A Duty to Die

With rising healthcare costs many disabled rights organisations worry that, if assisted suicide or euthanasia is legalised, people will come to feel an obligation or be urged to choose to end their lives.
  • The first human right is the right to life, and the first duty of the state is to protect that right.
  • Legalising assisted suicide would directly breach this duty and undermine the basis of society.
  • The quality of life will diminish for those with disabilities as discrimination towards them increases.
  • Many disabled people fear their wish to remain alive will be ignored.
  • In The Netherlands many people now carry "anti-euthanasia" cards in case they are unexpectedly admitted to hospital.
One of the biggest concerns for disabled rights organisations is that, if euthanasia is legalised, the 'right to die' will soon become a 'duty to die.'

Many disabled are not ready to die, they enjoy life and wish to continue to do so but if assisted suicide and voluntary euthanasia were available they might feel it was the responsible thing to do. Caregivers might consciously or unconsciously exert pressure to help them arrive at that decision.

A person who feels obligated to do away with themselves for the good of others may become depressed during which time these feelings may intensify and become the main priority of the patient. In time however these feelings may pass by which time a patient may have already taken steps which are irrevocable.

Voluntary Euthanasia today = Involuntary Euthanasia tomorrow
Many disability advocates take the position that legalising assisted suicide and active voluntary euthanasia today will lead to active involuntary euthanasia tomorrow.
"The voluntary self-elimination of individual and (sic) mortally diseased and crippled lives taken collectively can only enhance the preservation of public health and welfare."
 - Dr Kervorkian


Dr Jack Kevorkian, aquitted over the suicides of two women with non-terminal disabilities, is a staunch advocate of euthanaia and physician assisted suicide for the disabled. He told a Michigan Court in August 1990:

"The voluntary self-elimination of individual and (sic) mortally diseased and crippled lives taken collectively can only enhance the preservation of public health and welfare."
Many disability advocates take the position that legalising assisted suicide and active voluntary euthanasia today will lead to active involuntary euthanasia tomorrow.


Dr Kevorkian, who helped over 130 people die through assisted suicides during the 1990s, was charged with second-degree murder and convicted. He is serving a 10-25 sentence.

The Fundamental Human Right
The first and foundational human right is the right to life, and the first duty of every government is to protect that right by safeguarding the lives of its citizens.

Legalising euthanasia or assisted suicide would directly breach this duty because it would be legalising intentional killing. It would radically undermine the moral and legal basis of society. Many disability advocates take the position that legalising assisted suicide and active voluntary euthanasia today will lead to active involuntary euthanasia tomorrow.

The Hastings Centre Report

The Hastings Centre Report, a journal covering medical ethics, featured a lead article in the March/April 1997 issue entitled "Is There a Duty To Die?"

The article by John Hardwig, a teacher of medical ethics and social political philosophy at East Tennessee State University, thinks that we may have a duty to die when the burden of caring for us seriously compromises the lives of those who love us:
  • they may be physically exhausted by caring

  • they may be emotionally exhausted by caring

  • they may be financially destroyed by the cost of healthcare

  • they may be financially destroyed by having to give up work to care

  • their home may become a place of grief and sickness

  • other family members may be neglected as all attention is focused on the infirm person
He further states "modern medicine and an individualistic culture have seduced many [into believing] that they have a right to health care and a right to live, despite the burdens and costs to our families and society."

This directly contravenes the Declaration of Independence (1776) which claims "that all Men are created equal, that they are endowed, by their CREATOR, with certain unalienable Rights, that among these are Life, Liberty, and the Pursuit of Happiness".

In the future, the responsibility will fall upon the individual to chose death even when that individual may prefer to live.



He believes that in the future the responsibility will fall upon the individual to chose death even when that individual may prefer to live. This duty to die will be tied in with a person's self-respect and it will be seen as the right choice for the good of an individual's family and society as a whole. The elderly and disabled may well find they are urged into this action because they are seen as giving up less than other individuals.

Hardwig does offer a glimmer of hope however, he states that if society is willing to "pay for facilities that provide excellent long-term care (not just health care) for all chronically ill, debilitated, mentally ill or demented people in this country . . . the duty to die would then be virtually eliminated."

He tempers this with these cautionary words though "we Americans seem to be unwilling to pay for this kind of long-term care, except for ourselves and our own." So therefore there would need to be some fundamental change in the statutes of law to uphold the right of life for every human being.


Before Mr. McAfee could take his own life [following court approval], he was offered a place in an independent living project for disabled people. He took that option and began working towards getting a job...it was not his disability but his living conditions that were making him want to die. "


Submission to the Voluntary - Euthanasia Select Committee - House of Keys Isle of Man
Alison Jones in a submission to the Committee states "The lack of options for many disabled people was made clear by the case of Larry McAfee, an American quadriplegic, who used a ventilator, and had been living in a succession of nursing homes and hospitals.

He requested that his ventilator be turned off, and the judge hearing the case commented ‘Mr. McAfee is not committing suicide...his ventilator would not prolong his life but instead would prolong his death.’ In other words he was expressing the opinion that life for a disabled person is tantamount to death.

Before Mr. McAfee could take his own life, he was offered a place in an independent living project for disabled people. He took that option and began working towards getting a job. Euthanasia would have robbed him of life before it could be shown that it was not his disability but his living conditions that were making him want to die.

Many disabled people fear their rights will be undermined and their wish to remain alive will ignored by changes in euthanasia and assisted suicide legislation. Not only that but the quality of life will diminish for those who are disabled as there will increasing discrimination towards them.

The case of Sue Maynard-Campbell who uses a wheelchair and is Vice-Chair of an NHS Trust in Britain is also cited in the submission. She fears there will be a culture of "better off dead" towards the disabled. In hospital for a chest infection she found the words "Do Not Resuscitate" written on her medical notes. Her doctor had made the decision she had a "poor quality of life". She is now afraid to go back to that hospital.

Not only would there be a ‘duty to die,’ claim the No Less Human group, but the disabled group would become more vulnerable if euthanasia were legal.


Wesley J. Smith, a lawyer for the International Anti-Euthanasia Task Force describes in Culture of Death: The Assault on Medical Ethics in America how developments in the field of bioethics have fostered a "culture of death" in the United States.

He provides many examples to illustrate the "quickly developing ethical crisis in a medical world that increasingly devalues some human lives and views people at the margins as expendable. Traditional morality and medical ethics are crumbling before our very eyes."

Smith makes his case by explaining how the "right to die" has indeed morphed into a "duty to die" in the minds of many health care professionals who have abandoned the Hippocratic Oath.

Individual autonomy has increasingly given way to decision-making by health care professionals and bioethicists, whose "futile care theory" measures the value of human life according to the financial cost of keeping the individual alive.

We are now in the unenviable position where doctors and hospital staff make medical decisions contrary to the wishes and protests of individuals and their families, not in order to save life, but to end it.

One of the more disturbing cases Smith relates is that of Marjorie Nighbert, who was dehydrated to death in a Florida nursing home in 1995 despite her pleas for food and water. She had suffered a stroke that left her unable to swallow, and her brother, who had power of attorney, had her feeding tube removed.

A judge refused to override this decision, so Nighbert died, pleading for help.

Smith's work shows that support for euthanasia is strong among bioethicists and the practice of euthanasia is already fairly widespread in American hospitals.

Duty to Kill
Not only would there be a ‘duty to die,’ claim the No Less Human group, but the disabled group would become more vulnerable if euthanasia were legal. This group fear that discrimination would become common and be supported by medical practitioners whose judgements about their negative quality of life of some would have an invalidating impact on them all. Their lives would be seen to be of less worth than someone who was not disabled.

In the UK, doctors have the won the right to withdraw food and water from a patient, without needing permission from family members, unless the person has a living will stating they don't want food and water withdrawn.

In Holland where euthanasia is legal many people now carry ‘anti-euthanasia passports’ because they are afraid they may be killed if admitted to hospital.