric ward

[Editor’s note: to ensure anonymity of the patient data as well as the institution, all of the facts and quotes included have been altered, leaving a representative, but in no way replicable account. Further, the author has asked to remain anonymous.]

“When suffering from a mental illness one no longer has a free will.”

A floor plan of the ward should have been included here, illustrating the conditions in which patients are being forced to ‘live’. However, to ensure I am not legally compromised (trade and corporate secrets etc.), I have been advised against including this. In the hope of enabling some insight here is a brief description:

The ward’s capacity is 30 patients, though this is frequently surpassed. Patient rooms range from approx. 8㎡ to 20㎡, most of them double rooms, each with a toilet and shower. Some rooms can be locked from the inside, most cannot. The total garden space is less than 500㎡, divided into smaller segments, one length no longer than 25m. The total community space is approx. 60㎡, in which patients eat, relax, socialise and watch TV.

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The Ethics of Amputation

Certain phenomena in the medical realm are kept in abeyance; concealed from the public discourse in the hope that future research may provide more clarity. As appealing as this strategy of eschewal may be, it does little to relieve those individuals currently affected by the respective phenomena, and such force of circumstance thus requires a prima facie consensus to be found. One such phenomenon is a desire for the amputation of an otherwise functional limb, or else to sever the spinal cord resulting in paralysation. Medically speaking this desire has been attributed to a variety of conditions, ranging from Body Dysmorphic Disorder (BDD) to a form of paraphilia, and the most likely explanation: Body Integrity Identity Disorder (BIID) [1].

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