Should euthanasia or physician-assisted suicide be legal?
| 1. Legalization |
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“The right to die should be a matter of personal choice. We are able to choose all kinds of things in life from who we marry to what kind of work we do and I think when one comes to the end of one’s life, whether you have a terminal illness or whether you’re elderly, you should have a choice about what happens to you… I’m pro life – I want to live as long as I possibly can, but l also believe the law should be changed to let anyone with some severe medical condition which is causing unbearable symptoms to have an assisted suicide. I wouldn’t want to be unnecessarily kept alive against my own will.” Michael Irwin, MPH, MD
Coordinator, Society for Old Age Rational Suicide (SOARS) “Euthanasia: The Right to Die Should Be a Matter of Personal Choice,” Mirror Aug. 19, 2013 |
“[C]ampaigning to end certain people’s lives doesn’t end suffering – it passes on the suffering to other similar people, who now have to fear they are the next people in line to be seen as having worthless lives. And people who have died from a drug overdose have no freedom of choice at all. Moreover, societies that authorize suicide as a ‘choice’ for some people soon end up placing pressure on them to ‘do the right thing’ and kill themselves… Seeing suicide as a solution for some illnesses can only undermine the willingness of doctors and society to learn how to show real compassion and address patients’ pain and other problems. In states that have legalized assisted suicide, in fact, most patients request the lethal drugs not due to pain (or even fear of future pain), but due to concerns like ‘loss of dignity’ and ‘becoming a burden on others’ – attitudes that these laws encourage. The solution is to care for people in ways that assure them that they have dignity and it is a privilege, not a burden, to care for them as long as they live.” Richard Doerflinger, MA
Public Policy Fellow, Center for Ethics and Culture, University of Notre Dame “Q&A with the Scholars: Physician-Assisted Suicide and Euthanasia,” Lozier Institute website Jan. 30, 2017 |
| 2. Legalization: Medical Perspectives | |
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“I have long favored legalizing physician-assisted dying for terminally ill patients whose suffering cannot be relieved in any other way, and I was the first of the original fourteen petitioners to put the Massachusetts Death with Dignity Act on the ballot in November. In 1997, as executive editor of the New England Journal of Medicine, when the issue was before the US Supreme Court, I wrote an editorial favoring it, and told the story of my father, who shot himself rather than endure a protracted death from metastatic cancer of the prostate. It seems to me that, as with opposition based on whether the physician is ‘active,’ the argument that physicians should be only ‘healers’ focuses too much on the physician, and not enough on the patient. When healing is no longer possible, when death is imminent and patients find their suffering unbearable, then the physician’s role should shift from healing to relieving suffering in accord with the patient’s wishes. Still, no physician should have to comply with a request to assist a terminally ill patient to die, just as no patient should be coerced into making such a request. It must be a choice for both patient and physician.” Marcia Angell, MD
Senior Lecturer in Social Medicine, Harvard Medical School “May Doctors Help You to Die?,” New York Review of Books Oct. 11, 2012 |
“It is understandable, though tragic, that some patients in extreme duress–such as those suffering from a terminal, painful, debilitating illness–may come to decide that death is preferable to life. However, permitting physicians to engage in assisted suicide would ultimately cause more harm than good. Physician-assisted suicide is fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks… [P]ermitting physicians to engage in euthanasia would ultimately cause more harm than good. Euthanasia is fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks. Euthanasia could readily be extended to incompetent patients and other vulnerable populations. The involvement of physicians in euthanasia heightens the significance of its ethical prohibition. The physician who performs euthanasia assumes unique responsibility for the act of ending the patient’s life.” American Medical Association (AMA)
Code of Medical Ethics, ama-assn.org June 2016 |
| 3. Legalization: Lawmakers’ Views | |
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“The crux of the matter is whether the State of California should continue to make it a crime for a dying person to end his life, no matter how great his pain and suffering. I have carefully read the thoughtful opposition materials presented by a number of doctors, religious leaders and those who champion disability rights. I have considered the theological and religious perspectives that any deliberate shortening of one’s life is sinful. I have also read the letters of those who support the bill, including heartfelt pleas from Brittany Maynard’s family and Archbishop Desmond Tutu… In the end, I was left to reflect on what I would want in the face of my own death. I do not know what I would do if I were dying in prolonged and excruciating pain. I am certain, however, that it would be a comfort to be able to consider the options afforded by this bill. And I wouldn’t deny that right to others.” Jerry Brown, JD
Governor of California Statement upon signing ABx2 15, gov.ca.gov Oct. 15, 2015 |
“Legalising euthanasia would have a wide range of profoundly detrimental effects. It would diminish the protection offered to the lives of all. It would allow the killing of people who do not genuinely volunteer to be killed, and any safeguards, although initially observed, would inevitably weaken over time. There would be other long-term consequences of legalising euthanasia that we cannot yet envisage. We can be sure that these consequences would be pernicious, however, because they would emanate from an initiative which, while nobly motivated, is wrong in principle – attempting to deal with the problems of human beings by killing them.” Peter Kavanagh, LLB
Australian politician and former member of the Victorian Legislative Council “Opinion: Why We Should Not Legalize Euthanasia,” News Weekly Nov. 13, 2010 |
| 4. Vulnerable Groups | |
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“Data from places where assisted dying has been legalized, such as Oregon, suggest that the fears of these opponents of the bill are anyway largely unjustified… [T]he most significant vulnerability in many of the terminally ill is that to agonizing, chronic, and unrelievable pain. Because of the MPs who opposed the bill, thousands of people in the UK will have to continue to bear this pain against their will. For these MPs to describe their vote as protecting the vulnerable is grotesque.” Roger Crisp, DPhil
Professor of Moral Philosophy, University of Oxford “Assisted Dying and Protecting the Vulnerable,” blog.practicalethics.oc.ac.uk Sep. 17, 2015 |
“[I]n this profit-driven economic climate, is it realistic to expect that insurers are going to do the right thing, or the cheap thing? If insurers deny, or even delay, approval of costlier life-saving alternatives, then money saving but fatal measures become the deadly default. The truth is that assisted suicide as public policy is rife with dangerous loopholes and consequences, especially for the vulnerable in our society. We should reject laws that legalize the practice.” Helena Berger
President and CEO of the American Association of People with Disabilities “Assisted Suicide Laws Are Creating a ‘Duty-to-Die’ Medical Culture,” thehill.com Dec. 17, 2017 |
| 5. Hippocratic Oath | |
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“There’s people that tell me why are you doing this [advocating for PAS], you’re supposed to cure, you’re supposed to help this person, my answer to that is some people need help dying. To prolong a death in some cases is not helpful, it can be counter productive. My objective is that given the Hippocratic Oath, I’m not going against it, I’m helping people, people like my daughter [Emily, who died at 25 after a 17-year battle with leukemia] who need help at the end of their lives. What spurred me is Emily on two occasions when she was lucid and competent, she asked me to give her enough sleeping pills so that she could go to sleep permanently. She was blind, but in the bed and had to be carried, but her mind was still competent. Had I known it was legal in five other states… and understanding what her wishes were, I would have left [to go to a legal state] in a heartbeat.” Robert Olvera, MD
Retired family doctor “Doctors Debate the Ethics of Assisted Suicide,” scpr.org May 18, 2015 |
“[A]s a physician and medical ethicist, I believe that MAID/PAS flies in the face of a 2,000-year imperative of Hippocratic medicine: ‘Do no harm to the patient.’… I believe that the ambivalence and discomfort experienced by a substantial percentage of PAS-participating physicians is directly connected to the Hippocratic Oath – arguably, the most important foundational document in medical ethics. The Oath clearly states: ‘I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect.’… Indeed, when patients nearing the end of life express fears of losing control, or being deprived of dignity, compassionate and supportive counseling is called for – not assistance in committing suicide.” Ronald W. Pies, MD
Emeritus Professor of Psychiatry, SUNY Upstate Medical University “How Does Assisting Suicide Affect Physicians?,” theconversation.com Jan. 7, 2018 |
| 6. Legal Right | |
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“The right of a competent, terminally ill person to avoid excruciating pain and embrace a timely and dignified death bears the sanction of history and is implicit in the concept of ordered liberty. The exercise of this right is as central to personal autonomy and bodily integrity as rights safeguarded by this Court’s decisions relating to marriage, family relationships, procreation, contraception, child rearing and the refusal or termination of life-saving medical treatment.” ACLU Amicus Brief in Vacco v. Quill
 American Civil Liberties Union (ACLU) Dec. 10, 1996 |
“Do we want doctors deciding who lives and who dies? No, we do not want that. This is a slope, a real slope where we are going to become God. We do not have that power. The Declaration of Independence says that we should have the right to pursue life, liberty, and the pursuit of happiness. Nothing in it says we have the right to pursue death, nothing.” Tom Coburn, MD
US Senator (R-OK) Consideration of House Resolution 2260, Pain Relief Promotion Act of 1999, gpo.gov Oct. 27, 1999 |
| 7. Slippery Slope | |
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“The bottom line is that we have not seen evidence of the slippery slope and there is no good reason to believe that the experience on that front would be any different in Australia. [Reports by Australian groups] all conclude that the slippery slope arguments are not supported by valid and reliable evidence.” Jocelyn Downie, MA, MLitt, SJD
Professor of Law, Dalhousie University “Fact Check: Has Assisted Dying Been a Legal Slippery Slope Overseas?,” abc.net.au July 15, 2018 |
“[T]he empirical slippery slope cannot be ignored when one looks at the facts across the world… [T]here remains a real possibility of the extension of euthanasia to infants, those with mental incapacities or disabilities, and the elderly… Indeed, this has materialised to some degree, whether by a formal extension of categories of persons to whom euthanasia is allowed, or by loose application of criteria by personnel involved in the administration of euthanasia. For example, Belgium removed the age restriction for euthanasia in 2014; assisted death has extended beyond the line originally drawn by the law in the Netherlands to patients regarded as legally and mentally incompetent and the possibility of extension to those who are not terminally ill but feel their lives are complete is being considered; severe psychic pain in and otherwise healthy person has been thought sufficient ground for requesting euthanasia; and researchers have found cases of non-voluntary euthanasia in the form of the termination of lives of disabled infants in the Netherlands. Denying euthanasia honours the sanctity of life and the equal, underived, intrinsic moral worth of all persons, including the very weakest who can no longer contribute to society – principles of which so many other laws pivot.” Tan Seow Hon, SJD
Associate Professor of Law, Singapore Management University and Solicitor “The Case against Physician-Assisted Suicide and Voluntary Active Euthanasia,” Singapore Academy of Law Journal Aug. 2017 |
| 8. Palliative Care | |
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“Assisting death in no way precludes giving the best palliative care possible but rather integrates compassionate care and respect for the patient’s autonomy and ultimately makes death with dignity a real option… Opposing euthanasia to palliative care…neither reflects the Dutch reality that palliative medicine is incorporated within end-of-life care nor the place of the option of assisted death at the request of a patient within the overall spectrum of end-of-life care.” Gerrit Kimsma, MD
Associate Professor in Medical Philosophy, Center for Ethics and Philosophy at Vrije Universiteit, Amsterdam Evert van Leeuwen, PhD Professor in Philosophy and Medical Ethics, Center of Ethics and Philosophy at the Vrije Universiteit Medical Center, Amsterdam “Assisted Death in the Netherlands: Physician at the Bedside When Help Is Requested,” Physician-Assisted Dying: The Case for Palliative Care & Patient Choice 2004 |
“Given legal sanction, euthanasia, intended originally for the exceptional case, has become an accepted way of dealing with serious or terminal illness in the Netherlands. In the process, palliative care has become one of the casualties, while hospice care has lagged behind that of other countries.” Kathleen Foley, MD
Professor in the Department of Neurology, Weill Medical College of Cornell University Herbert Hendin, MD Professor in the Department of Psychiatry and Behavioral Sciences, New York Medical College The Case against Assisted Suicide: For the Right to End-of-Life Care 2002 |
| 9. Physician Obligation | |
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“It would be hard for me to construct addressing the suffering of a terminally ill patient as a harm. It is an obligation. The question is, how we can respond to those kinds of sufferings? Part of our job, in my opinion, is to help people die better. I say that in a direct way because it irks me when we say that doctors should not help people die. We need people who are committed to caring for people all the way through to their death as if they were family members, committed to relieving their suffering. Sometimes that requires helping people to die.” Timothy E. Quill, MD
Professor of Palliative Care, Medicine, and Psychiatry, University of Rochester “Should Physicians Help Terminal Patients Die?,” medscape.com Aug. 25, 2016 |
“Nothing, absolutely nothing, requires that physicians be the instruments of suicide aid… The physician’s task is to tell the patient…what’s wrong, and to the best of the doctor’s ability, what is going to happen. The physician’s job is to heal the sick, to stave off death, and to say as best as he or she can what the future will be like for each particular patient. The physician gets to be the helpless person’s medical guide because he or she is trusted to hold the patient’s good uppermost, and the patient’s good does not include death.” Stefan Bernard Baumrin, PhD, JD
Professor of Philosophy, City University of New York “Physician, Stay Thy Hand!,” Physician Assisted Suicide: Expanding the Debate 1998 |
| 10. Financial Motivations | |
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“There is no financial incentive to pressure patients… This myth is further dispelled by the fact that 92 percent of people in Oregon who choose medical aid in dying are enrolled in hospice care and not receiving expensive or intensive treatment. Therefore, there is no financial incentive to encourage people to accelerate their deaths.” Compassion and Choices
“The Facts: Medical Aid in Dying in the United States,” compassionandchoices.org Dec. 2016 |
“[I]n this profit-driven economic climate, is it realistic to expect that insurers are going to do the right thing, or the cheap thing? If insurers deny, or even delay, approval of costlier life-saving alternatives, then money saving but fatal measures become the deadly default. The truth is that assisted suicide as public policy is rife with dangerous loopholes and consequences, especially for the vulnerable in our society. We should reject laws that legalize the practice.” Helena Berger
President and CEO, American Association of People with Disabilities “Assisted Suicide Laws Are Creating a ‘Duty-to-Die’ Medical Culture,” thehill.com Dec. 17, 2017 |
