In September 2025, Lifeway Research found that over half of Americans (55 percent) agree that “physicians should be allowed to assist terminally ill patients in ending their life.”
The figure should be zero percent.
Physician-assisted suicide is an affront to the sanctity of human life, a sure-fire trap door into a dangerous slippery slope for state-sanctioned suicide-on-demand, and a threat to the integrity of the medical profession. As the West embraces physician-assisted suicide, the United States is uniquely positioned to restrain the practice.
What is physician-assisted suicide?
Physician-assisted suicide (PAS), known euphemistically to advocates as Medical Aid in Dying (MAID) or “Death with Dignity,” describes a practice where physicians prescribe, at a patient’s request, a lethal dose of drugs intended to end the life of the patient. PAS is distinct from euthanasia: PAS involves self-administered lethal drugs. With euthanasia, lethal drugs are administered directly by a doctor.
Background: Physician-assisted suicide and the Hippocratic Oath
At the heart of the physician-assisted suicide debate is a question of adherence to the historic Hippocratic Oath. Written over 2,500 years ago, the oath champions a physician’s life-affirming duties:
I will use those dietary regimens which will benefit my patients according to my greatest ability and judgment, and I will do no harm or injustice to them. I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan; and similarly I will not give a woman a pessary to cause an abortion. In purity and according to divine law will I carry out my life and my art.
The oath establishes a clear red line in the doctor’s profession: never, under any circumstances, may a doctor intentionally kill. The Hippocratic doctor does not bend to coercion or pressure (“If I am asked…”) but anchors medical decision-making in objective moral judgments, scientific expertise, and beneficence within explicit ethical boundaries.
However, the oath most medical doctors take today demonstrates a significant departure from the centuries-old original. Written in 1964, the Modern Hippocratic Oath reads: “Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty.”
The new oath erases Hippocrates’ red line and invites doctors to consider “taking a life” as an acceptable practice for a physician, inviting subjectivity into matters of life and death; it ignores America’s founding commitment to the belief that every man, woman, and child is “endowed by their Creator with certain unalienable Rights,” and it yields to man the power that God says belongs to Him alone: giving and taking life.
The abandonment of the Hippocratic Oath to “do no harm” has brought modern Western medicine to moral disaster—consider abortion, “gender-affirming care,” and physician-assisted suicide. What the Hippocratic Oath forbade (“a pessary to cause an abortion,” “I will do no harm,” and “I will not give a lethal drug to anyone”), the New Oath welcomes. Without its Hippocratic backbone, Western medical ethics have eroded hard and fast.
Physician-assisted suicide in the United States:
After 2,500 years of medicine governed by the original Hippocratic oath, it took only a mere twenty-five years for the new oath to give rise to legalized physician-assisted suicide in the United States.
In 1980, Derek Humphrey founded the Hemlock Society, the United States’ first “right-to-die” advocacy group (now known as Compassion and Choices), and in 1994, the society succeeded in passing Oregon’s Death with Dignity Law via ballot referendum. After three years of legal battles with National Right to Life, the law was upheld and enacted in 1997.
Oregon’s Death with Dignity Act faced significant popular pushback after its passage. Congress passed the Assisted Suicide Funding Restriction Act, barring the use of federal funds to “provide or pay for any health care item or service, or health benefit coverage, for the purpose of causing, or assisting to cause, the death of any individual including mercy killing, euthanasia, or assisted suicide.”
Also in 1997, the Supreme Court decided in Vaco v. Quill and Washington v. Glucksberg that there is no constitutional right to physician-assisted suicide. The Court established that the government has a compelling interest in “prohibiting intentional killing and preserving life; preventing suicide; maintaining physicians’ role as their patients’ healers; protecting vulnerable people from indifference, prejudice, and psychological and financial pressure to end their lives; and avoiding a possible slide towards euthanasia.”
After a decade of public resistance, Washington (2008), Montana (2009), Vermont (2013), California (2015), Colorado (2016), Washington D.C. (2017), Hawaii (2018), Maine (2019), New Jersey (2019), New Mexico (2021), and Delaware (2025) joined Oregon in legalizing physician-assisted suicide. In all twelve jurisdictions, an individual must meet five general criteria to be eligible for physician-assisted suicide:
- An adult, 18 years of age or older
- Resident of the state (except in Oregon and Vermont)
- Terminally ill with a prognosis of six months or less to live
- Mentally capable of decision-making
- Able to self-administer or self-ingest medication
Today, seventeen U.S. states are actively considering legalizing PAS.
Physician-assisted suicide presents deadly problems: The Slippery Slope
In the Netherlands, where euthanasia is available on demand, senior citizens “are so fearful of being killed by doctors that they carry cards saying they do not want euthanasia.”
In Canada, minors may seek PAS for any reason without notifying their parents. The Canadian government also offers PAS to people “too poor to live with dignity.”
While the United States, unlike Canada and Europe, has demonstrated a commitment to limiting PAS to terminal patients, concerns about a “slippery slope” are not unfounded—empirical and anecdotal evidence suggest PAS is already slipping in the United States.
Dr. Jennifer Gaudiani, a Colorado specialist in Anorexia Nervosa treatment, classifies some cases of anorexia as “terminal.” One known thirty-six-year-old anorexic woman died by PAS under Dr. Gaudiani’s consultation, and another thirty-six-year-old woman died of malnutrition the day she planned to ingest her lethal dose.
Gaudiani’s former patient testified before the Maryland Senate: “I was told that, although I wasn’t yet 30 years old at the time, she [Gaudiani] would ‘make an exception’ for me and ‘allow’ me to die, if that was my choice. It didn’t feel like my choice—I felt coerced.” Dr. Gaudiani’s practices suggest that even within the terminal illness framework, PAS allowances in the United States are just as prone to the slippery slope as in the Netherlands and Canada.
Further, the Oregon Health Authority reports that psychological and social concerns constitute the top five reasons patients seek PAS: 92 percent list “losing autonomy,” 90 percent list “less able to engage in activities that make life enjoyable,” 79 percent list “loss of dignity,” 42 percent list “losing control of bodily functions,” and 41 percent felt they were a “burden on family friends/caregivers.” Those who have chosen to die by PAS in Oregon chose suicide for social reasons—not to alleviate or avoid pain and terminal illness.
The slippery slope is a concern for the United States, even within the terminal illness requirement for PAS eligibility.
Is there a solution?
United States law must restore what was lost when the original Hippocratic Oath was abandoned in 1964. Congress should work to propose legislation stipulating that licensed medical professionals (medical doctors, osteopathic doctors, nurse practitioners, physician assistants, pharmacists, psychiatrists, etc.) are forbidden from discussing, suggesting, prescribing, and administering PAS. Such legislation will ensure that:
- A consistent, clear standard of end-of-life care is established in all fifty states where suicide is not considered a legitimate course of care for terminal illness;
- Vulnerable patients suffering from terminal illnesses are not pushed into PAS by doctors with inherent suggestive power by their professional mandate, and doctors are constrained to practice with benevolent paternalism and integrity;
- The slippery slope inherent to subjective terminal illness definitions and ambiguous prognostication standards (such as in the case of anorexia nervosa) is avoided by shutting down the assisted suicide conversation altogether;
- Innovations in end-of-life care are incentivized, and excellent palliative care options such as pain management, in-home treatment, and hospice are available and encouraged;
- The American healthcare system as it pertains to terminal illness care is free from corruption, collusion, and coercion, preserving patient trust and physician integrity; and
- End-of-life decision-making is not influenced or coerced
Considering the established legal availability of PAS in twelve United States jurisdictions, and especially one so long-standing as Oregon’s 1997 Death with Dignity Law, a flat ban on assisted suicide will face significant friction from both medical professionals and interest groups in those states.
But in a world where PAS is the norm and palliative care is the exception, death loses real dignity and gains a dangerous price tag. Suicide, in any circumstance, is never acceptable.
Real death with dignity is 1) embracing human life until its natural end, 2) diligent pain management in terminal patients’ final days or hours, 3) ensuring every suffering person of their inherent worth and dignity despite a terminal diagnosis, and 4) high-quality palliative care.
In a global community set on euthanizing not only the terminally ill, but also the chronically ill, mentally ill, minors, and the disabled, the United States must legislate the restoration and preservation of its healthcare system by enforcing a Hippocratic red line where every doctor promises: “I will use those dietary regimens which will benefit my patients according to my greatest ability and judgment, and I will do no harm or injustice to them. I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan.
