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Essay on End of Life Decisions: Assisted Suicide and Euthanasia
There are few more momentous and controversial questions facing contemporary society than the legalization of voluntary, active euthanasia (VAE) and active physician- assisted suicide (PAS). The campaign for their legalization shows little sign of abating. In January 1997, campaigners for PAS argued their case before the United States Supreme Court. They had persuaded two Federal Appeal Courts that the US Constitution recognized a right of mentally competent, terminally ill patients to PAS. Unanimously, the Supreme Court reversed both decisions.
As the Supreme Court's decisions illustrate, despite the popular support the campaign for legalization seems to enjoy and the considerable media attention it has generated, the campaign has as yet enjoyed surprisingly little success in changing laws around the world. This is largely because opposition to change remains strong. That opposition is partly based on the view that it is always morally wrong for one person, doctor or not, intentionally to kill another innocent person, even at their request. But it is also rooted in the concern that if VAE/PAS were permitted they would not remain voluntary for long, and that patients who did not really want to die, or who were not suffering severely, or whose suffering could be alleviated by palliative medicine, would nevertheless have their lives terminated. Indeed, fear of this 'slippery slope' is proving to be the major obstacle to reform. But is this fear justified or illusory? This is the question which has taken centre-stage in the current political debate, and it is the question which forms the centre-piece of this report.
Despite the major advances in medicine and palliative care witnessed by the last century, many patients, even in affluent Western nations, still die in pain and distress. Some entreat their doctors to put an end to their suffering either by killing them or by helping them to kill themselves. In almost every country in the world......
