Progressive Policy Changes on Physician-Assisted Suicide for Dementia Patients

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Greenwell, Jennifer L.

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2019

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Advanced Care Directive , Agency , Dementia , Dignity , Physician-Assisted Suicide , Velleman

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Many philosophers believe that physician-assisted suicide is morally permissible if a patient has a terminal illness, is suffering, and expresses a wish to die. J. David Velleman disagrees with this popular line of reasoning. He argues that human beings do not have a moral right to terminate themselves. On his account, physician-assisted suicide is morally permissible only if the patient no longer has the property of dignity. Velleman laments that current physician-assisted suicide legislation in the United States is too broad. It permits human beings who have not lost dignity to access the medical procedure. In the articles “Against the Right to Die” (1992) and “A Right of Self-Termination” (1999), Velleman states that he cannot figure out how to craft legislation that would make physician-assisted suicide available only to patients who no longer possess the property of dignity. I propose a solution to this problem of over-inclusive public policy. My argument that it is possible to craft legislation about physician-assisted suicide that is not too broad in its application has three premises. My first premise is that a human being cannot possess dignity if they do not have the capacity for agency. My second premise is that it is possible for observers to determine whether a human being has lost the capacity for agency, and thus lost dignity. My third premise is that it is morally permissible to end the existence of a patient with a terminal illness who has lost the capacity for agency and thus dignity if they have expressed their wish for physician-assisted suicide in an advanced care directive while they were cognitively competent. Legislation that permits patients to communicate their desire for physician-assisted suicide in an advanced care directive if they lose the property of dignity at a future time includes only the population for whom Velleman believes physician-assisted suicide is morally justified without legalizing a right to terminate oneself.

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