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Diane M. Komp

The Battle over Assisted Death Is Just Starting

Throughout the nation, Americans are engaged in an earnest and profound debate about the morality, legality, and practicality of physician-assisted suicide. Our holding permits this to continue, as it should in a democratic society.

--Chief Justice William Rehnquist

In retrospect, you have to wonder what we expected the Supreme Court would accomplish in its June 1997 ruling on physician-assisted death. Had the justices ruled for or against, half of the nation would have mourned that pronouncement. Instead, Rehnquist and his black-robed colleagues have returned the question to us and our neighbors. That debate will not be ended anytime soon, nor will the battle lines always be clearly drawn. (Polls indicate, for example, that evangelical Christians are far more ambivalent about this issue than they are about abortion.) Indeed, as the number of aging and infirm Americans continues to increase, the conflict will intensify.

But how does a nation conduct a debate when there is no consensus about the basis for ethical decisions?

Love beneath a hemlock

In a society obsessed with individual "rights" and personal autonomy, it is not surprising that the debate over physician-assisted suicide has centered on the "right to die." The emphasis on autonomy is, in fact, relatively modern in medical ethics. For many years, the first principle of doctor-patient relationship was that of beneficence—generosity of the healer toward one's fellow beings. But physician beneficence was not an adequate safeguard for Jews in Nazi Germany. Subsequently, the Geneva Convention and the Nuremberg Code supplanted the Hippocratic tradition and shifted to an emphasis on the rights of individuals.

Stephen Jamison's Final Acts of Love is a work that is firmly rooted in the primacy of such autonomy. He appeals to love as the ultimate standard, but it is up to the individual to decide what constitutes the loving action in any given situation. (Yes, those are the echoes of Joseph Fletcher's Situational Ethics ...

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