In “What is Wrong with Rational Suicide,” Pilpel and Amsel develop a counterexample that allegedly confounds attempts to condition the moral permissibility of suicide on its rationality. In this counterexample, a healthy middle aged woman with significant life accomplishments, but no dependents, disease, or mental disorder opts to end her life painlessly after reading philosophical texts that persuade her that life is meaningless and bereft of intrinsic value. Many people would judge her suicide “a bad mistake” despite its meeting “robust” (...) conditions for rationality. Hence, Pilpel and Amsel conclude, even robust conditions for the rationality of suicide “fail to do their job: to exclude intuitively unacceptable suicides from being permissible.” I argue here that this counterexample fails to cast doubt on philosophical attempts to account for the moral permissibility of suicide in terms of its rationality. (shrink)

As of 2019, ten jurisdictions in the United States—Oregon, Washington, Montana, Vermont, California, Colorado, the District of Columbia, Hawaii, New Jersey, and Maine—have authorized physicians to...

Western ethics and law have been slow to come to conclusions about the right to choose the time and manner of one's death. However, policies, practices, and legal precedents have evolved quickly in the last quarter of the twentieth century, from the forgoing of respirators to the use of Do Not Resuscitate (DNR) orders, to the forgoing of all medical technologies (including hydration and nutrition), and now, in one U.S. state, to legalized physician-assisted suicide. The sweep of history—from the Quinlan (...) case in New Jersey to legislation in Oregon that allows physician-assisted suicide—has been as rapid as it has been revolutionary. (shrink)

In the present article the concept of the right to die will be analyzed in English and American literature between 1990 and 1994.

The American Journal of Bioethics, Volume 11, Issue 7, Page 20-22, July 2011.

Prior to passage of the Oregon Death with Dignity Act, opponents of assistance in dying argued that legalization would have serious harmful consequences. Specifically, they argued that the quality and availability of palliative care would decline, that the harms of legalization would affect certain vulnerable groups disproportionately, that legal assisted dying could not be confined to the competent terminally ill who voluntarily request assistance, and that the practice would result in frequent abuses. Data from Oregon's decade-long experience decisively refute the (...) first three predictions. As to abuses, the record is not quite as clear, but if an appropriate framework for analysis is utilized, the most reasonable conclusion is that the risks of abuse do not outweigh the benefits of legalization. To the extent projected harmful consequences are relevant to the debate over legalization, Oregon's experience argues in favor of legalization of assistance in dying. (shrink)

The American Journal of Bioethics, Volume 11, Issue 7, Page 18-20, July 2011.

The Supreme Court, reluctant to find constitutional rights in areas marked by divisive social and legal debate, is not likely to constitutionalize a right to assisted suicide. The Court should cleave to the tradition of discouraging suicide and criminalizing its assistance.

It is often claimed that managed care organizations involve physicians in conflicts of interest by creating financial incentives for physicians to refrain from ordering treatments or making referrals. Such incentives, the argument goes, force the physician to balance the patient's health interests against the MCO's interests and the physician's own financial interest. I assume, for the sake of argument, that such arrangements at least provide reason to believe that physicians in MCOs are involved in conflicts of interest. Two approaches have (...) evolved for dealing with these conflicts. On one approach, MCOs disclose the financial arrangements under which their physicians work so that patients can consent to the managed care plan and thereby to the plan's limitations. The chief proponent of this approach is Mark Hall, whose recent book Making Medical Spending Decisions applies prior consent to a variety of decisions regarding medical financing and allocation. The other approach is simply to forbid conflicts of interest through regulations. (shrink)

It is often claimed that managed care organizations involve physicians in conflicts of interest by creating financial incentives for physicians to refrain from ordering treatments or making referrals. Such incentives, the argument goes, force the physician to balance the patient's health interests against the MCO's interests and the physician's own financial interest. I assume, for the sake of argument, that such arrangements at least provide reason to believe that physicians in MCOs are involved in conflicts of interest. Two approaches have (...) evolved for dealing with these conflicts. On one approach, MCOs disclose the financial arrangements under which their physicians work so that patients can consent to the managed care plan and thereby to the plan's limitations. The chief proponent of this approach is Mark Hall, whose recent book Making Medical Spending Decisions applies prior consent to a variety of decisions regarding medical financing and allocation. The other approach is simply to forbid conflicts of interest through regulations. (shrink)

Many people believe that it is permissible for people who are suffering from terminal illnesses to commit suicide or even that such people have a right to commit suicide. Some have also argued that it follows that it is permissible for them, or that they have a right, to use the assistance of another person. First, I assume that it is permissible for a person to commit suicide and ask whether it follows that it is also permissible for the person (...) to employ an agent to assist in the death. Second, I assume that people have a right to commit suicide and ask whether it follows that the right holders have a right to employ an agent to assist with the death. I argue that the permissibility of suicide does not by itself entail the permissibility of employing someone to assist in the suicide. I also argue that the right to commit suicide does not by itself entail the right to assisted death. Instead, what follows is that there is a right not to have unreasonable restrictions placed on the means by which one can exercise one's right to commit suicide. Whether a restriction is reasonable depends on the conclusion reached when one has weighed a number of policy considerations. (shrink)

Euthanasia and assisted suicide have proved to be very contentious topics in medical ethics. Some ethicists are particularly concerned that allowing physicians to carry out these procedures will undermine their professional obligations and threaten the very goals of medicine. However, I maintain that the fundamental goals of medicine not only do not preclude the practice of euthanasia and assisted suicide by physicians, but can in fact be seen to support these practices in some instances. I look at two influential views (...) of the goals of medicine, one based on the broad guiding principles of autonomy, beneficence and nonmaleficence, and the other focusing on several more concrete aims, concluding that both approaches can be seen to support euthanasia and assisted suicide. I then turn to the popular concern that allowing physicians to carry out euthanasia and assisted suicide will lead to widespread abuse. I argue that the possibility for abuse can be minimised if we make the patient's autonomous consent an essential requirement of the practice. (shrink)