Opposition to Medical Aid in Dying: Deserving Serious Consideration

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This article is in response to the From Our Readers article, “Medical Aid in Dying: Different Individuals, Different Choices” by Douglas W. Heinrichs, MD.

To continue my dialogue with Douglas W. Heinrichs, MD: I wonder if he is saying that the continuity between humans and other animals implies no ethical distinctions. If “differences appear to be continuous, not categorical,” should penalties for killing humans and other animals be the same?

I also wonder about the workability of his criteria for assigning priority to autonomy in decision making. For example, given the number of individuals who choose to use illegal drugs, there would seem to be “considerable disagreement” about what is the best choice for them, and yet society restricts their autonomy in the interest of protecting them. With regard to criterion (b), how is one to decide whether the “data relevant to making the decision are primarily in the realm of the first-person, subjective experience of the person most directly affected by the decision”? In the examples of taking drugs either for recreation or for ending one’s life, there are several objective data in the form of potentially irreversible medical consequences, interpersonal impacts on others, and the implications for society that need to be taken into account. Those opposed to medical aid in dying/physician-assisted suicide believe that these data also deserve serious consideration.

Dr Peteet is the Psychosocial Oncology Fellowship Site Director in the department of Psychosocial Oncology and Palliative Care at Dana-Farber Cancer Institute and Brigham and Women's Hospital.