Transcript Chapter 7: Euthanasia and Physician

Chapter 7: Euthanasia and
Physician-Assisted Suicide
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J. Gay-Williams, “The Wrongfulness of
Euthanasia”
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Defines “euthanasia” as the “intentional taking
of a life of a presumably worthless person”
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The argument from nature
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We have a “natural goal” of survival.
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So euthanasia sets us against “our own nature.”
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Moreover, since “our dignity comes from seeking our
ends,” euthanasia “does violence to our dignity.”
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This shows that euthanasia “requires that we regard
ourselves as less than fully human,” as creatures that
are not conscious of “our nature and our ends.”
Chapter 7: Euthanasia and
Physician-Assisted Suicide
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J. Gay-Williams, “The Wrongfulness of
Euthanasia”
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The argument from self-interest
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“Death is final and the chance of error too great to
approve the practice of euthanasia.”
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“There is always the possibility that an
experimental procedure or a hitherto untried
technique” will save the seemingly hopeless
person.
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“Knowing that we can take our life at any time (or
ask another to take it) might well incline us to give
up too easily.
Chapter 7: Euthanasia and
Physician-Assisted Suicide
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J. Gay-Williams, “The Wrongfulness of
Euthanasia”
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The argument from practical effects
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Allowing euthanasia “could have a corrupting
influence so that in any case that is severe
doctors and nurses might not try hard enough to
save the patient.”
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And “euthanasia as a policy is a slippery slope”
because it might give authorities an inappropriate
sort of control over deciding who ought to be
euthanized.
Chapter 7: Euthanasia and
Physician-Assisted Suicide
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James Rachels, “Active and Passive
Euthanasia”
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1973 American Medical Association policy:
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“The intentional killing of the life of one human
being by another—mercy killing—is contrary to
that which the medical profession stands and is
contrary to the policy of the [AMA],” but “the
cessation of the employment of extraordinary
means to prolong the life of the body when there
is irrefutable evidence that biological death is
imminent is the decision of the patient and/or his
immediate family.”
Chapter 7: Euthanasia and
Physician-Assisted Suicide
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James Rachels, “Active and Passive
Euthanasia”
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1973 American Medical Association policy:
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Rachels takes this policy to prohibit all mercy killing but
permitting some cases of allowing a patient to die.
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He argues, however, that there is no inherent moral
difference between killing and letting die (see his discussion
of the Smith/Jones thought experiment).
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On Rachels' view, discontinuing treatment with the intention
of letting the patient die is an example of “the intentional
killing of...one human being by another.”
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He concludes that the AMA policy is based on the false
assumption that there is an inherent moral difference.
Chapter 7: Euthanasia and
Physician-Assisted Suicide
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Bonnie Steinbock, “The Intentional
Termination of Life”
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Steinbock, against Rachels, argues that the 1973 AMA
policy is not based on the assumption that there is an
inherent moral difference between killing and letting die.
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Two situations where Steinbock says “the termination of
life-prolonging treatment cannot be identified with the
intentional termination of the life of one human being by
another”:
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Situations where the patient refuses treatment
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Situations where “continued treatment has little chance of
improving the patient's condition and brings greater
discomfort than relief”
Chapter 7: Euthanasia and
Physician-Assisted Suicide
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Dan W. Brock, “Voluntary Active Euthanasia”
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Voluntary active euthanasia: “the case in which a
clearly competent patient makes a fully voluntary
and persistent request for aid in denying”
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The value of autonomy/self-determination:
“people's interest in making important decisions
about their lives...according to their own values or
conceptions of a good life”
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The value of individual well-being: what is good for
an individual person
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Both values, according to Brock, make voluntary
active euthanasia permissible.
Chapter 7: Euthanasia and
Physician-Assisted Suicide
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Dan W. Brock, “Voluntary Active Euthanasia”
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The “moral center” objection: The “moral center” of
medicine will collapse “if physicians become killers
or are even licensed to kill...each physician...will
never again be worthy of trust and respect as
healer and comforter and protector of life in all its
frailty”
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Brock's response: “Patient's trust of their physicians
could be increased, not eroded, by knowledge that
physicians will provide aid in dying when patients
seek it.”
Chapter 7: Euthanasia and
Physician-Assisted Suicide
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Bonnie Steinbock, “The Intentional
Termination of Life”
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Steinbock concludes that there are distinctions that
explain the AMA policy's position, including:
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Intending vs. foreseeing consequences
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Intended consequences are desired by the
physician; foreseen consequences are merely
predicted
Ordinary vs. extraordinary treatment
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Ordinary treatment: “the care a doctor would
normally be expected to provide”
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Extraordinary treatment: treatment “that will cause
more discomfort than the [illness] and has little hope
of benefiting the patient”
Chapter 7: Euthanasia and
Physician-Assisted Suicide
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Richard Doerflinger, “Assisted Suicide: ProChoice or Anti-Life?”
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The “pro-choice” position: focus is on “respect
for personal autonomy” rather than “the
inherent worth of human life”
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Doerflinger argues that the pro-choice position
is self-contradictory, because it allows for “a
free act that by destroying human life, destroys
all the individual's future earthly freedom.”
Chapter 7: Euthanasia and
Physician-Assisted Suicide
Richard Doerflinger, “Assisted Suicide: ProChoice or Anti-Life?”
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He also provides a series of slippery slope
arguments, which appeal to:
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possible changes in legal doctrines and
definitions of “terminal illness”
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possible prejudice against citizens with disabilities
alterations in the character of the medical
profession
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the negative influence of the human “will to
power”
Chapter 7: Euthanasia and
Physician-Assisted Suicide
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David T. Watts and Timothy Howell, “Assisted
Suicide is Not Voluntary Active Euthanasia”
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Voluntary active euthanasia: the “administration
of medications or other interventions intended
to cause death at a patient's request”
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Assisted suicide: the “provision of information,
means, or direct assistance by which a patient
may take his or her own life.” Three kinds:
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Providing information
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Providing the means of suicide
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Supervising or directly aiding
Chapter 7: Euthanasia and
Physician-Assisted Suicide
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David T. Watts and Timothy Howell, “Assisted
Suicide is Not Voluntary Active Euthanasia”
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Watts and Howell deny three claims:
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That assisted suicide will lead to abuse of vulnerable
persons
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That it will undermine trust between patients and
physicians
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That it will weaken societal resolve to increase
resources allocated to care of the dying
They defend “limited” physician-assisted suicide, which
allows for providing information and providing the
means of suicide, but prohibits supervising or directly
aiding the act.