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Some critics have argued that the concept of dignity has outlived whatever usefulness it ever had, at least in bioethics. However, the concept of dignity has the annoying habit of turning up on both sides of the debate about the ethics and legality of physician-assisted death. This chapter distinguishes two conceptions of dignity: a thick one (commonly invoked by the pro side), which is derived from the experiences of patients at the end of life, and a thin one (often utilized by the anti side), which is rooted in a Kantian ethic. The chapter then provides reasons for preferring the former to the latter.

What is the relationship between ethics and law? Earlier we discussed the ethical status of physician-assisted death, surveying (in Chapters 3 and 4) arguments for and against its justifiability. There the focus was on what it might be right or wrong...

What is the argument from well-being? We now begin our inquiry into the ethical status of physician-assisted death, stating the case in favor in this chapter and the case against in the next. The former task is relatively straightforward since the principal arguments for the...

How do we tell when death has occurred? The answer to this question might seem straightforward: you are dead when you have stopped breathing and your heart has stopped beating. It’s actually a little more complicated than that since both respiration and circulation can stop...

The issue of physician-assisted death is now firmly on the American public agenda. Already legal in five states, it is the subject of intense public opinion battles across the country. Driven by an increasingly aging population, and a baby boom generation just starting to enter its senior years, the issue is not going to go away anytime soon. In Physician-Assited Death L.W. Sumner equips readers with everything they need to know to take a reasoned and informed position in this important debate. The book provides needed context for the debate by situating physician-assisted death within the wider framework of end-of-life care and explaining why the movement to legalize it now enjoys such strong public support. It also reviews that movement's successes to date, beginning in Oregon in 1994 and now extending to eleven jurisdictions across three continents. Like abortion, physician-assisted death is ethically controversial and the subject of passionately held opinions. The central chapters of the book review the main arguments utilized by both sides of the controversy: on the one hand, appeals to patient autonomy and the relief of suffering, on the other the claim that taking active steps to hasten death inevitably violates the sanctity of life. The book then explores both the case in favor of legalization and the case against, focusing in the latter instance on the risk of abuse and the possibility of slippery slopes. In this context the experience of jurisdictions that have already taken the step of legalization is carefully reviewed to see what lessons might be extracted from it. It then identifies some further issues that lie beyond the boundaries of the current debate but will have to be faced sometime down the road: euthanasia for patients who are permanently unconscious or have become seriously demented and for severely compromised newborns. The book concludes by considering the various possible routes to legalization, both political and judicial. Readers will then be prepared to decide for themselves just where they stand when they confront the issue both in their own jurisdiction and in their own lives.

What is the slippery slope argument? As the arguments in the previous chapter show, a strong case can be made for legalizing physician-assisted death. However, this is far from the end of the matter. While some opponents of legalization object to it on ethical grounds—usually...

What kind of legal regime should advocates aim for? The main business of this book is done. We have explored the nature, history, and ethics of physician-assisted death and the case that can be made for and against allowing it as a legal end-of-life option....

What is the end of life? The short answer to this question is pretty obvious: death. But we can be a little more relaxed about it. Patients who die of chronic diseases such as cancer usually enter a phase in the latter stages of their...

What is nonvoluntary physician-assisted death? We have now surveyed all of the ethical and legal issues concerning physician-assisted death, with one major exception. Thus far we have confined ourselves to PAD that is voluntary, meaning that it is freely chosen by the patient at the...

What is the right to life? Making the case in favor of physician-assisted death was a relatively straightforward exercise. Whether it took a consequentialist or a deontological form, the argument appealed to the two basic values of patient well-being and patient autonomy, the same values...

In her review of my book Assisted Death: A Study in Ethics and Law, Glenys Williams raises a number of substantive objections to its argument. In this note I reply to those objections.

When Amartya Sen defends his capability theory of well-being he contrasts it with the utility theory advocated by the classical utilitarians, including John Stuart Mill. Yet a closer examination of the two theories reveals that they are much more similar than they appear. Each theory can be interpreted in either a subjective or an objective way. When both are interpreted subjectively the differences between them are slight, and likewise for the objective interpretations. Finally, whatever differences may remain are less important than they might seem, since the two theories are developed by Sen and Mill for different purposes and are in that sense not genuine rivals.

If I lead a life of virtue, that may well be good for you. But will it also be good for me? The idea that it will—or even must—is an ancient one, and its appeal runs deep. For if this idea is correct then we can provide everyone with a good reason—arguably the best reason—for being virtuous. However, for all the effort which has been invested in defending the idea, by some of the best minds in the history of philosophy, it remains unproven. Worse, in this skeptical age hardly anyone really believes it. I don't really believe it either, at least not in its strongest forms, but I think that the question is nonetheless worth examining. Even if we cannot show that virtue and self-interest coincide, we can at least measure the breadth of the gap between them.

L'A. privilegie les theories subjectives du bien-etre qui proposent une interpretation pertinente de la relativite subjective du bien-etre, par rapport aux theories objectives du bien-etre qui sont inadequate precisement parce qu'elles sont objectives