Part of that is the fact that I’m subject to what I call dark spells, some of which have been long enough and dark enough that I understand the temptation to suicide as well as the need to try to wait it out to see if some light returns. You know the saying “so low I have to reach up to touch bottom?” Know that there are worse places, places where it seems there is no bottom and the sinking will never end.

The other has to do with the death of my mother, which was in 1986. She was at that point a brittle diabetic with end-stage renal disease. She had been in and out of the hospital several times over the preceding months and each time there was the possibility it would be her last. On this occasion, on top of everything else, she had a trach tube (so she couldn’t speak). We’d gotten her a little pad so she could write things out – but she suffered a string of TIAs (transient ischemic attacks, sometimes called mini-strokes) that left her hands unable to write the words her brain was screaming at them.

One day, I was standing at her bedside. One of her doctors and my father were across the room, talking. My mother looked at me and mouthed what I believe – but do not know – were the words “pull the plug.” I shook my head no. Wide-eyed with distress, she very clearly mouthed “Why?” I said “I can’t.” Not with my father and the doctor – both of who would try to physically prevent me – in the same room. Upset and unhappy, she turned her head away from me.

I intended to return later that day, when we would be alone, and ask her if she did say what I thought she said and if she meant what she appeared to mean. If the answer was yes, I would have done it. There is no question about that.

She slipped into a coma later that afternoon, before I could get back. She died two days later.

It was and remains one of the biggest regrets of my life that my mother may have died believing that I, who alone of all the people in her life would have been willing to fulfill that final request (as she surely knew), failed her.

So yeah, I have considered the ethics and emotions of both suicide and assisted suicide – from both sides of the situation.

I understand your desire for the involvement of a disinterested party, I do. It’s the reluctance to make assisted suicide seem too easy to get and do, an outcome I doubt anyone would favor. (And I’ll note that by “second party” I didn’t mean it necessarily was one individual; perhaps “outside party or parties” in place of “second party” would have been better.)

But again in terms of the ethics involved and not the legalities, I wonder, who would that third person be? How would you locate them? Consider the case of George Zygmaniak. What uninvolved third party could he have approached and how would they have been involved? And should a disinterested party have a say in the ethical aspects of what may well be the most intensely personal decision any of us could ever make?

In terms of the legalities, on the other hand, I could see a provision in a law about assisted suicide that would require an examination by some appropriate professional to determine that the person who wishes to end their life is mentally competent to understand the nature and consequences of their decision. But again, that is about competence, not ethics.

At the same time, I think the potential for abuse is rather small since even with an assisted suicide law, never mind without one, the possibility of being tried for murder if questions arise is quite real. Again referring to the Zygmaniak case, if the jury hadn’t been convinced that what Lester did was actually an act of mercy that was desired by George, Lester would very likely have been convicted of first degree murder.

I mostly like your ethical framework, but I’d like two additional parties involved, not just the one. Preferably one of the third parties would be someone not directly involved/related. But I can see how that could become cumbersome in some cases. I try to balance the right of someone to die with minimal suffering, and to get help in doing so, against the potential for abuse.

Does a mentally-competent person have to right to take their own life? Yes.

Given that, if unable to carry it out themselves in a way to minimize suffering, does that person have the right to ask another for help? Yes.

Given both of those and assuming their own conscience allows it, does that second party have the right to help? Yes.

Given all of those, does that second party have the right to refuse to help? Yes.

The sticker, of course, is the “mentally-competent” part. For example, I was brought up Catholic and I remember being taught at one point that the Church no longer regarded suicide as a sin on the grounds that life was such a previous gift of God that no sane person would willingly surrender it. But that becomes a catch-22 because it means that attempting suicide is proof that you aren’t mentally competent to make the decision to attempt suicide.

Which is why I included that last point above: If that second party believes the suicidal person is not thinking clearly or is acting out of a bout of clinical depression or similar cause, I’d say not only can they refuse, but they are morally and ethically obligated to do so.

This has been a conviction of mine of long-standing. I was tangentially involved in the case of Lester Zygmaniak, who in 1973 performed a mercy killing of his brother George. It could reasonably be called an assisted suicide because George had repeatedly asked Lester to kill him.

George had been in a motorcycle accident that left him in a great deal of pain and, doctors said, permanently and irreversibly paralyzed from the neck down. He repeatedly asked his doctors why they wouldn’t just let him die and begged Lester to put him out of his misery.

Ultimately, Lester smuggled a shotgun into the hospital, asked George one more time if he was sure this is what he wanted, and on getting an affirmative response, shot George in the head, killing him instantly. (Sidebar: Note that “minimizing suffering” does not necessarily mean the use of medications.) He then waited in the room until the police came. He was charged with first degree murder.

At his trial, his lawyer pleaded temporary insanity, a defense that rarely works. But the jury took just two and a-half hours to both acquit Lester and to find his sanity had returned, thus freeing him. I said at the time – and I still think – that I didn’t for a minute believe the jury actually believed the temporary insanity claim; rather that, given the circumstances, they took the attitude “no damn way we’re sending that boy to jail for who knows how many years.”

Precisely because the issue of assisted suicide is fraught with matters of conscience and judgment, it’s an area where people surely can disagree and agree to disagree – but for that very reason I think it’s an issue where we need to be extremely cautious in setting legal limits that would criminalize actions undertaken willingly and in good conscience by all directly involved.