Voluntarily Assisted Suicide

1

• Voluntarily Assisted Suicide
• and Euthanasia

2

• Introduction

• Why should we care?
• Our death
• Aging Society

• Discussion
• When to stop?
• Definitions
• Doctors
• Decisions

What this class is about
3

• Outline

Introduction
Important Distinctions
The argument from autonomy and its critics
The utilitarian argument and its refinement
A controversial distinction Active vs. Passive
Euthanasia
Slippery Slopes and the Pandora Box Fears vs.
Reality
Conclusion
4

• Outline

Introduction
Important Distinctions
The argument from autonomy and its critics
The utilitarian argument and its refinement
A controversial distinction Active vs. Passive
Euthanasia
Slippery Slopes and the Pandora Box Fears vs.
Reality
Conclusion
5

• Important Distinctions

Assisted Suicide /Euthanasia Assisted Suicide
the person kills herself with a medication
prescribed by a doctor Euthanasia the doctor
administrates herself the medication
Voluntary / Non-voluntary / Involuntary Involuntar
y against the patients will nobody defends
it! Non-voluntary the current desire of the
patient is unknown because she is physically or
mentally unable to express it Voluntary in
agreement with the patients will
? We will focus on the morality of Voluntary
Assisted Suicide (VAS) and Voluntary Euthanasia.
6

• Outline

Introduction
Important Distinctions
The argument from autonomy and its critics
The utilitarian argument and its refinement
A controversial distinction Active vs. Passive
Euthanasia
Slippery Slopes and the Pandora Box Fears vs.
Reality
Conclusion
7

• The argument from autonomy

The argument from autonomy P1 Each individuals
autonomy ought to be respected P2 Denying
someone the right to assisted suicide amounts to
disrespect her autonomy CC Nobody should be
denied the right to assisted suicide
? Is this a tenable argument?
8

• The argument from autonomy
• Problems

Doerflinger The argument is self-contradictory
because life is a necessary condition for the
exercise of ones autonomy. Suicide is not the
ultimate exercise of freedom but its ultimate
self-contradiction
Voluntary vs Non Voluntary The argument from
autonomy only works for voluntary assisted
suicide and euthanasia
? The argument from autonomy is not the best
argument!
9

• The Argument from Autonomy
• Conclusion

1. The argument from autonomy 2. Problems (a)
Suicide in the name of autonomy is
self-contradictory (b) Could only work for
voluntary cases
10

• Outline

Introduction
Important Distinctions
The argument from autonomy and its critics
The utilitarian argument and its refinement
A controversial distinction Active vs. Passive
Euthanasia
Slippery Slopes and the Pandora Box Fears vs.
Reality
Conclusion
11

• The Utilitarian Argument

The utilitarian argument P1 A given action is
right if and only if it serves to increase the
amount of happiness/ decrease the amount of
misery P2 Euthanasia for suffering patients with
terminal illnesses decreases the amount of
misery CC Euthanasia for suffering patients with
terminal illnesses is right
Advantage the argument applies to Voluntary
assisted suicide, voluntary and non-voluntary
euthanasia.
? Is this a tenable argument?
12

• The Utilitarian Argument
• Problems

General Problem for Utilitarianism Utility vs.
Rights
The Problem applied to Euthanasia It seems that
the utilitarian argument could be used to justify
involuntary euthanasia against the will Which
is of course unacceptable !
? The Utilitarian Argument is not acceptable as
it is.
13

• The Utilitarian Argument
• Refined by Rachels

The utilitarian argument P1 A given action is
right if and only if it serves to increase the
amount of happiness/ decrease the amount of
misery P2 Euthanasia for suffering patients
with terminal illnesses decreases the amount of
misery CC Euthanasia for suffering patients
with terminal illnesses is right
Refined
and violates no ones rights
and in many cases violates no ones rights
? The utilitarian argument as refined by Rachels
is tenable!
14

• The Utilitarian Argument
• Conclusion

1. The argument from mercy applies to VAS and
euthanasia 2. Problem Conflict with Rights 3.
Solution Refined argument from mercy
15

• Outline

Introduction
Important Distinctions
The argument from autonomy and its critics
The utilitarian argument and its refinement
A controversial distinction Active vs. Passive
Euthanasia
Slippery Slopes and the Pandora Box Fears vs.
Reality
Conclusion
16

• Active vs. Passive Euthanasia

The distinction Killing vs. Letting die Accepted
in the US AMA 1973 The intentional termination
of the life of one human being by another -mercy
killing - is contrary to that for which the
medical profession stands and is contrary to the
policy of the American Medical Association. The
cessation of the employment of extraordinary
means to prolong the life of the body when there
is irrefutable evidence that biological death is
imminent is the decision of the patient and/or
his immediate family. The advice and judgment of
the physician should be freely available to the
patient and/or his immediate family.
? Does this make moral sense?
17

• Active vs. Passive Euthanasia
• Pb 1 Is the distinction morally relevant?

Moral Responsibility Is passive euthanasia
really passive? - Rachels example Jones and
Smith and their cousin in the bathtub Is Jones
any less responsible than Smith is of his
cousins death? - Withhold food and fluids?
grand ma, infant - Withhold medication? diabetic
? The Distinction is not morally relevant
passive and active euthanasia involve the same
moral responsibility
18

• Active vs. Passive Euthanasia
• Pb 2 Which is morally preferable?

Example from Rachels infants with Down
Syndrome I can understand why some people are
opposed to all euthanasia and insist that such
infants must be allowed to live. I think I can
also understand why other people favor destroying
these babies quickly and painlessly. But why
should anyone favor letting dehydration and
infection wither a tiny being over hours and
days? The doctrine that says that a baby may be
allowed to dehydrate and wither, but may not be
given lethal injection that would end his life
without suffering, seems so patently cruel as to
require no further refutation. (Rachels)
? In some cases, active euthanasia seems morally
preferable
19

• Active vs. Passive Euthanasia
• Pb 3 Arbitrariness

The problem passive euthanasia (a) One agrees
that it would be better that the unnecessary
suffering ends (b) But one waits until a separate
health problem allows for a quicker death a
chancy event
Rachels argument - Either (a) is true, and then
our moral action should not depend on irrelevant
circumstances - Or (a) is false, and then, not to
treat the patient in (b) is wrong
? Passive Euthanasia makes our action depend on
arbitrary factors
20

• Active vs. Passive Euthanasia
• Conclusion

1. A distinction generally accepted by
physicians 2. Problems (a) The distinction is
not morally relevant no less responsible in the
case of passive euthanasia (b) Active euthanasia
seems morally preferable in some cases (c)
Passive euthanasia makes our action depend on
arbitrary factors
21

• Outline

Introduction
Important Distinctions
A controversial distinction Active vs. Passive
Euthanasia
The argument from autonomy and its critics
The utilitarian argument and its refinement
Slippery Slopes and the Pandora Box
Conclusion
22

• Slippery Slopes
• Fears and Reality

Slippery Slopes Beware!
Doerflingers slippery slopes Subtle coercion,
economic incentives, substituted judgment,
prejudice against people with disabilities etc.

• The Facts Oregons Death with Dignity Act
• Conditions to be eligible
• Conditions to receive the prescription
• Results?

23
Number of qualifying people 80,000!
24

• Outline

Introduction
Important Distinctions
A controversial distinction Active vs. Passive
Euthanasia
The argument from autonomy and its critics
The utilitarian argument and its refinement
Slippery Slopes and the Pandora Box Fears vs.
Reality
Conclusion
25

• Conclusion

Argument from autonomy limited and arguably
self-contradictory Utilitarian Argument
refinement protecting rights Passive vs Active
Euthanasia distinction not morally
acceptable Slippery Slopes not supported by
available evidence ? Fundamental divide
absolute rules vs about serving everyones best
interest