The Overton Window of Assisted Dying

December 15, 2020 Updated: December 16, 2020


The Hippocratic oath to “do no harm” is the cornerstone of any ethically functioning health-care system. As the solemn vow of physicians, this simple but powerful principle has underscored countless difficult decisions made in the operating room and emergency ward.

Regrettably, government legislation does not adhere to the same principle.

Bill C-7, which has passed in the House of Commons and awaits Senate approval, would expand the availability of assisted dying beyond those whose natural death is reasonably foreseeable. While adding additional eligibility requirements for those who are not near death, it removes safeguards that protect those who may be transient in their desire to end their lives, such as those suffering from permanent disabilities.

It’s useful to understand the proposed expansion of assisted dying legislation in light of the Overton window principle. Often used in a political context, the term refers to the range, or window, of policies or positions that the mainstream population will accept, and the concept that this window can be shifted. The idea is that policies that had once been unthinkable to the public can eventually become acceptable, having been moved inside the window over time, while policies that were once accepted are rejected, due to being pushed outside the window. The Overton window has shifted.

The shift toward a broader application of assisted dying, combined with the government’s expanding capacity to facilitate the death of its citizens, should concern us. It’s a slippery slope with broad moral implications.

The Sanctity of Life

There are few subjects as fraught with ethical peril as abortion, but it is the most apt comparison to the assisted dying legislation. Both involve the question of life and choice, both present a moral conundrum, and both prove incredibly divisive.

The shifting Overton window in relation to abortion provides a sense of where assisted dying legislation could lead if left unchallenged.

Abortion was legalized in part in the name of the need to ensure the health and safety of women who chose to abort their pregnancies when the only available options were unlicensed, unsanitary, underground clinics that put their lives at risk. There were also the complicated ethical factors surrounding a pregnancy that was the direct result of trauma.

We can leave the moral argument aside for a moment and focus instead on how the Overton window of abortion has shifted since it first became legal in Canada in 1988 and in the United States in 1973, when the landmark Roe vs. Wade case ruled that the U.S. Constitution protects a pregnant woman’s liberty to choose to have an abortion without excessive government restriction.

It was a morally and socially contentious issue from the beginning, and the stigma around abortion persisted despite its legalization.

In 1992, U.S. President Bill Clinton coined the term “safe, legal, and rare,” which became the Democratic Party’s adopted model for abortion. In 2012, the Democrats removed the word “rare” from its official platform, endorsing “safe and legal” abortion.

Last year, a Virginia Democrat introduced a bill that would ease restrictions on late-term, third-trimester abortions. Current Virginia law permits third-trimester abortions only when risk to the mother’s life is “substantial and irremediable.” The latest bill would broaden that restriction to allow for third-trimester abortion if the woman’s physical or mental health could be jeopardized through birth, even if the damage might not be irreversible. This would allow termination of a pregnancy days before birth under a broadly defined legal framework.

If assisted dying follows the same trend as abortion, restrictions on eligibility could be continually lifted until medically assisted death becomes a socially and legally accepted alternative for those who are not terminally ill or disabled.

The Legalities of Choice

Compassion dictates that we do our utmost to alleviate the suffering of our fellow citizens. Those who support the right to assisted death do so as an act of mercy—to grant a dignified death to those who are terminal and deteriorating. On an individual level, empathy is the correct response toward those who are considering death as the only viable alternative to their suffering, whatever the reason.

But legislation is not solely about the individual; it is about the adopted principles that make up a society. Although individual rights and freedoms must be protected, they cannot hold absolute sway over the fundamental checks and balances a functioning society employs to ensure its citizens enjoy the maximum amount of freedom while still honouring the ethical framework of the country.

Totalitarian states seldom put the sanctity of human life over managerial efficiency. The inherent worth of a person is always measured against the potential cost or burden on the collective. In that kind of regime, the Hippocratic principle of “do no harm” is far more likely to be applied to the well-being of the state over the long-term care of the individual citizen.

By readily offering death as a viable alternative to life, we are undermining the value and worth of the human experience, and that attitude will inevitably be reflected in how we view and value the infirm and elderly.

For now, proponents are saying assisted dying is “safe, legal, and rare,” but a trend has emerged, and this should worry us. The Overton window must not continue to shift in a direction that devalues life. Instead, as the Hippocratic oath implies, we should honour and cherish the sanctity of life, despite the suffering that is intrinsic to the human experience.

Ryan Moffatt is a journalist based in Vancouver.

Views expressed in this article are the opinions of the author and do not necessarily reflect the views of The Epoch Times.