David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Ezio Di Nucci
Jonathan Jenkins Ichikawa
Jack Alan Reynolds
Learn more about PhilPapers
Ethical Perspectives 9 (2):96-102 (2002)
Euthanasia and physician-assisted suicide are controversial issues in medical ethics and medical law. In the debate, several arguments against the moral acceptability and legal feasibility of active involvement of physicians in bringing about a patient’s death can be found.One argument refers back to the Ten Commandments: “Thou shall not kill”. Killing another human being is morally abject. According to the argument, this is certainly so for medical doctors, as can be seen in the Hippocratic Oath, which explicitly forbids abortion and euthanasia. A less apodictic argument refers to the slippery slope: if euthanasia would be permitted, a downhill movement is set in motion. The end of this movement would be, on the one hand, that physicians will feel forced to assist people who ask for termination of life on whatever grounds. On the other hand, it might lead to a situation in which it becomes normal to kill people who are no longer useful for society.In the literature and in the public debate, there are also arguments in favour of euthanasia and physician-assisted suicide. One such argument invokes the right to die. According to this argument, decisions concerning life and death should be up to the individual who is concerned. In many countries, suicide is morally and legally accepted. If people are allowed to kill themselves, why should they be without rights when they are no longer able to perform the act themselves?In medical ethics and medical law, patient autonomy is a central pivot. Patients have the right to refuse treatment even if this leads to their death. Shouldn’t people also have the right to determine the moment of dying, if they are in a situation which is unbearable, and without prospect of improvement? Another argument focuses on the duty of the physician to alleviate pain and suffering. If there is no other option, the doctor, in fulfilling this duty, should be allowed to actively end the patient’s life. This argument is not based on autonomy, but on beneficence.The debate concerning euthanasia involves fundamentally different moral principles. This makes the debate interesting, if not central to medical ethics and medical law. Yet, the principles are normally presented in an abstract way. Discussants stick to very general ideas, which lack reference to specific social and historical conditions, and are not related to concrete experiences. To invoke the Ten Commandments, or plea for a right to die, implies the use of universal standards, which tend to be general and empty.From a philosophical perspective, this type of argumentation can be criticized. Following Aristotle, ethics should be based upon experience. Ethical knowledge requires participation in concrete practices. Central to ethics is a feeling for the concrete situation, which is always contingent and historical. From this perspective, it makes sense to consider how practitioners in specific situations deal with moral issues, for instance concerning euthanasia. What role do they give to notions such as autonomy and beneficence, how do they interpret them and apply them to the concrete situation?In this paper I will present the Dutch experience with euthanasia. I will focus upon the way in which during the past thirty years the arguments in favour of euthanasia have been developed, in interaction with euthanasia practice. I will show that patient autonomy has been a crucial pivot. Yet, the Dutch interpretation of autonomy is not purely liberal. It does not only involve rights, but also obligations. Next, I will make clear that the physician plays a central role, in that the moral and legal basis of euthanasia is a conflict of duties on the side of the physician.This brings in the issue of beneficence. Yet the Dutch interpretation of the duty to help is not simply paternalistic. In Dutch health care, the physician-patient relationship is based upon deliberation and mutual agreement. Therefore, my conclusion will be that the Dutch practice of euthanasia has a moral ground, which goes beyond the traditional opposition between autonomy and beneficence
|Keywords||No keywords specified (fix it)|
|Categories||categorize this paper)|
Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
|Through your library|
References found in this work BETA
No references found.
Citations of this work BETA
No citations found.
Similar books and articles
Josie Fisher (2001). Lessons for Business Ethics From Bioethics. Journal of Business Ethics 34 (1):15 - 24.
Neelke Doorn (2011). Mental Competence or Capacity to Form a Will: An Anthropological Approach1. Philosophy, Psychiatry, and Psychology 18 (2):135-145.
Robert M. Sade (2001). Autonomy and Beneficence in an Information Age. Health Care Analysis 9 (3):247-254.
Thaddeus Metz (2010). For the Sake of the Friendship: Relationality and Relationship as Grounds of Beneficence. Theoria 57 (4):54-76.
Jos V. M. Welie (1999). Let's Move Beyond Autonomy, Beneficence and Justice Â a Commentary to Viafora. Medicine, Health Care and Philosophy 2 (3):305-308.
Hilde Lindemann (2009). Autonomy, Beneficence, and Gezelligheid: Lessons in Moral Theory From the Dutch. Hastings Center Report 39 (5):39-45.
J. Pasek (1995). Informed Consent. Patient Autonomy and Physician Beneficence Within Clinical Medicine. Journal of Medical Ethics 21 (2):119-120.
Edmund D. Pellegrino (1992). Beneficence, Scientific Autonomy, and Self-Interest: Ethical Dilemmas in Clinical Research. Cambridge Quarterly of Healthcare Ethics 1 (4):361.
Lori P. Knowles (1999). Steven Wear, Informed Consent: Patient Autonomy and Clinician Beneficence Within Health Care. Theoretical Medicine and Bioethics 20 (5):491-494.
Seana Valentine Shiffrin (2004). Autonomy, Beneficence, and the Permanently Demented. In Ronald Dworkin & Justine Burley (eds.), Dworkin and His Critics: With Replies by Dworkin. Blackwell Pub.
H. C. M. L. Rodrigues, P. P. van den Berg & M. Duwell (2013). Dotting the I's and Crossing the T's: Autonomy and/or Beneficence? The 'Fetus as a Patient' in Maternal–Fetal Surgery. Journal of Medical Ethics 39 (4):219-223.
Diego S. Silva (2010). Dignity Promotion and Beneficence. Journal of Bioethical Inquiry 7 (4):365-372.
Nora Jacobson & Diego Silva (2010). Dignity Promotion and Beneficence. Journal of Bioethical Inquiry 7 (4):365-372.
Veronique Fournier (2005). The Balance Between Beneficence and Respect for Patient Autonomy in Clinical Medical Ethics in France. Cambridge Quarterly of Healthcare Ethics 14 (3):281-286.
Sheila McLean (2010). Autonomy, Consent and the Law. Routledge-Cavendish.
Added to index2010-09-02
Total downloads17 ( #227,428 of 1,934,581 )
Recent downloads (6 months)1 ( #434,193 of 1,934,581 )
How can I increase my downloads?