Would Legalizing Physician-Assisted Suicide (PAS) Encourage the Healthcare Industry to Promote PAS, Endangering Vulnerable Groups?



PRO (yes)

Helena Berger, President and CEO of the American Association of People with Disabilities, in a Dec. 17, 2017 article, "Assisted Suicide Laws Are Creating a 'Duty-to-Die' Medical Culture," available at thehill.com, stated:

"[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."

Dec. 17, 2017 - Helena Berger 



JJ Hanson, Former President of Patients' Rights Action Fund, in a Sep. 27, 2017 article, "Assisted Suicide Laws Will Pressure Poor, Elderly, and Depressed to Die," available at thehill.com, stated:

"When assisted suicide becomes accepted public policy it threatens the lives of everyone, especially the poor, elderly, mentally ill, disabled, and terminally ill. Why? Well, for starters, abuse is unavoidable and doctors are fallible. Assisted suicide policy also injects government insurers and private insurance companies with financial incentives into every single person’s end of life decisions."

Sep. 27, 2017 - JJ Hanson 



Craig Wallace, Convenor of Lives Worth Living, in a Sep. 26, 2017 article, "Euthanasia a Choice for People with Disability? It's a Threat to Our Lives," available at theguardian.com, stated:

"We have cause to be concerned about perverse outcomes if euthanasia is adopted in Australia. In some countries where it has been introduced euthanasia has been offered to people with mental illness, people with dementia, twin brothers who were deaf, and even a woman with severe tinnitus...

Until every person with disability has equal access to screening, prevention and treatment in our health system, suicide prevention resources, and meaningful alternatives to ending it all, offering us euthanasia isn't an act of generous equality. It's our Hobson's choice – a fake, cruel one-way exit for vulnerable people locked out of basic healthcare and other social and community infrastructure that others take for granted."

Sep. 26, 2017 - Craig Wallace 



Monica Burke, Research Assistant at the DeVos Center for Religion and Civil Society at the Heritage Foundation, in an Apr. 16, 2018 article, "Physician-Assisted Suicide in Hawaii Is an Attack on All of Us," available at dailysignal.com, stated:

"Physician-assisted suicide further damages the broader health care context by giving insurance providers perverse incentives to provide a 'cheap fix' for patients who require additional, more expensive care.

Physician-assisted suicide also leaves patients vulnerable to pressure to end their lives, not only from their doctor or insurance provider but from family members. Families have intergenerational responsibilities to look after the young, the sick, and the aged. But the normalization of physician-assisted suicide destroys these intergenerational ties by encouraging families to view the elderly or disabled as burdens, a view which patients may then internalize themselves."

Apr. 16, 2018 - Monica Burke 



Kristen Hanson, Community Relations Advocate for Patients' Rights Action Fund, as quoted in a June 19, 2018 article by Maggie Maslak, "As Assisted Suicide Law Is Reinstated, Critics Say Californians 'Deserve Better,'" available at catholicnewsagency.com, stated:

"Assisted suicide limits choice for vulnerable people such as the terminally ill, elderly, individuals with disabilities, and anyone who relies on health insurance to cover treatment… It creates perverse economic incentives for insurance companies to deny coverage and deprive patients of lifesaving treatment when lethal drugs are so much cheaper."

June 19, 2018 - Kristen Hanson 



Brad Wenstrup, DPM, US Representative (R-OH), in a Sep. 29, 2017 House Congressional Resolution, H.Con. Res. 80, available at congress.gov, stated:

"Expressing the sense of the Congress that assisted suicide (sometimes referred to as death with dignity, end-of-life options, aid-in-dying, or similar phrases) puts everyone, including those most vulnerable, at risk of deadly harm and undermines the integrity of the health care system...

[A]assisted suicide most directly threatens the lives of people who are elderly, experience depression, have a disability, or are subject to emotional or financial pressure to end their lives."

Sep. 29, 2017 - Brad Wenstrup, DPM 



CON (no)

Joan Tollifson, MA, writer and teacher, in a June 19, 2015 article, "Death with Dignity and People with Disabilities," available at deathwithdignity.org, stated:

"Much of the opposition to physician-assisted dying comes from disability rights activists who falsely assume that legalizing the right to die poses a danger to them and undermines the value of their lives. Some people with disabilities fear that physician-assisted dying is a slippery slope and that if we legalize it in any form, soon we’ll be killing all disabled babies at birth, people will be bumping off their aging grandparents to get out of caring for them, and everyone in a wheelchair will feel obligated to kill themselves so as not to be a burden. Some people with disabilities hear in the right-to-die movement the old message that we disabled folks would be better off dead and that our lives are not worth living.

I understand from my own life experience where these fears come from. I am an older person, and I was born with a disability (my father was offered the chance to smother me at birth as a result). I have also had many friends over the years with severe disabilities, as well as friends who have lived well with serious chronic pain and incapacitation. But in the case of right-to die legislation, I feel that these concerns are enormously exaggerated and actually quite paranoid and misinformed."

June 19, 2015 - Joan Tollifson, MA 



Death with Dignity, in a Nov. 17, 2017 article, "Death with Dignity: A Report Card on Medical Aid in Dying Legislation in the United States," available at deathwithdignity.org, stated:

"Members of vulnerable groups such as the poor, less educated, or racial minorities have shown little interest in this end of life care option. The percentage of patients using Death with Dignity laws who are non-white is very small. The great majority availing themselves of medical aid in dying are white, and a majority have at least a high school degree and some college education. Since education is known to correlate with income, one can assume that most Death with Dignity deaths occur among those who are relatively well-off."

Nov. 17, 2017 - Death with Dignity National Center (DDNC) 



Arthur L. Caplan, PhD, Professor of Bioethics at the New York University Langone Health Medical Center, in a May 16, 2018 article, "Should Doctors Help People Die Just Because They're Elderly?," available at medscape.com, stated:

"It's a practice [PAS] that has also been around in Oregon and Washington State for some time. It doesn't seem to have been abused; that is, we're not taking poor people and rushing them off or taking people who don't really want to die and making them do so. In fact, of the people who make the request—and relatively few do in Oregon and Washington where it's been policy for many years—many of them don't take the pills. They like knowing that the pills are there, but they don't take them."

May 16, 2018 - Arthur L. Caplan, PhD 



Alicia Ouellette, JD, President and Dean of Albany Law School, in an Oct. 19, 2017 article, "Barriers to Physician Aid in Dying [PAD] for People with Disabilities," published in Laws, stated:

"Some disability rights advocates... support legalization on the ground that it promotes autonomy and independence at the end of life. For proponents, legalization in six states is proving to be an illusive victory. Emerging reports from the states where PAD is legal suggest that people with disabilities may face special and impenetrable barriers when seeking legal aid in dying. This article identifies four such barriers: procedural protections embedded in PAD statutes; physician objection; cost; and a rule pertaining to California veterans."

Oct. 19, 2017 - Alicia Ouellette, JD 



Roger Crisp, DPhil, Professor of Moral Philosophy, at the University of Oxford, in a Sep. 17, 2015 blog post, "Assisted Dying and Protecting the Vulnerable," available at blog.practicalethics.oc.ac.uk, stated:

"The most widely accepted argument in favour of rejecting the [assisted dying] bill seems to have been that doing so would protect the vulnerable.

This also seems somewhat paternalistic… If people are competent, should we not allow them to make their own decisions about the shape and direction of their own lives, even if we think those decisions will sometimes be mistaken?

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."

Sep. 17, 2015 - Roger Crisp, DPhil 



Ben White, DPhil, Professor of Law at Queensland University of Technology, Lindy Willmott, PhD, LLM, Professor of Law at the Queensland University of Technology, and Robert Douglas, MD, Emeritus Professor at Australian National University, in a May. 7, 2013 article, "Safe Assisted Dying Laws Are Possible, So Let's Make Them," available at the conversation.com, stated:

"But a body of international experience with assisted dying regimes has emerged since, including legislation in Oregon (1997) and the Netherlands and Belgium (2002). Although there have been critiques of these regimes and how they operate, there's now a body of reputable empirical evidence that concludes they’re generally operating as designed and within the scope of relevant laws.

So concerns about widespread abuse of voluntary euthanasia and assisted suicide laws appear to be unfounded…

Paying attention to the interests of the elderly and disabled people actually ensures we use appropriate eligibility criteria in the legislation. And that those criteria are supported by robust procedural safeguards as well as effective and independent oversight mechanisms."

May 7, 2013 - Robert Douglas, MD 
Ben White, DPhil 
Lindy Willmott, PhD, LLM