ABSTRACT
With technological change, norms about how and when to die are in flux. Popular support for “death with dignity” is growing. A recent New York Times-CBS poll reported that 53 percent of the respondents agree that doctors should be allowed to assist a severely ill person to commit suicide. The American Hospital Association has recognized that many of the approximately 6,000 hospital deaths per day are in some way planned by patients, their families, or physicians. Other estimates suggest that as many as 70 percent of all deaths in hospitals, where most mortality in the United States occurs, are preceded by ad hoc, often sub rosa, decisions to withdraw care. The high cost of medical care for the terminally ill in a nation where health care costs are the most rapidly rising portion of the consumer price index, where Medicare expenses are the highest in the last year of life, and where an estimated 35 million people remain uninsured, all this makes euthanasia an increasingly salient social policy issue. Faced with great pain and the emotional and financial burden on one’s family that accompanies the prolonging of life during terminal illness, the decision to take one’s life is not necessarily irrational, psychotic, or delusional, but pragmatic. The mode of suicide advanced by the Hemlock Society—self-administration of barbiturates (if one can obtain them) coupled with a plastic bag over one’s head to ensure successful death—highlights the grotesqueness of the means available for the final exit.
