The laws of all but one American state now forbid doctors to prescribe lethal pills for patients who want to kill themselves. These cases began when groups of dying patients and their doctors in Washington State and New York each sued asking that these prohibitions be declared unconstitutional so that the patients could be given, when and if they asked for it, medicine to hasten their death. The pleadings described the agony in which the patient plaintiffs were dying, and two federal Circuit Courts of Appeal-the Ninth Circuit in the Washington case and the Second Circuit in the New York case-agreed with the plaintiffs that the Constitution forbids the government from flatly prohibiting doctors to help end such desperate and pointless suffering.

Washington State and New York appealed these decisions to the Supreme Court, and a total of sixty amicus briefs were filed, including briefs on behalf of the American Medical Association and the United States Catholic Conference urging the Court to reverse the circuit court decisions, and on behalf of the AmericanMedical Students Association and the Gay Men's Health Crisis urging it to affirm them. The justices' comments during oral argument persuaded many observers that the Court would reverse the decisions, probably by a lopsided majority. The justices repeatedly cited two versions-one theoretical, the other practical-of the "slippery slope" argument: that it would be impossible to limit a right to assisted suicide in an acceptable way, once that right was recognized.

The theoretical version of the argument denies that any principled line can be drawn between cases in which proponents say a right of assisted suicide is appropriate and those in which they concede that it is not. The circuit courts recognized only a right for competent patients already dying in great physical pain to have pills prescribed that they could take themselves. Several justices asked on what grounds the right once granted could be so severely limited. Why should it be denied to dying patients who are so feeble or paralyzed that they cannot take pills themselves and who beg a doctor to inject a lethal drug into them? Or to patients who are not dying but face years of intolerable physical or emotional pain, or crippling paralysis or dependence? But if the right were extended that far, on what ground could it be denied to anyone who had formed a desire to die-to a sixteen-year-old suffering from a severe case of unrequited love, for example?

The philosophers' brief answers these questions in two steps. First, it defines a very general moral and constitutional principle-that every competent person has the right to make momentous personal decisions which invoke fundamental religious or philosophical convictions about life's value for himself. Second, it recognizes that people may make such momentous decisions impulsively or out of emotional depression, when their act does not reflect their enduring convictions; and it therefore allows that in some circumstances a state has the constitutional power to override that right in order to protect citizens from mistaken but irrevocable acts of self-destruction. States may be allowed to prevent assisted suicide by people who-it is plausible to think-would later be grateful if they were prevented from dying.
That two-step argument would justify a state's protecting a disappointed adolescent from himself. It would equally plainly not justify forcing a competent dying patient to live in agony a few weeks longer.