"The same can be said about "self determination" regarding death. The doctrines we saw in chapter two support this, and there are further instances I describe in chapter six in which the decision to die is made in the midst of the application of force. In other words, I choose to die when I feel that I do not have enough value to others and as a result I see myself as something of insufficient value to go on existing. This is the origin of the misgivings that arise around instances of "self determination" regarding death such as euthanasia and "death with dignity". What is to be done if we reject the unconditional acceptance of these kinds of self determination? In practice one part of the efforts that are made in this regard involve trying to establish systems or processes which reduce the influence of people around the individual in question on their decision to live or die, and in the past many of the criticisms that have been put forward regarding euthanasia and "death with dignity" have focused on criticisms of these efforts and doubts about their effectiveness.

The problem is therefore not only "coercion". Something is not necessarily unproblematic simply because it is "uncoerced" and therefore an instance of "self determination" or because it is carried out with the "consent" of those involved. The range of cases in which certain kinds of transfers/transplants are unacceptable is larger than that of simply those in which consent is not given (i.e., in which coercion is applied). I have indeed stated above that in the end I may accept the decision of person A. But this is because I acknowledge that person A's desires might be different from my own, not simply because anything is acceptable so long as the parties involved give their consent. In other words, this condition leads to the acceptance of the transfer of certain things, which in the case of another person might be objected to, based on the desire of the individual in question to give up the thing in question. This is not to say that what is part of the individual or happens to be in their possession can or must be used as a means to an end, nor is it to accept that such a state of affairs must be permitted because of "self determination".