Euthanasia & Assisted suicide Active and passive euthanasia Moral permissibility and legalisation of assisted suicide and voluntary euthanasia

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  • Euthanasia & Assisted suicide Active and passive euthanasia Moral permissibility and legalisation of assisted suicide and voluntary euthanasia
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  • Definition and distinctions Euthanasia (Gr. euthanatos, meaning easy death) refers to any action where a person is intentionally killed or allowed to die because it is believed that the individual would be better off dead than alive. Voluntary euthanasia: this happens when the person who undergoes it has requested it Non-voluntary euthanasia: this happens when persons other than the patient request it (e.g. if the patient has permanently lost consciousness). Involuntary euthanasia: this happens when the person in question wants to go on living.
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  • Definition and distinctions Active euthanasia is when an action is performed that directly causes someone to die (for example, disconnecting a patient from a life-support system). Passive euthanasia is allowing someone to die by not performing some life-sustaining action (for example, not giving a patient life- extending drugs). In the UK, voluntary and non-voluntary passive euthanasia is legal, but voluntary and non- voluntary active euthanasia is against the law.
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  • Active and passive euthanasia
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  • Two questions about active and passive euthanasia 1.What is the distinction between active and passive euthanasia? This distinction is also commonly referred to as the difference between killing and letting die. 2.Is the distinction also a moral one?
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  • Possible factors Time factor Responsible outside party Special responsibility We have significant reasons for doubting the relevance of these factors.
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  • This distinction matters when we have a conflict, and when either of the alternatives available to us are ones that will result in someones death. Killing Doing harm to someone Letting die Allowing harm to happen
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  • Understanding the debate: killing and letting die Passive euthanasia is legal, active euthanasia is against the law. Those who defend euthanasia: there is not a difference. The arguments that work for passive euthanasia can be extended to active euthanasia. Those who oppose euthanasia: there is a difference. And so the arguments that work for passive euthanasia cannot be extended to active euthanasia.
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  • The difference thesis A.If Anne holds Brians head under water until he drowns, then we can say that Anne kills Brian; we dont say that she merely lets him die. B.Anne is on the shore watching Brian, whos out at sea, drowning. Anne can swim well and she could save him, but she stays on the shore and watches him drown. We dont say in this case that Anne kills Brian, we say that she lets him die. Our moral intuitions tell us that Annes behaviour in the first case is morally worse than in the second, even though both of them result in Brians death.
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  • Interference and non- interference often agents step into the causal flow in such a manner as to alter the outcome of processes which were already under way. This is in contrast to cases where the agent simply lets the on-going process continue. In the former case, but not the latter, the agent can be said to interfere: he makes a difference in a way that he does not when he merely refrains from altering the causal flow. (Shelly Kagan, The Limits of Morality: 94)
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  • Act and omission Philippa Foot (Virtues and Vices) distinguishes two kinds of allowing: i.First is forbearing to prevent: this is when you dont stop a sequence of events, even though youre in a position to do so (e.g. Ann could rescue Brian, but she allows him to drown). ii.Secondly, enabling: the removal of some obstacle which is, as it were, holding back a train of events (e.g. when a doctor turns off the life-support machine and allows the patient to die). According to Foot, forbearing to prevent (an omission) and enabling (an act) are both cases of letting die.
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  • Michael Tooley The reason our moral intuitions favour the argument that there is a difference between killing and letting die is because most cases are not adequately set up. Besides motives, there are other morally relevant differences that affect our judgement. If we appeal to moral intuitions, we have to make sure that the pairs of cases are similar. In pairs of similar cases, the only difference being that in one case we have an act of killing and in the other we have a case of letting die, we would agree that in both cases the agent is as culpable as the other.
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  • The doctrine of double effect I.You want to bring about G II.But there is no way of bringing about G without bringing about B III.The goodness of G outweighs the badness of B IV.You would prefer that B not occur A.Action involves intentionally bringing about G, knowing that G will necessarily cause B to occur B.Action involves intentionally doing something that will give rise to two causal processes, one of which will lead to G, he other to B C.Action involves intentionally bringing about B, knowing that B will cause G to occur
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  • Voluntary euthanasia or assisted suicide
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  • Michael Tooley: in support of euthanasia 1.Say someone is suffering from an incurable illness, and as a result of this illness they are suffering extreme pain. Then in some cases, that persons death is in his or her own interest. 2.If a persons death is in that persons own interest, then committing suicide is also in that persons own interest. 3.Therefore, as a result of these two points, if someones suffering extreme pain due to an incurable illness, then in some cases committing suicide is in that persons own interest.
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  • Michael Tooley: in support of euthanasia 4.A persons committing suicide in such circumstances may very well satisfy the following two conditions: 1.It neither violates anyone elses rights, nor wrongs anyone 2.It does not make the world a worse place 5.If an action satisfies these two conditions, and it is not contrary to ones own interest, it cannot be morally wrong. 6.Our conclusion, therefore, is that if someones committing suicide satisfies all of these conditions, it cannot be morally wrong.
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  • Michael Tooley: in support of euthanasia 7.It is morally wrong to assist only if: 1.It was morally wrong for that person to commit suicide (in other words, the person committing suicide doesnt meet all of the above conditions). For example, committing suicide was contrary to that persons own interests. 2.Secondly, assisting that person in committing suicide violated an obligation one had to someone else. 8.Now, if committing suicide, nor assisting with it, dont violate any obligations you might have towards someone else, and if you satisfy the above conditions, then we can say that it is not morally wrong to commit suicide or to assist.
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  • Michael Tooley: in support of euthanasia 9.Whenever assisting a person in committing suicide is justified (i.e. it meets all the conditions weve talked about and doesnt violate any obligation you might have to someone else), then voluntary active euthanasia is also justified. In Defense of Voluntary Active Euthanasia and Assisted Suicide
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  • The Philosophers Brief The strongest argument in favour of active voluntary euthanasia is derived from the principle of autonomy. This is fundamental to the philosophers brief, which was written by six major liberal political philosophers: Ronald Dworkin, Thomas Nagel, Robert Nozick, John Rawls, Thomas Scanlon and Judith Jarvis Thomson. Core argument: if its permissible to omit or terminate medical treatment with the intention that the patient dies, then it is permissible to assist in killing with the intention that the patient dies (there is no intrinsic moral difference between killing and letting die).
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  • The Philosophers Brief The existence of a right to refuse treatment also implies a right to assistance in suicide from a willing doctor (cf. Cruzan case). Several justices rejected this link by appealing to a so-called common-sense distinction between the moral significance of acts and omissions. Philosophers Brief: the distinction between acts and omissions doesnt have much moral weight. the common-sense distinction, which is not between acts and omissions, but between acts or omissions that are designed to cause death and those that are not. The key moral argument is intending death versus not intending death, or intending death versus foreseeing death.
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  • The Philosophers Brief Philosophers Brief: intending versus foreseeing death matters. This doesnt mean nothing else matters. They argue against the act-omission distinction. This implies a criticism of the killing-letting die distinction (which is not an important distinction for them). But someone can act without killing.
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  • Against the moral permissibility of assisted suicide: David Velleman Argues against voluntary euthanasia: there isnt a fundamental right to choose between life and death and a persons rights dont expand when they become terminally ill or psychologically distressed. Velleman is a Kantian and argues that morality requires that we respect the dignity of persons. A persons dignity cant be traded against their well-being or happiness.
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