A Right to Die? Assisted Dying

The right to decide about one’s own death

Hume argued in “Of Suicide”, published only after his death, that someone who ends a life that has become a burden violates no duty to God, to others or to themselves. In 1997 six philosophers – Ronald Dworkin, Thomas Nagel, Robert Nozick, John Rawls, Thomas Scanlon and Judith Jarvis Thomson – submitted a brief to the US Supreme Court: competent people have a right to make the most intimate and momentous decisions about their lives, including how to face death, according to their own convictions; the state may protect them from pressure and ill-considered decisions, but may not impose its own view of what a dignified death is. The German Constitutional Court reasoned similarly in 2020: the general right of personality includes a right to a self-determined death and the freedom to seek the help of others – a right not limited to serious or incurable illness.

Held by

• David Hume1711–1776
• Thomas Nagelb. 1937
• Robert Nozick1938–2002
• John Rawls1921–2002
• Judith Jarvis Thomson1929–2020

Killing and letting die

James Rachels (1975) argued that the distinction between killing and letting die carries no moral weight in itself: if doctors may withdraw treatment from a patient who wants to die, letting them die slowly can be crueller than a quick, painless death at their request. Singer, from a utilitarian standpoint, holds that what matters is the person’s own wishes and wellbeing, so that voluntary euthanasia with proper safeguards relieves suffering without wronging anyone. Supporters point to studies from Oregon and the Netherlands that found no evidence that the elderly, the poor or people with disabilities were disproportionately affected (Margaret Battin and colleagues, 2007) – although such findings remain contested.

Held by

• Peter Singerb. 1946

The inviolability of life

Thomas Aquinas held that taking one’s own life is wrong because it goes against the natural inclination to preserve oneself, harms the community and usurps a decision that belongs to God. Kant argued without theology: someone who destroys themselves to escape a painful condition uses their own person merely as a means to a tolerable state, and so disregards the dignity of humanity in themselves. J. David Velleman (1999) turns this Kantian thought against a right to die: the value of a person is not the same as the value of a life that goes well for them; a person’s good matters only because the person matters, and so cannot justify giving up the person. John Keown (2002) adds, from the standpoint of natural law, that voluntary euthanasia rests on a doctor’s judgement that the patient’s life is no longer worth living – a judgement that, once accepted, can be extended to people who can no longer ask.

Held by

• Thomas Aquinasc. 1225–1274
• Immanuel Kant1724–1804

Protecting the vulnerable

Many disability rights advocates and palliative care physicians do not deny the autonomy of individuals, but doubt that a legal right to help in dying can remain a free choice for everyone. Where assisted death is an option, people who are old, ill, poor or disabled may feel they must justify going on living, and may choose death so as not to be a burden; and offering death before good palliative and social care is available everywhere turns a lack of support into a “choice”. Critics also point to how eligibility has widened: in Canada assisted dying was opened in 2021 to people whose death is not reasonably foreseeable, and its extension to people whose sole condition is a mental illness has been postponed several times; Theo Boer, who reviewed euthanasia cases in the Netherlands for nearly a decade, later warned that the number and range of cases had grown far beyond what he had expected.