This article examines the cultural influences on the debate about the legalization of physician-assisted suicide in America. Included is a discussion of the social consequences of hidden expectations & obligations with respect to access to health care, allocation of resources, terminal & chronic illness, disability, difference, suffering, & the nature of death itself. The author notes that the debate must also include reflections on the ways that euthanasia policy is likely to initiate long-term changes in social relations in society. (29 refs) (SC)