5 Mar, 16 | by Iain Brassington
There was a piece in the Washington Post the other day with a striking headline: Where the Prescription for Autism can be Death.
Normally, if we’re saying that the prescription for x is y, we mean to say that y is being suggested as a treatment for x. Painkillers are the prescription for a bad back, a steroid cream the prescription for eczema, and so on. Even if you find that phrasing a bit clunky, “prescription” implies the recommendation of a medical expert. On that basis, the implication here is that somewhere in the world, doctors are seeing patients, diagnosing autism, and saying, “I wonder if the best thing would be to kill you”. That would be uiruite a Big Deal.
The place in question is Holland. But a quick look at the article shows – surprise, surprise – nothing of what’s hinted at in the headline. Here’s the opening few sentences, edited slightly for formatting:
In early childhood, the Dutch psychiatric patient known as 2014-77 suffered neglect and abuse. When he was about 10, doctors diagnosed him with autism. For approximately two decades thereafter, he was in and out of treatment and made repeated suicide attempts. He suffered terribly, doctors later observed, from his inability to form relationships: “He responded to matters in a spontaneous and intense, sometimes even extreme, way. This led to problems.”
A few years ago, 2014-77 asked a psychiatrist to end his life. In the Netherlands, doctors may perform euthanasia — not only for terminal physical illness but also upon the “voluntary and well-considered” request of those suffering “unbearably” from incurable mental conditions.
The doctor declined, citing his belief that the case was treatable, as well as his own moral qualms. But he did transmit the request to colleagues, as Dutch norms require. They treated 2014-77 for one more year, determined his case was, indeed, hopeless and, in due course, administered a fatal dose of drugs. Thus did a man in his 30s whose only diagnosis was autism become one of 110 people to be euthanized for mental disorders in the Netherlands between 2011 and 2014.
So, then, it’s a story about a man, who happened to be autistic, and who asked a psychiatrist for euthanasia. After a little to-ing and fro-ing, that request was granted. There is no reason to believe that this was a case of death being prescribed for autism. It’s just that he happened to be autistic and to want to die, and a prescription for assistance was provided. Phrasing is important.
Dutch law on assisted dying is famously liberal; in considering the permissibility of euthanasia for psychiatric as well as somatic illnesses, it is in the minority of the minority of jurisdictions that consider the permissibility of any euthanasia. I have addressed the question of psychological suffering in relation to euthanasia elsewhere, and shan’t rehearse the details here; suffice it to say, I don’t see any reason in particular to think that mental illness and physical illness should be treated all that differently in principle: more…