Ethics and Moral Problems
Philosophy 1120
Fall 2011
Euthanasia Group Presentation
Introduction
Etymology: Greek “eu” (well or good) and thanatos (death). Euthanasia refers to
the intentional termination of a human life in order to end pain and suffering.
Definitions: “The House of Lords Select Committee on Medical Ethics of
England defines euthanasia as "a deliberate intervention undertaken with the express
intention of ending a life, to relieve intractable suffering".[1] In the Netherlands,
euthanasia is understood as "termination of life by a doctor at the request of a
patient".[2]”
Passive Euthanasia: The withholding of treatments, such as medicine,
chemotherapy, radiation treatment, etc. necessary to sustain the life of the patient.
Active Euthanasia: Administering a lethal substance with the express intent to
end the life of the patient.
Voluntary Euthanasia: Euthanasia occurring with the consent of the patient. Both
passive and active euthanasia fall under this category. Passive euthanasia is legal
throughout the United States; active euthanasia is legal in only the states of Montana,
Washington and Oregon and countries: The Netherlands, Belgium and Luxembourg. The
term, assisted suicide is often used when the patient takes his or her own life with the
assistance of the doctor.
Non-voluntary Euthanasia: “Euthanasia conducted where the consent of the
patient is unavailable is termed non-voluntary euthanasia. Examples include child
euthanasia, which is illegal worldwide but decriminalised under certain specific
circumstances in the Netherlands under the Groningen Protocol.” Wikipedia article
“Euthanasia”
In-voluntary Euthanasia: “Euthanasia conducted against the will of the patient is
termed involuntary euthanasia. Involuntary euthanasia is usually considered murder”
Wikipedia article “Euthanasia”
Wikipedia
[1]^ a b c d Harris, NM. (Oct 2001). "The euthanasia debate". J R Army Med Corps 147
(3): 367–70. PMID 11766225.
[2]^ Euthanasia and assisted suicide BBC. Last reviewed June 2011. Acessed July 25,
2011.
The Perspectives of Four Contemporary Philosophers
1. “Voluntary Active Euthanasia”
Dan Brock; Frances Glessner Lee Professor of medical ethics and Director of the
Division for Medical Ethics, Harvard University
Brock argues “[It is] that the very same two fundamental ethical values supporting
the consensus on patient’s rights to decide about life-sustaining treatment also support the
ethical permissibility of euthanasia. These values are individual self-determination or
autonomy and individual well-being.”
At the end of human life, it becomes more valuable to maintain a high quality of
life, avoid suffering, maintain dignity and ensure that we are remembered as we wish to
be than it is to extend the time of one’s existence. Thus, a sense of individual well-being
should dictate when a person is to die, when life has become a burden rather than a
benefit.
The two main arguments against euthanasia are, one: it is always ethically wrong,
even if the well-being of the patient supports it and, two: even if euthanasia is not
ethically wrong, the act of physicians performing euthanasia is in direct conflict with the
moral and legal code to which those physicians must adhere. “Permitting physicians to
perform euthanasia, it is said, would be incompatible with their fundamental moral and
professional commitment as healers to care for patients and to protect life.” Brock’s
answer to these arguments holds to his earlier statement centering the values of selfdetermination and well-being in the debate. These values should lie at physician’s moral
center and “these two values support physician’s administering euthanasia when their
patients make competent requests for it.”
All quotations: Dan Brock, “Voluntary Active Euthanasia,” Hastings Center Report. Vol
22, No. 2 (Mar-Apr 1992)
2. “The Wrongfulness of Euthanasia”
J. Gay-Williams; Professor of Philosophy
Gay-Williams begins his essay, “The Wrongfulness of Euthanasia” by mentioning
Karen Quinlan, a woman in a persistent vegetative state, and our compassion for her and
her family. Though the main viewpoint is that she and her family would be better off if
she were dead, Gay-Williams argues that euthanasia is still inherently wrong. It is also
wrong from the standpoints of self-interest and practical effects. His three main points:
1. The argument from Nature
We are built to survive; it is our natural inclination to protect ourselves from
harm. “Our bodies are similarly structured for survival right down to the
molecular level…Euthanasia does violence to this natural goal of survival. It
is literally acting against nature.”
2. The Argument from Self-Interest
“Because death is final and irreversible, euthanasia contains within it the
possibility that we will work against our own interest if we practice it or allow
it to be practiced on us.” Approving the practice of euthanasia does not take
into account any chance of error in diagnosis or prognosis; the finality of it is
too great.
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3. The Argument from Practical Effects
Accepting euthanasia would create a decline in the quality of the care of the
medical profession in addition to corrupting the profession at its heart.
Allowing euthanasia to step into public policy would be a moral downfall for
society. He argues that the issue is a slippery slope.
All quotations: J. Gay-Williams, “The Wrongfulness of Euthanasia,” Intervention and
Reflection: Basic Issues in Medical Ethics. 7th ed. Ronald Munson (ed.) (Belmont, CA:
Wadsworth)
3. “Active and Passive Euthanasia”
James Rachels; (1941-2003) Distinguished moral philosopher at New York University,
Duke University and the University of Alabama at Birmingham
Rachels begins his essay, “Active and Passive Euthanasia” discussing “[T]he
distinction between active and passive euthanasia is thought to be crucial for medical
ethics.” Most people seem to believe that passive is preferable to active, but Rachels
argues active is preferable to passive. “To say otherwise is to endorse the option that
leads to more suffering rather than less, and is contrary to the humanitarian impulse that
prompts the decision not to prolong his life in the first place.”
The conventional doctrine leads to decisions concerning life and death to be made
on irrelevant grounds. If a baby is born with a mental disease and a physical ailment, is
the decision to withhold surgery for the physical ailment based on the existence of the
mental disease? Is killing, in itself, worse than letting die? Rachels uses and example of
two men, both standing to gain a large inheritance. One man killed the relative to get the
inheritance, while the other man let his relative die and did nothing to help though he
could have. Did either man behave better, morally? Rachels says no: the difference
between killing and letting die does not, in itself, make a moral difference. The action is
inherently the same. Thus, the arguments in favor of passive euthanasia make active
euthanasia morally permissible also.
All quotations: James Rachels, “Active and Passive Euthanasia,” New England Journal
of Medicine, 292 (2), January 9, 1975
4. “Objections to the Institutionalisation of Euthanasia”
Stephen Potts; Physician at Royal Edinburgh Hospital, scholar of medical ethics, author
of children’s books
Potts main point is that even if it may be the best outcome for the individual
patient, euthanasia as an institution is too open for abuse and too difficult to control for it
to be socially morally permissible. “… the risks of such institutionalisation are so grave
as to outweigh the very real suffering of those who might benefit from it..”
Risks of Institutionalisation:
1. Reduced Pressure to Improve Curative or Symptomatic Treatment
2. Abandonment of Hope
3. Increased Fear of Hospitals and Doctors
4. Difficulties of Oversight and Regulation
5. Pressure on the Patient
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6. Conflict with Aims of Medicine
7. Dangers of Societal Acceptance
8. The Slippery Slope:
CURE: the central aim of medicine
CARE: the central aim of terminal care once
patients are beyond cure
KILL: the aim of the proponents of euthanasia for
those patients beyond cure and not helped by care
CULL: the feared result of weakening the
prohibition on euthanasia
(J. Gay-Williams also mentions the slippery slope)
9. Costs and Benefits
Probability of harm in question must be assessed: the odds, the stakes and the
reversibility.
Potts goes on to discuss weighing the risks, the right to die and the duty to kill and
assisted suicide. “The distinction between assistance in suicide and killing is so fuzzy as
to be simply unworkable in any legislation.” He claims: “I object, not so much to
individual acts of euthanasia, but to institutionalising it as a practice.”
Related Studies
Karen Ann Quinlan
Jack Kevorkian, “Dr. Death”
Historical Timeline: History of Euthanasia and Physician-Assisted Suicide
http://euthanasia.procon.org/view.resource.php?resourceID=000130#1950-1979
Name:
International Task Force on Euthanasia and Assisted Suicide
Position:
Con to the question "Should euthanasia or physician-assisted suicide be
legal?"
Reasoning: "... The government should not have the right to give one group of people
(e.g. doctors) the power to kill another group of people (e.g. their patients).
Activists often claim that laws against euthanasia and assisted suicide are
government mandated suffering. But this claim would be similar to saying
that laws against selling contaminated food are government mandated
starvation.
Laws against euthanasia and assisted suicide are in place to prevent abuse
and to protect people from unscrupulous doctors and others. They are not,
and never have been, intended to make anyone suffer."
www.internationaltaskforce.org (accessed Aug. 9, 2006)
http://euthanasia.procon.org/view.source.php?sourceID=658
Name:
American Medical Association (AMA)
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Position:
Con to the question "Should euthanasia or physician-assisted suicide be
legal?"
Reasoning: "It is understandable, though tragic, that some patients in extreme duress-such as those suffering from a terminal, painful, debilitating illness--may
come to decide that death is preferable to life. However, permitting
physicians to engage in euthanasia would ultimately cause more harm than
good. Euthanasia is fundamentally incompatible with the physician's role as
healer, would be difficult or impossible to control, and would pose serious
societal risks.
The involvement of physicians in euthanasia heightens the significance of
its ethical prohibition. The physician who performs euthanasia assumes
unique responsibility for the act of ending the patient's life. Euthanasia
could also readily be extended to incompetent patients and other vulnerable
populations.
Instead of engaging in euthanasia, physicians must aggressively respond to
the needs of patients at the end of life. Patients should not be abandoned
once it is determined that cure is impossible. Patients near the end of life
must continue to receive emotional support, comfort care, adequate pain
control, respect for patient autonomy, and good communication."
Letter written on behalf of the AMA by then AMA General Counsel Kirk
Johnson to then Michigan Attorney General Frank Kelley, Oct. 10, 1995
http://euthanasia.procon.org/view.source.php?sourceID=000549
Case Study Website:
http://www.rsrevision.com/Alevel/ethics/euthanasia/Euthanasia_Case_Studies.pdf
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