Assisted suicide for the terminally ill is a touchy subject that people tend to tiptoe around, and understandably so. Questions involving our own mortality are rarely comfortable. Of course, we need to be careful in our terminology and remember that there is a difference between assisted suicide (where the patient takes their own life) and voluntary euthanasia, in which a doctor terminates the patient at their request.

Being someone who has regularly argued in favor of assisted suicide being an option for those facing debilitating, painful illnesses with no reasonable hope for survival, I’m still willing to listen to arguments from those who oppose the practice. One of those came to us from Grazie Pozo Christie at National Review this week. The author is a policy adviser at the Catholic Foundation and her work is featured in a number of different outlets.

Christie argues in a compelling fashion that the real danger in allowing voluntary euthanasia is the slippery slope which looms behind it. In short, she cites several historical precedents to claim that once the door is opened to voluntary euthanasia, involuntary euthanasia will not be far behind. And she sees assisted suicide as the “cousin” to voluntary euthanasia because it normalizes the idea of ending a human life before it would normally expire.

History proves that it is altogether too easy to mix voluntary euthanasia — promoted as the individual’s right to choose death — and involuntary euthanasia — promoted as preventing a life of suffering or as a way to reach utilitarian goals. In the Netherlands, disabled infants who cannot consent to be killed are routinely and legally euthanized under a set of standards called the “Groningen Protocol.” In Belgium, where euthanasia is also legal, adults are routinely killed without consent, accounting for over 30 percent of those euthanized, according to one study. Doctor Peter Saunders of England’s Care Not Killing campaign warned, “Once you have legalized voluntary euthanasia, involuntary euthanasia will inevitably follow.”

Here in the U.S., euthanasia is not yet legal, but its cousin, physician-assisted suicide, is legal in several states. Social acceptance for ending lives that are “no longer worth living” is rapidly increasing, a dangerous trend when combined with the common prejudice against the value of the lives of those who suffer from severe psychiatric diseases. Tormented and terrified, homeless or imprisoned, these can certainly seem like lives not worth living. It’s easy to imagine the slide from purely voluntary suicide as a last resort to the mercy killing of the mentally ill who burden society. Looking at 20th-century history, it’s easy to understand why societies should be wary of allowing that slide to ever start.

The author cites a number of examples of times and places where euthanasia has seemingly spun out of control when such power is placed in the hands of the government. Her information about these practices in the Netherlands and Belgium are certainly chilling and represent models we need to be aware of. On a much darker note, Christie reminds us of the hundreds of thousands of “undesirables” who were purged in Germany as the Nazis began their march toward what their evil, demented leaders viewed as genetic perfection.

But as valid as all of these past and present examples may be, it’s an overreach to lump all euthanasia programs in with assisted suicide policies such as the ones which already exist in five U.S. states, including Oregon and Vermont. First of all, while a doctor may or may not be present at an assisted suicide, they don’t administer the drugs themselves. That’s up to the patient, and it has to be a decision they make themselves. Also, some of the truly horrifying cases coming to us from Europe involve policies which allow this option for older people who have simply “grown tired of life” or those who are suffering from depression or more serious mental illness. That’s not the case in the United States, where multiple doctors must be willing to attest to the fact that the patient is indeed terminally ill and facing a slow, painful death.

As to the euthanizing of children, that’s simply a horror show we shouldn’t allow. But children aren’t capable of giving consent to begin with. The point to all of this is to say that there isn’t always a slippery slope. Such things may indeed happen in socialist nations or under tyrannical regimes. But one benefit of our democratic republic is that the citizens can always act as a check on such excesses. We can easily avoid the temptation to blur the lines between assisted suicide for the terminally ill and government mandated death panels deciding whose life is or isn’t worth living.

If we expend all of our energy fretting over dystopian futures based on the policies of societies which are far different than our own we can begin ruling out any number of freedoms. After all, the Europeans live without meaningful freedom of speech or the right to bear arms. America isn’t Europe, nor is it Russia or Nazi-era Germany. I think we can safely combine responsibility with compassion in the small number of cases where this option is even considered. And on that note, it’s worth pointing out that in the first ten years they had assisted suicide in Oregon, less than 250 people were recorded as having exercised the option.