Physician-Assisted Suicide in the U.S.: Balancing Autonomy, Dignity, and Justice

The question of whether physician-assisted suicide (PAS) should be legalized throughout the United States involves the issues of autonomy, human dignity, and social justice. The dispute is that struggling adults facing a terminal diagnosis should be allowed to control their own death, especially to avoid prolonging suffering. Critics like bioethicists and disability rights activists are warning that legislative PAS could give a harmful signal regarding the value of lives affected by serious illness or disability and might lead to obligation or injustice. PAS needs to be legalized in all states under strong safeguards, with data and ethical principles, while responding to systemic concerns raised by disability justice organizers. 

Assisted suicide must be made legal across the country, as long as there is a rigorous qualification criteria and surveillance measures in place. The example of Brittany Maynard, a 29-year-old woman with terminal brain cancer, went to Oregon so she could take advantage of her "right to death with dignity" right. Maynard said, "death with dignity was the best choice for me and my family" when the outlook was six months or less . Her situation was very highly publicized, showing how legal PAS can allow individuals in the context of unavoidable death and suffering. Denying individuals the right to die on their own terms could cause unnecessary suffering for not only the patients, but their families as well. Most individuals are forced to die in hospitals, with machines all around them, instead of a peaceful setting. Legalizing PAS can help individuals to experience more dignity and empathy towards the end of their life. The Death with Dignity Act enacted in Oregon, during 1997, set the national standard. Oregon doctors prescribed 1,545 prescriptions during the period 1998–2015 under the Act; 991 patients took the drug and died (Blanke et al. 1403–06). A majority had cancer (77 percent), and their median age was 71. The two oral requests, written request, affirmation by two doctors of diagnosis, and self-administration of the medication are some of the requirements in the law (Blanke et al. 1403). The same law has been enacted in Washington with the same effects (New England Journal of Medicine, “Implementing a Death with Dignity Program”). It explains that the law has strict requirements, mostly used by older patients with terminal illnesses like cancer, and accounts for only a very small percentage of all deaths in the state.

A philosopher grounded in autonomy, such as Colburn, would state that individuals themselves determine what is to be lived for, not society or the state. While Reed contradicts that limiting physician-assisted suicide to only terminally ill patients or those experiencing severe suffering, still suggests that some disabled people's lives are considered less worth saving than others. Disability rights groups like Not Dead Yet, the National Council on Disability, and DREDF strongly oppose PAS statutes. They argue that these laws create a double standard by allowing assisted suicide for terminally ill patients while offering protection from it to everyone else. 

 Critics cite Helen's case as a breast cancer patient who was diagnosed with depression but still considered mentally competent, to argue that mental health evaluations are not always accurate. They also point out that missing information about complications and the lack of independent witnesses make it harder to know if everything was handled properly, even though the law protects healthcare providers who act in good faith. Additionally, in Gonzales v. Oregon (2006), the U.S. Supreme Court upheld Oregon's legislation, ruling that the federal Controlled Substances Act is not a grant of power to the Attorney General to ban physicians from prescribing lethal medication under state law (546 U.S. 243). This decision gave states the authority to regulate physician-assisted suicide and prevented the federal government from overriding those laws. The supporters of PAS include the right-to-die groups, a section of medical professionals, and patients' rights activists. They believe that the right to die is encompassed in an individual's freedom, more so in instances of terminal illness. Some assisted suicide advocates don't see passive allowing-to-die and active causing-death as greatly distinct. 

On the opposite side of the divide are religious figures, disability rights groups, and medical ethics boards. They believe that PAS has negative effects and even equates to exploitation. Euthanasia (2022) warns that allowing it may lead to a "devaluation of human life." One quote by Tominey (2024) says the fear that if PAS becomes too mainstream, patients without access to quality care would view it as their sole option, which would be a terrible breakdown of our health care system. 

Keeping detailed records and requiring regular reporting through a government agency is important to make sure physician-assisted suicide is handled fairly and responsibly. Ensuring hospice and counseling, as well as social support services, access ensures that patients are fully aware of all care options before deciding. Finally, anti-discrimination laws must be enforced in accordance with the Americans with Disabilities Act (ADA) to prevent indirect exploitation of disabled and poor individuals into PAS. Implementing these safeguards will ensure that a national PAS policy is of high ethical standards and protects vulnerable populations.

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Works Cited

Blanke, Charles D., et al. “Characterizing 18 Years of the Death With Dignity Act in Oregon.” JAMA Oncology, vol. 3, no. 10, 2017, pp. 1403–1406. 

Gonzales v. Oregon, 546 U.S. 243 (2006). U.S. Supreme Court decision. 

Haring, Chris. “Annual Death With Dignity Act Report Data, Takeaways.” Death with Dignity, 2024, deathwithdignity.org/news/2024/03/annual-oregon-dwd-report-data/. 

“How a Young Woman with Brain Cancer Moved to Oregon to Die.” Time, 8 Oct. 2014. 

Implementing a Death With Dignity Program at a Comprehensive Cancer Center. New England Journal of Medicine, Seattle Cancer Care Alliance authors, 2012. 

Jones, David Albert. “Twenty‑five Years of the ‘Oregon Model’ of Assisted Suicide: The Data Are Not Reassuring.” BMJ Medical Ethics Blog, 27 Oct. 2023.

National Council on Disability. Federal Study Finds Nation’s Assisted Suicide Laws Rife with Dangers to People with Disabilities, 2019. 

Philip Reed. “Does Euthanasia and Physician‑Assisted Suicide Disrespect the Disabled?” BMJ Bioethics Blog, 2020. 

“Assisted Dying Timeline.” SIRS Issues Researcher, 25 Jan. 2023, ProQuest. 

Assisted Suicide. Gale Encyclopedia of American Law, edited by M. J. Tyrkus and C. A. Schwartz, 4th ed., vol. 1, Gale, 2022, pp. 410–13. 

Breakey, Hugh. “The Worthless Life and the Worthy Death: Euthanasia through the Ages.” Gale Opposing Viewpoints Online Collection, Gale, 2024. Reprinted from The Conversation, 2023. 

Euthanasia. Gale Encyclopedia of American Law, edited by M. J. Tyrkus and C. A. Schwartz, 4th ed., vol. 4, Gale, 2022, pp. 281–87. 

Howland‑Murray, Donna. “Aid in Dying Is a Humane End to Physical Suffering—Not Suicide.” Hartford Courant, 29 Jan. 2023. 

Medical Aid in Dying. Gale Opposing Viewpoints Online Collection, Gale, 2023. 

Penna, David. “My Husband’s Death Made Me More Opposed to Assisted Suicide…” The Telegraph, 9 Jan. 2024. 

“Support for Physician‑Assisted Suicide and Euthanasia among US Adults, 2001–2017.” Gale Opposing Viewpoints Online Collection, Gale, 2018.

Tominey, Charles. “I’m Thankful Assisted Suicide Wasn’t an Option When My Mother Was…” The Telegraph, 5 Jan. 2024.