Right-to-die legislation will go into effect this year in California, which will join Oregon, Montana, Vermont, and Washington in providing for physician-assisted suicide. According to a Gallup poll last year, 70 percent of Americans believe that doctors should be allowed to help terminally ill patients end their lives—and that figure has been on the rise for several years.

In this issue, two writers take a hard look at the practice of physician-assisted dying. Both tell cautionary tales.

Dutch ethicist Theo Boer examines the effect of laws in the Netherlands in place since 1994 which have allowed physicians to assist in deaths. He argues that once laws permitting physician-assisted dying are established, they change people’s expectations in facing death. Once the door to assisted death is opened, it seems, it’s difficult to keep it from opening further.