Abstract
Opponents of medically assisted dying have long appealed to ‘slippery slope’ arguments. One such slippery slope concerns palliative care: that the introduction of medically assisted dying will lead to a diminution in the quality or availability or palliative care for patients near the end of their lives. Empirical evidence from jurisdictions where assisted dying has been practiced for decades, such as Oregon and the Netherlands, indicate that such worries are largely unfounded. The failure of the palliation slope argument is nevertheless instructive with respect to how slippery slope arguments can be appraised without having to await post-facto evidence regarding the effects of a proposed change in public policy. Close attention in particular to the norms operative in a given institution and how changes to policy will interact with those norms enable slippery slopes to be credibly appraised.
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Notes
- 1.
For examples of such skeptical responses, see Hugh LaFollette, “Living on a Slippery Slope,” Journal of Ethics 9 (2005): 475–499; Justin Oakley and Dean Cocking, “Consequentialism, Complacency, and Slippery Slope Arguments,” Theoretical Medicine and Bioethics 26 (2005): 227–239; and Georg Spielthenner, “A Logical Analysis of Slippery Slope Arguments,” Health Care Analysis 18 (2010): 148–163.
- 2.
J.A. Burgess, “The Great Slippery-Slope Argument,” Journal of Medical Ethics 19 (1993): 169–174; Jeffrey P. Whitman, “The Many Guises of the Slippery Slope Argument,” Social Theory and Practice 20 (1994): 85–97.
- 3.
“The Basic Slippery Slope Argument,” Informal Logic 35 (2015): 273–311.
- 4.
See Ben A. Rich, “Assisted Dying and Palliation,” in Michael J. Cholbi, ed., Euthanasia and Assisted Suicide : Global Views on Ending Life (Santa Barbara: Praeger, 2017), pp. 288–89.
- 5.
Diane E. Meier, Carol-Ann Emmons, Sylvan Wallenstein, et al., “A National Survey of Physician-Assisted Suicide and Euthanasia in the United States,” New England Journal of Medicine 338 (1998): 1193–1201 (available at: http://www.nejm.org/doi/full/10.1056/NEJM199804233381706, accessed 22 Feb 2018); Ezekiel J. Emanuel, “Euthanasia and Physician-Assisted Suicide: A Review of the Empirical Data From the United States,” Archives of Internal Medicine 162 (2002): 142–152, doi:https://doi.org/10.1001/archinte.162.2.142. (Available at: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/214736#ira10015t4, accessed 5 Mar 2018); and Charles H. Baron, “Hastening death: the seven deadly sins of the status quo.,” in T.E. Quill and M.P. Battin (eds.), Physician-Assisted Dying: The Case for Palliative Care and Patient Choice (Baltimore: Johns Hopkins University Press, 2004), p. 313.
- 6.
Worries that medically assisted dying will weaken the provision of palliative care is a theme in several articles in Kathleen M. Foley and Herbert Hendin, eds., The Case Against Assisted Suicide : For the Right to End-of-Life Care (Baltimore: Johns Hopkins University Press, 2002).
- 7.
K. Foley and H. Hendin, “A Medical, Ethical, Legal, and Psychosocial Perspective,” introduction to Foley and Hendin, eds., The Case Against Assisted Suicide , p. 2.
- 8.
Rich, “Assisted Dying and Palliation,” p. 289.
- 9.
Tamara Dumanovsky, Rachel Augustin, Maggie Rogers, Katrina Lettang, Diane E. Meier., and Sean R. Morrison, “The Growth of Palliative Care in U.S. Hospitals: A Status Report.” Journal of Palliative Medicine 19 (2016) 8–15. https://doi.org/10.1089/jpm.2015.0351.
- 10.
Center to Advance Palliative Care, “America’s Care of Serious Illness: 2015 State-by-State Report Card on Access to Palliative Care in Our Nation’s Hospitals.” Available at: https://reportcard.capc.org/ (accessed 9 Mar 2018).
- 11.
Health and Sport Committee, “A report for the Scottish Parliament by Professor David Clark: International comparisons in palliative care provision: what can the indicators tell us?” 15 Sept 2015. Available at: http://endoflifestudies.academicblogs.co.uk/wp-content/uploads/sites/22/2015/09/Scottish-Parliament-Palliative-Care-Report-20150915.compressed.pdf (accessed 5 Mar 2018). See also Kenneth Chambaere and Jan L. Bernheim, “Does Legal Physician-Assisted Dying Impede Development of Palliative Care?” Journal of Medical Ethics 41 (2015): 657–60.
- 12.
Baron, “Hastening Death: The Seven Deadly Sins of the Status Quo,” pp. 314–315.
- 13.
Margaret P. Battin and Timothy E. Quill, “Introduction: False Dichotomy versus Genuine Choice: The Argument Over Physician-Assisted Dying,” in Margaret P. Battin and Timothy E. Quill, eds., Physician-Assisted Dying: The Case for Palliative Care and Patient Choice (Baltimore: Johns Hopkins University Press, 2004), p. 5.
- 14.
“Everyday Attitudes about Euthanasia and the Slippery Slope Argument,” in Michael Cholbi and Jukka Varelius, eds., New Directions in the Ethics of Assisted Suicide and Euthanasia (Cham: Springer, 2016), pp. 217–38.
- 15.
Anneli Jefferson, “Slippery Slope Arguments,” Philosophy Compass 9 (2014), pp. 675–76.
- 16.
Jan L. Bernheim, Reginald Deschepper, William Distelmans, Arsene Mullie, and Luc Deliens, “Development of Palliative Care and Legalization of Euthanasia: Antagonism or Synergy?” BMJ 336 (2008): 864–67; and Dick Willems, “Palliative Care and Assisted-Care Death,” in Stuart J. Younger and Gerrit K. Kimsma, eds. Physician-Assisted Death in Perspective (New York: Cambridge University Press, 2012), p. 211.
- 17.
Rich, “Assisted Dying and Palliation,” p. 294.
- 18.
Michael B. Gill, “Is the Legalization of Physician-Assisted Suicide Compatible with Good End-of-Life Care?,” Journal of Applied Philosophy 26 (2009), p. 41.
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Cholbi, M. (2018). Palliation and Medically Assisted Dying: A Case Study in the Use of Slippery Slope Arguments in Public Policy. In: Boonin, D. (eds) The Palgrave Handbook of Philosophy and Public Policy. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-319-93907-0_52
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