Chapter 11 :Deliberate Termination of Life and Physician Assisted Suicide: Aid in Dying

Section 3. Presentation of Issues.
Outline for Chapter 3 : Munson, Ronald. INTERVENTION AND REFLECTION . 6th ED.,Belmont, California: Wadsworth Publishing Company, 2000.

EUTHANASIA

Meaning of the term: A good Death! An easy death?

Types of Euthanasia?

Active / Passive Distinction

READ:  James Rachels Article on Active and Passive Euthanasia

Summary of James Rachels: Active and Passive Euthanasia

Killing vs Letting Die

Voluntary vs Involuntary

Self Administered - Active Self Administered - Passive

Other Administered Active and Voluntary Passive and Voluntary

Active and Involuntary Passive and Involuntary

Active non- voluntary Passive non-voluntary

The Autonomy Argument:


 


 


 


 

 


 

1

If the Principle of Autonomy is true then every rational agent has the right to be fully self-determining.
 

 

2

The Principle of Autonomy is true.
 

Therefore

3

Every rational agent has the right to be fully self-determining.

1&2


 

4

If voluntary active euthanasia VAE is morally impermissible then there are rational agents who do not have the right to be fully self-determining.
 

Therefore

5

VAE is morally permissible.

3&4

Callahan's Criticisms:

READ: Daniel Callahan: When Self Determination Runs Amok

  1. VAE by definition requires the involvement of another person. Hence even if premise (1) is true, it is not at all clear that premise (4) is true. The moral and subsequent legal prohibition of VAE is a legitimate constraint on self-determination. Recall the four constraints on the Principle of Autonomy.
  2. If VAE were morally permissible we would be requiring physicians to make judgments about the value of another person's life. But this is an impossible position in which to put a physician.

The Active/Passive Argument:


 


 


 


 

 


 

1

If killing is morally worse than letting die, then for any two cases C1 and C2, where C1 and C2 are exactly alike in all respects except that in C1 there is a killing while in C2 there is a letting die, C1 is morally worse than C2.
 

 

2

It is not the case that for any two cases C1 and C2, where C1 and C2 are exactly alike in all respects except that in C1 there is a killing while in C2 there is a letting die, C1 is morally worse than C2.
 

Therefore

3

It is not the case that killing is morally worse than letting die.

1&2


 

4

If it is not the case that killing is morally worse than letting die, then there is no moral difference between VAE and voluntary passive euthanasia (VPE).
 

Therefore

5

There is no moral difference between VAE and VPE.

3&4


 

6

If there is no moral difference between VAE and VPE, then ,if VPE is morally permissible, then VAE is morally permissible.
 

Therefore

7

If VPE is morally permissible then VAE is morally permissible.

5&6


 

8

VPE is morally permissible.
 

Therefore

9

VAE is morally permissible.

7&8

Callahan's Criticisms:

  1. If sub-conclusion (3) is true, then physicians cause the death of an injured or ill patient by not successfully treating the patient. But that is absurd.
  2. Sub-conclusion (3) is false because it rests on the confusion of causality with culpability.

      The physician may be morally responsible for failing to treat but is not causally responsible for the death.

      Moral responsibility changes with technology and knowledge, causal responsibility does not.

      Causal responsibility and Moral responsibility coincide only for cases of Active killing. They diverge in cases of Passive killing.



Utility

The Utilitarian Argument:


 


 


 


 

 


 

1

If VAE maximizes utility then VAE is morally permissible.
 

 

2

VAE maximizes utility.
 

Therefore

3

VAE is morally permissible.

1&2

Callahan's Criticisms:

    Premise (2) is false, since

    1. There would be an inevitable abuse of any laws permitting VAE.
    2. No laws permitting VAE could be written carefully enough to succeed in maximizing utility.
    3. Laws permitting VAE would inevitably lead to non-voluntary and perhaps even involuntary active euthanasia.

 

Physician Assisted Death

 SUICIDE

What is suicide?

What is required for an act of suicide?

actions or omissions

actions or intentions

outcome or intention

Attempted Suicide

Committed Suicide

How are these to be described? Suicide? Something else?

Situations:

1 Socrates

2 Jews at Masada

3 Christians in Coliseum

4 Irish in British Prisons

5 Buddhists in Indochina

6 Woman taken by would- be rapist

7 POW's

8 Spies

9 Slaves in the hold of a slave ship

10 Persons in intractable pain

11 persons with an incurable, life threatening, debilitating disease

12 Persons with an emotional problem in emotional pain

Would you act to prevent any of the acts above if you could?

Should family members be permitted to assist in suicides?

What conditions or safeguards should exist, if any?

Should health care personnel be permitted to assist in suicides?

Should doctors, nurses, others?

What conditions or safeguards should exist, if any?

State Intervention to Prevent Suicide

State Intervention to Compel Life Saving Treatment

Acts of Paternalism!

Issues: Self Determination, Autonomy, Individual Liberty, Competency

with Dependents and Incompetents, the guardian must decide in favor of treatment if there are such possible that will relieve , rectify or cure.

Only Life Saving Medical Treatment can be imposed on another

ETHICAL THEORIES:

Kant- No

St. Augustine- NO

Hume-Yes

St. Thomas Aquinas- No but maybe yes

The Principle of the Double Effect as used in Natural Law Theory

http://en.wikipedia.org/wiki/Principle_of_double_effect

 

RATIONAL SUICIDE - When Death is preferable both NOW and in the FUTURE.

What is the The Role of others? A. To refrain from interference  or  B. To Assist  ???

 

READ: Voluntary Euthanasia from http://plato.stanford.edu/entries/euthanasia-voluntary/

First published Thu Apr 18, 1996; substantive revision Mon Feb 19, 2007

The entry sets out five individually necessary conditions for anyone to be a candidate for legalized voluntary euthanasia (or, in some usages, physician-assisted suicide), outlines the moral case advanced by those in favour of legalizing voluntary euthanasia, and discusses five of the more important objections made by those opposed to the legalization of voluntary euthanasia.

  • 1. Introduction
  • 2. Five Individually Necessary Conditions for Candidacy for Voluntary Euthanasia
  • 3. A Moral Case for Voluntary Euthanasia
  • 4. Five Objections to the Moral Permissibility of Voluntary Euthanasia

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