1st Edition

What Kind of Death The Ethics of Determining One’s Own Death

By Govert den Hartogh Copyright 2023

    Many books have been published about physician-assisted death. This book offers a comprehensive and in-depth examination of that subject, but it also extends the discussion to a broader range of end-of-life decisions including suicide, palliative care and sedation until death. 

    In every jurisdiction that has laws permitting some kind of physician-assisted death, a central point of controversy is whether such assistance should only be available to dying patients, or to everyone who wants to end his life. The right to determine the manner and time of one’s own death, however, does not necessarily mean that physicians should be permitted to cooperate in ensuring a quick and peaceful death. In this book, Govert den Hartogh considers the fundamental and practical matters – including concrete issues of legal regulation – related to end-of life decision making. He proposes a two-tiered system. Everyone should have access to humane means of ending his life, if his decision to end it is voluntary, well-considered and durable. But doctors should only participate in a joint action of ending the patient’s life on his request if they also are convinced of acting in the patient’s best interests, in particular by ending intolerable and unrelievable suffering. And perhaps there is reason to restrict that second service to dying patients. The whole argument, however, depends on the extent to which, in both tiers of the system, we can design legal safeguards that will enable us to trust judgments about the requesting person’s request and about his suffering. The book considers much new evidence in regard to this issue.

    What Kind of Death will appeal to researchers and advanced students working in bioethics, applied ethics, philosophy of law and health law.

    Chapter 1. Introduction

    Part I: Suicide

    Chapter 2. Determining the manner and time of your own death

    Chapter 3. The invisibility of rational suicide

    Chapter 4. Which actions should we count as suicides?

    Chapter 5. What is implied by the right to suicide?

    Part II: Palliative care and palliative sedation

    Chapter 6. Suffering and dying well: on the proper aim of palliative care

    Chapter 7. Continuous deep sedation and homicide

    Chapter 8. Sedation until death: indications

    Part III: Euthanasia

    Chapter 9. Euthanasia and the right to self-determination

    Chapter 10. Ending lives with and without request

    Chapter 11. The risks of legalization

    Chapter 12. The Dutch and Belgian euthanasia laws: Potemkin villages?

    Part IV: Hard cases

    Chapter 13. Mental illness

    Chapter 14. Death wishes of the elderly

    Chapter 15. The authority of advance directives

    Chapter 16. Designing a regulatory system


    Govert den Hartogh is Emeritus Professor of Moral Philosophy at the University of Amsterdam, The Netherlands