Paternalismnbsp-- any action or policy in which some person


 

Watch the cases of EUTHANASIA & ASSISTED SUICIDE Jack Kevorkian and the Right to Die | Retro Report | The New York Times": https://www.youtube.com/watch?v=J_EKwSXOsVE  and write a short position paper (less than 3pp) in which you explain the Kantian theory based on the categorical imperative). Subsequently, apply this theory either top one of the cases discussed in class or (in the video), generally, to the issue of euthanasia and assisted suicide.

 

Some pointers:

* Morally speaking, what is the right thing to do? Why?

* Address this problem from the point of view of but one theory: Kant's deontology (use the Categorical Imperative, formula of respect). Ideally, use a different theory than one you have already applied to a previously discussed case.

* Explain the theory in sufficient detail to convince me you understand it. Also, this way you will be able to use this part while you write your term paper. Then, apply it to the case.

  you use Kantian Theory, so write what are the main tenets of Kantian Ethics (K) as this theory was explained in class and the book. Please, start with a clear formulation of the Kant's 2nd Categorical Imperative, the formula of respect. Explain what it means to treat someone merely as a means (and not also as an end)? How is it different from using someone as a means (but not merely as a means)? How is it related to autonomy and rational consent? 

use the handout of EUTHANASIA & ASSISTED SUICIDE to get a background about it. 

Assignments:

Rachels, Chapter 7.2

Synopsis:

PATERNALISM AND RESPECT FOR AUTONOMY

THE EXAMPLES OF EUTHANASIA AND ASSISTED SUICIDE 

BASIC CONCEPTS:

Paternalism -- any action or policy in which some person (or group) treats another person the way a parent treats a child; that is, any action that strives to promote the other's good even against the other's wishes. To wit, you constrain someone's freedom for his/her sake (e.g., drivers are forced to use safety belts because it is good for them).

Autonomy -- self-directed freedom, the governing of one's self according to one's own system of value convictions (in particular, moral convictions) and factual beliefs.

Informed consent -- consent given after full disclosure of risks, benefits, and alternative treatments to any proposed procedure, both in therapy and in medical experimentation.

Law entitles patients to such disclosure, except in emergencies or when the patient is incompetent in which case proxy consent is required.

EUTHANASIA (GOOD DEATH):

In typical (or most paradigm) cases, euthanasia involves the following elements:

(1)  Some person is killed or allowed to die;

(2)  this person is terminally and irreversibly ill and would die soon anyway;

(3)  this person suffers a terrible (physical or mental) pain (his or her conditions are for him/her intolerable);

(4)  this person requests to be killed (or to be allowed to die);

(5)  euthanasia is an act (or omission) of mercy; that is, the reason for killing (letting die) is to spare someone further excruciating suffering, and to provide this person with as "good death" as it is possible under the circumstan­ces.

If an act (omission) is sufficiently similar to the case just described than it is an act of euthanasia (even if it is not a standard, or central, case of euthanasia).

FEW DISTINCTIONS AND CLARIFICATIONS

Killing vs. Letting dieActive euthanasia involves deliberate killing. Passive euthanasia involves allowing someone to die.

Voluntary euthanasia: a person actually requests (or did request) to be killed (or to be allowed to die).

Nonvoluntary euthanasia: a person has not requested to be killed (or to be allowed to die) and did not request to be kept alive either.

Involuntary euthanasia: a person has requested to be kept alive. It is plausible to assume that all cases of involuntary euthanasia are morally unjustified, they are cases of unjustified murder.

ASSISTED SUICIDE AND EUTHANASIA ARE ALMOST IDENTICAL

Euthanasia: one person kills another (or, allows this person to die). I

Assisted suicide: One person provides another person with the means that allows this person to die; the person who dies kills himself/herself using this means.

 

TYPES OF EUTHANASIA AND THEIR MORAL STATUS

 

LETTING DIE

(ALLOWING)

KILLING

(ACTING)

EXPLICIT REQUEST

(VOLUNTARY)

Morally permissible

???

NO REQUEST

(NON-VOLUNTARY)

Morally permissible

???

REQUEST TO BE KEPT ALIVE (INVOLUNTARY)

Morally wrong

(murder)

Morally wrong

(murder)

A. Most people and organizations allow various forms of passive euthanasia.

B. There is a serious ethical debate about moral permissibility of voluntary and non-voluntary active euthanasia.

C. Most people and organizations assume that involuntary euthanasia is always (or almost always) morally wrong.

This form of euthanasia would cause  lots of suffering and anguish, etc.

It violates the autonomy of individual.

It violates human right; especially, the right to life.

 

THE MAIN ARGUMENT IN SUPPORT OF EUTHANASIA

1.  An Ethical Premise: Any act (or omission) is morally permissible, if it satisfies all of the following conditions:

A. it respects autonomy of everyone who is involved;

B. it violates no one's rights; and

C. It promotes the best interest of everyone concerned.

2.  A factual claim: In typical cases, the acts of euthanasia and assisted suicide are A, B, C.

3.  Therefore, in typical cases the acts of euthanasia and assisted suicide are morally permissible. [from (1) and (2)]

 

AN ARGUMENT FROM CONSISTENCY (in Support of Active Euthanasia)

1.    There is no moral difference between killing someone (per se), and letting someone die (per se). [Other things being equal, killing is just as good/bad as letting someone die.]

2.    In typical cases, the only difference between active euthanasia (AE) and passive euthanasia (PE) is this: AE involves killing while PE involves letting someone die.

3.    If (1) and (2), then in typical cases there is no moral difference between AE and PA. [That is, if (1) and (2), then... AE is just as good/bad as PE.]

______________

4.     Therefore, in typical cases, there is no moral difference between AE and PA. [That is, AE is just as good/bad as PE.] [from (1), (2), and (3)]

5.     In typical cases, passive euthanasia is morally permissible. [This premise is granted by AMA and various religious organizations.]

______________

6.     Therefore, in typical cases, active euthanasia is morally permissible. [from (4) and (5)]

TWO CASES IN SUPPORT OF Premise (1): Based J. Rachels, "Active and Passive Euthanasia", The New England Journal of Medicine 282 [1975], pp. 78-80):

CASE I (Killing): Smith stand to gain a large inheritance if anything should happen to his six-year-old cousin. One evening while the child is taking his bath, Smith sneaks into the bathroom and drowns the child, and then arranges things so that it will look like an accident.

CASE II (Letting die): Jones also stands to gain if anything should happen to his six-year-old cousin. Like Smith, Jones sneaks in planning to drown the child in his bath. However, just as he enters the bathroom Jones sees the child slip and hit his head, and fall face down in the water. Jones is delighted; he stands by, ready to push the child's head back under if it is necessary, but it is not necessary. With only a little thrashing about the child drowns all by himself, "accidentally", as Jones watches and does nothing.

An Argument In Support of Premise (1):

A.            If there moral difference between killing someone (per se) and letting someone die (per se), then there is moral difference between what Smith did and what Jones did.

B.            But there is no difference between what Smith did and what Jones is did.

__________

Therefore, premise (1) is true; that is, there is no moral difference between killing someone (per se) and letting someone die (per se).

TWO CONCEPTS OF EXTRAORDINARY MEANS

THE FIRST (PURELY DESCRIPTIVE) CONCEPT OF ORDINARY MEANS:

All medicines, treatments, and operations, which are common, easily administered, and cheap (e.g., insulin and antibiotic).

            For the physician, ordinary means of preserving health are standard, recognized, or established medicines or procedures of the time period one is acting in, at the level of prevailing medical practice, and within the limits of availability.

For the physician, extraordinary means for preserving life would be medicaments or procedures that are fanciful, bizarre, experimental, incompletely established, unorthodox, or not recognized. (The Catholic Bishops of Florida, AThe Pastoral Letter on Death ... (See also: https://www.culturalcatholic.com/CatholicLivingWill.htm)

PROBLEMS: This is not what ethicists, theologians, and AMA assume and is not what is relevant from the moral point of view. E.g., all of them allow that it is sometimes permissible to discontinue antibiotics.

THE SECOND CONCEPT OF ORDINARY MEANS

From the viewpoint of the theologian, ordinary means for preserving life include "all medicines, treatments, and operations which offer a reasonable hope of benefit for the patient and which can be obtained and used without excessive expense, pain, or other inconvenience." For the theologian, extraordinary means for preserving life are "all medicines, treatments, and operations which cannot be obtained or used without excessive expense, pain, or other inconvenience for the patient or for others or which, if used, would not offer reasonable hope or benefit for the patient. (The same letter)

Ordinary means of preserving life are all medicines, treatments, and operations, which offer a reasonable hope of benefit for the patient and which can be obtained and used without excessive expense, pain, and other inconveniences. Extra-ordinary meansof preserving life are all those medicines, treatments, and operations which cannot be obtained without excessive expense, pain, and other inconveniences, or which, if used, would not offer a reasonable hope of benefit (Paul Ramsey, Patient as a Person...)

By this definition, insulin and antibiotics are ordinary means of preserving life only if they offer a reasonable hope of benefit. If the situation is hopeless, the insulin and the antibiotics are extraordinary.

IMPLICATIONS OF THE SECOND CONCEPT OF ORDINARY MEANS

The concept of a reasonable hope of benefits must be explained. What do we mean, exactly, by this concept?

To use this concept we must assume that, sometimes, it is not overall good (beneficial) for a person to stay alive. Otherwise we would always have to use whatever means are available to prolong someone's life.

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