A Critique of Three Objections to Physician-Assisted Suicide.

Dan W. Brock, A Critique of Three Objections to Physician-Assisted Suicide, 109 Ethics 519 (1999).

In June 1997 the U.S. Supreme Court reversed decisions in the Ninth and Second Federal Circuit Courts of Appeals that had held that state laws prohibiting physician-assisted suicide (PAS) in Washington and New York, respectively, were unconstitutional. The decisions left states free to craft policy on PAS and to prohibit it, as most states do now, or to permit it under one or another regulatory system, as Oregon now does. The objections of the Supreme Court and other opponents of PAS are: (1) forgoing life support is justified by the right to bodily integrity and against unwanted bodily invasion, whereas this right provides no justification for PAS; (2) PAS is morally wrong because it involves intending the patient's death, whereas, in forgoing life support and palliative care that hastens death, the patient's death is not intended; and (3) the potential for abuse and other harmful consequences is much greater with PAS than with forgoing life support and palliative care that hastens death.

The first argument addresses one of the central reasons typically offered to differentiate a right to forgo life support from a right to obtain PAS from a willing physician--that the former, but not the latter, follows from people's right to bodily integrity. The author argues that patient self-determination is the more fundamental ground of the right to forgo treatment, not bodily integrity, and it equally supports both practices. The second argument addresses one of the most prominent moral objections, particularly from physicians, against ever performing PAS--that it involves intending the patient's death, which is always morally impermissible. The author's principal response has been to show that this cannot differentiate PAS from the other main forms of end-of-life decisions and care--including forgoing life support, use of pain medications that...