Slippery slope arguments have been especially pervasive in discussions of euthanasia, in which physicians actively end patients’ lives, and physician-assisted dying (or physician-assisted suicide), in which physicians supply medications to patients that enable them to end their own lives.^1,2 The concern, fueled by the German experience with racially motivated euthanasia in the last century, has been that approving either of these procedures for a few individuals will inevitably lead to overuse and abuse.

In this issue of JAMA Internal Medicine, Snijdewind et al³ and Dierickx et al⁴ report recent findings about physician-assisted suicide and euthanasia from the Netherlands and Belgium, respectively. Although neither article mentions the term slippery slope, both studies^3,4 report worrisome findings that seem to validate concerns about where these practices might lead. These findings, and other recent data regarding the speeding of patients’ deaths,^5– 8 make this a key moment to revisit efforts in the legalization of assisted dying in the United States and elsewhere, and, specifically, the role of the medical profession.

Snijdewind et al³ report data from the End-of-Life Clinic, an organization established in the Netherlands in 2012 to consider euthanasia or physician-assisted suicide requests from patients whose primary physicians turned down a request or declined to participate. Although not legal, speeding of death is tolerated in the Netherlands for patients with unbearable conditions, without prospect of relief. The End-of-Life Clinic is thus a second opinion for patients who claim this status and who seek aid in dying.

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