{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:38:26Z","timestamp":1787017106810,"version":"build-2736575974"},"reference-count":37,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Med Ethics"],"accepted":{"date-parts":[[2020,2,17]]},"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:p>Some disability rights advocates criticise prenatal testing and selective abortion on the grounds that these practices express negative attitudes towards existing persons with disabilities. Disability rights advocates also commonly criticise and oppose physician-assisted suicide (PAS) and euthanasia on the same grounds. Despite the structural and motivational similarity of these two kinds of arguments, there is no literature comparing and contrasting their relative merits and the merits of responses to them with respect to each of these specific medical practices. This paper undertakes such a comparison. My thesis is that a number of potentially significant weaknesses of the expressivist argument against reproductive technologies are avoided when the argument is used against PAS. In particular, I try to show that three common criticisms of the expressivist argument applied to reproductive technologies, whatever merit they have, have even less merit when they are used to reply to the expressivist argument applied to PAS. This is important because the expressivist argument applied to the end of life scenario does not get as much attention as the argument applied to the beginning of life scenario, and yet it has a relatively stronger position.<\/jats:p>","DOI":"10.1136\/medethics-2019-105875","type":"journal-article","created":{"date-parts":[[2020,7,1]],"date-time":"2020-07-01T17:25:23Z","timestamp":1593624323000},"page":"538-544","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Expressivism at the beginning and end of life"],"prefix":"10.1136","volume":"46","author":[{"given":"Philip","family":"Reed","sequence":"first","affiliation":[{"name":"Philosophy, Canisius College, Buffalo, NY 14209, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,7,1]]},"reference":[{"issue":"5","key":"2025092415021887000_46.8.538.1","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.2307\/3527746","article-title":"The disability rights critique of prenatal genetic testing. reflections and recommendations","volume":"29","author":"Parens","year":"1999","journal-title":"Hastings Cent Rep"},{"key":"2025092415021887000_46.8.538.2","unstructured":"Asch A . Why I still haven\u2019t changed my mind about prenatal diagnosis: reflections and refinements. In: Asch A , Parens E , eds. Prenatal testing and disability rights. Washington, DC: Georgetown University Press, 2000: 234\u201358."},{"key":"2025092415021887000_46.8.538.3","unstructured":"Coleman D . Not dead yet. In: Foley K , Hendin H , eds. The case against assisted suicide: for the right to end-of-life care. Baltimore, MD: The Johns Hopkins University Press, 2002: 213\u201337."},{"key":"2025092415021887000_46.8.538.4","doi-asserted-by":"crossref","unstructured":"Ackerman F . Assisted suicide, terminal illness, severe disability, and the double standard. In: Battin MP , Rhodes R , Silvers A , eds. Physician assisted suicide: expanding the debate. New York, NY: Routledge, 1998: 149\u201361.","DOI":"10.4324\/9781315811369-12"},{"key":"2025092415021887000_46.8.538.5","doi-asserted-by":"crossref","unstructured":"Keown J , Jackson E . Debating euthanasia. Portland, OR: Hart, 2012.","DOI":"10.5040\/9781509955688"},{"key":"2025092415021887000_46.8.538.6","doi-asserted-by":"publisher","DOI":"10.1002\/pon.1612"},{"key":"2025092415021887000_46.8.538.7","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0037117"},{"issue":"8","key":"2025092415021887000_46.8.538.8","doi-asserted-by":"crossref","first-page":"339","DOI":"10.5694\/mja16.00132","article-title":"Euthanasia and physician-assisted suicide: focus on the data","volume":"206","author":"Emanuel","year":"2017","journal-title":"Med J Aust"},{"key":"2025092415021887000_46.8.538.9","unstructured":"Oregon Health Authority . Oregon death with dignity act 2017 data summary, 2018."},{"key":"2025092415021887000_46.8.538.10","unstructured":"National Council on Disability . The danger of assisted suicide laws. Washington, DC, 2019."},{"issue":"2","key":"2025092415021887000_46.8.538.11","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1017\/S0265052500003447","article-title":"Choosing who will be disabled: genetic intervention and the morality of inclusion","volume":"13","author":"Buchanan","year":"1996","journal-title":"Soc Philos Policy"},{"issue":"2","key":"2025092415021887000_46.8.538.12","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1353\/ken.1998.0011","article-title":"The meaning of the act: reflections on the expressive force of reproductive decision making and policies","volume":"8","author":"Nelson","year":"1998","journal-title":"Kennedy Inst Ethics J"},{"key":"2025092415021887000_46.8.538.13","doi-asserted-by":"publisher","DOI":"10.1136\/jme.2002.002634"},{"key":"2025092415021887000_46.8.538.14","doi-asserted-by":"publisher","DOI":"10.1037\/1076-8971.6.2.526"},{"issue":"4","key":"2025092415021887000_46.8.538.15","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1353\/pbm.1996.0034","article-title":"Legistrothanatry: a new specialty for assisting in death","volume":"39","author":"Sade","year":"1996","journal-title":"Perspect Biol Med"},{"issue":"7064","key":"2025092415021887000_46.8.538.16","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1136\/bmj.313.7064.1088a","article-title":"Philosopher assisted suicide and euthanasia","volume":"313","author":"Elliott","year":"1996","journal-title":"BMJ"},{"key":"2025092415021887000_46.8.538.17","doi-asserted-by":"crossref","unstructured":"Shakespeare T . Disability rights and wrongs. New York, NY: Routledge, 2006.","DOI":"10.4324\/9780203640098"},{"key":"2025092415021887000_46.8.538.18","doi-asserted-by":"publisher","DOI":"10.1136\/jme.2009.034645"},{"key":"2025092415021887000_46.8.538.19","unstructured":"Harris J . Enhancing evolution: the ethical case for making better people. Princeton University Press, 2007."},{"key":"2025092415021887000_46.8.538.20","unstructured":"Steinbock B . Disability, prenatal testing, and selective abortion. In: Parens E , Asch A , eds. Prenatal testing and disability rights. Washington, DC: Georgetown University Press, 2000: 108\u201323."},{"issue":"7","key":"2025092415021887000_46.8.538.21","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1111\/bioe.12365","article-title":"'You are inferior!' revisiting the expressivist argument","volume":"31","author":"Hofmann","year":"2017","journal-title":"Bioethics"},{"issue":"4","key":"2025092415021887000_46.8.538.22","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1111\/japp.12121","article-title":"Respecting embedded disability","volume":"33","author":"Akhtar","year":"2016","journal-title":"J Appl Philos"},{"key":"2025092415021887000_46.8.538.23","doi-asserted-by":"crossref","unstructured":"Brock DW . Preventing genetically transmitted disabilities while respecting persons with disabilities. In: Wasserman D , Bickenbach J , Wachbroit R , eds. Quality of life and human difference: genetic testing, health care, and disability. New York, NY: Cambridge University Press, 2005: 67\u2013100.","DOI":"10.1017\/CBO9780511614590.004"},{"key":"2025092415021887000_46.8.538.24","doi-asserted-by":"crossref","unstructured":"Bickenbach JE . Disability and Life-Ending Decisions. In: Battin MP , Rhodes R , Silvers A , et al , eds. Physician assisted suicide: expanding the debate. New York: Routledge, 1998: 123\u201332.","DOI":"10.4324\/9781315811369-10"},{"key":"2025092415021887000_46.8.538.25","unstructured":"Parens E , Asch A , eds. Prenatal Testing and Disability Rights. Washington, DC: Georgetown University Press, 2000."},{"key":"2025092415021887000_46.8.538.26","unstructured":"Yuill K . Assisted suicide: the liberal, humanist case against legalization. New York, NY: Palgrave Macmillan, 2015."},{"key":"2025092415021887000_46.8.538.27","doi-asserted-by":"crossref","unstructured":"Davis A . A disabled person's perspective on euthanasia. Disabil Stud Q 2004;24(3).doi:10.18061\/dsq.v24i3.512","DOI":"10.18061\/dsq.v24i3.512"},{"issue":"1","key":"2025092415021887000_46.8.538.28","first-page":"37","article-title":"Suicide intervention for people with disabilities: a lesson in inequality","volume":"8","author":"Gill","year":"1992","journal-title":"Issues Law Med"},{"key":"2025092415021887000_46.8.538.29","doi-asserted-by":"crossref","unstructured":"Scoccia D . The disability case against assisted dying. In: Wasserman DT , Cureton A , eds. The Oxford Handbook of philosophy and disability. New York, NY: Oxford University Press, forthcoming, 2018.","DOI":"10.1093\/oxfordhb\/9780190622879.013.36"},{"key":"2025092415021887000_46.8.538.30","unstructured":"Wendell S . The rejected body. New York, NY: Routledge, 1996."},{"key":"2025092415021887000_46.8.538.31","doi-asserted-by":"publisher","DOI":"10.1136\/jme.2010.037861"},{"key":"2025092415021887000_46.8.538.32","unstructured":"Kittay EF , Kittay L . On the expressivity and ethics of selective abortion for disability: conversations with my son. In: Parens E , Asch A , eds. Prenatal testing and disability rights. Washington, DC: Georgetown University Press, 2000: 165\u201395."},{"issue":"2","key":"2025092415021887000_46.8.538.33","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1111\/japp.12199","article-title":"Selecting against disability: the liberal eugenic challenge and the argument from cognitive diversity","volume":"35","author":"Gyngell","year":"2018","journal-title":"J Appl Philos"},{"key":"2025092415021887000_46.8.538.34","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.326.7383.271"},{"key":"2025092415021887000_46.8.538.35","doi-asserted-by":"crossref","unstructured":"Barnes E . The minority body: a theory of disability. New York, NY: Oxford University Press, 2016.","DOI":"10.1093\/acprof:oso\/9780198732587.001.0001"},{"issue":"3","key":"2025092415021887000_46.8.538.36","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1086\/684709","article-title":"Disability and mere difference","volume":"126","author":"Kahane","year":"2016","journal-title":"Ethics"},{"key":"2025092415021887000_46.8.538.37","doi-asserted-by":"crossref","unstructured":"Glover J . Choosing children: genes, disability, and design. New York, NY: Oxford University Press, 2006.","DOI":"10.1093\/acprof:oso\/9780199290925.001.0001"}],"container-title":["Journal of Medical Ethics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/medethics-2019-105875","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T22:02:27Z","timestamp":1758751347000},"score":1,"resource":{"primary":{"URL":"https:\/\/jme.bmj.com\/lookup\/doi\/10.1136\/medethics-2019-105875"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,1]]},"references-count":37,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2020,7,23]]},"published-print":{"date-parts":[[2020,8]]}},"alternative-id":["10.1136\/medethics-2019-105875"],"URL":"https:\/\/doi.org\/10.1136\/medethics-2019-105875","relation":{},"ISSN":["0306-6800","1473-4257"],"issn-type":[{"value":"0306-6800","type":"print"},{"value":"1473-4257","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,1]]}}}