Preventing the Slide down the Slippery Slope from Assisted Suicide to Euthanasia While Protecting the Rights of People with Disabilities Who Are “Not Dead Yet.”

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Taylor & Francis




Since at least the advent of Jack Kevorkian’s “suicide machine” the major argument against adopting physician-assisted suicide laws has been that they will lead us down a slippery slope to state-sanctioned killing by physicians (usually termed “euthanasia”) (Kevorkian, Citation1991). In the United States the legal line between physician-assisted suicide and euthanasia has not been breached in any of the 10 states that have adopted “Medical Aid in Dying” (also termed “physician-assisted suicide”) laws. But as well illustrated by Shavelson et al. “Neurologic Diseases and Medical Aid in Dying,” efforts continue to move us down the slope, at least a little, toward a model where physicians are expected to kill patients whose voluntary suicide efforts are not successful (Shavelson et al. Citation2023).

The strongest arguments for expansion include honouring the autonomy of patients with physical disabilities who are unable to end their own lives; and that limiting “medical aid in dying” to patients who can manage to take death-producing medications without assistance creates a new method of discrimination. We should dispose of this last argument first, as it has already been decided by the US Supreme Court. In Vacco v. Quill it was argued that New York law which permitted refusing life-sustaining medical treatment, but did not permit assisting suicide, denied people who had no medical intervention to refuse equal protection of laws. The Court was not persuaded because “the two acts are different,” and “by permitting everyone to refuse unwanted medical treatment while prohibiting anyone from assisting a suicide, New York law [treats everyone the same and] follows a longstanding and rational distinction.” (Vacco v. Quill, Citation1997) The same legal rationale applies to the ALS patient who needs assistance to commit suicide and resides in a MAID state.

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