Last week, actress Ruth Posner and her husband Michael, both in their late 90s, died at a suicide clinic in Switzerland. Their decision has renewed the polarising debate on assisted death, at the heart which is the idea of suffering.For proponents, suffering is the core justification for assisted death. For opponents, such a justification leads to a dangerous slippery slope. As one article in the conservative American journal Nation Review put it: “Once we decide that killing is an acceptable answer to suffering, the kind of suffering that qualifies us to be made dead continually expands.”The argument for: Dying as ultimate act of autonomy“There came a point when failing senses, of sight and hearing and lack of energy was not living but existing that no care would improve,” Ruth Posner, 96, wrote in an e-mail to friends and family before dying by suicide.This is the standard justification for assisted death. And not a new one at that. Greek philosopher Plato (c. 4th century BCE) in The Republic stated that those living with illness, who were not physically healthy, should be left to die. (Yelson Alejandro Picón-Jaimes et al, ‘Euthanasia and assisted suicide’, 2022).Story continues below this adThe idea is that at some point of time, suffering makes life not worth living, that a life without dignity is not worth living. In such an instance, an individual should be able to exercise her agency to die.Experts Explain | The right to die with dignity — SC rulings and what the law says in IndiaAnthropologists (and sociologists) broadly define agency as “the socio-culturally mediated capacity to act”. (Julia Vorhölter, ‘Agency’ in The Open Encyclopedia of Anthropology, 2024). While in everyday parlance, the idea of agency often evokes an image of a “human actor whose intentional actions should produce the intended effects” (Illana Gershon, ‘Neoliberal Agency’, 2011), these effects are often constrained by external factors beyond any one person’s control.This cannot be said, however, about dying. While the decision to die may be socio-culturally mediated (more on that later), the finality of death means that there are no mediating circumstances that influence the effects of one’s actions. This makes dying of one’s own volition the ultimate act of individual autonomy.This is particularly important because multiple surveys have shown that the fear of losing autonomy at the end of life is the primary rationale for most geriatrics seeking assisted death. Assisted dying is essentially an act of taking back control.Story continues below this adThe argument against: ‘What is suffering?’Critics argue that assisted dying is not an act of autonomy because there is no autonomy without life. “Assisted dying arises from a dignity that has a shape that corrupts itself. In the process of exalting the person’s choice, it removes the very basis for doing this,” wrote philosopher Stephen Richards. (‘The Morality of Assisted Dying’, 2025).Moreover, the rise of assisted dying in society creates a self-fulfilling cycle, “generat[ing] forces that influence people and reinforce its usage” (Richards). This fundamentally undermines the autonomy argument. As the previously-quoted National Review article put it, “There was a time that joint geriatric suicides were considered tragedies. Now they are accepted by many without so much as a raised eyebrow.”Critics also argue that the idea of suffering lacks definitional clarity, opening a can of worms that can eat away at the heart of the social fabric. The Posners, for instance, did not have any terminal illness; they simply felt their lives, with impaired senses and faculties, were not worth living. The same argument can also be made by a teenager who is suicidal due to pressures in school, or new mothers suffering from post-partum depression.At what point, then, does suffering make it justifiable to make the choice to die? If this choice were to be absolute, then all suicide would be justifiable. What does such a world look like?Story continues below this adAt the end of the day, a core function of ethics is to shape stable, just world. The fear is that a nebulous concept like suffering being justification for death can be misused by oppressive forces. After all, Adolf Hitler sent the disabled to death camps on the basis of the argument that their lives “were not worth living”.In the real world: Safeguards & caveatsAssisted death remains illegal, even criminal, in most jurisdictions. Places that do allow assisted death often heavily regulate the practice.The UK’s Terminally Ill Adults (End of Life) Bill, 2024, for instance, only allows those above 18 years of age who are terminally ill to opt for assisted death. It explicitly excludes persons with disabilities and mental disorders, requires the patient to receive permission from a High Court judge, and has multiple “periods of reflection” during which an individual can change her mind. The law also requires a person to be a resident of the UK for at least 12 months before filing an application.For more details | What UK’s assisted dying bill says, how it compares to Indian lawWhile the UK law is considered to be among the strictest, there are countries, like Switzerland, who have loosened restrictions such to become destinations for “death tourism”. Swiss laws do not have any residence caveat; the process for assisted dying is also much less tedious.Story continues below this adIn 2018, the Supreme Court of India held that the “right to die with dignity” formed a part of the right to life with dignity under Article 21 of the Constitution of India, and recognised the legality of “passive euthanasia” — the withdrawal of life support from terminally ill patients or patients in a “permanent vegetative state”.This not, however, assisted dying which requires a positive intervention to cause death. In India, concerns regarding misuse of such a law for the exploitation of the elderly by their families remains the primary impediment to an assisted dying law coming in any time soon.