PRO or Physician-Assisted CON Euthanasia or Physician-Assisted Suicide 1. PRO: "The right of a competent, terminally CON: "The history of the law's treatment of ill person to avoid excruciating pain and in this country has been and embrace a timely and dignified death bears continues to be one of the rejection of nearly the sanction of history and is implicit in the all efforts to permit it. That being the case, concept of ordered liberty. The exercise of our decisions lead us to conclude that the this right is as central to personal autonomy asserted 'right' to assistance in committing and bodily integrity as rights safeguarded by suicide is not a fundamental liberty interest this Court's decisions relating to marriage, protected by the Due Process Clause." family relationships, procreation, contraception, child rearing and the refusal or -- Washington v. Glucksberg(63 KB) termination of life-saving medical treatment. US Supreme Court Majority Opinion In particular, this Court's recent decisions June 26, 1997 concerning the right to refuse medical treatment and the right to abortion instruct that a mentally competent, terminally ill person has a protected liberty interest in choosing to end intolerable suffering by bringing about his or her own death.

A state's categorical ban on physician assistance to suicide -- as applied to competent, terminally ill patients who wish to avoid unendurable pain and hasten inevitable death -- substantially interferes with this protected liberty interest and cannot be sustained."

-- ACLU Amicus Brief in Vacco v. Quill(72 KB)

American Civil Liberties Union (ACLU) Dec. 10, 1996

2. Patient Suffering at End-of-Life PRO: "At the we get calls CON: "Activists often claim that laws against daily from desperate people who are looking euthanasia and assisted suicide are for someone like to end their government mandated suffering. But this lives which have lost all quality... claim would be similar to saying that laws should enjoy a right guaranteed in the against selling contaminated food are European Declaration of Human Rights -- the government mandated starvation. right not to be forced to suffer. It should be considered as much of a crime to make Laws against euthanasia and assisted suicide someone live who with justification does not are in place to prevent abuse and to protect wish to continue as it is to take life without people from unscrupulous doctors and others. consent." They are not, and never have been, intended to make anyone suffer." -- Faye Girsh, EdD Senior Adviser, Network, -- Rita Marker, JD "How Shall We Die," Free Inquiry Executive Director Winter 2001 Kathi Hamlon Policy Analyst International Task Force on Euthanasia and Assisted Suicide "Euthanasia and Assisted Suicide: Frequently Asked Questions," www.internationaltaskforce.org Jan. 2010

3. Slippery Slope to Legalized Murder PRO: "Especially with regard to taking life, CON: "In a society as obsessed with the costs slippery slope arguments have long been a of health care and the principle of utility, the feature of the ethical landscape, used to dangers of the slippery slope... are far from question the moral permissibility of all kinds fantasy... of acts... The situation is not unlike that of a doomsday cult that predicts time and again Assisted suicide is a half-way house, a stop the end of the world, only for followers to on the way to other forms of direct discover the next day that things are pretty euthanasia, for example, for incompetent much as they were... patients by advance directive or suicide in the elderly. So, too, is a We need the evidence that shows that horrible half-way house to involuntary and slope consequences are likely to occur. The nonvoluntary euthanasia. If terminating life is mere possibility that such consequences a benefit, the reasoning goes, why should might occur, as noted earlier, does not euthanasia be limited only to those who can constitute such evidence." give consent? Why need we ask for consent?"

-- R.G. Frey, DPhil -- Edmund D. Pelligrino, MD Professor of Philosophy, Bowling Green State Professor Emeritus of Medicine and Medical University Ethics, Georgetown University "The Fear of a Slippery Slope," Euthanasia "The False Promise of Beneficent Killing," and Physician-Assisted Suicide: For and Regulating How We Die: The Ethical, Against Medical, and Legal Issues Surrounding 1998 Physician-Assisted Suicide 1998

5. Government Involvement in End-of-Life Decisions PRO: "We'll all die. But in an age of CON: "Cases like Schiavo's touch on basic increased longevity and medical advances, constitutional rights, such as the right to live death can be suspended, sometimes and the right to due process, and indefinitely, and no longer slips in according consequently there could very well be a to its own immutable timetable. legitimate role for the federal government to play. There's a precedent--as a result of the So, for both patients and their loved ones, real highly publicized deaths of infants with decisions are demanded: When do we stop disabilities in the 1980s, the federal doing all that we can do? When do we government enacted 'Baby Doe Legislation,' withhold which therapies and allow nature to which would withhold federal funds from take its course? When are we, through our hospitals that withhold lifesaving treatment own indecision and fears of mortality, from newborns based on the expectation of allowing wondrous medical methods to disability. The medical community has to perversely prolong the dying rather than the have restrictions on what it may do to people living? with disabilities - we've already seen what some members of that community are willing These intensely personal and socially to do when no restrictions are in place." expensive decisions should not be left to governments, judges or legislators better -- Stephen Drake. MS attuned to highway funding." Research Analyst, "End of Life Planning: Q & A with -- Los Angeles Times Disabilities Advocate," Reno Gazette-Journal "Planning for Worse Than Taxes," Opinion Nov. 22, 2003 Mar. 22, 2005

6. Palliative (End-of-Life) Care PRO: "Assisting death in no way precludes CON: "Studies show that hospice-style giving the best palliative care possible but palliative care 'is virtually unknown in the rather integrates compassionate care and Netherlands [where euthanasia is legal].' respect for the patient's autonomy and There are very few hospice facilities, very ultimately makes death with dignity a real little in the way of organized hospice activity, option... and few specialists in palliative care, although some efforts are now under way to try and The evidence for the emotional impact of jump-start the hospice movement in that assisted dying on physicians shows that country... euthanasia and assisted suicide are a far cry from being 'easier options for the caregiver' The widespread availability of euthanasia in than palliative care, as some critics of Dutch the Netherlands may be another reason for the practice have suggested. We wish to take a stunted growth of the Dutch hospice strong stand against the separation and movement. As one Dutch doctor is reported opposition between euthanasia and assisted to have said, 'Why should I worry about suicide, on the one hand, and palliative care, palliation when I have euthanasia?'" on the other, that such critics have implied. There is no 'either-or' with respect to these -- Wesley J. Smith, JD options. Every appropriate palliative option Senior Fellow in Human Rights and available must be discussed with the patient Bioethics, Discovery Institute and, if reasonable, tried before a request for Forced Exit assisted death can be accepted... 1997

Opposing euthanasia to palliative care... neither reflects the Dutch reality that palliative medicine is incorporated within end-of-life care nor the place of the option of assisted death at the request of a patient within the overall spectrum of end-of-life care."

-- Gerrit Kimsma, MD, MPh Associate Professor in Medical Philosophy Evert van Leeuwen, PhD Professor in Philosophy and Medical Ethics Center for Ethics and Philosophy at Free University in Amsterdam (Amsterdam, Netherlands) "Assisted Death in the Netherlands: Physician at the Bedside When Help Is Requested" Physician-Assisted Dying: The Case for Palliative Care & Patient Choice 2004

7. Healthcare Spending Implications PRO: "Even though the various elements that CON: "Savings to governments could make up the American healthcare system are become a consideration. Drugs for assisted becoming more circumspect in ensuring that suicide cost about $35 to $45, making them money is not wasted, the cap that marks a far less expensive than providing medical zero-sum healthcare system is largely absent care. This could fill the void from cutbacks in the ... Considering the way for treatment and care with the 'treatment' of we finance healthcare in the United States, it death." would be hard to make a case that there is a financial imperative compelling us to adopt -- International Task Force on Euthanasia physician-assisted suicide in an effort to save and Assisted Suicide money so that others could benefit..." "Frequently Asked Questions," www.internationaltaskforce.org -- Merrill Matthews, Jr., PhD (accessed May 27, 2010) Director, Council for Affordable Health Insurance "Would Physician-Assisted Suicide Save the Healthcare System Money?," Physician Assisted Suicide: Expanding the Debate 1998

8. Social Groups at Risk of Abuse PRO: "One concern has been that CON: "It must be recognized that assisted disadvantaged populations would be suicide and euthanasia will be practiced disproportionately represented among through the prism of social inequality and patients who chose assisted suicide. prejudice that characterizes the delivery of Experience in Oregon suggests this has not services in all segments of society, including been the case. In the United States, socially health care. Those who will be most disadvantaged groups have variably included vulnerable to abuse, error, or indifference are ethnic minorities, the poor, women, and the the poor, minorities, and those who are least elderly. Compared with all Oregon residents educated and least empowered. This risk does who died between January 1998 and not reflect a judgment that physicians are December 2002, those who died by more prejudiced or influenced by race and physician-assisted suicide were more likely to class than the rest of society - only that they be college graduates, more likely to be Asian, are not exempt from the prejudices manifest somewhat younger, more likely to be in other areas of our collective life. divorced, and more likely to have cancer or amytrophic lateral sclerosis... Moreover, While our society aspires to eradicate although 2.6 percent of Oregonians are discrimination and the most punishing effects African American, no African American of poverty in employment practices, housing, patients have chosen assisted suicide." education, and law enforcement, we consistently fall short of our goals. The costs -- Linda Ganzini, MD, MPH of this failure with assisted suicide and Professor of Psychiatry and Medicine Senior euthanasia would be extreme. Nor is there Scholar, Center for Ethics in Health Care at any reason to believe that the practices, Oregon Health & Science University whatever safeguards are erected, will be "The Oregon Experience," Physician- unaffected by the broader social and medical Assisted Dying: The Case for Palliative Care context in which they will be operating. This and Patient Choice assumption is naive and unsupportable." 2004 -- New York State Task Force on Life and the Law "When Death Is Sought: Assisted Suicide and Euthanasia in the Medical Context," newyorkhealth.gov 1994

9. Religious Concerns PRO: "Guided by our belief as Unitarian CON: "As Catholic leaders and moral Universalists that human life has inherent teachers, we believe that life is the most basic dignity, which may be compromised when gift of a loving God- a gift over which we life is extended beyond the will or ability of a have stewardship but not absolute dominion. person to sustain that dignity; and believing Our tradition, declaring a moral obligation to that it is every person's inviolable right to care for our own life and health and to seek determine in advance the course of action to such care from others, recognizes that we are be taken in the event that there is no not morally obligated to use all available reasonable expectation of recovery from medical procedures in every set of extreme physical or mental disability... circumstances. But that tradition clearly and strongly affirms that as a responsible steward BE IT FURTHER RESOLVED: That of life one must never directly intend to cause Unitarian Universalists advocate the right to one's own death, or the death of an innocent self-determination in dying, and the release victim, by action or omission... from civil or criminal penalties of those who, under proper safeguards, act to honor the We call on Catholics, and on all persons of right of terminally ill patients to select the good will, to reject proposals to legalize time of their own deaths; and... euthanasia."

BE IT FINALLY RESOLVED: That -- United States Conference of Catholic Unitarian Universalists, acting through their Bishops congregations, memorial societies, and "Statement on Euthanasia," on appropriate organizations, inform and petition www.usccb.org legislators to support legislation that will Sep. 12, 1991 create legal protection for the right to die with dignity, in accordance with one's own choice.

-- Unitarian Universalist Association: The Right to Die With Dignity, 1988 General Resolution Unitarian Universalist Association 1988

10. Living Wills PRO: "Living wills can be used to refuse CON: "Not only are we awash in evidence extraordinary, life-prolonging care and are that the prerequisites for a successful living effective in providing clear and convincing wills policy are unachievable, but there is evidence that may be necessary under state direct evidence that living wills regularly fail statutes to refuse care after one becomes to have their intended effect... terminally ill. When we reviewed the five conditions for a A recent Pennsylvania case shows the power successful program of living wills, we a living will can have. In that case, a Bucks encountered evidence that not one condition County man was not given a feeding tube, has been achieved or, we think, can be. First, even though his wife requested he receive despite the millions of dollars lavished on one, because his living will, executed seven propaganda, most people do not have living years prior, clearly stated that he did 'not want wills... Second, people who sign living wills tube feeding or any other artificial invasive have generally not thought through its form of nutrition'... instructions in a way we should want for life- and-death decisions... Third, drafters of living A living will provides clear and convincing wills have failed to offer people the means to evidence of one's wishes regarding end-of-life articulate their preferences accurately... care." Fourth, living wills too often do not reach the people actually making decisions for -- Joseph Pozzuolo, JD incompetent patients... Fifth, living wills Professor, Neuman College seem not to increase the accuracy with which Lisa Lassoff, JD surrogates identify patients' preferences." Associate, Reed Smith Jamie Valentine, JD -- Angela Fagerlin, PhD Associate, Pozzuolo & Perkiss Core Faculty Member, Robert Wood Johnson "Why Living Wills/Advance Directives Are an Clinical Scholar Program, University of Essential Part of Estate Planning," Journal Michigan Medical School of Financial Service Professionals Carl E. Schneider, JD Sep. 2005 Chauncey Stillman Professor for Ethics, Morality, and the Practice of Law, University of Michigan Law School "Enough: The Failure of the Living Will," Hastings Center Report 2004

PRO Euthanasia atau Dokter-Assisted CON Euthanasia atau Dokter-Assisted Suicide Suicide 1. Hak untuk Die PRO:. "Hak yang kompeten, orang yang CON: "Sejarah pengobatan hukum dari sakit parah untuk menghindari rasa sakit luar bunuh diri yang dibantu di negara ini telah biasa dan merangkul kematian tepat waktu dan terus menjadi salah satu penolakan dan bermartabat dikenakan sanksi sejarah dan hampir semua upaya untuk mengizinkan hal tersirat dalam konsep memerintahkan itu yang terjadi, keputusan kita membawa kita kebebasan Pelaksanaan hak ini sebagai pusat untuk menyimpulkan bahwa menegaskan otonomi pribadi dan integritas tubuh sebagai 'benar'. untuk bantuan dalam melakukan hak dilindungi oleh keputusan ini Pengadilan bunuh diri bukanlah bunga kebebasan yang berkaitan dengan pernikahan, hubungan mendasar dilindungi oleh Proses Klausul keluarga, prokreasi, kontrasepsi, Karena. " membesarkan anak dan penolakan atau penghentian pengobatan yang menyelamatkan jiwa. Secara khusus, keputusan ini Pengadilan baru-baru ini -. Washington v Glucksberg (63 KB) tentang hak untuk menolak perawatan medis Mahkamah Agung AS Mayoritas Opini dan hak untuk aborsi menginstruksikan 26 Juni 1997 bahwa kompeten secara mental, orang yang sakit parah memiliki minat kebebasan dilindungi dalam memilih untuk mengakhiri penderitaan tak tertahankan dengan membawa tentang kematiannya sendiri.

Larangan kategoris Sebuah negara pada bantuan dokter untuk bunuh diri - seperti yang diterapkan untuk kompeten, pasien sakit parah yang ingin menghindari rasa sakit tak tertahankan dan mempercepat kematian tak terelakkan - secara substansial mengganggu ini bunga kebebasan dilindungi dan tidak dapat dipertahankan ".

- ACLU Amicus Brief di vacco v Quill. (72 KB)

American Civil Liberties Union (ACLU) 10 Desember 1996

2. Penderitaan Pasien Akhir-of-Life PRO: "Pada Hemlock Masyarakat kita CON: "Para aktivis sering mengklaim bahwa mendapatkan panggilan sehari-hari dari hukum terhadap euthanasia dan bunuh diri orang-orang putus asa yang mencari yang dibantu pemerintah yang diamanatkan seseorang seperti Jack Kevorkian untuk penderitaan Tapi klaim ini akan sama dengan mengakhiri hidup mereka yang telah mengatakan bahwa undang-undang terhadap kehilangan semua kualitas ... Amerika harus menjual makanan yang terkontaminasi adalah menikmati hak yang dijamin dalam Deklarasi pemerintah diamanatkan kelaparan.. Hak Asasi Manusia Eropa - yang hak untuk tidak dipaksa untuk menderita. Ini harus Hukum terhadap euthanasia dan bunuh diri dipertimbangkan sebanyak kejahatan untuk yang dibantu berada di tempat untuk membuat seseorang hidup yang dengan mencegah penyalahgunaan dan untuk pembenaran tidak ingin terus seperti itu melindungi orang dari oknum dokter dan adalah untuk mengambil hidup tanpa lain-lain. Mereka tidak, dan tidak pernah persetujuan. " telah, dimaksudkan untuk membuat orang menderita. " - Faye Girsh, EdD Senior Adviser, Final Exit Network, - Rita Marker, JD "Bagaimana Kami Akan Die," Gratis Kirim Direktur Eksekutif Musim Dingin 2001 Kathi Hamlon Analis Kebijakan Task Force internasional tentang Euthanasia dan Bunuh Diri Assisted "Euthanasia dan Bunuh Diri Assisted: Pertanyaan yang Sering Diajukan," www.internationaltaskforce.org Januari 2010

3. Slope Slippery untuk Pembunuhan dilegalisir PRO: "Khusus mengenai mengambil CON: "Dalam masyarakat seperti terobsesi kehidupan, argumen lereng licin telah lama dengan biaya perawatan kesehatan dan menjadi fitur dari lanskap etis, digunakan prinsip utilitas, bahaya lereng licin ... yang untuk mempertanyakan kebolehan moral jauh dari fantasi ... semua jenis tindakan ... Situasi ini tidak berbeda dengan kultus kiamat yang Bunuh diri yang dibantu adalah rumah memprediksi waktu dan lagi akhir dunia, setengah jalan, berhenti dalam perjalanan ke hanya untuk pengikut untuk menemukan hari bentuk lain dari euthanasia langsung, berikutnya bahwa hal-hal yang cukup banyak misalnya, untuk pasien yang tidak kompeten karena mereka ... oleh muka direktif atau bunuh diri pada orang tua. Jadi, juga, adalah euthanasia sukarela Kita perlu bukti yang menunjukkan bahwa setengah jalan rumah untuk disengaja dan konsekuensi lereng mengerikan yang nonvoluntary euthanasia. Jika mengakhiri mungkin terjadi. Hanya dengan kemungkinan hidup adalah manfaat, penalaran berjalan, bahwa konsekuensi seperti itu mungkin mengapa harus euthanasia dibatasi hanya terjadi, seperti disebutkan sebelumnya, tidak untuk mereka yang dapat memberikan merupakan bukti tersebut. " persetujuan? Mengapa perlu kita meminta persetujuan? " - RG Frey, DPhil Profesor Filsafat, Bowling Green State - Edmund D. Pelligrino, MD University Profesor Emeritus of Medicine dan Etika "The Fear dari Lereng Slippery," Euthanasia Kedokteran, Universitas Georgetown dan Dokter-Assisted Suicide: Untuk dan "The Promise Salah dari Pemurah Killing," Terhadap Pengaturan Bagaimana Kami Die: The 1998 Ethical, Medis, dan Masalah Hukum Sekitarnya Dokter-Assisted Suicide 1998

4. Sumpah Hipokrates dan Larangan Membunuh PRO: "Seiring waktu Sumpah Hipokrates CON: "Larangan terhadap pasien telah diubah pada sejumlah kesempatan membunuh ... berdiri sebagai janji pertama sebagai beberapa prinsip yang menjadi menahan diri dilantik dalam Sumpah kurang dan kurang dapat diterima Referensi Hipokrates, sebagai tabu utama obat ini: 'Aku untuk wanita tidak belajar kedokteran dan tidak akan memberikan obat yang mematikan dokter tidak melanggar kulit telah dihapus kepada siapa saja jika diminta untuk itu, dan Yang banyak dikutip referensi untuk '.. tidak tidak akan saya membuat saran untuk efek ini membahayakan 'juga membutuhkan '... Di forswearing pemberian racun ketika penjelasan. Tidak merugikan berarti bahwa ditanya untuk itu, dokter Hipokrates menolak kita harus memperpanjang hidup yang pasien pandangan bahwa pilihan pasien untuk melihat sebagai beban menyakitkan? kematian dapat membuat membunuhnya Tentunya, para' bahaya 'dalam hal ini tepat. Untuk dokter, setidaknya, kehidupan dilakukan ketika kita memperpanjang hidup, manusia dalam kehidupan badan perintah dan' tidak membahayakan 'berarti bahwa kita menghormati dan hormat - sifatnya Sebagai harus membantu pasien mati Membunuh kehormatan yang tidak tergantung pada pasien - teknis, ya Apakah hal yang baik - kesepakatan manusia atau persetujuan pasien, kadang-kadang, ya Apakah konsisten dengan pencabutan izin seseorang untuk hidup tidak baik akhir-hidup perawatan medis.... benar- menghilangkan seseorang hidup tubuh benar ya " kehormatan The terdalam prinsip etis menahan kekuatan dokter tidak.. otonomi - , MD atau kebebasan pasien;. juga bukan kasih Direktur dan Pendiri, sayang sendiri atau baik niat Sebaliknya, itu "Euthanasia Set Sail," National Review adalah martabat dan kekuatan misterius dari Online kehidupan manusia itu sendiri, dan karena itu, 5 Juni 2001 juga apa Sumpah panggilan kemurnian dan kesucian hidup dan seni yang ia telah bersumpah pengabdian. "

- Leon Kass, MD, PhD Addie Clark Harding Professor, Komite Pemikiran Sosial dan College, University of Chicago "Baik untuk Cinta atau Uang," Kepentingan Umum Musim dingin 1989

5. Keterlibatan Pemerintah dalam End-of-Life Keputusan PRO: "Kita semua akan mati Tapi di zaman CON: "Kasus-kasus seperti sentuhan Schiavo umur panjang meningkat dan kemajuan pada hak konstitusional dasar, seperti hak medis, kematian bisa ditunda, kadang-kadang untuk hidup dan hak untuk proses hukum, tanpa batas waktu, dan tidak ada lagi slip di dan akibatnya ada bisa sangat baik menjadi menurut jadwal berubah sendiri.. peran yang sah bagi pemerintah federal untuk bermain Ada preseden - sebagai hasilnya. dari Jadi, bagi pasien dan orang yang mereka kematian yang dipublikasikan bayi dengan cintai, keputusan nyata dituntut: Kapan kita cacat pada 1980-an, pemerintah federal berhenti melakukan semua yang bisa kita diberlakukan 'Bayi Doe Legislasi,' yang akan lakukan? Ketika kita menahan yang terapi menahan dana federal dari rumah sakit yang dan memungkinkan alam untuk mengambil menahan pertolongan perawatan dari bayi