Using and Refusing

2012 ◽  
Vol 16 (3) ◽  
pp. 317-329
Author(s):  
Jim Gerrie ◽  

James Rachels has argued on Utilitarian grounds that since removing life-sustaining treatment and physician-assisted suicide both aim at the very same end,hastening death to limit suffering, there are no morally significant moral distinctions between them. Others have argued for maintaining this distinction based on various forms of deontological and rights-based ethical theories that maintain that all acts of killing are inherently wrong. I argue that the enduring controversy over physician-assisted suicide might not be caused by such fundamental differences of opinion about moral theory, such as that which exists between Utilitarianism and Deontology, so much as by a commonly held misunderstanding of technology. In particular, the conclusion that there are no relevant ethical distinctions between killing and letting die can only be drawn by a Utilitarian, such as Rachels, by ignoring the recent work of philosophers of technology on the non-neutrality thesis.

2018 ◽  
Vol 44 (10) ◽  
pp. 657-660 ◽  
Author(s):  
Eric Blackstone ◽  
Stuart J Youngner

In 1989, Susan Wolf convincingly warned of a troublesome consequence that should discourage any movement in American society towards physician-assisted death—a legal backlash against the gains made for limiting life-sustaining treatment. The authors demonstrate that this dire consequence did not come to pass. As physician-assisted suicide gains a foothold in USA and elsewhere, many other slippery slope arguments are being put forward. Although many of these speculations should be taken seriously, they do not justify halting the new practice. Instead, our courts, regulatory agencies, journalists, professional organisations and researchers should carefully monitor and study it as it unfolds, allowing continuous improvement just as our society has done in implementing the practice of limiting life-sustaining treatment.


Author(s):  
John Keown

This chapter identifies several respects in which medical law in England and Wales suffers from a lack of ethical coherence in relation to its protection of human life. It argues that it is philosophically incoherent for the law to calibrate its protection of human life according to arbitrary stages of human development such as birth, viability, the fourteenth day after fertilization, and implantation. To the extent that the law permits life-sustaining treatment to be withheld or withdrawn from incompetent patients on the ground that their ‘quality of life’ is insufficient, and even with an intent to hasten death, it again displays ethical incoherence. If legislators or judges were to make it lawful for physicians to intentionally assist suicidal refusals of treatment, or to endorse a right to physician-assisted suicide for the ‘terminally ill’, the law's ethical incoherence would be seriously aggravated.


Author(s):  
Elizabeth Ford

Chapter 7 describes three cases that involve an individual’s right, in certain circumstances, to choose death. Cruzan v. Missouri is more specifically about a right to refuse life-sustaining treatment and surrogate decision-making; Washington v. Glucksberg and Vacco v. Quill are physician-assisted suicide cases, both decided on the same day by the U.S. Supreme Court and both declaring the practice unconstitutional.


Author(s):  
Carolina Sartorio

This article examines potential applications of the concept of cause to some central ethical concepts, views, and problems. In particular, it discusses the role of causation in the family of views known as consequentialism, the distinction between killing and letting die, the doctrine of double effect, and the concept of moral responsibility. The article aims to examine the extent to which an appeal to the concept of cause contributes to elucidating moral notions or to increasing the plausibility of moral views. Something that makes this task interestingly complex is the fact that the notion of causation itself is controversial and difficult to pin down. As a result, in some cases the success of its use in moral theory hinges on how certain debates about causation are resolved.


BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e020519 ◽  
Author(s):  
Young Ho Yun ◽  
Kyoung-Nam Kim ◽  
Jin-Ah Sim ◽  
Shin Hye Yoo ◽  
Miso Kim ◽  
...  

ObjectivesThis study determined attitudes of four groups—Korean patients with cancer, their family caregivers, physicians and the general Korean population—towards five critical end-of-life (EOL) interventions—active pain control, withdrawal of futile life-sustaining treatment (LST), passive euthanasia, active euthanasia and physician-assisted suicide.Design and settingWe enrolled 1001 patients with cancer and 1006 caregivers from 12 large hospitals in Korea, 1241 members of the general population and 928 physicians from each of the 12 hospitals and the Korean Medical Association. We analysed the associations of demographic factors, attitudes towards death and the important components of a ‘good death’ with critical interventions at EoL care.ResultsAll participant groups strongly favoured active pain control and withdrawal of futile LST but differed in attitudes towards the other four EoL interventions. Physicians (98.9%) favoured passive euthanasia more than the other three groups. Lower proportions of the four groups favoured active euthanasia or PAS. Multiple logistic regression showed that education (adjusted OR (aOR) 1.77, 95% CI 1.33 to 2.36), caregiver role (aOR 1.67, 95% CI 1.34 to 2.08) and considering death as the ending of life (aOR 1.66, 95% CI 1.05 to 1.61) were associated with preference for active pain control. Attitudes towards death, including belief in being remembered (aOR 2.03, 95% CI 1.48 to 2.79) and feeling ‘life was meaningful’ (aOR 2.56, 95% CI 1.58 to 4.15) were both strong correlates of withdrawal of LST with the level of monthly income (aOR 2.56, 95% CI 1.58 to 4.15). Believing ‘freedom from pain’ negatively predicted preference for passive euthanasia (aOR 0.69, 95% CI 0.55 to 0.85). In addition, ‘not being a burden to the family’ was positively related to preferences for active euthanasia (aOR 1.62, 95% CI 1.39 to 1.90) and PAS (aOR 1.61, 95% CI 1.37 to 1.89).ConclusionGroups differed in their attitudes towards the five EoL interventions, and those attitudes were significantly associated with various attitudes towards death.


Author(s):  
Elizabeth Ford

Chapter 7 describes three cases that involve an individual’s right, in certain circumstances, to choose death. Cruzan v. Missouri Department of Health is more specifically about a right to refuse life-sustaining treatment and surrogate decision-making; Washington v. Glucksberg and Vacco v. Quill are physician-assisted suicide cases, both decided on the same day by the U.S. Supreme Court and both declaring the practice unconstitutional.


1996 ◽  
Vol 24 (3) ◽  
pp. 198-206 ◽  
Author(s):  
John E. Linville

The legal treatment of physician-assisted suicide (PAS) is in flux. Reform has been impelled by several forces, including the recent success of novel constitutional arguments in the Ninth and Second Circuit Courts of Appeals. I will review and discuss Compassion in Dying v. State of Washington and Quill v. Vacco, addressing the constitutional arguments, and then briefly considering the attractions and difficulties of these new constitutional theories.Before 1990, state criminal laws dealing with assisted suicide had reached a remarkably stable consensus: suicide was not illegal, but assisting suicide was a criminal action with no distinction typically made between physicians and others who assisted. The details of the relevant criminal law varied from state to state. Some states had criminal statutes specifically addressing assisted suicide, while others treated the practice under more general homicide statutes. But in no state was it clearly legal for a physician to prescribe a lethal medication at the request of a dying patient. While remarkable legal developments took place during the 1970s and 1980s regarding other aspects of the rights of dying patients (including the right to refuse resuscitation and other life-sustaining treatments and the right to withdraw from life-sustaining treatment including nutrition and hydration), there was relative quiescence regarding the law of PAS.


Crisis ◽  
1998 ◽  
Vol 19 (3) ◽  
pp. 109-115 ◽  
Author(s):  
Michael J Kelleher † ◽  
Derek Chambers ◽  
Paul Corcoran ◽  
Helen S Keeley ◽  
Eileen Williamson

The present paper examines the occurrence of matters relating to the ending of life, including active euthanasia, which is, technically speaking, illegal worldwide. Interest in this most controversial area is drawn from many varied sources, from legal and medical practitioners to religious and moral ethicists. In some countries, public interest has been mobilized into organizations that attempt to influence legislation relating to euthanasia. Despite the obvious international importance of euthanasia, very little is known about the extent of its practice, whether passive or active, voluntary or involuntary. This examination is based on questionnaires completed by 49 national representatives of the International Association for Suicide Prevention (IASP), dealing with legal and religious aspects of euthanasia and physician-assisted suicide, as well as suicide. A dichotomy between the law and medical practices relating to the end of life was uncovered by the results of the survey. In 12 of the 49 countries active euthanasia is said to occur while a general acceptance of passive euthanasia was reported to be widespread. Clearly, definition is crucial in making the distinction between active and passive euthanasia; otherwise, the entire concept may become distorted, and legal acceptance may become more widespread with the effect of broadening the category of individuals to whom euthanasia becomes an available option. The “slippery slope” argument is briefly considered.


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