The Journal of Ethics

, Volume 19, Issue 2, pp 143–157 | Cite as

No Last Resort: Pitting the Right to Die Against the Right to Medical Self-Determination

  • Michael Cholbi


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.


Assisted 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.


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Copyright information

© Springer Science+Business Media Dordrecht 2015

Authors and Affiliations

  1. 1.California State Polytechnic University, PomonaPomonaUSA

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