065 - Are We Preventing Suicide in One Room and Assisting It in Another? A/Prof Kristin Collier

We all agree that something is deeply wrong with how we die today. In many modern healthcare systems, death feels over-medicalised, isolating, and often stripped of meaning, dignity, and human connection. No one is defending the status quo.Yet on the deeply contentious issue of assisted dying, we are sharply divided — not necessarily on the existence of suffering, but on how we should respond to it, and what it truly means for human dignity, autonomy, and the role of medicine.In this episode, I’m joined by Dr. Kristin Collier — practicing internist, Associate Professor at the University of Michigan, and Director of the Program on Health, Spirituality, and Religion. We explore the fundamental tension between our strong societal commitment to suicide prevention and the growing push for physician-assisted dying.A central challenge in this conversation is language itself. Terms like “death with dignity” and “medical aid in dying” carry powerful emotional weight for many. Others, including the American Medical Association, insist on the term “physician-assisted suicide,” arguing that softer language can obscure reality and erode the healing identity of medicine.Dr. Collier offers a thoughtful, principled critique rooted in concerns about patient vulnerability, ableism, bracket creep, unintended consequences for disabled communities, and the integrity of the medical profession. We also examine how different worldviews understand autonomy and dignity — one sees dignity as the right to control the timing and manner of death, while another sees it as intrinsic to every person, independent of suffering or disability.We discuss power differentials in healthcare, financial incentives, and the critical distinction between aiming at death versus making difficult choices to forgo burdensome treatments near the end of life.While the conversation is uncomfortable, we find important common ground: No one believes we are dying well right now. Better palliative care, deeper accompaniment of suffering, stronger support systems, and honest cultural reform around death are urgently needed — no matter where one stands on assisted dying.This is a nuanced and respectful exploration of one of the most important ethical questions of our time.Chapters00:00 The Dilemma of Life and Death03:04 Understanding Human Dignity06:04 The Role of Medicine in Suffering11:09 The Language of Dignity and Death15:51 Compassionate Responses to Suffering21:19 The Ethics of Physician-Assisted Suicide25:56 Financial Incentives and Healthcare Choices32:05 The Role of Disability Advocacy in Medical Ethics35:43 Ableism and Ageism in Medicine39:08 The Complexity of Suffering and Assisted Dying46:28 The Slippery Slope of Assisted Dying Legislation51:46 Moral Perspectives on Physician-Assisted Suicide54:02 Building Consensus on End-of-Life Care