Assisted Death and the Slippery Slope—Finding Clarity Amid Advocacy, Convergence, and Complexity

Abstract

This paper unpacks the slippery slope argument as it pertains to assisted death. The assisted-death regimes of the Netherlands, Belgium, Luxembourg, Switzerland, and the states of Washington and Oregon are discussed and examined with respect to the slippery slope analytical rubric. In addition to providing a preliminary explanation of how the slippery slope argument has been academically defined and constructed, the paper examines assisted-death models from the perspective of considering what might exist at the top and at the bottom of the slippery slope. It also explores the nature and scope of safeguards implemented to avoid slippage, and shows that what lies at the top and bottom of the slippery slope may be different from jurisdiction to jurisdiction. After identifying some of the recent concerns that have arisen within each of the jurisdictions (concerns that might be viewed by some as evidence of slide), the paper concludes by making note of certain critical issues in the current assisted-death debate that merit deeper examination.

Attitudes Toward Active Voluntary Euthanasia Among Community-Dwelling Older Subjects

“…This generation, on average less educated and raised during the difficult times of World War II, also exhibits in later life withdrawn and observant characteristics, recognizing one's own role in society as less autonomous, more hierarchically organized, and prescriptively directed along rigid structural values (Hanse & Leuty, 2012). However, such cultural explanations must also be integrated with the physical decline of the older-old respondents, who are typically affected by the worst health conditions and often suffer disability impairments, therefore potentially fearing involuntary euthanasia and abuses if physician-assisted dying were legalized (Appelbaum, 2016;Buiting et al, 2012;Malpas et al, 2014;Rietjens et al, 2012;Shariff, 2012).…”

Nursing staff and euthanasia in the Netherlands. A nation-wide survey on attitudes and involvement in decision making and the performance of euthanasia

“…The legal conditions and actual practice of euthanasia in the aforementioned countries have been the subject of much international debate [3]. Yet there are no indications that after euthanasia has been made legal, the number of euthanasia cases increased.…”

When Suicide is Not Suicide: Self-induced Morbidity and Mortality in the General Hospital

“…Laws like Oregon’s are usually opposed by such physician organizations as the American Medical Association, which specifically objects to physicians actively assisting in hastening death. 16 Palliative care specialists, supported by the 1997 Vacco vs. Quill ruling, find an intermediate stance in which palliative sedation and withdrawal of life-sustaining treatments are acceptable as long as the primary purpose is to reduce suffering as life ebbs. 17 , 18 …”