Shineups for Euthanasia

 


Euthanasia

Euthanasia – the practice of ending a life so as to release an individual from an incurable disease and/or intolerable suffering.

Active vs. Passive Euthanasia:
- Corresponds to the distinction between killing and letting die
- In active euthanasia, deliberate steps are taken to cause the death of the patient (e.g., lethal injection)
- In passive euthanasia either doctors withdraw medical treatment with the intention of causing death or they intentionally neglect to take some action that would prevent death (e.g., unplugging a dialysis machine, failing to resuscitate).

Voluntary, Involuntary, Nonvoluntary
- If euthanasia is requested by the patient, or by someone authorized to speak for the patient, it is voluntary euthanasia.
- Involuntary euthanasia occurs when the patient’s life is ended against his or her expressed wishes.
- Nonvoluntary euthanasia occurs when the patient has given no indication of her wishes one way or the other – no requests to be euthanized, but no requests not to be euthanized either.


Gay-Williams’ Definition of Euthanasia: the deliberate and intentional taking of the life of a human being who is believed to be suffering from some disease or injury from which recovery cannot reasonably be expected.


Some Moral Questions

Under what conditions, if any, is ________ _________ euthanasia morally permissible?

Under what conditions, if any, is voluntary active euthanasia morally permissible?

Under what conditions, if any, should voluntary active euthanasia be legally permissible?

Under what conditions, if any, is voluntary passive euthanasia morally permissible?

If voluntary passive euthanasia is in certain circumstances morally permissible, why is it morally permissible in those circumstances?



Suicide

Under what conditions, if any, is it morally permissible to commit suicide?

A passage from St. Thomas Aquinas’s Summa Theologica (1273):

Suicide is completely wrong for three reasons. First, everything naturally loves itself, and it is for this reason that everything naturally seeks to keep itself in being and to resist hostile forces. So suicide runs counter to one’s own natural inclinations. ... Second, every part belongs to the whole in virtue of what it is. But every man is part of the community, so that he belongs to the community in virtue of what he is. Suicide therefore involves damaging the community. ... Third, life is a gift made to man by God, it is subject to him who is master of death and life. Therefore, a person who takes his own life sins against God. ... God alone has authority to decide about life and death.


The Natural Law Argument Against Suicide
1. Every act of suicide runs counter to natural inclinations.
2. Any act that runs counter to natural inclinations is morally wrong.
3. Therefore, every act of suicide is morally wrong.

 

 

Suicide and Self-Interest

Self-Interest
an action A is in an agent S’s best interest if and only if the life S would lead were S to perform A is at least as good as the life S would lead if S were to perform any alternative to A.


Theories of Welfare
Theories of welfare provide a ranking of lives in terms of how good each would be for the person living it.

Things That Might Make
A Life Good for the
Person Living It
:
pleasure / enjoyment
happiness
getting what you want
freedom
knowledge
love
accomplishment

Things That Might Make
A Life Bad for the
Person Living It
:
pain / suffering
misery
not getting what you want
bondage
ignorance
hate
failure

 


Gay-Williams’s Argument from Nature


The Argument from Nature:
1. Any act of active euthanasia runs counter to natural inclinations.
2. Any act that runs counter to natural inclinations is morally wrong.
3. Therefore, every act of active euthanasia is morally wrong.



The No-Moral-Difference Argument
(inspired by Rachels)

The No-Moral-Difference Argument for Voluntary Active Euthanasia
1. VPE is morally permissible in some cases.
2. In every case in which VPE is morally permissible, VAE is also morally permissible.
3. Therefore, VAE is morally permissible in some cases.


Regarding Premise 2: to see if VAE is really ok in every case in which VPE is, we need to do two things: (i) ensure that any reason in favor of VPE is also present in cases of VAE; and (ii) ensure that there are no reason against VAE that are not also present in VPE.


Regarding (ii): Are there any morally relevant facts present in VAE that are not present in VPE? It seems the only way there could be a moral difference between performing VPE and VAE would be if there were a morally significant difference in the either (a) the intentions behind the act, (b) the consequences of the act, or (c) the act itself.



Hippocratic Oath (classical version)

“I swear by Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods and goddesses, making them my witnesses, that I will fulfil according to my ability and judgment this oath and this covenant: …

I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.

I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art.

I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work.
… ”

Hippocratic Oath (modern version)

“I swear to fulfill, to the best of my ability and judgment, this covenant:

I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.
… ”

 

 



Brock

Principles that Support the Moral Permissibility of VAE:

A Principle of Autonomy: It is prima facie permissible for people to make the important decisions about the own lives as they see fit.

A Principle of Medical Autonomy: If a patient has an informed and stable desire to receive some treatment, then prima facie the treatment should be given to him.

A Principle about Well-Being: If some course of action is in some person’s best interests, then that is a reason in favor of performing that action.


Brock’s Position about the Morality of Active Euthanasia: Active euthanasia is morally permissible when (i) the patient has an informed and stable desire for active euthanasia, (ii) the patient is competent, and (iii) active euthanasia would be most in the patient’s interest.

The Legalization Question: Under what conditions, if any, should it be legal to perform voluntary active euthanasia?

Potential Good Consequences of Legalization of VAE:
1. Autonomy would be respected
2. People would be reassured
3. Suffering would be reduced
4. Death would be more humane

Potential Bad Consequences of Legalization of VAE:
1. Patients would lost trust in doctors
2. Care for the dying would get worse
3. People would be pressured to request AE
4. Prohibition against homicide would be weakened
5. The Slippery Slope