Legal Definitions - assisted self-determination

Assisted self-determination refers to a situation where an individual makes a conscious, informed, and voluntary decision to end their own life, and another person provides the means or support to carry out that decision. This concept emphasizes the individual's autonomy and control over their own life and death, with assistance provided to fulfill their determined choice. It is most commonly discussed in the context of medical aid in dying or physician-assisted suicide, where legal frameworks often exist to permit such actions under strict conditions.

Here are some examples illustrating assisted self-determination:

• Example 1: Maria, a 68-year-old woman, has been diagnosed with a rapidly progressing and incurable neurological disease that will soon lead to complete paralysis and an inability to communicate. After extensive discussions with her family, doctors, and a mental health professional, and in accordance with the laws of her state that permit medical aid in dying, Maria makes the firm decision to end her life before her condition deteriorates further. Her physician, after confirming her eligibility and understanding, prescribes a lethal medication that Maria can choose to self-administer at a time of her choosing.

  This illustrates assisted self-determination because Maria's decision to end her life is entirely her own (self-determination), and her physician provides the necessary means (assistance) within a legally sanctioned framework.

• Example 2: John, a 90-year-old man, is suffering from a terminal illness causing him unbearable and intractable pain, despite all available palliative care. He lives in a country where voluntary euthanasia is legal under very specific and stringent conditions. After multiple evaluations by independent medical professionals confirming his prognosis, mental capacity, and consistent desire to end his suffering, John formally requests assistance in dying.

  This demonstrates assisted self-determination because John's clear and persistent choice to end his life due to suffering (self-determination) is carried out with the direct help of a medical professional (assistance), adhering to the legal and ethical guidelines for voluntary euthanasia.