About the Book

The Future of Assisted Suicide and Euthanasia provides the most thorough overview of the ethical and legal issues raised by assisted suicide and euthanasia--as well as the most comprehensive argument against their legalization--ever published. In clear terms accessible to the general reader, Neil Gorsuch thoroughly assesses the strengths and weaknesses of leading contemporary ethical arguments for assisted suicide and euthanasia. He explores evidence and case histories from the Netherlands and Oregon, where the practices have been legalized. He analyzes libertarian and autonomy-based arguments for legalization as well as the impact of key U.S. Supreme Court decisions on the debate. And he examines the history and evolution of laws and attitudes regarding assisted suicide and euthanasia in American society. After assessing the strengths and weaknesses of arguments for assisted suicide and euthanasia, Gorsuch builds a nuanced, novel, and powerful moral and legal argument against legalization, one based on a principle that, surprisingly, has largely been overlooked in the debate--the idea that human life is intrinsically valuable and that intentional killing is always wrong.At the same time, the argument Gorsuch develops leaves wide latitude for individual patient autonomy and the refusal of unwanted medical treatment and life-sustaining care, permitting intervention only in cases where an intention to kill is present. Those on both sides of the assisted suicide question will find Gorsuch's analysis to be a thoughtful and stimulating contribution to the debate about one of the most controversial public policy issues of our day.

Table of Contents:
Acknowledgments xi Chapter 1: Introduction 1 Chapter 2: The Glucksberg and Quill Controversies: The Judiciary's (Non)Resolution of the Assisted Suicide Debate 8 2.1 The Washington Due Process Litigation 8 2.2 The New York Equal Protection Litigation 11 2.3 The Final Battle? The Supreme Court Does (and Does Not) Decide 14 2.4 The Aftermath of Glucksberg and Quill 17 Chapter 3: The Debate over History 19 3.1 Which History? 20 3.2 The Project 22 3.3 The Ancients 22 3.4 Early Christian History 25 3.5 English Common Law 28 3.6 Colonial American Experience 29 3.7 The Modern Consensus on Suicide and Its Assistance 30 3.8 The Euthanasia Movement 33 3.9 Prevailing Law Today 43 3.10 Conclusion 46 Chapter 4: Arguments from Fairness and Equal Protection: If a Right to Refuse, Then a Right to Assisted Suicide? 48 4.1 An Act /Omission Distinction? 49 4.2 A Causation-Based Distinction? 51 4.3 Toward an Intent-Based Distinction: The Insight of the Double Effect Principle 53 4.4 Some (Initial) Arguments against Double Effect: Conflating Intent and Foresight 57 4.5 Distinguishing Suicide, Assisted Suicide, and Euthanasia from the Right to Refuse: Intending versus Foreseeing Death 62 4.6 Some (Additional) Criticisms of Double Effect as Applied to the Assisted Suicide Debate 69 4.7 Conclusion 75 Chapter 5: Casey and Cruzan: Do They Intimate a Right to Assisted Suicide and Euthanasia? 76 5.1 The "Reasoned Judgment" Test and Its Critics 76 5.2 Casey-Based Arguments 79 5.3 Cruzan-Based Arguments 82 5.4 Conclusion 84 Chapter 6: Autonomy Theory's Implications for the Debate over Assisted Suicide and Euthanasia 86 6.1 The Autonomy Debate 86 6.2 The Neutralist View of Autonomy 87 6.3 The Harm Principle's Competing View 89 6.4 Perfectionism and Autonomy 90 6.5 The Implications of Autonomy Theory for the Assisted Suicide and Euthanasia Debate 93 Chapter 7: Legalization and the Law of Unintended Consequences: Utilitarian Arguments for Legalization 102 7.1 The Dutch Experience: "Virtually Abuse-Free"? 103 7.2 The Oregon Experience: An "All-Too Conscientious" Statutory Regime? 115 7.3 Legalization and Other Unintended Consequences 125 7.4 Decriminalization as a "Costless" Enterprise? 132 7.5 How to "Balance" the Costs and Benefits of Legalization? 138 7.6 Conclusion 141 Chapter 8: Two Test Cases: Posner and Epstein 143 8.1 Posner's Utilitarian Case for Assisted Suicide 143 8.2 Posner's and Epstein's Libertarian Case for Assisted Suicide 152 Chapter 9: An Argument against Legalization 157 9.1 The Inviolability of Human Life 157 9.2 What Does It Mean to Respect Human Life as a Basic Good? 163 9.3 Some Objections 167 9.4 The Future of the Oregon Experiment? 176 Chapter 10: Toward a Consistent End-of-Life Ethic: The "Right to Refuse" Care for Competent and Incompetent Patients 181 10.1 The Inviolability of Life and the "Right to Refuse" for Competent Persons 182 10.2 The "Right to Refuse" and Infant Patients 191 10.3 The "Right to Refuse" and Incompetent Adult Patients 204 10.4 Conclusions 215 Epilogue 219 Appendix A: Certain American Statutory Laws Banning or Disapproving of Assisted Suicide 227 Appendix B: Statistical Calculations 229 Notes 231 Bibliography 285 Index 303