Physician Aid-in-Dying, Suicide, and the Ethical Significance of the Interpersonal

Recent polling has found that a large majority of Americans believe that physician aid-in-dying (PAD) should be legally permitted in some cases, while a slim majority of Americans believe that PAD is morally permissible. Other studies on Americans’ attitudes towards PAD have found that, of all reasons given for ending one’s own life, incurable disease is the only reason most Americans find morally acceptable. While PAD continues to face staunch moral, philosophical, and legal opposition, the mere fact that there are widely shared divergent attitudes about the permissibility of PAD and the impermissibility of other acts of self-killing demands philosophical investigation.

This paper offers an account of the moral difference between PAD and other acts of self-killing. In searching for this moral difference, I consider—and ultimately reject—other proposed accounts of the moral difference between the two acts, including Velleman’s concern over patient autonomy and free choice, and Bartlett and Finder’s argument that PAD springs from a variety of suffering that is unique in both type and degree. I argue that interpersonality is the morally relevant feature that distinguishes PAD from mere suicide, as interpersonality allows PAD to be understood as an act of mercy initiated by a physician.

Through understanding PAD as an act of mercy dependent upon the interpersonal interaction of physician and patient, I present a deeper philosophical picture of mercy itself. This moral analysis of PAD ultimately provides a greater understanding of the relationship between mercy and consent as well as the impossibility of self-mercy.