Socrates’ Choice Offers Little Help In Determining the Moral Value of Medical Assistance In Dying: A Response to Vincenzo di Nicola

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In a recent blog, Vincenzo Di Nicola, MPhil, MD, PhD, FCAHS, DLFAPA, DFCPA, FACPsych, invokes Socrates’ execution as an opportunity to think philosophically about euthanasia, suicide, and assisted suicide—that is, medical assistance in dying (MAID).¹ di Nicola also invokes Socrates’ choices leading up to his execution as an opportunity to think philosophically about autonomy, morality, and the nature of death. In doing so, di Nicola hopes to show that Socrates’ choice applies to “philosophy as a life practice” and to “the practice of psychiatric medicine.”

That the debate over the ethics of MAID can benefit from an understanding of philosophical ethics is true at its face, given the philosophical foundations of the study of ethics. It also makes sense to invoke Socrates in a general introduction to philosophical ethics, since Socrates is the godfather of Western philosophy writ large and Western ethics in particular. Of course, we know Socrates primarily through the work of his disciple Plato, about whom Alfred North Whitehead famously said²:

“The safest general characterization of the European philosophical tradition is that it consists of a series of footnotes to Plato. I do not mean the systematic scheme of thought which scholars have doubtfully extracted from his writings. I allude to the wealth of general ideas scattered through them.”

So, kudos to di Nicola for suggesting that people engaged in the debate about the morality of MAID should study philosophy, starting with Socrates.

On the other hand, di Nicola’s claim that the MAID debate can benefit from studying “the choice made by Socrates to end his life through suicide” is problematic in its apparent effort to draw an analogy between Socrates’ death and the death that MAID patients seek.

To begin, Socrates did not commit suicide, seek physician-assisted death, or seek euthanasia. Socrates was executed. Had he not drunk the hemlock, he probably would have been thrown into a pit, nailed to a board, bludgeoned to death, or decapitated.³

At Socrates’ trial, in which he was convicted of impiety and corrupting the youth of Athens, he was given the chance to recommend his punishment.⁴ His accuser, Meletus, called for death. Socrates disagreed, claiming that he should be given what he was due. He claimed first that he should receive “maintenance in the Prytaneum,” that is, free meals and lodging from Athens, for the services he offered her.⁵ Socrates knew that that would not be accepted, so he proposed next that he pay a fine of 30 minae (3000 drachmas—a drachma being a day’s wages for a soldier), which his friends offered to cover.⁶ He would not recommend prison or exile, because he would be unable to practice philosophy in the marketplace, which he saw as his sacred duty. He did not address the penalty of death until the jury voted to impose it.

Upon receiving the sentence of death, Socrates refused to plead for leniency, claiming that (1) it is foolish to fear death, since only the gods know whether it is bad or a blessing, and (2) he must see his divine purpose—promoting the examined life—to the end and running from this duty would be shameful.⁴ A few days later, when his friend Crito offered to help Socrates escape from prison, Socrates added that by escaping he would be unjustly violating the laws of Athens.⁷ Even though Socrates felt that the jury had acted unjustly (that it was morally wrong for them to have him killed), he did not think it was morally good to repay injustice with injustice.

Thus far, while one might be tempted to say that Socrates died well, it would be misleading to call it a good death. Plato thought it was an outrage, and he committed to preaching the Gospel of Socrates for the rest of his life, thus perpetuating the “crime” for which Socrates was executed.⁸

To be sure, neither Socrates nor Plato thought death itself was necessarily bad; indeed, it might be a blessing. But this was by no means an argument for a premature death, suicide, or killing a legally innocent person. In Phaedo, Socrates explicitly condemns taking one’s own life.⁹

Aristotle, Socrates’ philosophical grandson and promoter of his virtue theory, thought death was “a fearful thing,” and thus “an evil thing.”^10,11 Upon learning that Demophilus and Eurymedon the Hierophant had accused Aristotle of impiety, Aristotle fled Athens into exile “lest Athens sin against philosophy twice.”¹²

Thus, it is not helpful to look at “Socrates’ choice” for insight about the possibility of morally good MAID.

To illustrate this point further, imagine a psychiatrist who encounters two people, both with death on their minds. The first, a 70-year-old mason turned philosophical marketplace gadfly, and in apparently good mental and physical health, reports that he has been unjustly sentenced to death by an Athenian Jury, but that he is not upset about it. After all, death may be a blessing, and he feels duty bound to obey the laws and corresponding decisions of his beloved city-state. He has no wish to die, and God forbid he should take his own life, but he is at peace with the circumstances. He asks nothing of the doctor, other than to engage in a bit of dialectic while he awaits his end. Perhaps the doctor questions the rationality of Socrates’ accepting the death penalty when he could have argued for a lesser penalty or escaped, but there appears to be no call for the doctor’s professional intercession.

The second person, experiencing unbearable suffering or terminal illness, but of sound mind, asks the doctor to kill him or to show him how to kill himself. What has the doctor learned from the first person’s choice that enables the doctor to determine the morally right response to the second?

Socrates was not experiencing unbearable suffering or a terminal illness, while would-be MAID patients present with either or both of those complaints. Socrates did not seek to die or be killed, while would-be MAID patients seek either to die at their own hand or to have a doctor kill them. Socrates believed that his killing was unjust, while would-be MAID patients and advocates argue that the request for death and the doctor’s compliance are just—indeed, some argue that to deny the patient’s request is unjust. Socrates’ courageous acceptance of his death may have been good, but his death was not.

Perhaps there are other aspects of Socrates’ philosophy that can inform conversation about MAID, autonomy, morality, and the nature of death, but Socrates’ “choice”—that is, his trial and execution—are not such aspects.

Concluding Thoughts

Philosophical ethics has an essential role in any debate about the morality of MAID. And Socrates, as the godfather of Western philosophy and ethics, should be included in any comprehensive study of philosophy and its practical applications.

Still, given the differences between Socrates’ death and the death of MAID, the attempt to draw an informative analogy between the two fails.

Rev Dr Dreisbachis associate director of Organizational Leadership in Johns Hopkins University’s Kreiger School of Arts & Sciences, professor of Moral & Systematic Theology (part-time) at St. Mary’s Ecumenical Institute, and an Episcopal priest. He has been a philosophy professor since 1980, with an emphasis on public philosophy and applied ethics. He has served on the Ethics Committee of Sheppard Pratt Psychiatric Hospital since 2009, and he was recently appointed by Maryland Governor’s Office to serve as a bioethicist on the Maryland Stem Cell Commission.

References

1. Di Nicola V.Socrates’ choice: a philosophical perspective on euthanasia, suicide, and assisted suicide. Psychiatric Times. April 28, 2025. https://www.psychiatrictimes.com/view/socrates-choice-a-philosophical-perspective-on-euthanasia-suicide-and-assisted-suicide

2. Whitehead AN. Process and Reality: An Essay in Cosmology. Free Press; 1978.

3. Brouwers J. The death penalty in Athens. Ancient World Magazine. April 6, 2018. Accessed May 1, 2025. https://www.ancientworldmagazine.com/articles/death-penalty-classical-athens/

4. Plato. The Apology. Project Gutenberg; 1999:24b-28a, 38c-42a.

5. What did Socrates mean by “there is no more fitting reward than maintenance in the prytaneum?” Philosophy Stack Exchange. October 5, 2015. Accessed July 23, 2025. https://philosophy.stackexchange.com/questions/28527/what-did-socrates-mean-by-there-is-no-more-fitting-reward-than-maintenance-in

6. Andreyev S. What was the cost of Socrates death? Syllogism. March 21, 2018. Accessed July 23, 2025. https://sergeyand.wordpress.com/2018/03/21/what-was-the-cost-of-socrates-death/

7. Plato. Crito. Project Gutenberg; 1892:46b-50a.

8. Mark J. Plato's greater, better world in the last days of Socrates. April 11, 2023. Accessed July 23, 2025. https://www.worldhistory.org/article/825/platos-greater-better-world-in-the-last-days-of-socrates

9. Plato. Phaedo. Project Gutenberg; 1892:61c-62c.

10. Werner D. Suicide in the Phaedo.De Gruyter;2018:157-188.

11. Aristotle. Nicomachean Ethics. Project Gutenberg; 1915:1115a8, 26.

12. Nussbaum M, Osborne C, Aristotle. The Oxford Companion to Classical Civilization. Oxford University Press; 2014.