PRO Euthanasia or Physician-Assisted
Suicide
CON Euthanasia or Physician-Assisted
Suicide
1. Right to Die
PRO: "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. In
particular, this Court's recent decisions concerning the
right to refuse medical treatment and the right to
abortion instruct that a mentally competent, terminally
ill person has a protected liberty interest in choosing to
end intolerable suffering by bringing about his or her
own death.
CON: "The history of the law's treatment of assisted
suicide in this country has been and continues to be
one of the rejection of nearly all efforts to permit it. That
being the case, our decisions lead us to conclude that
the asserted 'right' to assistance in committing suicide
is not a fundamental liberty interest protected by the
Due Process Clause."
-- Washington v. Glucksberg
(PDF) 62.8KB
U.S. Supreme Court Majority Opinion
1997
A state's categorical ban on physician assistance to
suicide -- as applied to competent, terminally ill patients
who wish to avoid unendurable pain and hasten
inevitable death -- substantially interferes with this
protected liberty interest and cannot be sustained."
-- American Civil Liberties Union
Amicus Brief, Vacco v. Quill
1996
2. Patient Suffering at End-of-Life
PRO: "At the Hemlock Society we get calls daily from
desperate people who are looking for someone like
Jack Kevorkian to end their lives which have lost all
quality... Americans should enjoy a right guaranteed in
the European Declaration of Human Rights -- the right
not to be forced to suffer. It should be considered as
much of a crime to make someone live who with
justification does not wish to continue as it is to take life
without consent."
-- Faye Girsh, Ed.D.
Senior Adviser, Final Exit Network
"How Shall We Die," Free Inquiry
Winter 2001
CON: "Activists often claim that laws against
euthanasia and assisted suicide are government
mandated suffering. But this claim would be similar to
saying that laws against selling contaminated food are
government mandated starvation.
Laws against euthanasia and assisted suicide are in
place to prevent abuse and to protect people from
unscrupulous doctors and others. They are not, and
never have been, intended to make anyone suffer."
-- International Task Force on Euthanasia and Assisted
Suicide
"Euthanasia and Assisted Suicide: Frequently Asked
Questions," www.internationaltaskforce.org
Aug. 9, 2006
3. Slippery Slope to Legalized Murder
PRO: "Especially with regard to taking life, slippery
slope arguments have long been a feature of the
ethical landscape, used to question the moral
permissibility of all kinds of acts... The situation is not
unlike that of a doomsday cult that predicts time and
CON: "In debates with those bioethicists and
physicians who believe that euthanasia is both deeply
compassionate and also a logical way to cut health
care costs, I am invariably scorned when I mention 'the
slippery slope.' When the states legalize the deliberate
again the end of the world, only for followers to
discover the next day that things are pretty much as
they were...
ending of certain lives -- I try to tell them -- it will
eventually broaden the categories of those who can be
put to death with impunity.
We not only can distinguish between [voluntary and
non-voluntary] cases [of euthanasia] but do...
I am told that this is nonsense in our age of highly
advanced medical ethics. And American advocates of
euthanasia often point to the Netherlands as a model -a place where euthanasia is quasi-legal for patients
who request it...
We need the evidence that shows that horrible slope
consequences are likely to occur. The mere possibility
that such consequences might occur, as noted earlier,
does not constitute such evidence."
-- R.G. Frey, D.Phil.
Professor of Philosophy, Bowling Green State
University
"The Fear of a Slippery Slope," Euthanasia and
Physician-Assisted Suicide: For and Against
1998
Yet the September 1991 official government
Remmelink Report on euthanasia in the Netherlands
revealed that at least 1,040 people die every year from
involuntary euthanasia. Their physicians were so
consumed with compassion that they decided not to
disturb the patients by asking their opinion on the
matter."
-- Nat Hentoff
Columnist, The Village Voice
"The Slippery Slope of Euthanasia," The Washington
Post
Oct. 3, 1992
4. Hippocratic Oath and Prohibition of Killing
PRO: "If the prevention and relief of suffering are the
aims of medical interventions -- and not only the
preservation or prolongation of life -- it seems
imperative to rethink our profession's reluctance to
participate in euthanasia or even be present during an
assisted suicide without legal guarantees of protection.
Many opponents of these practices point to the
Hippocratic Oath and its prohibition on hastening
death. But those who turn to the oath in an effort to
shape or legitimize their ethical viewpoints must realize
that the statement has been embraced over
approximately the past 200 years far more as a symbol
of professional cohesion than for its content. Its pithy
sentences cannot be used as all-encompassing
maxims to avoid the personal responsibility inherent in
the practice of medicine. Ultimately, a physician's
conduct at the bedside is a matter of individual
conscience.
The wisdom of past years and moments enters into the
deliberation, but decision making in the present bears a
burden that is unique to the particular transaction
between the doctor and the individual patient who has
come for help. To seek refuge in ancient aphorisms is
to turn away from the unique needs of each of our
patients who have entrusted themselves to our care."
-- Sherwin Nuland, MD
Clinical Professor of Surgery, Yale School of Medicine
"Physician-Assisted Suicide and Euthanasia in
Practice," New England Journal of Medicine
Feb. 24, 2000
CON: "The prohibition against killing patients ... stands
as the first promise of self-restraint sworn to in the
Hippocratic Oath, as medicine's primary taboo: 'I will
neither give a deadly drug to anybody if asked for it,
nor will I make a suggestion to this effect'...
In forswearing the giving of poison when asked for it,
the Hippocratic physician rejects the view that the
patient's choice for death can make killing him right.
For the physician, at least, human life in living bodies
commands respect and reverence -- by its very nature.
As its respectability does not depend upon human
agreement or patient consent, revocation of one's
consent to live does not deprive one's living body of
respectability. The deepest ethical principle restraining
the physician's power is not the autonomy or freedom
of the patient; neither is it his own compassion or good
intention. Rather, it is the dignity and mysterious power
of human life itself, and therefore, also what the Oath
calls the purity and holiness of life and art to which he
has sworn devotion."
-- Leon Kass, MD, PhD
Addie Clark Harding Professor, Committee on Social
Thought and the College, University of Chicago
"Neither For Love Nor Money," Public Interest
1989
5. Government Involvement in End-of-Life Decisions
PRO: "We'll all die. But in an age of increased
longevity and medical advances, death can be
suspended, sometimes indefinitely, and no longer slips
in according to its own immutable timetable.
So, for both patients and their loved ones, real
decisions are demanded: When do we stop doing all
that we can do? When do we withhold which therapies
and allow nature to take its course? When are we,
through our own indecision and fears of mortality,
allowing wondrous medical methods to perversely
prolong the dying rather than the living?
These intensely personal and socially expensive
decisions should not be left to governments, judges or
legislators better attuned to highway funding."
-- Los Angeles Times
Editorial: "Planning for Worse Than Taxes"
Mar. 22, 2005
CON: "Cases like Schiavo's touch on basic
constitutional rights, such as the right to live and the
right to due process, and consequently there could
very well be a legitimate role for the federal
government to play. There's a precedent--as a result of
the highly publicized deaths of infants with disabilities
in the 1980s, the federal government enacted 'Baby
Doe Legislation,' which would withhold federal funds
from hospitals that withhold lifesaving treatment from
newborns based on the expectation of disability. The
medical community has to have restrictions on what it
may do to people with disabilities--we've already seen
what some members of that community are willing to
do when no restrictions are in place."
-- Not Dead Yet
"End of Life Planning: Q & A with Disabilities
Advocate," Reno Gazette-Journal
Nov. 22, 2003
6. Palliative (End-of-Life) Care
PRO: "Palliative care has been the main beneficiary of
the Oregon Death with Dignity Act [which legalized
physician-assisted suicide] so far. Since its passage,
we've seen a great resurgence of interest in the
medical community in palliative care. Hospice referrals
have increased by 20 percent, and now Oregon leads
the nation in prescription of morphine. This has a
salutary effect on end of life care."
-- Barbara Coombs Lee, JD
President, Compassion & Choices
"A Right to Die?," PBS Newshour
Nov. 26, 1997
CON: "Once a patient has the means to take their own
life, there can be decreased incentive to care for the
patient's symptoms and needs. The case of Michael
Freeland is an example. Michael had been given a
lethal prescription and when his doctors were planning
for his discharge to his home from the hospital, one
physician wrote that while he probably needed
attendant care at home, providing additional care may
be a 'moot point' because he had 'life-ending
medication'. His assisted suicide doctor did nothing to
care for his pain and palliative care needs. This
seriously ill patient was receiving poor advice and
medical care because he had lethal drugs."
-- Physicians for Compassionate Care
"Top 10 FAQs," www.pccef.org
2006
7. Healthcare Spending Implications
PRO: "Even though the various elements that make up
the American healthcare system are becoming more
circumspect in ensuring that money is not wasted, the
cap that marks a zero-sum healthcare system is largely
absent in the United States... Considering the way we
finance healthcare in the United States, it would be
hard to make a case that there is a financial imperative
compelling us to adopt physician-assisted suicide in an
effort to save money so that others could benefit."
-- Merrill Matthews, Jr., PhD
Director, Center for Health Policy Studies
CON: "Cost containment well could become the engine
that pulls the legislative train along the track to death
on demand. Those who advocate dismantling the
barriers that now protect patients from assisted suicide
recognize the power of cost containment."
-- Rita Marker, JD
Executive Director, International Task Force on
Euthanasia and Assisted Suicide
"Assisted Suicide and Cost Containment,"
www.internationaltaskforce.org
1999
"Would Physician-Assisted Suicide Save the
Healthcare System Money?," Physician Assisted
Suicide: Expanding the Debate
1998
8. Social Groups at Risk of Abuse
PRO: "To date, persons who have chosen to use the
[Oregon Death with Dignity] law have been well
educated, have had excellent health care, have had
good insurance, have had access to hospice and have
been well supported financially, emotionally and
physically."
-- Death With Dignity National Center
"Frequently Asked Questions,"
www.deathwithdignity.org
Jan. 22, 2006
CON: "Assisted suicide and euthanasia would carry us
into new terrain. American society has never
sanctioned assisted suicide or mercy killing. We
believe that the practices would be profoundly
dangerous for large segments of the population,
especially in light of the widespread failure of American
medicine to treat pain adequately or to diagnose and
treat depression in many cases. The risks would
extend to all individuals who are ill. They would be
most severe for those whose autonomy and well-being
are already compromised by poverty, lack of access to
good medical care, or membership in a stigmatized
social group. The risks of legalizing assisted suicide
and euthanasia for these individuals, in a health care
system and society that cannot effectively protect
against the impact of inadequate resources and
ingrained social disadvantage, are likely to be
extraordinary."
-- New York State Task Force on Life and the Law
"When Death is Sought - Assisted Suicide and
Euthanasia in the Medical Context,"
http://newyorkhealth.gov
1994
9. Physician's Role as Patients Approach Death
PRO: "Suicide assisted by a humane physician spares
the patient the pain and suffering that may be part of
the dying process, and grants the patient a 'mercifully'
easy death...
The most plausible party for providing such assistance
[in death] is the physician. It is the physician who has
access to drugs, who has specialized knowledge of
appropriate dosages, and who knows how to prevent
side effects such as nausea and vomiting. Equally
important, the physician can be a source of emotional
support for both patient and family. Seen in this light,
the right to assistance in suicide is plausibly construed
as the dying patient's right to help from his or her own
physician, at least where there is a personal physician
who knows the patient well, who has been directly,
extensively, and intimately connected with and
responsible for that person's care, who may know the
family, and who understands, better than any other
physician or other party able to provide assistance in
suicide, that person's hopes, fears, and wishes about
how to die."
-- Margaret Battin, PhD
CON: "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 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.
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.
Euthanasia could also readily be extended to
incompetent patients and other vulnerable populations.
Instead of engaging in euthanasia, physicians must
aggressively respond to the needs of patients at the
end of life. Patients should not be abandoned once it is
determined that cure is impossible. Patients near the
end of life must continue to receive emotional support,
comfort care, adequate pain control, respect for patient
Distinguished Professor of Philosophy and Adjunct
Professor of Internal Medicine, Division of Medical
Ethics, University of Utah
"Is a Physician Ever Obligated to Help a Patient Die?,"
Regulating How We Die
1998
autonomy, and good communication."
-- American Medical Association
Policy E-2.21 Euthanasia, www.ama-assn.org
1996
10. Value of Life as Patients Approach Death
PRO: "Life itself is commonly taken to be a central
good for persons, often valued for its own sake, as well
as necessary for pursuit of all other goods within a life.
But when a competent patient decides to forgo all
further life-sustaining treatment then the patient, either
explicitly or implicitly, commonly decides that the best
life possible for him or her with treatment is of
sufficiently poor quality that it is worse than no further
life at all. Life is no longer considered a benefit by the
patient, but has now become a burden. The same
judgement underlies a request for euthanasia:
continued life is seen by the patient as no longer a
benefit, but now a burden. Especially in the often
severely compromised and debilitated states of many
critically ill or dying patients, there is no objective
standard, but only the competent patient's judgment of
whether continued life is no longer a benefit."
CON: "The equality-of-human-life ethic requires that
each of us be considered of equal inherent moral
worth, and it makes the preservation and protection of
human life society's first priority.
Accepting euthanasia would replace the equality-ofhuman-life ethic with a utilitarian and nihilistic 'death
culture' that views the intentional ending of certain
human lives as an appropriate and necessary answer
to life's most difficult challenges... [T]he dire
consequences that would flow from such a radical shift
in morality are profound and disturbing."
-- Wesley Smith, JD
Consultant, International Anti-Euthanasia Task Force
"Introduction," Forced Exit
1997
-- Dan Brock, PhD
Frances Glessner Lee Professor of Medical Ethics and
Director of the Division of Medical Ethics, Harvard
Medical School
"Voluntary Active Euthanasia," Hastings Center Report
1992
PRO Euthanasia or Physician-Assisted
Suicide
CON Euthanasia or Physician-Assisted
Suicide