“The 360” shows you diverse perspectives on the most important stories and debates of the day.
What is going on
Thirty years ago, Dr. Jack Kevorkian the face of the incredibly controversial medically assisted death debate. Called “Dr. Death” in the media, he claimed to have helped at least 130 patients die before he was convicted of manslaughter in 1998.
Kevorkian died in 2011, but the debate over whether it should be legal for doctors to help people end their lives is far from settled. Today, ten states and Washington DC allow medically assisted suicide – a process in which life-ending drugs are provided to patients, who administer the dose themselves. The laws vary, but they generally state that individuals must have a terminal illness and a prognosis of less than six months to qualify. Only two states, Oregon and Vermont, allow medically assisted suicide for non-residents.
Although the US is one of the few countries to legalize what is often called medical assistance in dying (MAID), our laws are significantly more restrictive than those in some of our peer countries. For example, America is the only country where a terminal diagnosis is required. All others allow people with incurable diseases that cause them “unbearable pain” to opt for medically administered death. Most allow both assisted suicide and euthanasia, with doctors directly administering life-ending drugs. Several of these also allow MAID for people with serious mental illness and allow individuals to make “advance requests” in cases where they are expected to lose their ability to make their own decisions in the future, such as with dementia.
In recent years, Canada has become the site of the highest number of medically assisted deaths in the world. There were more than 10,000 MAID cases in Canada in 2021. That’s more than the total number of assisted suicides estimated to have occurred in the U.S. since Oregon became the first state to legalize the practice in 1997.
Why there is discussion
At its most basic level, the debate over medically assisted death comes down to morality. Either you believe that it is categorically wrong for a doctor to help someone end his or her life, or you believe, like nearly three-quarters of Americans, that there are cases in which people should be granted the “right to die” at their own conditions.
The issue becomes much more complicated when it comes to defining what those cases should be and what criteria people must meet before they can opt for a medically assisted death.
Supporters of expanding MAID options say that limiting access only to terminally ill patients causes unnecessary suffering to countless people and denies them the opportunity to choose a peaceful, pain-free death. They argue that a truly compassionate society would trust individuals to make their own choices, rather than insisting that they die in ways that satisfy others’ sense of right and wrong.
But critics worry that more permissive assisted death laws could lead to a “death on demand” system or create circumstances in which people are pushed to make the choice to die when they may not have to. There are also concerns that MAID could provide a way for society to avoid the hassle and expense of caring for its most vulnerable members, including the disabled, the mentally ill, and even the poor. Many critics point to disturbing reports from Canada — including one case in which a patient’s family claims he was “effectively put to death” — as a sign of the slippery slope that can arise if not enough guardrails are in place.
What’s next
Advocates of medically assisted death hope to expand the practice to more parts of the country. Bills legalizing assisted suicide have been introduced in at least 10 states in the past year, although it is unclear whether any of these bills will become law.
Perspectives
It is inhumane to force people to suffer when they want to take a different path
“It is nothing short of cruel to prevent anyone from having any control in the most difficult hours when life is coming to an end. Of course there must be safeguards. … But for those who choose to end their suffering and for the families who support their decision, the option for a dignified death must be available.” –Judy Kugel, Boston Globe
Assisted death should only be available in very limited circumstances
‘Is it really more humane to deny a miserable person a clean assisted suicide than to allow it? The authorities should say yes: we will not help you die because of your depression, poverty or unsuitable living conditions for the same reason that we will not remove your appendix if you have a broken leg, or prescribe lithium for a nasty form of psoriasis.” – Chris Selley, Wall Street Journal
The freedom to die must be treated as a basic human right
“The ability to end someone’s life is an important freedom. Our bodies belong to us, not to the government. We must have the power to decide whether we want to continue living, especially if we are in constant pain or suffer from debilitating or fatal diseases.” – Scott Shackleford, Reason
The foundations of our humanity begin to crumble when life loses its value
“The idea that human rights include the right to self-destruction, the conceit that people in a state of terrible suffering and vulnerability are truly ‘free’ to make a choice that ends all choices, the idea that a profession in medicine death should include the battery of treatments – these are inherently destructive ideas.” – Ross Douthat, New York Times
Canada has shown how dangerous MAID can be for vulnerable people
“The introduction of euthanasia in Canada has become the slipperiest of all slippery slopes. Of course, expanding assisted suicide legislation in the US will create the same troubling problems. …Canadians have the right to die, but do they also have the right to live despite medical challenges?” – Valerie Hudson, Desert News
We do not have to choose between protecting the vulnerable and giving people the right to die with dignity
“Let’s be clear: finding the right balance between protecting patients and helping them die will always be complicated. Complicated but feasible. It should absolutely be possible to write laws that protect the elderly, sick, disabled and otherwise vulnerable people from manipulation or coercion, while still providing opportunities for competent adults to provide relief from unbearable suffering or incurable diseases.” –Nicholas Goldberg, Los Angeles Times
The worst scenario is a world where people can choose to die at any time and for any reason
“The ultimate goal – or at least the consequence – of allowing assisted suicide/euthanasia is death on demand.” –Wesley J. Smith, National Review
Banning MAID ensures that people face death entirely on their own and often choose it themselves
“People faced with the grim, painful finality of their lives are currently committing suicide, many without a doctor there to ease their suffering – or to talk them out of it. Patients cannot be the primary decision maker about end-of-life options if the government refuses to allow a decision to exist. Patients cannot consult with doctors or loved ones about their end-of-life preferences if the consultation itself is illegal.” – David Colborne, Nevada Independent
Current restrictions are so restrictive that the “right to die” largely exists only on paper
“The few places in the United States that allow assisted suicide impose restrictions so strict that it makes it difficult for people in the state, and often nearly impossible for anyone outside the state, to meet.” – Pamela Paul, New York Times
Sometimes life is no better than death
“The idea that any life is better than no life at all goes largely unexamined and unchallenged, especially by young and healthy people. … But isn’t the principle itself – life at all costs – in need of a revaluation, with more attention paid to the wishes of the individual? Wouldn’t more control over the time, place, and circumstances of our death alleviate some of our fear of death, if not death itself? —John M. Crisp, Tribune News Service
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