Institutionalizing Inequality: The Physical Criterion of Assisted Suicide

The recent legalization of assisted dying in California, along with similar bills before other states, returned assisted suicide to the national spotlight. In Anglo-American dying bills, two criteria restrict eligibility for assisted suicide: (1) the uncoerced request to die (roughly, the “autonomy” criterion) and (2) severely deteriorated health of a certain kind (roughly, the “physical” criterion) from a six-month terminal illness (US jurisdictions) to severe and irreversible conditions (the Netherlands, Belgium). I argue that the physical criterion in any form violates the equality of respect and moral status of a large class of people, thereby degrading them, and I supplement this with theological considerations drawn from Thomas Aquinas. Even if the slope were not slippery and the autonomy firewall prevented Dutch-style mission creep, the physical criterion itself degrades tens of thousands of sick, disabled, and dying people by insinuating that their lives—but crucially, not other people’s—are “objectively” the sort of thing they might reasonably want to dispose of.