Throughout this argument, S, NS, AS, PAS abbreviate 'suicide', 'no suicide', 'assisted suicide', 'physician-assisted suicide'
This is an argument for favouring the introduction of legislation that founds an administrative system (here broadly-defined) for granting Canadians access to physician-assisted suicide in limited cases. Before getting into the specifics, I want to discuss some important differences between this argument and (purely) natural language, non-deductive arguments also in favour of physician-assisted suicide (PAS).
The conclusion of this argument is weaker than the conclusions of the non-deductive arguments. In particular, the advocated (underspecified) PAS system is under-inclusive: it would not grant access to all people who I (or almost any proponent of physician-assisted suicide) think should have access. I am prepared to argue, informally, that this --and by "this" I mean under-inclusiveness in general, not the particular kind/degree of under-inclusive that the system involved here has-- that this is a necessary feature of any sufficiently-rigorous argument that does not make stronger assumptions than this one. More specifically, for any argument
there will be applicants who should, in a subjective moral sense according to proponents like me, have access to PAS, but who are indistinguishable from (hypothetical) applicants whose assisted suicide would be regrettable.
Even so, one could argue that this system is especially or unnecessarily under-inclusive, and that I won't dispute. This argument should be taken as a proof-of-concept. A more-serious attempt would have to involve much more research about this particular issue (e.g. data from the history of the systems in places like the Netherlands and Oregon) than I can afford to do for my thesis. A recent source of such information and much more is Quebec's Committee report on dying with dignity.
At this point I could enumerate the ways that existing non-deductive/natural language arguments use stronger assumptions than those employed here. But here is a method that you can use to collect most of those ways yourself: for each Assumption and Simplifying Assumption, consider how one could use natural language to hide the details of the problem that the assumption addresses. For example, I will spend a surprising amount of time delineating the things that I consider possibly-pertinent to the decision of whether or not to support the legislation. I have never seen this done in such a clear and explicit way in informal arguments; often the best one can hope for is that it can be unambiguously gleaned from reading nearly the entire text of the argument (which is book-length in some cases, e.g. the committee report linked to in the previous paragraph). Another example is the unusually-specific weighing of the (sometimes theoretical) pros and cons of such legislation; in this argument I go a level deeper than any natural language argument I have seen in the justification for the main required subjective proposition ✓Lemma 74.
There may already exist a natural language argument about PAS that is every bit as fair and disciplined as the one I give here (the best concise argument I've read was written by the supreme court justices in the minority opinion for the Sue Rodriguez case). A similar thing can be said for any proposed prescription or standard; always there are actors in the scope of the prescription that have come to comply with it on their own. In the case of maximally fair/disciplined argumentation, like in the case of prescriptions for limiting pollution, or the protection of human rights, etc, those actors should be applauded, but their existence should not detract from the importance of the prescription unless they are sufficiently common (where "sufficiently common" is relative: we would need them to be very common in the case of pollution, or universal in the case of human rights).
First, a person must opt-in before being diagnosed with their terminal illness. The purpose of this feature is to lower the (already low) incidence of some forms of difficult instances of regrettable assisted suicides (‹difficult-regrettable PAS›), which are regrettable assisted suicides in which
Second, a person must take the drugs in the presence of their physician. This is not ideal, and is not required in Oregon, for example, but it is useful for justifying the assumption that with very high probability, the negations of items 2 and 3 above never happen.
Third, there is a fixed list of eligible terminal diseases, which includes only those for which it can be established with "high" probability that a person has the disease and will "very likely" not live for more than X months. Each of "high", "very likely" and X can differ for different patients; the first two only need to be high enough and the third small enough that the patient is unwilling to try to beat the doctors' reported odds.Interesting note: ALS, the condition that Sue Rodriguez and Gloria Taylor suffered from, is regarded as having no definite diagnoisis. It is always diagnosed in part by excluding other conditions. It can be falsely diagnosed, for example, when the real disease is myasthenia gravis, which is treatable.
Fourth, in some parts of Canada, prosecution for illegal assisted suicide is rare relative to its incidence. This must remain the case even after a PAS law is passed. This is to justify the assumption that ‹S, NS because of incr fear of prosecution› happens to no one with high probability (in Assumption 2). In particular, a person answering a request to assist another person in dying, where the second person is ineligible for legal PAS, should not be, or perceive to be, at increased risk of prosecution, compared to the risk before the law is passed.
Fifth, to justify the assumption that ‹NS, NS & worse palliative care› happens to no one with high probability (in Assumption 2), the government will monitor private donations towards palliative care and research on palliative care, and if the appropriately-adjusted funds per person drops below what it was before the PAS law was passed, the government will increase public funding to compensate.
Sixth, to support all of Assumption 2 through Assumption 6, since all can be broken by incompetence, the government will adopt one of the provisions from Quebec's bill 52, which they summarize as follows:
A commission on end-of-life care is established under the name “Commission sur les soins de fin de vie”, as well as rules with respect to its composition and operations. The mandate of the Commission is to examine all matters relating to end-of-life care and to oversee the application of specific requirements relating to medical aid in dying.
The person's death is not a suicide in the status-quo future or the assisted suicide future, and the quality of palliative care available to them is worse in the assisted suicide future compared to in the status-quo future.The problem is that worse palliative care depends on both of the futures. Such a Δ could be defined by a family of IFR-pairs, but that would appear to require quantifying the quality of palliative care, which is difficult to do right (in a way that is satisfactory to everyone), and even if done right introduces an unnecessary abstract entity into the argument (namely the partially-ordered set of quantities).
Note that, at the current level of detail of this proof, the next two symbols are only used in the semantic descriptions of other symbols - not in any axioms.