the person that ppl who call it “assisted suicide” have in mind as most deserving of this right are, i think, usually physical cripples of some kind – paralysed, demented etc, the idea being that this person would kill themselves but the flesh is weak and so they need someone else to do it for them.
but in practice it would appear many of the people who are referred to death are quite physically capable of killing themselves – i read many cases from the Low Countries and Canada where the people being killed have some sort of incurable melancholia. perhaps the main thing about incurable melancholics is their tendency to kill themselves, despite the presence of a Christian taboo against it, and a state-backed medical service that will lock them up and drug them if they, the medics, get any tingling sense that they are going to do it.
much of the assistance, therefore, is moral. it is to say “yes we agree, suicide is wrong – that is what the psychiatric unit down the corridor is for, but in your case we have decided to grant you absolution – and mind, this isn’t a blanket licence to shoot yourself or whatever, but there’s a specific way we want to kill you, and it’s like an animal that is of no further service to us”. And this absolution can only be granted by the state’s doctor.
even the “far out” addition is still the same logic of “the best death is submission to some ‘shaman’ (read: fuckup with a magic stick and a drum) who takes authority over you as you die and comes bearing a message from the Other Side that death is great actually so everyone present can relax and stop thinking negative thoughts”.
consider, instead, famous suicides such as Cato the Younger (cutting his belly open, twice, against medical advice), Mohamed Atta (9/11), King Saul (fell on his sword after his retainer feared to slay him due to bad things happening to those who injure the LORD’s anointed), That Buddhist Monk In Vietnam (self-immolation and demonstration of extremely advanced Buddhist practice) etc.
The list of ways a self-actualising suicide can look like is very long and goes far beyond “a doctor puts you down like a dog except he is wearing a feather headdress and there is Goa trance playing and everyone present agrees that yeah you killed yourself sure why not”.