When it comes to euthanasia, not all slippery slope arguments are 'bullshit'

The Twittersphere went into meltdown on Monday night after a spat on ABC’s Q&A between bioethics professor Margaret Somerville and 81-year-old audience member Patricia Fellows.

Somerville defended, at some length, her opposition to euthanasia. Fellows responded to Somerville’s academic exposition with one word: “bullshit!”.

For many this was the highlight of the episode. Yet I was more intrigued to see Tony Jones’ suspicion of Somerville’s so-called “slippery slope” argument against legalising assisted dying. As Somerville discussed the steady liberalisation of euthanasia laws in the Netherlands, Jones himself called “bullshit” (albeit in a more intellectual sophisticated way).

“Are you making a slippery slope argument Margo?”, he interjected.

The background to the sort of question Jones asked, and widespread community suspicion of arguments about so-called “euthanasia creep”, is that these sorts of claims rely on what in ethics and philosophy we call the “slippery slope fallacy”.

They assume that event A will necessarily be followed by event B, even when there is no demonstrated causal or probable relationship between event A and B. As philosophers are at pains to point out, there is a need for empirical evidence or sound inferential reasoning to support the claim that event B will necessarily (or probably) follow on from event A.

Without this evidence, the argument is invalid. I can’t just claim, for example, that the legalisation of medicinal marijuana leads to the legalisation of ice - I need to show some empirical or logical connection between the two.

But (and it’s a big but) there is such a thing as a good and valid slippery slope argument. A good slippery slope argument demonstrates a causal or probable relationship between event A and B, such that event B can legitimately be expected to occur if event A is allowed to occur.

Bad slippery slope claims

In the context of the euthanasia debate, it is in the interest of intellectual honesty as well as prudent policy deliberation that we clearly distinguish good slippery slope claims from the bad ones.

There is certainly no shortage of dubious slippery slope arguments. Examples are the apocalyptic warnings of Nazi-Germany style euthanasia if we legalise assisted dying.

In last year’s euthanasia debate in South Australia, for example, Liberal MP Adrian Pederick made precisely this comparison when he said:

This is the sort of thing that was done in the 40s in Nazi Germany […] I just feel that comments like that lead us down a slippery slope.

As it stands, this is an invalid slippery slope argument. What Pederick didn’t show, and needs to show, is some sort of causal or logical relationship between a concern for the allocation of scarce health care resources and the mass, involuntary killing of tens of thousands of disabled, sick and elderly members of the community.

Maybe evidence can be provided, but the claim is not self-evident, as his comment seems to suggest.

Valid slippery slope claims

There are, nevertheless, compelling empirical and logical slippery slope arguments available to defend more modest claims about the “normalisation” of assisted dying.

Critics of assisted dying often argue euthanasia rates will increase with each year following legalisation. For example, in the Victorian Parliament’s Inquiry into End of Life Choices, Daniel Mulino MLC warned of a progressive increase in assisted dying if it were legalised in Victoria:

once legalised, euthanasia and assisted suicide are increasingly taken for granted and seen to be unexceptional both within the medical profession and more broadly within society.

There is significant evidence from the Benelux countries (Belgium, Netherlands, Luxembourg), as well as the US and Canada, to support this claim. Around 3.7% of all deaths in the Netherlands in 2015 were by virtue of euthanasia or assisted suicide, up from 1.3% when the procedure was legalised in 2002.

And while Dutch legislation changed several times during that period, the steady rate of increase continued even in years when there was no legislative change. Similar figures are available in Belgium, and alarming initial figures have just been released for Quebec.

It is true Australian legislatures may adopt an Oregon model of assisted dying legislation, rather than a Benelux model.

Yet there has been a similar documented increase of assisted-suicide deaths in Oregon. In fact, the increase has actually been greater, from 16 deaths in 1998 to 132 in 2015.

All of which is to say, there is significant evidence to suggest that if we do legalise assisted dying in Australia jurisdictions, the practice will be normalised, and we will see a steady but significant increase in deaths by such means.

Let’s not get emotional

It is true social dynamics are complex, and there are a variety of factors that could effect how euthanasia legislation is received in Australian society.

And claims about euthanasia creep don’t constitute an argument against euthanasia as such. They are only claims about what might happen when we do legalise assisted dying. Indeed, some proponents of assisted dying might see “normalisation” as a positive development.

But by the same token, we shouldn’t dismiss such arguments as manifestly false or logically invalid. No one profits from impolitic policy, and it would be a monumental blunder to ignore the experience of other countries in our deliberation on this issue.

So returning to the catalyst of this discussion, was Margaret Somerville’s argument “bullshit”?

I don’t think it would be fair to critique her views based solely on what was said on Monday’s program. Q&A panellists rarely have the opportunity to discuss their views at length, and Monday night’s episode was no exception.

But rather than offering a glib and emotional dismissal of the arguments, we need to review the hard facts about euthanasia creep and the social costs of assisted dying. Anything less than this would be, well, “bullshit”.