(The author has a graduate certificate in bioethics from Florida State University. This is Part 2 of a 2-part post.)
Your friend Alice says to you:
“I loved my life and I lived it the best I could. I now recognize that my life’s potential has been exhausted and is rapidly approaching its end. My circumstances and sense of dignity now tell me that I have one important task left to accomplish and that is to achieve my best possible death. I now desire and welcome my death, and as in most other things I have accomplished in life, I hope to accomplish this task with the comfort and support of my loved ones and friends.”
What is the word we should use to identify what Alice wants to do?
It should be clear, as we argued in the first part of this two-part post, that the word “suicide” is not appropriate. Alice is not choosing suicide. She is doing something else, something we don’t have a word for, something for which we need a word. In this second part of our post, we will look at some precedent, identify some desirable characteristics for such a word, and offer a candidate word.
In “NeuroDiversity: The Birth of an Idea”, Judy Singer (2017) tells the story of how the word “neurodiversity” came to life. It began with the emergence, in the 1990’s, of online communities of social outsiders who self-identified as high-functioning members of the autistic spectrum and who began to advocate for themselves as being different neurologically. They didn’t see themselves as defective or in need of a cure. They wanted recognition, civil rights, and appropriate services. They claimed they should not be diagnosed with a deficit or abnormality, but only as different from the “neurotypical”, a word that sprouted to avoid the use of the word “normal” and its prescriptive implications.
Singer was both the daughter and the mother of a person with Asperger’s Syndrome. It was her university honors thesis that told the story of the online communities. That thesis was later turned into chapter 7 of the book “Disability Discourse” where we find the second use of the word “neurodiversity” in a published work. Singer tells us that she is generally credited with coining the word “neurodiversity”, but that one of her correspondents is generally credited with being the first to put it in a published work.
The word “neurodiversity” is not without controversy and even today is not well-defined. But it has had an enormous impact on how we talk about, view, and study those communities and their issues. The right-to-die community does not have to accept the terminology that it inherited. Since we don’t currently have a word for what Alice wants to do, and since we are the community most vested in the issue, we are in the best position to decide what that word should be. Naturally, we should choose wisely so that it gains acceptance by academia and the public.
Assisted suicide is legal and openly permitted in Germany. Offering assisted suicide as a business activity was banned in 2015 but the ban was overturned in 2020 by Germany’s highest court, which found its citizens have a “right to self-determined dying”. Battin (1992) explains that the difference between German and English terminology for “assisted suicide” means that Germans are “able to talk differently about it and presumably think differently about it as well.” English has a single word, while German has at least four distinct words. For our purposes, we care most about “freitod”, which is literally “free death” and conveys the idea of a “voluntary choice of death as a personal expression [of values]”, while being completely void of any negative overtones.
“Freitod” is not a euphemism; it is not an attempt to put spin on the act of suicide. It is an attempt to accurately convey what is taking place. There is a qualitative and perceived difference between the typical case of suicide and the case Alice represents. The German language has the terminology needed to communicate this difference, the English language does not, and it is well understood that language helps shape our thought. The Dutch language also has appropriate terminology.
When Emile Durkheim formalized the definition for “suicide”, it was to facilitate its study as a sociological phenomenon. At the time he defined and categorized it, in 1897 life expectancy in the U.S. was 50 years (Our World in Data n.d), and death was largely caused by infectious and parasitic disease instead of chronic and degenerative conditions. There was little need for “assisted suicide” at that time. But if there had been, is it believable that Durkheim would not have included a category for it, perhaps even given it a different word, or more likely excluded the idea from the definition altogether, since it makes little sense to hold that someone is committing suicide, in the way Durkheim was thinking about it, when they are already dying.
So, we need a neologism for what Alice wants to do. But before we choose it, we should decide on what requirements that word must fulfill. These are my suggested requirements:
- It should be a single word and without hyphens.
- It should convey the idea of death and eschew the idea of killing.
- It should be a neutral term, free of positive or negative associations.
- It should have a root or roots that give the word a sense of authenticity and accuracy.
- It should not carry extraneous or alternative meanings.
In a previous post on this blog (Simmons 2020), Bill Simmons proposed the word “dignicide”. This violates at least two of our requirements. “Self-deliverance”, though preferable to “suicide”, also violates at least two of our requirements.
One candidate word that occurs to me is “fexit”, a portmanteau of “final exit”. “Alice is considering fexit.” “How did Alice die? She fexited.” But if you google this word, you will find it already used for other purposes. I mention it only as a brainstorming example.
The word I wish to put forth as a serious candidate is “authanasia”. Note that this is not a typo, the first letter is “a”, not “e”.
“Alice is considering authanasia.”
“Alice wants to authanize.”
“How did Alice die? She authanized.”
“How did she authanize? She got a prescription from her doctor.”
In addition to fulfilling all our requirements, its noun and verb forms are different, which is not a requirement, but is a nice-to-have. I don’t have the space in this post, but more work needs to be done to settle on a formal definition and argue for its adoption. What I do need to say before I end, though, is perhaps the most intriguing and attractive aspect of the entire argument for Alice’s word: There is no such thing as “assisted authanasia”. Indeed, any such modifier is grammatically incorrect. We would never refer to something like “childbirth” as “physician-assisted childbirth” and the same holds true for “authanasia”.
authanasia
noun: The facilitation and acceleration of one’s own death when one is already dying, or near the end of one’s life, to avoid further suffering and to ensure a peaceful and dignified death.
authanize
intransitive verb: to facilitate and accelerate one’s own death when one is already dying, or near the end of one’s life, so that further suffering can be avoided, and a peaceful, dignified death can be achieved.
Though I very much like “authanasia” in many ways, I also fear it is entirely too close to EUthanasia, which not only is the wording used by many people who oppose hastening one’s death for any reason, but sadly also is a term historically used for various horrendous removals of people a system wanted gone, people with disabilities, people of disliked or oppressed class or race.
I agree with Ellen about the word “authanasia.” I also have issues with your definition. You say “when one is already dying, or near the end of one’s life,” and this actually excludes quite a few people whom FEN works with. Of course everyone is dying from the time of their birth, but people who have diseases such as MS can live many years with a quality of life that is unacceptable to them. I want the definition to acknowledge that people may quite appropriately choose to end their lives when they are NOT near the end of them. It’s about quality of life!
I agree with Ellen and Janet and I don’t think it’s necessary to invent a neologism. I think we should use an existing term which is unambiguous and familiar sounding to most people. “Exiting” comes to mind and is the term I use when talking to friends and family and even relative strangers about leaving the planet on my own terms. They all seem to understand what I mean without providing a dictionary definition.
All sorts of name alternatives to ‘suicide’ have been mentioned, recommended over the years but none of them fly in public or the media. This is an American discussion– in Europe they seem satisfied with ‘assisted suicide’ and ‘euthanasia’. I feel people should use whichever term they are comfortable with. In my writings I use whichever word seems appropriate to the context.
A Rose by any other name… More important for a person deciding to leave life is not the word that defines the behavior, but that the behavior, which leads to a last breath, a final beat, a concluding wave, can be achieved in a supportive environment in the presence of close others, if one wishes, instead of alone in darkness, disengaged from love.
There’s nothing inherently wrong with the word “suicide.” It means the intentional ending of one’s life. It’s a politically inconvenient term for us because so many suicides are deemed premature, unwarranted and therefor unacceptable and tragic. FEN’s position, as I understand it is that there are circumstances wherein suicide is not premature, quite warranted and even a blessing for all concerned. The difference between our position and our opponents’ is value based and I do not think linguistics will help bridge that gap. “Freitod” is not a Euphanism because German values are different from ours and not the other way around. I believe that looking for a better word distracts from the issue. Reinventing language has never seemed to me, to be an effective way to influence policy. We do have a long way to go but we have also made a great deal of progress and we did that by changing hearts and minds, not words.
Good try! It might work as a medical term. But how do we talk about Alice? “She authanized” or “She died from authanasia” sounds truly scary. (Yikes, she did WHAT?) In contrast, “Alice voluntarily ended her life” or “chose to complete her life” or even “hastened her death” are nicely reassuring, though they don’t meet Wussler’s five requirements. Whatever her age or condition or motives, her death is a suicide because she managed it herself. For better or worse, we’re probably stuck with that.
At last, this subject, a substitute for the word suicide, has been given deep, scholarly thought. I certainly like authenasia better than dignicide, the word that I actively promoted for years (but not recently — it has no chance). I hope that Doug can keep his suggestion going. The comments so far merit discussion, especially Ellen’s, Janet’s, and Ruth’s. I will be doing what I can to keep it going, first by forwarding Doug’s blog and the comments so far to those who also supported dignicide. Anyone wishing to be involved please let me know directly @ vermilionsim@gmail.com Bill
Bill – Your comments inspire a quick response, first to the people you mention, then more generally. I rely on people knowing that authanasia is derived from Greek roots meaning “self” and “death”, just as euthanasia is derived from Greek roots meaning “good” and “death”. Neither of these words have negative associations. I suspect Ellen is thinking of the widely discredited idea of eugenics, which has nothing to do with authanasia or euthanasia. If she is thinking of something else, she needs to cite it specifically.
As to the definition, nothing about it excludes the person with MS. I would expect the definition to include me if I was diagnosed with dementia tomorrow. Much more interesting issues remain, e.g., a gun may be my only available means of authanasia, yet one could argue it is a more “peaceful” and “dignified” ending than the alternative. Especially vexing is how the person with severe mental distress fits in. Englehart devotes an excellent chapter in her book. We want an inclusive definition, but things are not black and white. And remember, it’s not being codified legally, it’s for giving a name to something we all know and understand but which does not currently have a name. What we want is something that can be used to classify a phenomenon for study, and by the public for discussion. Imagine if we already distinguished between suicide and authanasia and studied them distinctly. What might we learn about both.
Ruth is voicing unfamiliarity with a new word. It’s just something we must learn to use. Like you would learn to use any new word in your vocabulary.
Finally, the general impression I get from the commentary is that the community is comfortable with the status quo. But consider, it has been 25 years since Oregon passed their act. I don’t mean to diminish our victories but in the big picture the needle has not moved far. Maybe we live in a bubble. If we want more meaningful progress, maybe we need to do something different. Perhaps we need to change if we want society to change. Perhaps we need more empathy for how people outside our circle think of suicide. It’s more than “killing one’s self”. Perhaps we should look inward before we look outward.
“Authanasia” gives a name to something a majority of people (I claim) would support. It gives science a new way to classify a person’s death and opens the door to statistical information to better guide public policy. Our community is not maximizing its potential. We need to name the thing we support, we need to use that name widely and in unison, and we need to stop using alternatives. This is the first step towards normalization.
Thank you Doug for leading this discussion. I also believe that it is time to pursue a new term for a concept that is gaining support, but is currently housed in the category on this site as: Rational Suicide. I direct a master’s in psychology program that has a suicide prevention specialization. Given the enormity and complexity of teaching suicidology, prevention, and best-practices, there is little if any room to introduce a topic like self-deliverance or rational suicide; though euthanasia and MaID are components that are taught. It is easy in this forum to use the word suicide because we are in large part “preaching to the choir.” But for those outside the small circle, especially teens and young adults, the word “suicide” is heavily charged and value-laden to the degree that associating self-deliverance with the word is virtually impossible. In order to prepare the next generation of advocates, we need to equip them with a way to communicate and research the nuances of rational suicide in order for them to be able to distinguish it from conventional suicide. I do like the word authanasia, which got me to thinking of other possibilities. I would throw out for consideration: Euthanauto. Whereas euthanasia is the active or passive hastening of death by an external actor (physician) [greek: good, death, medical state], Euthanauto would be guided from within [greek: good, death, self-administered]. Thus, Alice is considering Euthanauto; Alice died by Euthanauto. To Janet’s point, I would also leave room in the definition for choosing quality prior to life’s end stage…the “facilitation of one’s own death for the purpose of experiencing a dignified and peaceful deliverance.”
John – I greatly appreciate hearing this feedback. “Euthanauto” fulfills all the requirements I listed for our neologism and I think it makes an excellent candidate. I would support any such word that the choir wanted to start singing. The important thing is that we agree on a name and sing it in tune everywhere we go.
Your comments about the word suicide echo the message I tried to convey in part 1 of my post at https://www.thegooddeathsocietyblog.net/2022/07/24/is-the-word-suicide-appropriate-in-the-end-of-life-context/
Interestingly, the FEN Board President wrote this in his report after attending the World Federation of Right to Die Societies Conference earlier this month: “Language frames the debate, e.g., use Assisted Dying vs. Suicide.” I would argue that every time we use a modifier like “assisted,” “rational,” or “medical,” we are letting someone else frame the debate. We diminish our position because we don’t use a single, universal name for the thing we support.
My fantasy is that an academic, such as yourself, recognizes the huge gap between “suicide” and “euthanauto” and takes it as their cause. If we see “euthanauto/authanasia” sprout in dissertations or academic journals, it will eventually find its way to the dinner table and then, armed with data and the right language, into our social policy.
As to the definition, we agree on that but I want to avoid an enumeration of qualifying conditions, as well as words like “deliverance.” I believe we want simple, straightforward language and we should not fear the word “death.” Finding the right wording for such a definition is a large task worthy of collaboration and thought.