April 18, 2024

Progressive US bioethicist warns of euthanasia slippery slope

Data from Belgium and the Netherlands are alarming, says Art Caplan

“Of all the arguments against voluntary euthanasia, the most influential is the ‘slippery slope’: once we allow doctors to kill patients, we will not be able to limit the killing to those who want to die. There is no evidence for this claim.” So wrote Professor Peter Singer in an article in 2009.

Some more recent reports agree. A group in the UK which called itself the Commission on Assisted Dying declared in 2010 that there was no evidence of a slippery slope. Earlier this year the Supreme Court of Canada explicitly rejected the idea of a slippery slope when it legalised assisted suicide.

So it is surprising to find America’s most quoted bioethicist, Art Caplan, warning that euthanasia in Belgium and the Netherlands is a slippery slope to abuse of vulnerable groups. In a comment in JAMA Internal Medicine on reports from the Netherlands and Belgium, he and co-author Barron H. Lerner, ring alarm bells. “Although neither article mentions the term slippery slope, both studies report worrisome findings that seem to validate concerns about where these practices might lead.”

Caplan was a strong supporter of a 2012 referendum in Massachusetts to legalise assisted suicide, and has been consistently “progressive” in his bioethics. However, he is deeply troubled by the data from Europe. “The slippery slope is not always a persuasive argument. However, these data and the other recent reports require that it be taken very seriously,” the article says. 

“… the increasing rates of euthanasia may alternatively represent a type of reflexive, carte blanche acquiescence among physicians to the concept of patient self-determination. Or worse, is it simply easier for physicians to accede to these sad and ailing patients’ wishes than to re-embark on new efforts to relieve or cope with their suffering? As one Dutch ethics professor has said, ‘The risk now is that people no longer search for a way to endure their suffering.’ In other words, are the Netherlands and Belgium turning to physicians to solve with euthanasia what are essentially psychosocial issues? …

“Although the euthanasia practices in the Netherlands and Belgium are unlikely to gain a foothold in the United States, a rapidly aging population demanding this type of service should give us pause. Physicians must primarily remain healers. There are numerous groups that are potentially vulnerable to abuses waiting at the end of the slippery slope—the elderly, the disabled, the poor, minorities, and people with psychiatric impairments. When a society does poorly in the alleviation of suffering, it should be careful not to slide into trouble. Instead, it should fix its real problems.”

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Arthur Caplan
slippery slope