Assisted Suicide and Euthanasia: A Natural Law Ethics Approach / Craig Paterson Ethics & Medicine, 26:1 Spring 2010 by Phillips, Stephen A Assisted Suicide and Euthanasia: A Natural Law Ethics Approach Craig Paterson. Burlington, Vermont: 2008. ISBN 978-07546-5746-0; 228 PAGES, PAPER, $34.95 Both assisted suicide and euthanasia are growing areas of ethical concern in our society. Natural law can play a role in bridging the gap between Christian and secular ethics, which is what makes this book intriguing. Paterson attempts to accomplish two things: analysis of the ethics of assisted suicide and euthanasia and establishment of a purely secular version of natural law ethics upon which to ground his conclusions about the morality of euthanasia. It appears to me that he has handled his first objective quite well, while failing at the second. The analysis of the ethics of assisted suicide and euthanasia is very well done. Paterson analyzes the justifications for euthanasia in its various forms and demonstrates the weaknesses of each. Included are arguments that rejection of euthanasia is solely based on religious doctrine which is unsupportable in the secular arena, that opposition to euthanasia based on sanctity of life is inconsistent with an allowance of intentional killing in cases of self-defense or capital punishment, and that the value of human life must be weighed against other things such as suffering which may outweigh it. It also includes a discussion of the emphasis by euthanasia supporters on personal autonomy, the rejection of the principle of double effect, and the limitation of role of the state in responding to differing ideas of the good life. In support of the position that euthanasia should be ethically prohibited, Paterson discusses reasons for considering euthanasia a form of homicide, the unreasonableness of thinking that a person can benefit from their own death, the idea that the worth of a human life is not dependent on the quality ofthat life, and the significant ethical distinction between intentionally causing death and allowing death to occur. He also makes the important point that personal autonomy needs to be subject to moral limits. Paterson attempts to ground his arguments in his own version of secular natural law, but that is where he fails. He starts with a concept of primary goods which are the observed reasons for human action that are ends unto themselves. These goods are nonnormative. That means they are descriptive of what is, but not an expression of what ought to be. From the descriptive primary goods, by what appears to be a linguistic sleight of hand, he derives what is good in a moral sense. He is missing an adequately grounded moral first principle that other systems of natural law find in the purpose of a designer or creator. Overall, the analysis of euthanasia and assisted suicide is a positive addition to the discussion of this timely issue, but it requires a firmer foundation than his system of secular natural law ethics is able to provide. Reviewed by Stephen A. Phillips MD, MA (Bioethics) who has practiced Family Medicine full-time in Plymouth, Indiana for the last 28 years and is currently involved in establishing an Ethics Center at Taylor University in Upland, Indiana, USA.