Monday, March 7, 2016

Physician-Assisted Dying – Part Two – The Arguments Against Legalization

I’ve changed my terminology from physician-assisted suicide to physician-assisted dying. The latter term seems to carry less baggage.

To be clear, this discussion is about public policy – should physician-assisted dying be legalized? This is not about the personal decision individuals might make about whether to exercise this option.

Here are the most common arguments against legalizing physician-assisted dying, and my thoughts on each one.

Any Form of Suicide is Against God’s Will

In most faith traditions, orchestrating your own death is considered a sin. Only God gives life or takes life away.

Because the United States is a secular democracy, not a theocracy, this argument applies only to personal decision making. It has no place in public policy making.

Legalizing Assisted Dying Would Invite Abuse – the Slippery Slope Argument

There’s a disability rights group, called Not Dead Yet, that actively opposes the legalization of assisted dying, precisely because many of them would be potential candidates. They fear legalization would lead to pressure on individuals within the disabled community and other vulnerable groups to agree to be euthanized when that’s not their preference. Some folks even fear that legalized, physician-assisted death could come to be viewed as a cost-effective way to treat the terminally ill.

This is a legitimate concern, but not a reason to disqualify physician-assisted dying. Slippery slope arguments are problematic. According to, these arguments take the form of “You say that if we allow A to happen, then Z will eventually happen too, therefore A should not happen.”

The website goes on to say, “The problem with this reasoning is that it avoids engaging with the issue at hand, and instead shifts attention to extreme hypotheticals. Because no proof is presented to show that such extreme hypotheticals will in fact occur, this fallacy has the form of an appeal to emotion fallacy by leveraging fear. In effect, the argument at hand is unfairly tainted by unsubstantiated conjecture.”

Slippery slope arguments can be used to build the checks and balances into a system, but not to argue against the system itself.

Advances in Palliative Care Make Assisted Dying Unnecessary

Hospice facilities have become better at what they do. Death can be made comfortable and painless.

This is true some of the time, but not all of the time. There are too many cases when it was impossible to provide a relatively comfortable and dignified natural death.

The Logistics are too Messy

When does the assisted death option legally come into play? What if the patient’s mental state is unclear? What provisions would we need in order to weed out unscrupulous family members who are just tired of taking care of grandma, and are pressuring her? Which medical methods are acceptable? Must a patient be in imminent danger of death, or is quality of life sufficient reason for euthanasia? Wherever society draws the lines, the first person on the other side of the line will cry “foul.”

Yes, the logistics are complicated, but can be managed. If rule makers are compassionate and open-minded, systems can be developed that fairly address the needs of most individuals. There will always be someone just on the other side of the line whenever public policy is made. This is not a justification to stop making public policy.

What If They Find a Cure the Day after I Die?

What a horrible shame it would be if people practiced physician-assisted dying when they didn’t need to. Medical advancements occur every day. How can anyone be sure that their situation is hopeless?

This is another legitimate concern, but one of personal choice, not public policy. Patients would have to accept this risk. But it’s a small risk. Instances of unforeseen medical advancement are rare. Most ailments that would lead to assisted death have existed for some time, and will continue to exist.

Another version of this argument is, “What if an individual would have gone into remission had they not been euthanized?” Checks and balances can be put in place so that only patients who are unlikely to experience remission, and only people with diseases that aren’t likely to be cured in the near future will be allowed to undergo physician-assisted dying.

In my next post I’ll discuss the arguments for legalizing physician-assisted dying, also referred to as Death with Dignity.

Click here for Physician-Assisted Dying – Part One – An Uplifting Subject?

Click here for Physician-Assisted Dying – Part Three – The Arguments in Favor of Legalization


  1. My father supported aid in dying, but he didn't think physicians should be responsible for providing such aid. The disabled people who are most opposed to aid in dying tend to be those who were born with disabilities.

    1. Lisa, I think we need physicians to be involved, but of course only if they are comfortable with it.

    2. Dad took the idea of "do no harm" seriously; he felt that most physicians were too invested in prolonging and preserving life to be the best candidates for helping people end it. Clearly they need to be involved in determining whether aid in dying is appropriate. Perhaps this should be a medical specialty in itself.

  2. Being a nurse for 19 years and being a part of the dying experience for so many patients allows me to understand why choices are so important. How we suffer. . If we have to. . And for how long is a very individual choice. <3

    1. Bobbi, your perspective is so helpful. You've been in the trenches.