Article: A Slippery Slope

Theoretical Slippery Slopes: conceptual boundaries drawn by supporters of PAS and euthanasia are often arbitrary and weak.

Supporters often claim there is a key difference between PAS and euthanasia.  In euthanasia, people claim the doctor directly kills a person by injecting them with a drug, while in PAS, the doctor “only” provides the patient with the means to kill himself, expecting and intending that the patient will use the drugs for that purpose. 

But there is no significant difference here.  In both cases the physicians directly acts intending the death of the patient.  Is it very different if a person shoots depressed and suicidal person himself or if a person merely buys a gun and ammunition for a suicidal person, loads the gun, and shows him/her how to use it.  And then leaves them alone fully intending that person would use the gun to kill themselves?  What if a person bought a gun and ammunition for an angry, bullied student knowing the student intended to use them to carry out a school shooting?  Surely, such a person would not be able to claim that his/her hands were clean.

What about the limits on who could receive PAS or euthanasia?  Proponents claim that it would be limited to those in unbearable physical pain within 6 months of death.  But why 6 months?  If it is right for such a person, why should it not be right for a person with only 9 months to live, but also in unbearable pain?  Why unbearable pain and not just severe pain?  Why only physical pain?  Surely mental anguish can also be unbearable and severe.  Why should the chronically ill be deprived if they may have years to live, but are still in severe pain?  What about the terminally ill who are not in great pain, but are depressed from the supposed indignity of their lives?  As Craig Paterson points out, arbitrary boundaries are not a problem when deciding if the speed limit should be 65 to 70 mph.  But they are unacceptable when determining if person A or B can exercise a right to end his/her life.  “The logic driving mercy killing does not end with the relief of those who have less than 6 months to live and endure unbearable physical pain” (Paterson 175). 

Slippery Slopes in Practice:

Empirical evidence from assisted suicide and euthanasia in practice in states like Oregon and the Netherlands also support the idea that in practice, conceptual boundaries have not held up.  (See also sections on the experience in the Netherlands and Oregon.  Empirical evidence shows that estimating life expectancy is full of uncertainty.  Neil Gorsuch has pointed out that evidence suggests that patients likely to live longer than 6 months and who are not in severe pain are being allowed PAS.  In fact, most patients do not cite unbearable pain as the reason they seek PAS.  More cite the inability to engage in activities they previously enjoyed or the fear of being a burden as reasons they commit suicide (Patterson, 176, Gorsuch 123).

Cases of involuntary euthanasia, where patients have been killed without their consent are also not mere alarmist fears.  Roughly 1,000 such cases each year happen in the Netherlands, suggesting that euthanasia, once legalized, has led physicians on their own to begin deciding which patients should live and which patients should die.  See further, the article on what happened in the Netherlands.

Further Reading:

Craig Paterson, Assisted Suicide and Euthanasia, (2008), pp.173-178.

Neil Gorsuch, The Future of Assisted Suicide and Euthanasia, (2006), especially chapter 7.