The act of assisted dying is one of the most controversial and important ethical issues which we face today. To talk of euthanasia is also to talk of the realities of human suffering, of death and of the limits of human freedom and of governmental law. By providing an analysis of the way in which Barabara Mackinnon deals with the topic, this paper will draw attention to some of these difficulties and the contradictions and issues which they bring to light.

For me, the most important part of this chapter was the way that MacKinnon was initially careful to tie the problem of euthanasia to actually existing circumstances and cases. By drawing attention to cases of assisted suicide which occurred in the state of Oregon she is able to make sure that the conversation takes place from a realistic perspective which is informed by actually existing ethical decisions. One of the major weaknesses which can take place with regard to arguments surrounding euthanasia occurs when the idea is treated as an abstract philosophical concept rather than something which emerges from, and severely impacts, peoples’ experience of everyday life. By beginning her debate with a focus on statistics than MacKinnon is able to balance carefully between philosophical ideas and actual life.

Despite this, I found that I was confused that MacKinnon did not draw more on the class relationships which seemed to emerge from the statistics which she provides. According to her, then almost all of the people who had sought to die via assisted suicide in Oregon were white, middle class and well educated. These statistics could be used to frame a debate about the ways in which the idea of euthanasia is inherently tied to a certain understanding of life and to the capacity to think critically about it. It could also be used to develop an argument regarding the life expectancy, and expectancy of quality of life, which exists amongst different demographics in the U.S.A. There are several reasons why few non-white and working class people may have obtained lethal prescriptions, however none of these were, to my mind, explored sufficiently. Considering the breadth of the rest of the chapter, I found this omission confusing.

The point that I found I agreed most strongly with in the chapter was MacKinnon’s the statement against the idea that disabled people necessarily have a lower quality of life than others (197). When talking about the proliferation of the euthanasia, especially in terms of its consideration for those born with disabilities then is an extremely important point to make. One of the convincing arguments made against involuntary euthanasia is that it relies on a conception of quality of life which can never be definitive and will always be mediated by certain prejudices. By drawing attention and attacking these prejudices, MacKinnon clarifies a major argument.

I found that I disagreed most strongly with the idea that death has not occurred when a person is being kept alive via machines and has little or no brain function (200). This seems to be an obvious fallacy. Although it is logically sound, it involves such an abstraction way from the actual existing conditions of a person and how the might be able to live in the world that I believe the argument to be meaningless.

Despite these arguments and the controversial nature of the issue, MacKinnon manages to navigate the complexities of euthanasia admirably and to articulate each perspective which informs the various debates around it. In conclusion, I would state that apart from missing an obvious opportunity to understand the way that views on life expectancy and quality of life are mediated by class position and race, she manages to present an articulate and careful exposition of arguably the most pressing ethical issue of today.