Euthanasia and assisted suicide are only legal in a handful of countries, but their supporters are already thinking of creative ways to integrate them into the economy and social life. Doctors in Belgium and the Netherlands are using organs from people who time their euthanasia for organ donation programs, for instance.
And recently an American law journal has published a study of euthanasia for prisoners serving life sentences. This is not a new idea. Australian activist Dr Philip Nitschke described it in his book Killing Me Softly as the “last frontier in prison reform”.
The article in the latest issue of the Virginia Journal of Social Policy & the Law takes a serious look at the hurdles such a scheme would encounter in Europe and in the United States. The authors are an Estonian Fullbright Scholar, Kärt Pormeister, and two officials at Baylor Scott & White Health, the largest not-for-profit health care system in Texas and one of the largest in the US. They conclude that
Where there is no feasible chance of the prisoner regaining freedom during their lifetime, [physician-assisted suicide] as a means of mercy could provide relief to suffering prisoners and closure to victims' loved ones, while also enabling more efficient allocation of resources.
The springboard for this frank discussion of the merits of allowing lifers to kill themselves is a case in Belgium, where euthanasia is legal. In 2014 a man convicted of rape and murder and sentenced to life imprisonment, Frank Van Den Bleeken, applied for euthanasia in accordance with the law. He was not ill, but he claimed that he was in a state of unbearable psychological anguish. He preferred to die with dignity rather than spend the rest of his life behind bars. A Belgian court granted his request, but at the last minute he was transferred to a more modern facility in the Netherlands where he could be better cared for.
Although Van Den Bleeken’s euthanasia never happened, his case was an instructive precedent for the authors. He was not seeking death as an end to unbearable physical pain, but as a “mercy”. Could this be incorporated into European and US legal systems?
It certainly is different from euthanasia for terminally ill patients. They typically ask for death because of a diminished quality of life. However, the whole point of prison is to diminish quality of life. Euthanasia is often described as the ultimate exercise of autonomy, but prison is an environment in which autonomy is severely limited in many ways, physical and psychological. In fact, the authors point out that “penal institutions might be inclined to maintain or even create harsher environments to encourage recourse to PAS” as a cost-saving measure.
So there are tricky legal issues to work through in both Europe and the US. In Europe prisoner euthanasia might be regarded as a revival of the death penalty, which is banned nearly everywhere. In the US, it might violate constitutional protections of people who are in the custody of the state, including self-inflicted harm. The victims and their relatives might think that escaping life imprisonment is unfair.
Although the difficulties in making a legal case for prisoner euthanasia are substantial, there are persuasive arguments for it, according to the authors.
The first are financial. There would be real benefits for society:
First, the choice of PAS as a means of mercy as an alternative to life in prison would eliminate costs of incarceration that accumulate during a prisoner's lifetime … Second, allowing PAS as a means of mercy could influence society to move towards the abolition of the death penalty …
Thus, PAS as a means of mercy would enable tax revenue to be used in ways more beneficial to society than keeping someone in prison for their entire lifetime or executing them for retributive purposes. Instead, money could be reallocated to further help those prisoners who still stand a feasible chance of rehabilitation to become productive members of society again. Alternatively, such funds could be used to support the families of the perpetrator's victims.
From another angle, it could be argued – as Frank Van Den Bleeker did – that a life sentence is a kind of torture.
considering the limited resources to offer proper psychiatric or other complex care to inmates, not offering PAS as a means of mercy to people serving life sentences could, in rare cases, constitute torture or cruel or inhuman treatment which is prohibited in both the U.S. and European human rights systems.
It’s not difficult to imagine courts accepting these arguments if euthanasia were already legal.
The conclusion reached by the authors is far from a ringing endorsement of prisoner euthanasia. They concede that there is a risk of coercion by prison officials and that drafting regulations would be difficult. But it could be “a viable option in rare cases”.
Coming from writers who are involved in shaping health care policy (Ms Pormeister works in the Ministry of Social Affairs in Estonia), the arguments in the journal article are alarming.
The experience in Belgium and the Netherlands is that supporters of euthanasia keep widening the boundaries. At the beginning, it was meant only for people who were terminally ill and in great pain. Now it is available for children of all ages in Belgium and for the mentally ill. Euthanasia for prisoners in a few exceptional cases is certain to expand to all prisoners who demand it. In the claustrophobic atmosphere of prison life, it could become an epidemic, like tattooing or drugs.
And the idea will have a seductive attraction for politicians who have already reconciled their consciences to euthanasia for free citizens – the dregs of society find relief and the state is relieved of the cost of their care. What’s not to like?
The answer is given in the paper: prisoners are amongst the most vulnerable people in society. Their crimes notwithstanding, they deserve to be treated with dignity and helped to discover a meaning in their lives – not helped to kill themselves.
Michael Cook is editor of MercatorNet.