Euthanasia Flashcards
Voluntary Euthanasia
receives the patients consent
Nonvoluntary Euthanasia
does not receive patient consent
Active Euthanasia
directly causing death
Passive Euthanasia
indirectly causing (allowing to die/letting nature take its course)
Passive Voluntary
patient consent to allow die
Active Voluntary
patient consent to physician assisted suicide
Passive Nonvoluntary
See Karen Quinlan. Non-consenting allowing to die
Active Nonvoluntary
Non-consenting physician-assisted suicide
Logical Slippery Slope Argument
a fallacy will directly follow through the argument (total wrong)
Does it follow?
Practical Slippery Slope Argument
A correlation (could be right)
Does it often follow?
The Question of Euthanasia
Physician-Assisted Suicide
Do I have a right to ask a doctor to help me die?
Moral Agent
Someone who has the ability to make choices
The Philosopher’s Brief
a legal argument not compelling practitioners
famous philosophers added such as Dworkin, Jarvis Thomson, Nozick, Rawls, and More
Main Point: people have a right to self-determination, that the court upholds/has upheld.
-considered a slippery slope argument as it is based on past judgements
-critics ask at what point do we stop allowing government sanctioned death
Kant would say
physician-assisted suicide is immoral
Can something be legal but still immoral? And vice versa?
Yes
Least problematic stance
Voluntary passive euthanasia
Most problematic stance
involuntary active euthanasia
Rights can established by…. and equally be taken away by…
wherever/whoever grants them
Callahan presents…
The slippery slope argument
-once we allow assisted suicide, at what point does it end?
-the government could set out a eugenics ideology and kill/allow the killing of certain demographics
-how do you transfer the right to your life to someone else?
-how do you task the physician with such a choice?
-there is a difference between killing and letting die
-if we say yes to killing, abuse would run rampant
-there would be different levels allowing doctors to make decisions on quality of life
Lach’s argument on Euthanasia
-Callahan has taken it too far
-if physicians took off holds on drugs, people could just do it themselves
-we’ve already got doctors doing too much and making huge life-changing decisions
-if I can donate one kidney, why not both?
-the only difference is my loss
-but I gave up that willingly, so its mine to give up
-if medicine is about quality of life, then why can’t it be about poor quality as well?
Is there a difference between…
killing and letting die?
James Rachels: Active and Passive Euthanasia
-the doctrine of the AMA has arguments against it
-there is no difference between killing and letting die
-if both situations have equal intention, then certainly there is no difference in that case
-to let die in some instances can cause more suffering
-it can also cause suffering for those around
-causing suffering is contrary to the humanitarian impulse that says not to prolong life (allowing to die can be slow and painful, directly injecting can be a quick and painless death)
James Rachels example
Smith vs. Jones
-Smith and Jones both want to kill their nephew (a child) to get their inheritance
-Smith kills him in the bathtub by actively drowning him
-Jones lets him die by seeing him drowning and not doing anything
-these are obviously the same as the intentions were, but the only difference is their action/inaction
James Rachels appeal to practitioners/AMA
If a doctor lets a patient die for humane reasons, he is in the same moral position as if he had given the patient a lethal injection for humane reasons
-intention matters
-active is no worse than passive
-doctors should be concerned with their position on this issue
The utilitarian stance against killing and possibly even letting die. Also can be used to support killing and letting die
pain and suffering is the greatest evil
-Used in support of active euthanasia by Rachels
Other questions of allowing Euthanasia
-Would it be morally permissible for one to take their own life?
-What if a doctor gets involved?
-Where does it end legally?
Kants greatest evil is…
-not doing your duty
-we have a duty to love and to teach
-so we cannot kill ourselves
Rachels is…
-A consequentialist
-A utilitarian
-his greatest evil is pain/suffering
Religions would say the greatest evil is
Sin
Winston Nesbitt: Is Killing No Worse Than Letting Die?
-a difference theory (there is a difference)
-euthanasia is a different and urgent issue
-there is more to the issue as well
-motive/intent should be highlighted
-not allowing to kill intentionally would stop letting die intentionally/generally
-do not let die when you could save
-do not kill at all
Leon Kass: Why Doctors Must Not Kill
-the consequences to the doctor-patient relationship if we allow euthanasia
-the rule in medicine is Doctors Must Not Kill
-without that rule, medicine cannot do its job of healing, loses its claim to an ethical and trustworthy profession, and we will all suffer
-medicine is about healing
-to intend and to act for someone’s good requires his continued existence to receive the benefit
-we can instead focus on easing and enhancing life before death, as discontinuance does not equal death
-doctors must allow to die
-we must limit the medication of life and death
Kass’ Consequences for doctors and patients when allowing Euthanasia
- broken trust
-doctor may lose devotion to patients best interests for the sake of ease on their part - abuse will run rampant
-how good is the consent really? - Legal battles concerning other areas besides voluntary active
-what about the disabled? or depressed people? - medicine is about healing, not killing
- discontinued care does not always equal death, so we cannot treat it as if so
-Karen Ann Quinlan
Karen Quinlan
Karen Quinlan was a vegetable in a comatose state involved in the infamous court case about her parents, her physician, her life, and her death
Karen was on life support until her parents won their court case to discontinue life support
A case of letting die
Karen lived for another 10 years or so before her inevitable death, without life support
Where is Euthanasia legal?
The Netherlands/Holland, and Oregon
Dan W. Brock: Voluntary Active Euthanasia
-the main problem is the “active” part
-there is no difference between killing and letting die (main point) it is still the deliberate killing of an innocent person
-we should not be too quick to allow, but we should allow active voluntary and assisted suicide with considerations
-there is not enough evidence of the bad to outweigh the good
Brock’s Pros for Euthanasia
- respect for self-determination of competent patients
- it will benefit the majority of people who want a controlled death
- relieving unrelievable pain and suffering
- once death has been accepted, it is often more humane to end life peacefully and quickly if the patient so wishes
Brock’s Cons for Euthanasia
- permitting euthanasia is incompatible with the physicians moral commitment to healing and protecting life
- erosion in the care of dying patients
- the threat to progress made in securing the rights of patients to decide about life-sustaining treatment
- the slippery slope
Dr Jack Kevorkian
“the suicide machine” or “Dr. Death”
-An American pathologist and euthanasia proponent
-championed a patient’s right to die
-assisted in at least 130 patients to their death, and was convicted of murder in 1999
“Dying is not a crime”
Dr Timothy Quill
“cancer patient diane”
-a NY physician who helped his dying cancer patient, “Diane,” commit suicide by administering drug
-wrote about and voiced his opinion on the stance of assisted suicide
Brock’s Example
-the greedy and hostile son has a mother intubated with ALS. Worrying about his inheritance, he de-intubates her, letting her die
- a physician de-intubates the mother after receiving her consent. Actively killing her
-in that case, the difference between active and passive is moot as the action is the same
-but, the intentions are different
-still, there is no sound argument against on the sole basis of the difference theory
Common arguments for active voluntary/assisted suicide
individual right to self-determination
individual right to wellbeing
Brock’s Cases for comparison of killing vs letting die
Case 1. A gravely ill patient comes to the ICU. The family and physician have previously discussed his care tactics. They follow the patients advance directive to not continue savior
Case 2. the same as case 1, except, the physician and family could not be there. The ICU staff extubate the patient, who dies of respiratory failure
In case 1 he is allowed to die, in case 2 he is killed, but it is hard to see any moral difference between the two cases
The case of “Its Over Debbie”
a famous medical ethics case anonymously described in the Journal of the American Medical Association
-Debbie had a terminal illness with extreme suffering, and no hope for recovery
-her physician administers a lethal dose of morphine
-published in 1988 and supposedly the first time a doctor provided public account of a mercy killing
-raised questions about whether it is ever permissible to intentionally hasten death
Do more people think physician assisted suicide should be legal?
Yes, 48% believe it should be legal
44% believe it should be illegal
Even more so in cases of considered severe pain/illness
Do people find euthanasia morally acceptable?
49% find it acceptable
44% find it morally wrong
