Thursday, September 27, 2007

On euthanasia and slippery slopes

Colleagues at the Journal of medical ethics published research results this week indicating that the availability of voluntary euthanasia does not lead us down a slippery slope to all sorts of involuntary euthanasia. Here's a summary of the findings from eurekaalert.

No evidence physician-assisted death leads to 'slippery slope'

Legal physician-assisted dying in Oregon and the Netherlands: evidence
concerning the impact on patients in vulnerable groups

There is no evidence that legalised physician assisted suicide, results
in disproportionate numbers of vulnerable people having their lives
ended prematurely by doctors, finds research in the Journal of Medical
Ethics .

Opponents of legislation, which enables doctors to help people to die,
have claimed that it leads to a "slippery slope."

It makes it easier to end the lives of those who might be deemed a
burden to society or their families, such as those with disabilities,
stigmatised disease, or mental illness, they say.

But an analysis of figures from the Netherlands and Oregon, USA, where
physician assisted dying is legal, shows that this is not the case.

The authors assessed all cases recorded as physician assisted deaths in
Oregon, USA, between 1998 and 2006, as well as three independent studies
on the topic.

And they looked at end of life decisions in The Netherlands in four
government sponsored nationwide surveys conducted in 1990, 1995, 2001
and 2005, as well as specialised research.

The figures show that only a few people choose the option of physician
assisted suicide.

In Oregon, 292 people have taken advantage of the legislation since it
came on to the statute books in 1997. This amounts to 0.15% of all

In The Netherlands, voluntary euthanasia and physician assisted suicide
have been tolerated since the 1980s, and legal since 2002, provided
strict guidelines are followed.

Advance directives, requesting euthanasia in the event of a coma or
dementia, are now also legal.

Around 1.7% of all deaths are categorised as voluntary euthanasia, and
0.1% as physician assisted suicide in The Netherlands.

The average age of people receiving help to die was around 70 in both
places. Most had cancer. There were higher numbers of people with AIDS
among those choosing to die with the aid of their doctor, the data

But there was no evidence of any excess bias towards race, gender, age,
socioeconomic status, disability, chronic illness or mental ill health
in either place.

No prosecutions related to illegal deaths have been brought in Oregon.
And of those brought in the Netherlands, there was no evidence that
those from vulnerable groups have featured more heavily.

"We found no evidence to justify the grave and important concern often
expressed about the potential for abuse," say the authors.

The evidence "does show that there is no current factual support for so
called slippery slope concerns about the risks of legislation of
assisted dying - concerns that death in this way would be practised more
frequently on persons in vulnerable groups," they conclude.


  1. As I note on my own blog, not only does this study rely mostly on soft data, the authors have used a narrow - even idiosyncratic definition of slippery slope.

    You can read more about it here:

    Short version (in addition to the "soft data" concern) is that there has been expansion of "eligibility" in the Netherlands - most recently in regard to the killing of disabled newborns.

    In Oregon, a scandal involving the Oregon Nursing Review Board is evidence that there is little accountability or oversight in regard to nurses - I wouldn't be surprised if the same were true in regard to doctors.

  2. This comment has been removed by a blog administrator.

  3. just for the record, the deleted commentary was a spam advertisement.


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