The relatively new practice of continuous sedation at the end of life (CS) is increasingly being debated in the clinical and ethical literature. This practice received much attention when a U.S. Supreme Court ruling noted that the availability of CS made legalization of physician-assisted suicide (PAS) unnecessary, as CS could alleviate even the most severe suffering. This view has been widely adopted. In this article, we perform an in-depth analysis of four versions of this ?argument of preferable alternative.? Our goal (...) is to determine the extent to which CS can be considered to be an alternative to PAS and to identify the grounds, if any, on which CS may be ethically preferable to PAS. (shrink)

One prevalent type of slippery slope argument has the following form: (1) by doing some initial act now, we will bring it about that we subsequently do some more extreme version of this act, and (2) we should not bring it about that we do this further act, therefore (3) we should not do the initial act. Such arguments are frequently regarded as mistaken, often on the grounds that they rely on speculative or insufficiently strong empirical premises. In this article (...) I point out another location at which these arguments may go wrong: I argue that, in their standard form, the truth of their empirical premises constitutes evidence for the falsity of their normative premises. If we will, as predicted, do the further act in the future, this gives us at least a prima facie reason to believe that the performance of this further act would be good, and thus something we should try to bring about. I end by briefly assessing the dialectic implications of my argument. I delineate a subset of slippery slope arguments against which my objection may be decisive, consider how the proponents of such arguments may evade my objection by adding further premises, and examine the likely plausibility of these additional premises. (shrink)

The Dutch experience has influenced the debate on euthanasia and death with dignity around the globe, especially with regard to whether physician-assisted suicide and euthanasia should be legitimized or legalized. Review of the literature reveals complex and often contradictory views about the Dutch experience. Some claim that the Netherlands offers a model for the world to follow; others believe that the Netherlands represents danger, rather than promise, and that the Dutch experience is the definitive answer regarding why we should not (...) make active euthanasia and physician-assisted suicide part of our lives.Having investigated the Dutch experience for a number of years, in the summer of 1999 I went to the Netherlands to visit the major centers of medical ethics as well as some research hospitals, and to speak with leading figures in euthanasia policy and practice. This essay commences by providing some background information on the practice of euthanasia and on the legal framework, and then reports the main answers to my first question: Why the Netherlands? (shrink)

The Dutch experience has influenced the debate on euthanasia and death with dignity around the globe, especially with regard to whether physician-assisted suicide and euthanasia should be legitimized or legalized. Review of the literature reveals complex and often contradictory views about the Dutch experience. Some claim that the Netherlands offers a model for the world to follow; others believe that the Netherlands represents danger, rather than promise, and that the Dutch experience is the definitive answer regarding why we should not (...) make active euthanasia and physician-assisted suicide part of our lives.Having investigated the Dutch experience for a number of years, in the summer of 1999 I went to the Netherlands to visit the major centers of medical ethics as well as some research hospitals, and to speak with leading figures in euthanasia policy and practice. This essay commences by providing some background information on the practice of euthanasia and on the legal framework, and then reports the main answers to my first question: Why the Netherlands? (shrink)