Physician-Assisted Suicide: What the Laws Don’t Tell You
Based on analysis by Billy Barvick author of “Physician-Assisted Suicide: Vague Legislation and Weak Data Mislead the Public.” Download PDF version here.
Physician-assisted suicide (PAS) is often portrayed as a humane, peaceful way for people with terminal illnesses to end their lives with dignity. Advocacy campaigns describe it as safe, controlled, and reserved for the most extreme cases of suffering. But as Billy Barvick’s recent paper shows, the reality is far more complicated—and far more troubling.
Loopholes Hidden in “Safeguards”
On paper, PAS laws include ethical “guardrails” meant to protect patients: only the terminally ill can access it, patients must be mentally capable, and the process must be free from coercion. Yet when you look at the legislative details, those safeguards weaken under scrutiny.
Doctor shopping is possible. A patient does not need a pre-existing relationship with the prescribing physician, allowing them to seek out doctors who are more willing to approve PAS.
Prognoses are unreliable. The definition of “terminal illness” is vague, and studies show that life expectancy predictions are often inaccurate.
Disabilities blur the lines. Conditions that are incurable but manageable, such as anorexia, have already been used as grounds for PAS. Disability rights groups are united in their opposition.
No oversight at the moment of death. A physician does not need to be present when the patient ingests the lethal medication, meaning no one can confirm whether it was voluntary or whether complications occurred.
“Good faith” provisions shield providers. As long as a physician claims to have acted in “good faith,” they are protected from legal liability—even in cases of negligence or abuse.
Perhaps most concerning, death certificates are required to list the underlying illness, not PAS, as the cause of death. This deliberate misrepresentation prevents accurate data collection and makes abuse almost impossible to track.
The Problem With PAS Data
If legislation is full of loopholes, surely state reporting requirements help ensure accountability? Unfortunately, they don’t.
Barvick highlights that state data collection on PAS is inconsistent, incomplete, and in some cases non-existent. Oregon, the first state to legalize PAS, is often cited as the “model,” yet even its system lacks rigor. Other states vary widely in what they track, how often they report, and what details they disclose.
Some release reports only every other year, some never at all. The categories of data differ so much across states that it is impossible to create a clear national picture. Even so, what numbers are available reveal significant discrepancies in reported deaths year over year—raising questions about reliability.
The Larger Cultural Question
Why, in a country that has invested so much in suicide prevention—including the national 988 lifeline—do we frame suicide as a public health crisis in one context but a dignified “choice” in another?
Barvick suggests part of the answer lies in America’s culture of rugged individualism, especially among Baby Boomers. Having grown up believing in self-reliance and independence, many see PAS as a final opportunity to exercise control. Yet this mindset risks redefining dependency and vulnerability as weakness—and can leave people feeling pressure to choose death rather than burden others.
Toward True Dignity in Dying
The American Medical Association recently reaffirmed its stance that physician-assisted suicide is “fundamentally incompatible with the physician’s role as healer.” Instead of expanding PAS, Barvick argues that we should focus on improving access to palliative care, hospice, and advance care planning—approaches that honor dignity without resorting to lethal drugs.
If the goal is to give people peace at the end of life, then vague laws, weak oversight, and misleading data are the wrong path. True dignity comes not from shortcuts, but from compassionate care that affirms life, even in its final chapter.