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This article intervenes in the debate, among US disability rights advocates, about physician-assisted suicide (PAS). Through an ethnographic study, I situate this debate in the context of the dominant form of end-of-life care in the US hospice. Based on this analysis, I argue that PAS should be an issue of secondary concern to disability rights advocates, and that their primary concern, at the end-of-life, should be the improvement of US hospice care. By thus “putting the ‘right to die’ in its place,” they can achieve consensus among themselves and leverage this consensus to achieve the most substantial advancement of disability rights.

This chapter examines disability rights movement's rejection of a right to physician-assisted suicide (PAS). Supporters of PAS frame the right to enlist a physician's help in determining the nature and timing of one's death as a fundamental liberty interest and as a right to privacy. The disability opposition counters this with disparate impact and slippery slope arguments and stories of disability pride as a rhetorical rejection of a right it deems dangerous and discriminatory. In examining this clash of rights talk, this chapter analyzes the legal and political consequences of anti-rights rhetoric by a movement that is grounded in notions of autonomy and self-determination.

Euthanasia and assisted suicide is about changing the law to enable doctors, under certain circumstances, to intentionally kill patients. For proponents the issues have been determining what are “appropriate circumstances” for such activity and gathering up enough political support to win the day on numbers. The community and medical profession have been exposed to years of misinformation about euthanasia, and advocates have become so vocal that contrary positions are now barely heard. Nevertheless, there are enormous adverse implications for all healthcare professionals. Clinical management in the twenty-first century has moved well past scenarios painted to justify killing the patient. The inclusion of killing in the therapeutic armamentarium will cause an inexorable erosion of what is at present an absolute protection for the patient, the doctor, and other healthcare professionals.

Law attempts to govern life and death through the appropriation of images which give a fantasy of control over death. The functioning of the thanatopolitical state is underpinned by a perceived control over death and its representation. This means of controlling death is challenged when someone wishes to die in an untimely fashion. Death may be timely when the State engages in the officially sanctioned killing of the death penalty but not when the individual assumes such a power to decide. When an individual goes before the law to obtain a right to die, instead of confronting death, legal institutions evade the issue and instead talk about life, and its sacred and inviolable nature. Yet, in the same move, many exceptions to this sacred quality of life are carved out. One can see an example of this phenomenon in the area of Supreme Court decision making on physician-assisted suicide. In Washington v. Glucksberg the applicants had died by the time of the Supreme Court’s decision. Where did they go? Were they ever really there for the law? The Supreme Court decision attempts to recompose the notion of identic wholeness in the face of bodies associated with death and decay. It is, in other words, an attempt to arrest the process of death by composing a narrative which valorises life. The case becomes a narrative about the threat to life or, more precisely, a threat to a particular way of life. In other words, the state’s interest in preserving life becomes the interest in preserving the life of the state. The state must live on. The question then moves from being one of whether the individual applicant in a case concerning physician-assisted suicide should live or die, to one which asks should we the court live or die?

Natural Law philosophy asserts that there are universally binding and universally evident principles that can be determined to guide the actions of persons. Moreover, many of these principles have been enshrined in both statute and common law, thus ensuring their saliency for staff and institutions charged with palliative care. The authors examine the often emotive and politicized matter of (non-voluntary) euthanasia – acts or omissions made with the intent of causing or hastening death – with reference to Natural Law philosophy. This leads us to propose a number of important public policy remedies to ensure dignity in dying for the patient, and their associates.