ABSTRACT
This chapter attempts to deal with two fundamental questions. First, what forces of restraint and activism have shaped the right to die into an important policy issue in the United States today? And second, how have the institutions of policy mediation responded? The chapter presents answers to these core questions by resorting to an inspection of American culture, medical professionalism, social activism, state-court case law, and legislative activity across the fifty states. If a problem survives the battle of activism versus restraint, then policy alternatives are fashioned and applied by policy mediators. The forces of activism may have unwittingly conspired to create a policy issue, but the nature of American culture has helped keep the right-to-die debate submerged as an item of extensive public discussion. Probably the most important force of policy activism in the right-to-die area is medical technology.
