No Last Resort: Pitting the Right to Die Against the Right to Medical Self-Determination
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Many participants in debates about the morality of assisted dying maintain that individuals may only turn to assisted dying as a ‘last resort’, i.e., that a patient ought to be eligible for assisted dying only after she has exhausted certain treatment or care options. Here I argue that this last resort condition is unjustified, that it is in fact wrong to require patients to exhaust a prescribed slate of treatment or care options before being eligible for assisted dying. The last resort condition effectively pits one right of patients, their right to refuse medical treatment or interventions, against another patient right acknowledged by advocates of assisted dying, the right to die. Drawing on an analogy with the legal notion of an unconstitutional condition, I argue that the last resort condition unjustly demands that an arguably more fundamental right—the right to refuse medical treatment or intervention—be foregone in order to acquire a less fundamental right—the right to die. I then address three rationales for the last resort condition and find that they subject individuals to arbitrarily stringent standards for exercising the right to die, standards to which those who seek to end their lives by voluntarily ending life-sustaining treatments are not subject. Subjecting those who seek assisted dying to the last resort condition therefore wrongfully infringes on their right to refuse medical treatment or interventions.
KeywordsAssisted dying Patient rights Self-determination Right to die
Audiences at the 2014 annual meeting of the Association for Practical and Professional Ethics and at the International Conference on End of Life Law, Ethics, Policy, and Practice at the University of Queensland, Australia (August 2014) provided valuable feedback on this manuscript. I also wish to especially thank my colleague David Adams for drawing my attention to the legal literature on unconstitutional conditions.
- Beauchamp, Tom. 1995. Intending death. New York: Pearson.Google Scholar
- Brock, Daniel W. 2004. Physician-assisted suicide as a last- resort option at the end of life. In Physician-assisted dying: The case for palliative care and patient choice, ed. Timothy E. Quill, and Margaret Pabst Battin, 130–149. Baltimore: Johns Hopkins University Press.Google Scholar
- Campbell, Courtney S. 2007. E-mail statement to ProCon.org. Quoted at http://euthanasia.procon.org/view.answers.php?questionID=001320, Accessed 9 Sept 2014.
- Cholbi, Michael. 2011. Suicide: The philosophical dimensions. Peterborough, Ontario: Broadview Press.Google Scholar
- Dworkin, Ronald, et al. 1997. Assisted suicide: the philosophers’ brief. New York Review of Books. http://www.nybooks.com/articles/archives/1997/mar/27/assisted-suicide-the-philosophers-brief/, Accessed 18 June 2014.
- Gomez, C.F. 1991. Regulating death: Euthanasia and the case of the Netherlands. New York: Free Press.Google Scholar
- Hendin, Herbert. 1998. Seduced by death: Doctors, patients, and assisted Suicide. New York: W.W. Norton.Google Scholar
- Keown, John (ed.). 1997. Euthanasia examined: Ethical, clinical, and legal perspectives. Cambridge: Cambridge University Press.Google Scholar
- Miller, Franklin G., and Robert D. Truog. 2012. Death, dying, and organ transplantation: Reconstructing medical ethics at the end of life. Oxford: Oxford University Press.Google Scholar
- Moreno, Jonathan (ed.). 1995. Arguing euthanasia. New York: Touchstone.Google Scholar
- Quill, Timothy E., and Margaret Pabst Battin (eds.). 2004. Physician-assisted dying: The case for palliative care and patient choice. Baltimore: Johns Hopkins University Press.Google Scholar
- Smith, Wesley J. 2012. Oregon assisted suicide not “last resort.” National Review Online, 12 July 2012. http://www.nationalreview.com/human-exceptionalism/328089/oregon-assisted-suicide-not-last-resort, Accessed 26 Feb 2014.