Physician-Assisted Suicide: Arguments From Both Sides
This paper examines the ethical debate surrounding physician-assisted suicide (PAS) by analyzing two opposing scholarly articles published in the Journal of the American Medical Association. The pro-PAS argument, presented by Quill, Back, and Block (2016), holds that patient autonomy, dignity, and legal transparency justify the practice under certain circumstances. The opposing argument, advanced by Appelbaum (2016), contends that legalization creates a dangerous slippery slope, particularly for patients with mental disorders, as evidenced by Dutch data. The paper evaluates the logical strengths and weaknesses of each position, concludes that the pro-PAS argument is stronger because it avoids the slippery slope fallacy, and emphasizes the importance of critical source evaluation in medical ethics research.
- Introduction: Why Is Physician-Assisted Death Controversial?: Context and moral complexity of physician-assisted death
- Arguments in Favor of Physician-Assisted Death: Quill et al. argument for patient autonomy and legalization
- Arguments Against Physician-Assisted Death: Appelbaum's slippery slope argument using Dutch data
- Evaluation of Scholarly and Non-Scholarly Sources: Comparing source quality and identifying logical fallacies
- Conclusion: Lesson on critical evaluation of all research sources
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What makes this paper effective
- The paper structures its analysis symmetrically, presenting each side's argument in a clear premise-conclusion format that makes logical evaluation straightforward for the reader.
- It identifies a specific logical fallacy — the slippery slope — in one of the scholarly sources, demonstrating that peer-reviewed articles are not immune to flawed reasoning.
- The paper honestly acknowledges the limitations of both sources (neither article presents original empirical data), which strengthens the objectivity of the final evaluation.
Key academic technique demonstrated
The paper demonstrates argument mapping — breaking scholarly arguments into explicit premises and conclusions before evaluating their logical validity. This technique separates the quality of evidence from the persuasiveness of presentation, which is essential in applied ethics writing.
Structure breakdown
The paper opens with a contextual introduction establishing why PAS is controversial. Two body sections each present one scholarly article's argument in premise-conclusion form. A third body section compares the two arguments and evaluates their relative strength. A brief conclusion generalizes the lesson about critical source evaluation to all academic research.
Introduction: Why Is Physician-Assisted Death Controversial?
Physician-assisted suicide, or physician-assisted death, is now legal in four American states as well as in several countries including Canada and the Netherlands (Appelbaum, 2016). Generally, physician-assisted death applies to patients diagnosed with a terminal illness. The request to terminate life prematurely is based on the patient's tremendous suffering. In Canada, for example, "physicians whose patients disclose a wish to die must always be listening for underlying deep sorrow" (Chochinov, 2016, p. 253). However, it can be difficult — if not impossible — to determine whether a patient's expression of sorrow is temporary, influenced by physical pain, or exacerbated by underlying mental illness.
Physician-assisted suicide can also be framed as a moral issue, with some physicians claiming that assisting a patient to die goes against the tenets of the medical profession (American Medical Association, 2018). This paper uses two scholarly articles to evaluate the opposing views on the ethics of physician-assisted death.
Arguments in Favor of Physician-Assisted Death
In an article published in the Journal of the American Medical Association, Quill, Back, and Block (2016) argue that physician-assisted death is justifiable under certain circumstances. The authors use a case study to demonstrate that physician-assisted suicide is not a black-or-white ethical issue, but one that involves situational variables and moral grey areas. Their argument is structured as follows:
Premise 1: Patients with a serious illness have the right to self-determination and to "control over their own bodies, their own lives, and concern about…distress" (Quill, Back & Block, 2016, p. 245).
Premise 2: Physician-assisted death is the best way to address these concerns in a legal and ethical manner.
Premise 3: The concerns about "coercion, vulnerability, and slippery slopes" have "not been borne out by experience with legal open access to physician-assisted death" (Quill, Back & Block, 2016, p. 245).
Conclusion: Legalizing physician-assisted death eliminates some of the thorny ethical and legal problems, and prevents abuses of power and ambiguities.
Although the Quill, Back, and Block (2016) study is not empirical and does not involve quantitative data, it is a thoughtful presentation of multiple points of view on the issue. The authors ultimately come out in favor of physician-assisted suicide based on several concerns — namely, that the practice promotes the ethical imperatives of patient autonomy, respect, and dignity. Moreover, the authors reason that when physician-assisted death is legal, it can be conducted in a straightforward fashion that eliminates subversion and possible dangerous consequences.
Arguments Against Physician-Assisted Death
In "Physician-Assisted Death for Patients with Mental Disorders," Appelbaum (2016) argues against physician-assisted suicide primarily on the grounds that it constitutes a slippery slope. Published in the Journal of the American Medical Association, this scholarly source cites an abundance of data from surveys conducted in the Netherlands, where the practice of physician-assisted suicide is legal. The author's arguments are as follows:
Premise 1: Legalized physician-assisted suicide "opens the door for people whose suffering is primarily due to mental disorders" (Appelbaum, 2016, p. 325).
Premise 2: The Dutch data contains "red flags" indicating that physician-assisted suicide is being used in lieu of "effective psychosocial intervention and support" (Appelbaum, 2016, p. 325).
Premise 3: Dutch law does not have sufficient safeguards in place, such as the requirement for unanimity among the medical team.
Conclusion: Legal physician-assisted suicide is too dangerous a practice and can be too easily abused to be considered ethical.
Appelbaum's (2016) arguments are sound and logical, and are supported by actual data collected by Dutch researchers. The article is persuasive because of the way this data is presented. However, the underlying logical premise of Appelbaum's argument relies on the slippery slope fallacy. Physician-assisted death does not necessarily serve as a means by which clinically depressed or otherwise mentally ill patients can gain access to easy suicide, and it does not preclude therapeutic interventions.
Conclusion
This analysis shows how scholarly articles can also contain logical fallacies. Even if these two scholarly articles had been based on original empirical studies, the authors could still have jumped to conclusions or built their arguments on faulty evidence and slippery slope reasoning. When conducting research, it is important to critically review all sources and recognize their logical fallacies, regardless of where the studies are published.
References
American Medical Association. (2018). Physician-assisted suicide. https://www.ama-assn.org/delivering-care/physician-assisted-suicide
Appelbaum, P. S. (2016). Physician-assisted death for patients with mental disorders. JAMA Psychiatry, 73(4), 325–326. https://doi.org/10.1001/jamapsychiatry.2015.2890
Chochinov, H. M. (2016). Physician-assisted death in Canada. JAMA, 315(3), 253–254. https://doi.org/10.1001/jama.2015.17435
Death with Dignity. (n.d.). Terminology of assisted dying. https://www.deathwithdignity.org/terminology/
Quill, T. E., Back, A. L., & Block, S. D. (2016). Responding to patients requesting physician-assisted death. JAMA, 315(3), 245–246. https://doi.org/10.1001/jama.2015.16210
Whitcomb, D. (2018, May 15). California judge tosses state's physician-assisted suicide law. Reuters.
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