Bulletin 13: The Vulnerable Aren't Vulnerable

10th June 2008

Opponents of Physician Assisted Dying (PAD) often use the “slippery slope” argument that if PAD were legalised, then “vulnerable” groups of society would be at increased risk of using the provisions of such an Act. We congratulate those who raise such a concern and would be worried by anyone who dismissed the issue out of hand.

However, the worry turns out to be baseless and continuing to assert a slippery slope for “vulnerable” groups flies in the face of fact. A study published in the prestigious Journal of Medical Ethics last year specifically investigated the actual evidence in regard to “vulnerable” groups and PAD as practiced in the Netherlands and Oregon, where it is legal.¹

The investigation showed no evidence of heightened risk for:

• The elderly
• Women
• People of low educational status
• The poor
• The uninsured
• The physically disabled
• The chronically ill
• Minors
• People with psychiatric illness / depression
• Racial or ethnic minorities

The only group found to have increased use of PAD was those suffering HIV/AIDS, and this on the basis of older data from the Netherlands, not confirmed by more recent Oregon data.

In fact, the paper reports that “those who received physician-assisted dying in the jurisdictions studied appeared to enjoy comparative social, economic, educational, professional and other privileges.”

The “vulnerable” in fact, are not.

1 Battin, M.P., van der Heide, A., Ganzini, L., van der Wal, G. and Onwuteaka-Philipsen, B.D., Legal physician-assisted dying in Oregon and the Netherlands: evidence concerning the impact on patients in “vulnerable groups, Journal of Medical Ethics, 2007, 33: 591-597.