NEED ASSIGNMENT BY 4PM EST NO LATER $40 BUDGET
cencej263h
phil2306_ppt_ch8.pptJames Rachels’s, “Active and Passive Euthanasia”
1973 American Medical Association policy:
“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.”
© Oxford University Press
© Oxford University Press
*
James Rachels, “Active and Passive Euthanasia”
1973 American Medical Association policy (Cont’d):
Rachels takes this policy to prohibit all mercy killing but permitting some cases of allowing a patient to die.
He argues, however, that there is no inherent moral difference between killing and letting die (see his discussion of the Smith/Jones thought experiment).
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.”
He concludes that the AMA policy is based on the false assumption that there is an inherent moral difference.
© Oxford University Press
© Oxford University Press
*
Philippa Foot, “Killing and Letting Die”
Difference between killing and letting die is marked by saying that a person may or may not be “the agent” of harm that befalls someone else.
Two “subsidiary ideas” that compose this idea of agency:
We can ask what sequence of events led to a death (e.g., we might say somebody died of cancer.)
We can ask whether a particular person initiated a fatal sequence.
© Oxford University Press
© Oxford University Press
*
Philippa Foot, “Killing and Letting Die”
Example cases
Rescue 1: Rushing to save five people who are about to die. One additional person asks for help on the way, but we regretfully leave him to die so we can save the five.
Rescue 2: Rushing to save five people who are about to die. One additional person is in the way, and we run over him to save the five.
Foot claims that there seems to be a morally relevant difference between leaving one person to die to save the five and actually running somebody over to save the five.
© Oxford University Press
© Oxford University Press
*
Philippa Foot, “Killing and Letting Die”
How to explain the difference?
Rights of noninterference (and corresponding negative duties to not interfere)
Rights to goods and services (and corresponding positive duties to provide these goods/services)
“Typically, it takes more to justify an interference than to justify the withholding of goods and services.”
Applying this explanation to killing/letting die (e.g., Rachels’s cases of the child in the bathtub.)
© Oxford University Press
© Oxford University Press
*
Daniel Callahan, “A Case against Euthanasia”
Main position: Euthanasia is a form of suicide, and as such it “goes against the grain ... of reason, emotion and tradition.”
Reason: It is an unreasonable way to deal with the tribulation of life (partly because rationality implies predictability, and those suffering from a lethal illness are less likely to commit suicide).
Emotion: It provokes a negative emotional response in people.
Tradition: Doctors traditionally use their skills to preserve lives, not take them.
© Oxford University Press
© Oxford University Press
*
Daniel Callahan, “A Case Against Euthanasia”
Three arguments for the moral permissibility of suicide:
1. We have “the right of self-determination.”
Response: Legalizing euthanasia would allow more “socially sanctioned killing” as well as reinstating “private killing.”
2. “We owe it to each other ... to relieve suffering when we can do so.”
Callahan's response: This duty can be overridden.
© Oxford University Press
© Oxford University Press
*
Daniel Callahan, “A Case Against Euthanasia”
Three arguments for the moral permissibility of suicide (cont’d):
3. No serious difference between withholding treatment and killing by euthanasia.”
Callahan argues in response that there is a difference.
© Oxford University Press
© Oxford University Press
*
Daniel Callahan, “A Case against Euthanasia”
Discussion of euthanasia laws and practices
Main question: Even if euthanasia is morally problematic, would it still be okay for the laws to allow it?
Compare the wrongness of insulting an innocent person in private and the legality of doing so.
Doctor-patient confidentiality would make it impossible to know whether the laws are being abused. (Dutch law example: “Out of 3,300 euthanasia deaths, nearly one-third were non-voluntary.”)
Legalization of euthanasia would create a fundamental change in medical values.
© Oxford University Press
© Oxford University Press
*
Michael B. Gill, “A Moral Defense of Oregon's Physician-Assisted Suicide Law”
Why suicide is not intrinsically wrong
Arguments that reject the autonomy-based justification for physician-assisted suicide (PAS).
Proponents of PAS could argue that the Oregon laws only allow the suicide of someone who is going to die soon anyway.
The “nasty dilemma” faced by proponents: They must oppose the killing of those who are not able to make their own decisions and of those who will be able to make their own decisions in the future (i.e., everyone).
© Oxford University Press
© Oxford University Press
*
Michael B. Gill, “A Moral Defense of Oregon's Physician-Assisted Suicide Law”
Why suicide is not intrinsically wrong (cont'd)
The value of autonomy: big decisions and little decisions
Why the option of PAS can enhance one's ability to make big decisions
© Oxford University Press
© Oxford University Press
*
Michael B. Gill, “A Moral Defense of Oregon's Physician-Assisted Suicide Law”
Why a physician's participating in PAS is not intrinsically wrong
Objections that it is inappropriate for doctors to decide whether a life is worth living
Gill responds that the Oregon law does not allow doctors to make these decisions.
Kass’s objection that “better off dead” is incoherent
Gill responds that one can still coherently prefer to be dead.
© Oxford University Press
© Oxford University Press
*
Michael B. Gill, “A Moral Defense of Oregon's Physician-Assisted Suicide Law”
Why a physician's participating in PAS is not intrinsically wrong (cont'd)
The principle of double effect
Gill claims that even if the principle is defensible, “not all defensible moral principles ought to be enforced by law.”
Gill also points out that the principle will imply the wrongness of PAS “only if it is bad that a person with a terminal disease die sooner rather than later.”
Principle cannot be used to argue that the Oregon law would increase manipulation and coercion—because this is a consequentalist point.
© Oxford University Press
© Oxford University Press
*
- David Velleman, “Against the Right to Die”
Velleman offers a consequentialist, harm-based argument against an institutional right to die, i.e., a right requiring caregivers to honor a patient’s request to be helped to die.
Velleman’s idea: Offering the option of euthanasia can constitute a harm, irrespective of whether the patient exercises the option. This possible harm is a reason against offering patients the option of euthanasia, i.e., against an institutional right to die.
© Oxford University Press
© Oxford University Press
- David Velleman, “Against the Right to Die”
But what’s the harm?
When an patient has the option of choosing death, the default of staying alive is replaced with an option of staying alive or choosing death.
Given certain features of contemporary culture, having this option will likely bring a felt burden, on the part of the patient, to justify his or her continued existence.
This burden is unwelcome (at least for many patients), and so constitutes a harm.
So, according to Velleman, offering a patient the option of choosing death can constitute a harm.
© Oxford University Press
© Oxford University Press
