Euthanasia, Ethics and Public Policy An Argument against Legalisation

This book argues against the legalisation of voluntary euthanasia and/or physician-assisted suicide on the ground that, even if they were ethically defensible in certain 'hard cases', neither could be effectively controlled by law. It maintains that the experience of legalisation in the Netherlands, Belgium and Oregon lends support to the two 'slippery slope' arguments against legalisation, the 'empirical' and the 'logical'. The empirical argument challenges the feasibility of drafting and enforcing adequate safeguards against abuse and mistake; the logical argument shows that acceptance of the case for euthanasia in the case of suffering patients who request it logically involves acceptance of euthanasia for suffering patients who are unable to request it, such as infants and those with advanced dementia.

Part I. Definitions: 1. Euthanasia and physician-assisted suicide; 2. Intended v. foreseen life-shortening; Part II. The Ethical Debate: Human Life, Autonomy, Legal Hypocrisy, and the 'Slippery Slope'; 3. The value of human life; 4. The value of autonomy; 5. Legal hypocrisy?; 6. The slippery slope arguments; Part III. The Dutch Experience: 7. The guidelines; 8. The first survey: the incidence of 'euthanasia'; 9. Breach of the guidelines; 10. The slide towards NVAE; 11. The second survey; 12. The Dutch in denial?; 13. The Euthanasia Act and the Code of Practice; 14. Effective control since 2002?; 15. Continuing concerns; 16. A right to physician-assisted suicide by stopping eating and drinking?; 17. Assisted suicide for the elderly with 'completed lives'; Part IV. Belgium: 18. The Belgian Legislation; 19. The lack of effective control; Part V. Australia: 20. The Northern Territory: ROTTI; Part VI. The United States: 21. The United States: Oregon and six other jurisdictions; 22. The US Supreme Court: Glucksberg and Vacco; Part VII. Canada: 23. The Supreme Court of Canada: the Carter case; 24. Canada's euthanasia legislation; 25. Conclusion.

The book explains to the reader (general or specialist) the powerful 'slippery slope' arguments against legalising 'assisted dying'. Drawing on the experience of legalisation in the Netherlands, Belgium and Oregon, it shows that 'assisted dying' cannot be effectively controlled by law.

John Keown is a leading and widely-published authority on the law and ethics of medicine. Before being appointed to the Rose Kennedy Chair in the Kennedy Institute of Ethics at Georgetown, he taught medical law in the Faculty of Law at Cambridge. In 2015 he was made a Doctor of Civil Law by Oxford for his contribution to law and bioethics. A focus of his research, which has been cited by the Law Lords and by the US Supreme Court, has been the law and practice of euthanasia in the Netherlands. That research formed the centrepiece to the first edition of this work, which was widely acclaimed.