What is the great benefit of legalizing euthanasia or physician-assisted suicide?

Abstract

Euthanasia and physician-assisted suicide (PAS) are not ends in themselves with intrinsic value. At best, they are means to realize the end of a good death or, more accurately, a quality dying experience.1 The current debate has tended to focus on whether euthanasia or PAS is appropriate for this or that individual, or whether passive is the same as active euthanasia, or whether providing morphine for pain relief with the risk of respiratory depression and premature death is the same as euthanasia. But the issue that has exercised this country for the past five to ten years is legalization—or otherwise publicly sanctioning a social practice 2 —of euthanasia or PAS. This issue is not about the morality of a specific decision regarding the care of an individual patient, but the ethics of having a particular social policy and practice. Ultimately, the ethical question we should consider is: Will legalizing—or permitting—euthanasia and PAS promote—or thwart—a good death for the 2.3 million Americans who die each year in the United States? Will people who die be helped or harmed by having euthanasia or PAS available to them? In confronting this question, we must first acknowledge that figuring out the benefits and harms of permitting euthanasia or PAS is speculative, at best. As will become clear, we inherently lack some of the essential information we need for this assessment. But judgment under uncertainty and with incomplete data is precisely the type of ethical judgment that we—laymen and legislators—must make in deciding whether on balance it is better to legalize euthanasia or PAS or not. And, far