In this chapter, I consider the idea that physician-assisted death might come into question in the cases of psychiatric patients who are incapable of making autonomous choices about ending their lives. I maintain that the main arguments for physician-assisted death found in recent medical ethical literature support physician-assisted death in some of those cases. After assessing several possible criticisms of what I have argued, I conclude that the idea that physicianassisted death can be acceptable in some cases of psychiatric patients (...) who lack autonomy ought to be taken into account in assessing the moral and legal acceptability of physician-assisted death. (shrink)

Many philosophers find welfare perfectionism implausible because it is arguably underinclusive, as it fails to count as good certain acts, events, and things that intuitively improve one's quality of life. Likewise, philosophers intuit that the experience of pleasure directly contributes to well-being. The problem for welfare perfectionism is straightforward: neither desire-satisfaction nor the experience of pleasure seem to perfect one's nature. This leaves two options for the welfare perfectionist. He can “bite the bullet” and argue that these intuitions are mistaken (...) and that pleasure and desire-satisfaction don't impact well-being. Alternatively, he can explain how such intuitive goods can directly contribute to well-being, despite initial appearances. I advance the latter approach. I argue that at least for some perfectionists, desire-satisfaction and pleasure both directly contribute to well-being. One cannot argue that welfare perfectionism necessarily neglects the intuitive importance of desire-satisfaction and pleasure. (shrink)