Is suicide prevention an absolute? Considerations when medical assistance in dying is an option

Suicide prevention services do their utmost to prevent suicides with all persons, regardless of the suicidal individual’s characteristics and reasons given for wanting to die. Their assumptions are that doing otherwise constitutes discrimination and that they would venture into an ethical morass if they attempt to determine whether some lives are more worthy of saving than others. At least, this is how it is supposed to work in principle. Doctors are meant to work equally hard to save the life of a wounded murderer as they do with the victim of a homicide attempt. The suicidal 90-year-old patient who has cancer should obtain the same quality of suicide prevention services as the 16-year-old whose girlfriend abandoned him. Today, an increasing number of countries permit or are considering legalizing euthanasia (“termination of life upon request”) and assisted suicide, together referred to as medical assistance in dying (MAID). In this context, should we continue to strive to prevent all suicides, or are there some circumstances where we should abstain from preventing a death by suicide or even encourage people to seek MAID?