Legalization and the Law of Unintended
Consequences: Utilitarian Arguments
UNLIKE advocates of neutralism and the harm principle, utilitarians cannot be said to be bound by adherence to philosophical principle that might lead to an assisted suicide right open to all rational adults regardless of motive or physical condition. Instead, approaching the question of assisted suicide (like any other) by asking the practical question what legal rule would provide the greatest social benefits with the fewest attendant costs, utilitarianism holds out the promise of defending a more appealingly limited right, one open only to the incurably suffering or terminally ill.
While this approach offers an apparent advantage over arguments from autonomy that tend toward a right to consensual homicide open to all adult persons, focusing exclusively on social utility raises at least the possibility that the practice of euthanasia might be expanded in other troublesome ways. Disconnected from autonomy and choice, euthanasia might be extended on a utilitarian account even to persons who do not consent to it (involuntary euthanasia) if doing so would promote overall social welfare; to a utilitarian, the question whether to permit involuntary euthanasia cannot be easily dismissed.1 As we saw in chapter 3.8, the American euthanasia movement has long made all sorts of utilitarian arguments for involuntary euthanasia, arguing that the practice is justified by, say, the social benefit of having to care for fewer “defective” persons and the reduction of medical costs associated with expensive end-oflife care; even recent liberal advocates of an autonomy-based right to assisted suicide have sometimes argued for involuntary euthanasia on grounds of social costs and utility. And, as we shall see, the Dutch experience is trending in that direction as well.
Some members of the U.S. Supreme Court gave hints of utilitarian thinking in Glucksberg and Quill. Before deciding to read any right to assistance in suicide and euthanasia into the due process or equal protection guarantees of the federal Constitution, Justice Souter and Justice O'Connor both said they