Assignment task:
Problem 1: What would you do if you found yourself in a situation, as Rachels describes, having a baby with Down's syndrome and a life-threatening intestinal blockage? Would you tell the doctors to operate to save the baby's life? Why or why not?
Problem 2: Does Rachels think there is a moral difference between killing someone and letting him die? What reasons does he give for his view? Do you find his position plausible?
Problem 3: Explain the difference between "passive euthanasia" and "cessation of life-prolonging treatment" according to Steinbock, and then give an example of each. Steinbock thinks there is an important moral difference between the two. Is she right?
CASE:
The word euthanasia originated in Greece and meant "a good death."
Euthanasia encompasses various dimensions:
1. Active (introducing something to cause death);
2. Passive (withholding treatment or supportive measures);
3. Voluntary (consent);
4. Involuntary (consent from guardian);
5. Physician assisted (where a physician prescribes the medicine and patient or a third party administers the medication to cause death)
Arguments in support of euthanasia:
- Not every life is worth living. Only the good life does.
- Everyone has the right to end their life, and they should be provided with the means to do so.
- There is a moral duty to reduce the amount of pointless ongoing suffering of an individual.
Arguments against euthanasia:
- Religious convictions - Life was given to man by God, and only God should take life.
- Eliminating the invalid: If we embrace 'the right to death with dignity, people with incurable and debilitating illnesses will be disposed of from our civilized society.
- The state must protect life and the physician's duty to provide care and not harm patients.
- Euthanasia may result in the State's refusal to invest in health (working towards the Right to life).
- Symptom of mental illness: Attempts at suicide or completed suicide are commonly seen in patients suffering from depression, schizophrenia, and substance abuse.
- We have seen in our lifetime that many incurable diseases become curable.
- Even the incapacitated, agonized patient, in despair most of the time, may still get some joy from existence.
Active and Passive Euthanasia, James Rachels
- The American Medical Association takes the position that while at a patient's request, a physician may withhold extraordinary means of prolonging the patient's life, a physician should not take steps, even if requested by the patient, to terminate that life intentionally.
- Rachel argues against this position.
Key concepts:
- The distinction between active and passive euthanasia seems to be rooted in the belief that it is morally worse to kill someone than to let him die.
- Rachels argues that killing is not in itself any worse than letting die.
- Active euthanasia is actually preferable to passive euthanasia. To say otherwise is to endorse the opinion that leads to more suffering rather than less.
For Example, Smith and his six-year-old cousin.
- There is no general moral difference between killing and letting die
- Cases of Smith and Jones
- Smith drowns a child in order to gain a fortune
- Jones conveniently allows a child to drown for the same reason
- Smith and Jones are equally culpable of wrongdoing
- The same motive and end in view
- A doctor allowing a patient to die needlessly is as blameworthy as one who kills a healthy patient.
Key concepts:
- Once the decision has been made to cease treatment of a terminally ill patient, active euthanasia (mercy killing) is often more morally consistent than passive euthanasia (allowing the patient to die).
- It is a "patently cruel" doctrine that says a doctor must stand by as someone suffers a slow and painful death when it would be possible to end that person's life quickly and painlessly (Example: throat cancer patient).
The Intentional Termination of Life, Bonnie Steinbock
Steinbock's Responses to Rachels's arguments. He believes that Rachels is misinterpreting the American Medical Association's (AMA) statement on euthanasia.
The AMA is not making a distinction between active euthanasia versus passive euthanasia.
Instead the distinction is between euthanasia of any kind, which the AMA forbids, and the withholding or cessation of life-prolonging treatment, which in some cases can be justifiable.
Steinbock argues the cessation of life-prolonging treatment is not the same as passive euthanasia in two kinds of cases.
1. A patient may exercise her right to refuse treatment, even if treatment is necessary to prolong life.
2. In some cases, continued treatment may bring greater discomfort without much chance of improving the patient's condition.
Steinbock argues, against Rachels, that there may be other purposes to terminating treatment than terminating the patient's life.
Two situations where stopping treatment does not equal euthanasia (because the physician doesn't intend the patient's death):
1. Patient has a right to refuse further treatment
2. Physician decides further treatment won't help the patient get better and may cause unnecessary pain.
The right to refuse treatment does not entail the right to die
- Its purpose is to protect patients from others' interference
R. v. Latimer case
- Latimer was convinced of first-degree murder. The jury was unanimous in their recommendation that the court imposes a minimum sentence with parole as soon as possible.
- The case was sent to the supreme court of Canada, which recommended a new trial.
- The new jury of the new court refused again to recommend the mandatory punishment (life imprisonment) and instead suggested a year in jail.
- The decision was appealed again to the Supreme Court refused to accept that the sentence of 10 years was not deserved.