What is a ‘terminal illness’, and why do some claim we need assisted suicide for it?

assisted suicide, euthanasia, terminal illness, palliative care

For advocates of assisted suicide, there is a reason often given for why it is supposedly needed: so people with terminal illnesses can have the ability to kill themselves, rather than suffer painfully until they die. Eight states, along with Washington, D.C., have legalized assisted suicide for people with terminal illness, as have numerous countries around the world, like Belgium, Canada, and the Netherlands. New Zealanders will be voting next month on a referendum legalizing euthanasia. But what really makes an illness “terminal”? And why do assisted suicide advocates insist that it be legal for these types of illnesses?

Simply put, a terminal illness is a disease which cannot be cured, and which is expected to cause the death of the patient at some point. But it is important to note that there is no time limit on when the terminal illness is expected to cause death. Before insulin was discovered, Type 1 diabetes was considered a “terminal” disease. HIV is now considered a chronic disease rather than a terminal illness, thanks to antiretroviral therapy. Without antiretroviral drugs, HIV will develop into AIDS, which is a terminal illness. Most people who are diagnosed with HIV in the United States are able to manage the disease, and therefore, do not develop AIDS. However, for those that do, life expectancy is generally three years after AIDS develops.


Other examples of common terminal illnesses can include cancer, liver disease, and dementia. Cystic fibrosis, a “life-limiting disease,” is also considered a terminal illness, even though those who have it are expected to live into their 30s. Numerous disabilities can be considered terminal illnesses, even if it could take decades before the patient will die from the disability or disease.

Many conditions previously considered to be terminal are not any longer, because over time, treatments were developed that were able to save people’s lives. A new miracle drug is currently making remarkable differences in the lives of people with cystic fibrosis. In addition, some illnesses are not necessarily deemed terminal (like cancer) until the patient decides to refuse treatment.

Vicki Walsh, for example, was diagnosed with brain cancer. She was told it was terminal and that she had just one year to live. That diagnosis initially led her to have suicidal thoughts and actions, which she eventually overcame. “Do you know what, I woke up the next day and I had the best day. I kept thinking, ‘What if you’d done it?’” she told Newshub. “Why would I take away the fun parts? And people say to me, ‘What happens if there aren’t any fun parts?’ I say I don’t know. But I am prepared to see that journey through because I don’t believe in anybody deliberately ending someone else’s life.”

Walsh has now lived eight years longer than anyone expected, and though her cancer is growing and she believes she will die soon, she has held on to the beauty and meaning of her life.

READ: Woman with cystic fibrosis planned assisted suicide until a miracle drug gave her hope

But these nuances are never mentioned in the debate surrounding assisted suicide, nor is it acknowledged that a person can live for years with a terminal illness. It is commonly understood that a “terminal” condition is something that will kill someone, and soon. But this is not always the case.

Palliative and end-of-life care are available for people dealing with difficult conditions, even when someone is not actively dying, to help improve their quality of life. This care can include managing physical symptoms, emotional and psychological support, social care, and help for loved ones. And palliative care can be given alongside other treatments, like chemotherapy.

Assisted suicide advocates use fear and ableism to make killing oneself seem like not only a viable option, but also as a more “dignified” option. Rarely will those pushing for euthanasia admit that someone can live years with a terminal illness, or that a person’s life is still worth living with a severe disease or disability. That extra time could be all someone needs to wait before a life-saving cure (like insulin for diabetics) is found. But even without miracle cures, life is always worth living, even if not for as long as expected.

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