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On the relevance of an argument as regards the role of existential suffering in the end-of-life context
  1. Jukka Varelius
  1. Correspondence to Dr Jukka Varelius, Department of Behavioural Sciences and Philosophy, University of Turku, Turku FIN-20014, Finland; jukka.varelius@.utu.fi

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In an article recently published in the Journal of Medical Ethics, I assessed the position that voluntary euthanasia (VE) and physician-assisted suicide (PAS) can be appropriate only in cases of persons who are suffering unbearably because they are ill or injured, not in cases of unbearably distressed persons whose suffering is caused by their conviction that their life will never again be worth living. More precisely, I considered one possible way of defending that position, the argument that the latter kind of distress—to which I referred to as existential suffering—does not qualify as grounds for VE and PAS because doctors are not experts on questions pertaining to the meaning, value and purpose of life: existential questions, as I called them. I maintained that cases of VE and PAS related to illness and injury involve existential questions relevantly similar to those faced in connection with existential suffering. Therefore, I concluded, if VE and PAS based on suffering arising from illness or injury falls within the domain of medical expertise, it is consistent that VE and PAS cannot be denied in cases of purely existential suffering by maintaining that the professional expertise of doctors does not extend to existential questions.1

The article inspired some interesting discussion. Robert Young offered two reasons for thinking that its argument is of limited practical significance.2 Julian Savulescu maintained that, within current medical ethics and human rights, there already is a method of assisted suicide: voluntary palliated starvation (VPS), which allows that existential distress can sometimes provide grounds for assisted dying and which could fall within the limits of the law.3 The discussion by Young and Savulescu suggest that my argument, or rather the nature of the project of which it is purported to be a part, could benefit from some clarification. That …

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