The Hidden Realities of Physician-Assisted Suicide: A Closer Look Behind the Rhetoric

In recent years, physician-assisted suicide (PAS) has gained ground across the United States, with 12 jurisdictions legalizing the practice. Advocates often frame it as a compassionate, empowering option for terminally ill patients seeking control and dignity at the end of life. But a new report, Physician-Assisted Suicide: Vague Legislation and Weak Data Mislead the Public by Billy Barvick, asks a critical question: Are Americans really getting the full story?

According to the report, the answer is no. Through detailed analysis of legislative language and state reporting practices, Barvick argues that the rosy image of PAS masks significant concerns around oversight, safeguards, and transparency. While the idea of “death with dignity” appeals to many—especially among aging populations—Barvick contends that current laws often fail to protect the very individuals they claim to serve.

Loopholes and Lax Safeguards

At the core of Barvick’s argument is the observation that PAS legislation is often written in vague or permissive language. Terms like “terminal illness” and “mental capacity” are poorly defined, allowing wide discretion for interpretation. There is no requirement for a pre-existing relationship between physician and patient—raising concerns about “doctor shopping,” where patients can seek out providers more likely to approve their requests.

Moreover, while advocates promise tight guardrails, the report finds that key “safeguards” are either optional or easily circumvented. Psychiatric evaluations are often not required, and physicians are not mandated to be present when the medication is ingested—leaving open the possibility of coercion, errors, or distressing complications. The drugs themselves are experimental, unregulated by the FDA, and can cause prolonged or painful deaths. In some cases, the drugs include morphine at 60 times the lethal dose—raising serious public safety concerns.

“Good Faith” Provisions and Missing Data

Perhaps the most controversial legal component is the so-called “good faith” provision, which protects individuals involved in the process from legal consequences as long as they claim to have acted in good faith. According to Barvick, this clause all but eliminates accountability, even in cases of negligence or abuse.

Adding to the opacity, PAS-related deaths are not listed as such on death certificates. Instead, the underlying illness is recorded, making it impossible to track how many deaths result from assisted suicide—further undermining transparency.

Even more troubling, the report highlights that data collection across states is inconsistent, minimal, or nonexistent. Some states issue annual reports; others release data every other year or not at all. The quality and specificity of the data vary drastically, making it difficult to assess whether the laws are being followed—or abused. As Barvick puts it, PAS operates in a “Wild West” environment where loopholes are many and oversight is scarce.

A Question of Dignity, or a Dangerous Illusion?

Barvick also offers a cultural critique of how PAS has taken hold in American society. He points to a deep-seated belief in self-reliance—especially among Baby Boomers—as a driving force behind the popularity of assisted suicide. In a society that idolizes independence, the reality of aging, disability, and dependence can feel like a loss of identity. PAS, he suggests, is being sold not just as a medical choice, but as one final assertion of control in a culture uncomfortable with vulnerability.

Yet this illusion of control may come at great cost. National disability rights organizations overwhelmingly oppose PAS, arguing that it opens the door to abuse, misdiagnosis, and discrimination against people with chronic illnesses or disabilities. And while PAS is pitched as a solution for uncontrollable pain, the data—limited as it is—suggests most patients cite reasons like “loss of autonomy” or “being a burden” as their primary motivations, not pain.

The Need for a Different Conversation

Ultimately, Barvick’s report urges a shift in focus—from expanding access to PAS toward improving palliative care, strengthening hospice services, and supporting those at the end of life with dignity and compassion. In a health care system already plagued by inequality and limited resources, the report warns that PAS may become a path of least resistance rather than a truly free choice.

With state legislatures continuing to debate PAS laws, Physician-Assisted Suicide: Vague Legislation and Weak Data Mislead the Public is a timely and necessary wake-up call. If Americans want to make informed decisions about the future of end-of-life care, the conversation must begin with facts, not euphemisms.

This article is based on the report “Physician-Assisted Suicide: Vague Legislation and Weak Data Mislead the Public” by Billy Barvick, published by the Euthanasia Prevention Coalition USA. The full report can be downloaded here