Last month, a Massachusetts ballot initiative that would have legalized physician-assisted suicide in that state narrowly failed. It was only the latest in a decades-long set of legal and electoral battles over what we might call the last choice: when and how we may end our own lives, and with what forms of assistance.

Cato Unbound this month features a lead essay on physician-assisted dying by Howard Ball, a Professor Emeritus of political science at the University of Vermont and author of At Liberty to Die: The Battle for Death with Dignity in America.

Joining him are Patrick Lee, the John N. and Jamie D. McAleer Chair in Bioethics at Franciscan University of Steubenville, who argues that assisting suicide devalues the intrinsic good of human life; and Philip Nitschke, the Founder and Director of Exit International, a leading group advocating for end-of-life rights, who questions whether the act of deliberately terminating one’s life really needs a doctor – and by extension, the state – at all.

Powerful ethical and legal questions surround this choice. While a libertarian might be tempted to affirm that physician-assisted suicide is an exercise in personal autonomy, the matter is by no means so simple. The legal and constitutional traditions of our country have only occasionally affirmed such a right, and the potential for abuse in various assisted-suicide regimes may be unacceptably high. Add to this the concerns raised by those who argue for the essential dignity, not of a painless death, but of a natural one, and we confront a vast terrain of ethical issues.

As always, Cato Unbound readers are encouraged to take up our themes, and enter into the conversation on their own websites and blogs, or on other venues. We also welcome your letters. Send them to jkuznicki at cato dot org. Selections may be published at the editors’ option.