Research in Medical Ethics:
Physician-Assisted Suicide and
Daniel P. Sulmasy
The issue of physician-assisted dying, including both physician-assisted suicide and euthanasia, provides an excellent example with which to demonstrate how many methods of medical ethics have contributed to the examination of a single (but particularly vexing) set of questions. This chapter is not a comprehensive review of the literature, but rather a survey of some of the highlights of this vast array of scholarship. My aim is to mention enough of the work to give the reader a feel for the breadth of the investigation and the interactions between a variety of contributing disciplines and their methods, and to point out some of the failures of medical ethicists to take up important aspects of this question or to pursue interdisciplinary dialogue to its greatest potential. While the morality of suicide and euthanasia has been argued for many centuries, I will largely confine my discussion to the literature of the 1980s and 1990s, discussing some of the most recent work in the field.
In this chapter, I use the term physician-assisted suicide (PAS) to refer to situations in which physicians enable patients to take their own lives, typically by prescribing medicines that are intended to bring about death. Euthanasia refers to situations in which a physician (or another person) acts to create a new, lethal pathophysiological state in a patient with the specific intention that the patient should die by way of that action.
Although it has not always been so obvious that philosophers should be doing medical ethics, twenty-five years ago, when questions about the morality of PAS and euthanasia were being raised stridently in the United States, philosophers were already deeply enmeshed in the field. They readily took up these controversial questions.
Perhaps the first major strong, proeuthanasia paper in the modern medical ethics literature was written by James Rachels and published in the New England Journal of Medicine