Educational Resource
Assisted Suicide and Euthanasia From Voluntary to Involuntary (2017)
Assisted Suicide and Euthanasia: From Voluntary to Involuntary, June 28, 2017
This USCCB fact sheet argues that physician-assisted suicide and euthanasia, although initially justified as voluntary choices made by competent adults, tend to expand over time to include cases where patients have not given explicit consent. The document presents evidence from Europe and the United States to support concerns about a progression from voluntary to involuntary life-ending practices.
The document argues that physician-assisted suicide and euthanasia cannot be reliably limited to voluntary requests by competent, terminally ill adults. It contends that legal acceptance of these practices can lead to broader eligibility, increased involvement of third parties in end-of-life decisions, economic pressures on vulnerable patients, and cases where life-ending actions occur without clear consent.
Key arguments
- The Netherlands as a cautionary example. The document cites Dutch government studies from the early 1990s reporting thousands of voluntary euthanasia and assisted-suicide cases, alongside cases in which physicians allegedly ended patients' lives without their knowledge or explicit consent.
- Questions about consent in dementia cases. It highlights a Dutch case in which a physician administered a sedative to a woman with dementia before performing euthanasia, despite resistance from the patient during the procedure. The case is presented as evidence of challenges in determining and respecting consent.
- Expansion to psychiatric illness. The fact sheet notes that in countries such as the Netherlands, Belgium, and Switzerland, euthanasia or assisted suicide may be available for patients whose primary condition is mental illness. It cites studies indicating that some cases involved patients with depression and that psychiatric assessments were not always unanimous.
- Euthanasia of newborns and children. The document discusses Dutch policies and protocols concerning severely disabled newborns, arguing that they represent forms of nonvoluntary euthanasia because infants cannot provide consent. It also points to Belgium's removal of age limits for euthanasia and efforts in the Netherlands to extend eligibility to younger children.
- Reports of life-ending actions without explicit request in Belgium. The fact sheet cites studies reporting cases in which life-ending drugs were administered without an explicit patient request, particularly among older and hospitalized patients.
- Concerns about future expansion in the United States. The document references statements from leaders of right-to-die organizations suggesting that current assisted-suicide laws do not address patients with dementia or those unable to make informed decisions, but that such cases may become subjects of future advocacy.
- Economic pressures. A major theme is that healthcare cost considerations may influence end-of-life decisions. The fact sheet cites examples from Oregon and California involving insurance coverage disputes, where patients reported being offered coverage for assisted suicide while facing difficulties obtaining coverage for certain treatments.
- Impact on people with disabilities. The document quotes the National Council on Disability's concerns that legalizing assisted suicide may create subtle or direct pressures on people with disabilities, particularly in healthcare systems facing cost constraints.