Giving Death a Helping Hand: Physician-Assisted Suicide and Public Policy—An International Perspective

In brief compass, I will touch on three of the central ethical and public policy issues that divide those who are opposed to physician-assisted dying from those who are supportive of this practice. These are: (1) the moral distinction (if any) between actively hastening death and passively allowing to die; (2) how to interpret the Hippocratic tradition in medicine with respect to physician-assisted death; and (3) whether physician-assisted suicide can be effectively regulated. I shall summarize the arguments pro and con with respect to each issue, and also indicate my own position.

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The Legitimacy of Prohibiting Euthanasia

BioéthiqueOnline ◽

10.7202/1035512ar ◽

2016 ◽

Vol 4 ◽

Author(s):

Peter Gildenhuys

Keyword(s):

Public Policy ◽

Assisted Suicide ◽

Social Costs ◽

Active Euthanasia ◽

Physician Assisted Suicide ◽

Policy Debates ◽

The Social

John Arras argues against the legalization of physician-assisted suicide and active euthanasia on the basis of social costs that he anticipates will result from legalization. Arras believes that the legalization of highly restricted physician-assisted suicide will result in the legalization of active euthanasia without special restrictions, a prediction I grant for the sake of argument. Arras further anticipates that the practices of physician-assisted suicide and euthanasia will be abused, so that many patients who engage in these practices will lose out as a result. He refers to these losses as social costs to legalization. But the social costs at play in typical public policy debates are borne by individuals other than the agent who engages in the controversial activity, specifically by people who cannot be held responsible for enduring those costs. Even if plausible interpretations of Arras’ predictions about the abuse of the practice are granted, legalization of physician-assisted suicide or euthanasia brings no social costs of this latter sort. For this reason, and also because a ban on euthanasia is unfair to those who would profit from it, the losses in utility brought about by legalization would have to be very great to justify a ban.

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Euthanasia and Physician-Assisted Suicide

10.1093/oxfordhb/9780199284238.003.0027 ◽

2009 ◽

Author(s):

Margaret P. Battin

Keyword(s):

Public Policy ◽

Assisted Suicide ◽

The Other ◽

Physician Assisted Suicide ◽

The Public ◽

Public Figures ◽

Voluntary Active Euthanasia ◽

Private Citizens ◽

Public Consciousness ◽

The One

When the debate over euthanasia and physician-assisted suicide emerged into public consciousness in the mid-1970s, the debate got off to a rousing start, as philosophers, doctors, theologians, public-policy theorists, journalists, social advocates, and private citizens became embroiled in the debate. On the one side were liberals, who thought physician-assisted suicide and perhaps voluntary active euthanasia were ethically acceptable and should be legal; on the other side were conservatives, who believed that it was imoral and/or dangerous to legalize assisted dying as a matter of public policy. Over the next few decades in which this debate was accelerating it achieved a lively, florid richness, both as a philosophical dispute and as a broad, international public issue. This article aims to explore the richness of this debate by showing something of the terrain of the debate and the figures who have inhabited it, both the public figures and the academic ones partly behind the scenes.

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2. Euthanasia and Freedom

Introducing Political Philosophy ◽

10.1093/hepl/9780198783275.003.0002 ◽

2021 ◽

pp. 13-27

Author(s):

William Abel ◽

Elizabeth Kahn ◽

Tom Parr ◽

Andrew Walton

Keyword(s):

Public Policy ◽

Assisted Suicide ◽

The State ◽

Physician Assisted Suicide ◽

Sanctity Of Life

This chapter examines whether the state should permit an individual to end their own life. Physician-assisted suicide is only one way in which a doctor can hasten an individual’s death. In fact there are three ways in which a doctor may act. First, they can be passive by allowing an individual to die. Second, they can assist an individual by enabling them to bring about their own death. Third, they can be active in hastening an individual’s death by administering life-ending medication. The chapter argues that a doctor should be permitted to assist an individual to end their own life, as well as to intervene to hasten their death. It supports this view by appealing to the value of freedom, specifically the freedom to choose how to live and die. The chapter then considers the worry that it is wrong for the state to allow a doctor to assist an individual to end their life, since this is an affront to the sanctity of life. It outlines some implications of this argument for the design of public policy.

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The Instability of the Standard Justification for Physician-Assisted Suicide

Cambridge Quarterly of Healthcare Ethics ◽

10.1017/s0963180101001141 ◽

2001 ◽

Vol 10 (1) ◽

pp. 103-109

Author(s):

THOMAS A. CAVANAUGH

Keyword(s):

Public Policy ◽

Assisted Suicide ◽

Good Reason ◽

Common Elements ◽

Physician Assisted Suicide ◽

Natural Connection ◽

The Common

Proponents commonly justify the legalization of physician-assisted suicide (PAS) in terms of a patient's wanting to die (autonomy) and the patient's having a medically established good reason for suicide. These are the common elements of the standard justification offered for the legalization of PAS. In what follows, I argue that these two conditions exist in significant tension with one another, operating according to distinct dynamics that render the justification for PAS an unstable “let it be so” basis for public policy. Moreover, no natural connection keeps these two criteria united. Indeed—as I argue—the two elements of the justification oppose and threaten to exclude one another. Thus, the PAS justification is too labile a basis for sound public policy.

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Currently Accepted Practices That Are Known to Lead to Death, and PAS: Is There an Ethically Relevant Difference?

Cambridge Quarterly of Healthcare Ethics ◽

10.1017/s0963180198704062 ◽

1998 ◽

Vol 7 (4) ◽

pp. 375-381 ◽

Cited By ~ 1

Author(s):

THOMAS A. CAVANAUGH

Keyword(s):

Public Policy ◽

End Of Life ◽

Assisted Suicide ◽

Lethal Dose ◽

Medical Intervention ◽

Physician Assisted Suicide ◽

Relevant Difference ◽

Relieve Pain

A number of common and generally noncontroversial practices in the care of patients at the end of life lead to their deaths. For example, physicians honor a patient's refusal of medical intervention even when doing so leads to the patient's death. Similarly, with a patient's or surrogate's consent, physicians administer sedatives in order to relieve pain and distress at the end of life, even when it is known that doing so will cause the patient's death. In contemporary U.S. public policy, these practices are accepted as ethical and legal while physician-assisted suicide (PAS) is—for the most part—rejected in current U.S. law and public policy. Some think, however, that if one accepts practices that are known to lead to a patient's death, then one cannot reasonably reject a patient's request for a lethal dose of medication so that she may kill herself (PAS).

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Euthanasia and Related Practices Worldwide

Crisis ◽

10.1027/0227-5910.19.3.109 ◽

1998 ◽

Vol 19 (3) ◽

pp. 109-115 ◽

Cited By ~ 9

Author(s):

Michael J Kelleher † ◽

Derek Chambers ◽

Paul Corcoran ◽

Helen S Keeley ◽

Eileen Williamson

Keyword(s):

Assisted Suicide ◽

International Association ◽

Active Euthanasia ◽

Physician Assisted Suicide ◽

Passive Euthanasia ◽

Medical Practitioners ◽

General Acceptance ◽

International Importance ◽

Controversial Area ◽

Active And Passive Euthanasia

The present paper examines the occurrence of matters relating to the ending of life, including active euthanasia, which is, technically speaking, illegal worldwide. Interest in this most controversial area is drawn from many varied sources, from legal and medical practitioners to religious and moral ethicists. In some countries, public interest has been mobilized into organizations that attempt to influence legislation relating to euthanasia. Despite the obvious international importance of euthanasia, very little is known about the extent of its practice, whether passive or active, voluntary or involuntary. This examination is based on questionnaires completed by 49 national representatives of the International Association for Suicide Prevention (IASP), dealing with legal and religious aspects of euthanasia and physician-assisted suicide, as well as suicide. A dichotomy between the law and medical practices relating to the end of life was uncovered by the results of the survey. In 12 of the 49 countries active euthanasia is said to occur while a general acceptance of passive euthanasia was reported to be widespread. Clearly, definition is crucial in making the distinction between active and passive euthanasia; otherwise, the entire concept may become distorted, and legal acceptance may become more widespread with the effect of broadening the category of individuals to whom euthanasia becomes an available option. The “slippery slope” argument is briefly considered.

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