In considering physician-assisted suicide, the real challenge lies in understanding the nature of culture itself. Missing from the debate is a discussion of the social consequences of hidden expectations and obligations with respect to access to health care, allocation of resources, terminal and chronic illness, disability, difference, suffering, and the nature of death itself. Part I explores the hidden dimensions of culture that operate at the level of the unconscious. In order to examine the ways in which our cultural expectations are likely to change with the legalization of physician-assisted suicide and active euthanasia it is imperative that we consider some of our current hidden social expectations, and the ways in which the more vulnerable segments of our society may be affected by new expectations. Part II explores euthanasia from the perspective of the disable. Thus far, clinicians, resource managers, lawyers, journalists and bioethicists have dominated the debate concerning euthanasia policy. Disabled consumers view these individuals as controlling information given to terminally ill patients about future quality of life and prospects for pain and suffering. The debate must include reflections on the ways that euthanasia policy is likely to initiate long-term changes in social relations in our society.



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