By Corinne Carey, New York Campaign Senior Director

A June 14 column by Ross Douthat in The New York Times, “Why the Euthanasia Slope Is Slippery,” is built on a mistaken idea. Because it gathered a fair amount of attention, I want to explain why his argument just doesn’t hold up.

Douthat argued that “you can have an opening to death that will be narrow only at the start — and in the end, a wide gate through which many, many people will be herded.” He invokes Canada’s system in an attempt to make his case.

One major problem with his argument is the thesis that “the dying are not really a category unto themselves.” This is simply not true. People who are dying face a unique reality: their time is limited, and often filled with physical or emotional suffering.

Canada’s law is not comparable to U.S. laws, which have much stricter eligibility rules. Canada’s medical assistance in dying law has expansive eligibility criteria, while U.S. laws require that a patient be mentally capable and terminally ill (with an illness that is incurable and irreversible) with a prognosis of 6 months or less to live, certified by at least one health care provider. These strict requirements are in place to ensure that patients are making informed, voluntary choices.

As Kevin Díaz, President and CEO of Compassion & Choices, and Bernadette Nunley, National Director of Policy, wrote in the American Journal of Bioethics, statutes in the U.S. stipulate that the clinician attending a patient for Medical Aid in Dying is also the one primarily responsible for treating the patient’s terminal illness. Thus, participating healthcare providers are typically general practitioners, oncologists, or palliative care specialists. These healthcare professionals offer Medical Aid in Dying within the broader context of patient-directed treatment plans, ensuring it remains integrated into comprehensive end-of-life care rather than existing as a standalone medical service.

It is also worth remembering that euthanasia  — the painless killing of one person by another — remains illegal in every state in this country.  The fact is, no U.S. jurisdiction, state, or district has ever expanded the strict criteria for eligibility since Oregon passed its Death with Dignity Law in 1994. These safeguards are built into every U.S. law to prevent misuse and ensure patient control. For over a quarter of a century, all U.S. Medical Aid in Dying laws have always required that an eligible patient:

• make the request on their own, no one can make the request on their behalf — no healthcare provider, no family member, no legal guardian; 
• be terminally ill, defined as having an illness that is incurable and irreversible; 
• have a prognosis of living 6 months or less, confirmed by at least one healthcare provider; 
• be mentally capable of making the decision; 
• be able to self-ingest the medication; and
• be reminded that they have the opportunity to change their mind at any point in the process. 

The conservative columnist George Will once wrote a column in support of the option of Medical Aid in Dying: Affirming a Right to Die with Dignity in 2015,  and addressed the “slippery slope” argument: 

Life . . . is inevitably lived on multiple slippery slopes: Taxation could become confiscation, police could become instruments of oppression, public education could become indoctrination, etc. Everywhere and always, civilization depends on the drawing of intelligent distinctions.

The “slippery slope” is a fallacy. Passing legislation is a slow and careful process, with many opportunities for public engagement and debate. It is also important to note that Compassion & Choices, along with many of the major advocacy groups in the movement to expand end-of-life options, opposes expanding the strict eligibility criteria for Medical Aid in Dying. 

Medical Aid in Dying is not really about death at all, because death is certain for terminally ill people. It’s about reducing suffering, restoring dignity, and giving people a say in how their final moments unfold. It’s about giving terminally ill people the autonomy to make their own end-of-life decisions, consistent with their own faith and values. 

Douthat’s column serves as a call to action. We can expect opponents of Medical Aid in Dying to continue making these arguments. When they do, it is helpful for those who support the option of Medical Aid in Dying to write letters to the editor in response.

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