The article examines from an historical perspective some of the key ideas used in contemporary bioethics debates both for and against the practices of assisted suicide and euthanasia. Key thinkers examined--spanning the Ancient, Medieval and Modern periods--include Plato, Aristotle, Augustine, Aquinas, Hume, Kant, and Mill. The article concludes with a synthesizing summary of key ideas that oppose or defend assisted suicide and euthanasia.
As medical technology advances and severely injured or ill people can be kept alive and functioning long beyond what was previously medically possible, the debate surrounding the ethics of end-of-life care and quality-of-life issues has grown more urgent. In this lucid and vigorous book, Craig Paterson discusses assisted suicide and euthanasia from a fully fledged but non-dogmatic secular natural law perspective. He rehabilitates and revitalises the natural law approach to moral reasoning by developing a pluralistic account of just why (...) we are required by practical rationality to respect and not violate key demands generated by the primary goods of persons, especially human life. Important issues that shape the moral quality of an action are explained and analysed: intention/foresight; action/omission; action/consequences; killing/letting die; innocence/non-innocence; person/non-person. Paterson defends the central normative proposition that ‘it is always a serious moral wrong to intentionally kill an innocent human person, whether self or another, notwithstanding any further appeal to consequences or motive’. (shrink)
In the chapter “A History of Ideas Concerning the Morality of Suicide, Assisted Suicide and Voluntary Euthanasia” author Craig Paterson explores questions concerning the legitimacy of the practices of suicide, assisted suicide, and voluntary euthanasia. The aim of this article is of identifying some of the main historical protagonists, and delineating some of the key arguments that have been used for the acceptance or rejection of these practices.
Though Kant calls the prohibition against suicide the first duty of human beings to themselves, his arguments for this duty lack his characteristic rigor and systematicity. The lack of a single authoritative Kantian approach to suicide casts doubt on what is generally regarded as an extreme and implausible position, to wit, that not only is suicide wrong in every circumstance, but is among the gravest moral wrongs. Here I try to remedy this lack of systematicity in order (...) to show that Kant's position on suicide is more appealing and credible than it seems at first glance. Kant in fact offers three distinct lines of argument against suicide. The first, the chief argument in his Lectures on Ethics, holds that suicide violates the divine will, for in willing our own deaths we usurp God's right to determine the duration of our existence; as God's property, we are not entitled to end our own lives willfully. The second, rooted in the Groundwork, holds that suicide is incompatible with a system of willed ends conceived analogously with a system of nature, so a maxim to commit suicide cannot be coherently willed as a universal practical principle. The third argument, drawn from the Metaphysics of Morals, holds that because suicide obliterates the rational will from the world, and as the rational will is the source of moral worth, suicide cannot be consistently willed by beings subject to moral requirements. To authorize oneself to take one's own life, Kant claims, is to attempt 'to withdraw from all obligation.' We cannot, under the color of morality, seek to cancel the will that authorizes all obligation in the first place. This third argument is demonstrably superior to the other two in being both more philosophically plausible in its own right and more Kantian in flavor. (shrink)
Contributors explore the social, medical, and ethical dilemma of assisted suicide in this revised edition that includes international as well as domestic viewpoints. The federal government's continued challenges to Oregon's Death with Dignity Act, the disabled community's response to assisted suicide, and the slippery slope argument are all examined.
Kant's claim that the rational will has absolute value or dignity appears to render any prudential suicide morally impermissible. Although the previous appeals of Kantians (e. g., David Velleman) to the notion that pain or mental anguish can compromise dignity and justify prudential suicide are unsuccessful, these appeals suggest three constraints that an adequate Kantian defense of prudential suicide must meet. Here I off er an account that meets these constraints. Central to this account is the contention (...) that some suicidal agents, because they are unable to fashion a rational conception of their own happiness, are diminished with respect to their dignity of humanity, and as a result, lack the pricelessness that makes prudential suicide wrong on a Kantian view. (shrink)
Chapter one argues for the important contribution that a natural law based framework can make towards an analysis and assessment of key controversies surrounding the practices of suicide, assisted suicide, and voluntary euthanasia. The second chapter considers a number of historical contributions to the debate. The third chapter takes up the modern context of ideas that have increasingly come to the fore in shaping the 'push' for reform. Particular areas focused upon include the value of human life, the (...) value of personal autonomy, and the rejection of double effect reasoning. Chapter four engages in the task of pointing out structural weakness in utilitarianism and deontology. The thesis argues that major systemic weaknesses in both approaches can be overcome by a teleology of basic human goods. John Finnis' work becomes the underpinning of subsequent applied natural law analysis. Chapter five proceeds to argue for the defence of the intrinsic good of human life from direct attack. The thesis holds out for the proposition "that it is always a serious moral wrong to intentionally kill a human person, whether self or another, regardless of a further appeal to consequences or motive." In support of this, it defends the validity of double effect reasoning as an indispensable part of applied moral decision making. Chapter six critically assesses the arguments of anti-perfectionists that it is not the business of the state to enforce deep or substantive conceptions of the 'good life.' The chapter moves on to argue that the natural law conception of the person in society, centred on the common good, provides a solid framework for assessing both the justification for, as well as the limits on, the role of the state to use its power to legally impose certain moral standards. Chapter seven addresses the concrete relationship between natural law and legal policy by exploring the issue of assisted suicide in the constitutional context of the United States.
Debate about physician-assisted suicide has typically focused on the values of autonomy and patient well-being. Margaret Battin, Rosamond Rhodes and Anita Silvers note that both those in favour of legalizing physician-assisted suicide and those who want this activity to be legally prohibited claim these values in support of their case. This is understandable, even reasonable, given the importance of these values in bioethics. However, these are not the only moral values there are. The purpose of this paper is (...) to examine physician-assisted suicide on the basis of the values of equality and justice. In particular, I evaluate two arguments that invoke equality, one in favour of physician-assisted suicide, one against it, and I argue that a convincing equality-based argument in support of physician-assisted suicide is available. I conclude by showing how an equality-based perspective transforms some secondary features of debate about this issue. (shrink)
Stressing that the pronoun "I" picks out one and only one person in the world (i.e., me), I argue against Hunt (and other like-minded Rand commentators) that the supposed "hard case" of destructive people who do not care for their own lives poses no special difficulty for rational egoism. I conclude that the proper response to a terse objection like "What about suicide bombers?" is the equally terse assertion "But I don't want to get blown up.".
Steven Hales constructs a novel argument against the possibility of presentist time travel called the suicide machine argument. Hales argues that if presentism were true, then time travel would result in the annihilation of the time traveler. But such a consequence is not time travel, therefore presentism cannot allow for the possibility of time travel. This paper argues that in order for the suicide machine argument to succeed, it must make (at least) one of two assumptions, each of (...) which beg the question. The argument must either assume that the sequence of moments is invariant, or that time travel requires distinct, co-instantiated moments. Because the former disjunct assumes that presentist time travel is impossible and the latter assumes that presentism is impossible, the suicide machine argument fails. (shrink)
In this paper, I defend my original objection to Hales’ suicide machine argument against Hales’ response. I argue Hales’ criticisms are either misplaced or underestimate the strength of my objection; if the constraints of the original objection are respected, my original objection blocks Hales’ reply. To be thorough, I restate an improved version of the objection to the suicide machine argument. I conclude that Hales fails to motivate a reasonable worry as to the supposed suicidal nature of presentist (...) time travel. (shrink)
1. The traditional position and the pressures for change. The Western legal tradition -- The Christian ethical hinterland -- The exceptional value of human life -- The justification of taking human life -- Suicide -- Christian ethics, assisted suicide, and voluntary euthanasia -- The cultural pressures for change -- 2. The value of human life -- 3. The morality of acts of killing -- 4. Slippery slopes.
In this article, I argue that depression and suicide are natural kinds insofar as they are classes of abnormal behavior underwritten by sets of stable biological mechanisms. In particular, depression and suicide are neurobiological kinds characterized by disturbances in serotonin functioning that affect various brain areas (i.e., the amygdala, anterior cingulate, prefrontal cortex, and hippocampus). The significance of this argument is that the natural (biological) basis of depression and suicide allows for reliable projectable inferences (i.e., predictions) to (...) be made about individual members of a kind. In the context of assisted suicide, inferences about the decision-making capacity of depressed individuals seeking physician-assisted suicide are of special interest. I examine evidence that depression can hamper the decision-making capacity of individuals seeking assisted suicide and discuss some implications. (shrink)
Suicide is a controversial ethical issue in large part because the reasonings of (a) and (b) above appear plausible but support contradictory conclusions. (a) in effect asks: Why should we be granted an exemption to the prohibition on human killing when the person we kill is ourselves? What makes killing oneself so special? (b) on the other hand starts from the intuition that there is something special or distinctive about the moral relationship we stand in to ourselves, a relationship (...) that can at least sometimes morally justify suicide. The reasoning of (a) and (b) thus establishes the contours of the ethical debate concerning the permissibility of suicide and explains why suicide is one of the most hotly debated issues in bioethics (see Bioethics). (shrink)
Euthanasia and physician assisted-suicide are terms used to describe the process in which a doctor of a sick or disabled individual engages in an activity which directly or indirectly leads to their death. This behavior is engaged by the healthcare provider based on their humanistic desire to end suffering and pain. The psychiatrist's involvement may be requested in several distinct situations including evaluation of patient capacity when an appeal for euthanasia is requested on grounds of terminal somatic illness or (...) when the patient is requesting euthanasia due to mental suffering. We compare attitudes of 49 psychiatrists towards euthanasia and assisted suicide with a group of 54 other physicians by means of a questionnaire describing different patients, who either requested physician-assisted suicide or in whom euthanasia as a treatment option was considered, followed by a set of questions relating to euthanasia implementation. When controlled for religious practice, psychiatrists expressed more conservative views regarding euthanasia than did physicians from other medical specialties. Similarly female physicians and orthodox physicians indicated more conservative views. Differences may be due to factors inherent in subspecialty education. We suggest that in light of the unique complexity and context of patient euthanasia requests, based on their training and professional expertise psychiatrists are well suited to take a prominent role in evaluating such requests to die and making a decision as to the relative importance of competing variables. (shrink)
It has been argued that voluntary euthanasia (VE) and physician-assisted suicide (PAS) are morally wrong. Yet, a gravely suffering patient might insist that he has a moral right to the procedures even if they were morally wrong. There are also philosophers who maintain that an agent can have a moral right to do something that is morally wrong. In this article, I assess the view that a suffering patient can have a moral right to VE and PAS despite the (...) moral wrongness of the procedures in light of the main argument for a moral right to do wrong found in recent philosophical literature. I maintain that the argument does not provide adequate support for such a right to VE and PAS. (shrink)
Guidelines provided by the Director of Public Prosecutions suggest that anyone assisting another to commit suicide in England and Wales, or elsewhere, will not be prosecuted provided there are no self-seeking motives and no active encouragement. This reflects the position in Switzerland. There, however, no difference is made between assistance and inducement. In addition, the Swiss approach makes it possible to establish organisations to assist the suicides of both their citizens and foreign visitors. It should not be assumed that (...) this approach is without controversy in Switzerland. Proposals for reform continue to be debated there, not least because of the concern about some of the actual practices of certain end-of-life organisations. It is likely that a few English citizens will continue to avail themselves of these services in Switzerland if they cannot find the help they require here. This paper explores the legitimacy of the current restrictive position adopted towards assisted suicide in England. It argues that the provisions within the guidelines prohibiting organisations that assist suicides, leaves some without the help they need. While legislative decriminalisation of assisted suicide and the establishment of state-sponsored suicide centres would represent the most permissive regime, this paper proposes that this would be a step too far. The preference here is for decriminalisation but adopting a ‘middle way’ between the two extremes: the more permissive approach provided by the ‘Swiss model’ is one that could be employed here, albeit within a more robust regulatory regime. (shrink)
The goal of this article is to shed light on Deep Brain Stimulation (DBS) postoperative suicidality risk factors within Treatment Resistant Depression (TRD) patients, in particular by focusing on the ethical concern of enrolling patient with history of self-estrangement, suicide attempts and impulsive–aggressive inclinations. In order to illustrate these ethical issues we report and review a clinical case associated with postoperative feelings of self-estrangement, self-harm behaviours and suicide attempt leading to the removal of DBS devices. Could prospectively identifying (...) and excluding patients with suicidality risk factors from DBS experimental trials—such as history of self-estrangement, suicide attempts and impulsive–aggressive inclinations—lead to minimizing the risk of suicidality harm? (shrink)
The Philosophical Dimensions Michael Cholbi. impermissible. Many Kantians, however, adopt what we could call a wide interpretation of autonomy. These Kantians remind us that autonomy is a capacity to make and be guided by our rational ...
The 1998 elections were held just about two weeks ago.1 All across the country, Americans went to the polls to vote for Senators, Representatives to the House, Governors, and local officials. In many states they were also given the opportunity to vote on a wide variety of ballot questions, and among these ballot questions several concerned physician assisted suicide.
Richard Brandt, following Hume, famously argued that suicide could be rational. In this he was going against a common ‘absolutist’ view that suicide is irrational almost by definition. Arguments to the effect that suicide is morally permissible or prohibited tend to follow from one’s position on this first issue of rationality. I want to argue that the concept of rationality is not appropriately ascribed – or withheld – to the victim or the act or the desire to (...) commit the act. To support this, I explore how the concept is ascribed and withheld in ordinary situations, and show that it is essentially future-oriented. Since the suicide victim has no future, it makes no sense to call his act rational or irrational. The more appropriate reaction to a declared desire for suicide, or to the news of a successful suicide, is horror and pity, and these are absent from Brandt’s account, as is a humble acknowledgement of the profound mystery at the heart of any suicide. (shrink)
abstract Many have held that there is some kind of incompatibility between a commitment to good end-of-life care and the legalization of physician-assisted suicide. This opposition to physician-assisted suicide encompasses a cluster of different claims. In this essay I try to clarify some of the most important of these claims and show that they do not stand up well to conceptual and empirical scrutiny.
In this article, I shall present three arguments for thc pcrmissibility 0f physician-assisted suicide (PAS), and then examine several objections 0f 21 "K21nti2m" and non-Kantian nature against them. These are really 0bjcctions against certain types of suicide. I shall focus 0n active PAS (eg., when 21 patient takes 21 lethal drug given by E1 physician, in which case both thc physician and patient are active). I shall assume the patient is 21 competent, responsible, rational agent, who gives his (...) being in physical discomfort (pain, nausea, ctc.) as thc reason for intending his death. I am assuming, therefore, thc pain while 21 sourcc of suffering docs not undermine his rational agency in 21 way that threatens responsibility for choice.] Current legal proposals for permitting PAS focus 0n procedures.. (shrink)
This essay first discusses the three major arguments in favor of euthanasia and physician-assisted-suicide in contemporary Western society, viz ., the arguments of mercy, preventing indignity, and individual autonomy. It then articulates both Confucian consonance and dissonance to them. The first two arguments make use of Confucian discussions on suicide whereas the last argument appeals to Confucian social-political thought. It concludes that from the Confucian moral perspectives, none of the three arguments is fully convincing.
The concept of death is of special importance in Schopenhauer''s metaphysics of appearance and Will. Death for Schopenhauer is the aim and purpose of life, that toward which life is directed, and the denial of the individual will to life. Despite his profound pessimism, Schopenhauer vehemently rejects suicide as an unworthy affirmation of the will to life by those who seek to escape rather than seek nondiscursive knowledge of Will in suffering. The only manner of self-destruction Schopenhauer finds philosophically (...) acceptable is the ascetic saint''s death by starvation. Here the individual will to life is so completely mastered as to refuse even the most basic desire for nourishment, and thereby passes into nonexistence in complete renunciation of the individual will. Schopenhauer''s attitude toward suicide nevertheless embodies an inconsistency. If, as Schopenhauer believes, the aim of life is death, and death is an unreal aspect of the world as appearance, then there appears to be no justification why the philosopher should not rush headlong into it - not to affirm the will to life in an abject effort to avoid suffering, but in order to fulfill life''s purpose by ending it for distinctly philosophical reasons immediately upon arriving at an understanding of the appearance-reality distinction. (shrink)
Anyone interested in the morality of suicide reads David Hume's essay on the subject even today. There are numerous reasons for this, but the central one is that it sets up the starting point for contemporary debate about the morality of suicide, namely, the debate about whether some condition of life could present one with a morally acceptable reason for autonomously deciding to end one's life. We shall only be able to have this debate if we think that (...) at least some acts of suicide can be moral, and we shall only be able to think this if we give up the blanket condemnation of suicide that theology has put in place. I look at this strategy of argument in the context of the wider eighteenth-century attempt to develop a non-theologically based ethic. The result in Hume's case is a very modern tract on suicide, with voluntariness and autonomy to the fore and with reflection on the condition of one's life and one's desire to carry on living a life in that condition the motivating circumstance. (shrink)
: In this essay, I examine the arguments against physician-assisted suicide (PAS) Susan Wolf offers in her essay, "Gender, Feminism, and Death: Physician-Assisted Suicide and Euthanasia." I argue that Wolf's analysis of PAS, while timely and instructive in many ways, does not require that feminists reject policy approaches that might permit PAS. The essay concludes with reflections on the relationship between feminism and questions of agency, especially women's agency.
In the first part of this article, I raisequestions about Dworkin''s theory of theintrinsic value of life and about the adequacyof his proposal to understand abortion in termsof different ways of valuing life. In thesecond part of the article, I consider hisargument in ``The Philosophers'' Brief on AssistedSuicide'''', which claims that the distinctionbetween killing and letting die is morallyirrelevant, the distinction between intendingand foreseeing death can be morally relevantbut is not always so. I argue that thekilling/letting die distinction can be (...) relevantin the context of assisted suicide, but alsoshow when it is not. Then I consider why theintention/foresight distinction can be morallyirrelevant and conclude by presenting analternative argument for physician-assistedsuicide. (shrink)
It is plausible that what possible courses of action patients may legitimately expect their physicians to take is ultimately determined by what medicine as a profession is supposed to do and, consequently, that we can determine the moral acceptability of voluntary euthanasia and physician-assisted suicide on the basis of identifying the proper goals of medicine. This article examines the main ways of defining the proper goals of medicine found in the recent bioethics literature and argues that they cannot provide (...) a clear answer to the question of whether or not voluntary euthanasia and physician-assisted suicide are morally acceptable. It is suggested that to find a plausible answer to this question and to complete the task of defining the proper goals of medicine, we must determine what is the best philosophical theory about the nature of prudential value. (shrink)
Contemporary theory is increasingly concerned with macro-micro integration. An attempt is made to integrate these levels of analysis in Durkheim's theory of egoistic suicide. Does Durkheim's theory, which is a social system analysis designed to explain differences in suicide rates between groups, have micro implications for specifying which particular individuals within the group will take their lives? In attempting to answer this question by exploring the causal linkages between integration and suicide, Durkheim's theory of egoistic suicide (...) was revealed not to be a singular theory but rather contained several different explanations. The numerous interpretations have resulted from his incompletely specified, inconsistent, unsystematized, and inadequately tested theory. These ambiguities also account for the historically inconsistent research findings that have limited sociologists' ability to advance beyond Durkheim's century-old formulations. Further areas for new research and illustrative hypothesis are suggested. (shrink)
Recently, the ‘right to die’ became a major social issue. Few agree suicide is a right tout court . Even those who believe suicide (‘regular’, passive, or physician-assisted) is sometimes morally permissible usually require that a suicide be ‘rational suicide’: instrumentally rational, autonomous, due to stable goals, not due to mental illness, etc. We argue that there are some perfectly ‘rational suicides’ that are, nevertheless, bad mistakes. The concentration on the rationality of the suicide instead (...) of on whether it is a mistake may lead to permitting suicides that should be forbidden. (shrink)
Suicide has been condemned in our culture in one way or another since Augustine offered theological arguments against it in the sixth century. More recently, theological condemnation has given way to the view that suicidal behavior must always be symptomatic of emotional disturbance and mental illness. However, suicide has not always been viewed so negatively. In other times and cultures, it has been held that circumstances might befall a person in which suicide would be a perfectly rational (...) course of action, in the same sense that any other course of action could be rational: that it could be sensible, i.e., defensible by good reasons, or that it could be in keeping with the agent's fundamental interests. Indiscriminate use of modern life-sustaining technologies has renewed interest in the possibility of rational suicide. Today proponents of rational suicide tend to equate the rationality of suicide with the competence of the decision to commit suicide. Keywords: suicide, rational, euthanasia CiteULike Connotea Del.icio.us What's this? (shrink)
This paper looks at the ambiguities which PAS (physician assisted suicide) and voluntary active euthanasia (VAE ) present to the patient, his or her loved ones and the health-care team. The author pleads for a greater emphasis on humanizing the experience of the dying so that a team can meet their physical, emotional and spiritual needs.
Recently, the ‘right to die’ became a major social issue. Few agree suicide is a right tout court. Even those who believe suicide (‘regular’, passive, or physician-assisted) is sometimes morally permissible usually require that a suicide be ‘rational suicide’: instrumentally rational, autonomous, due to stable goals, not due to mental illness, etc. We argue that there are some perfectly ‘rational suicides’ that are, nevertheless, bad mistakes. The concentration on the rationality of the suicide instead of (...) on whether it is a mistake may lead to permitting suicides that should be forbidden. (shrink)
In “What is Wrong with Rational Suicide,” Pilpel and Amsel develop a counterexample that allegedly confounds attempts to condition the moral permissibility of suicide on its rationality. In this counterexample, a healthy middle aged woman with significant life accomplishments, but no dependents, disease, or mental disorder opts to end her life painlessly after reading philosophical texts that persuade her that life is meaningless and bereft of intrinsic value. Many people would judge her suicide “a bad mistake” despite (...) its meeting “robust” conditions for rationality. Hence, Pilpel and Amsel conclude, even robust conditions for the rationality of suicide “fail to do their job: to exclude intuitively unacceptable suicides from being permissible.” I argue here that this counterexample fails to cast doubt on philosophical attempts to account for the moral permissibility of suicide in terms of its rationality. (shrink)
Philosophical discussions of the morality of suicide have tended to focus on its justifiability from an agent’s point of view rather than on the justifiability of attempts by others to intervene so as to prevent it. This paper addresses questions of suicide intervention within a broadly Kantian perspective. In such a perspective, a chief task is to determine the motives underlying most suicidal behaviour. Kant wrongly characterizes this motive as one of self-love or the pursuit of happiness. Psychiatric (...) and scientific evidence suggests that suicide is instead motivated by a nihilistic disenchantment with the possibility of happiness which, at its apex, results in the loss of the individual’s conception of her practical identity. Because of this, methods of intervention that appeal to agents’ happiness, while morally benign, will prove ineffective in forestalling suicide. At the same time, more aggressive methods violate the Kantian concern for autonomy. This apparent dilemma can be resolved by seeing suicide intervention as an action undertaken in non-ideal circumstances, where otherwise unjustified manipulation, coercion, or paternalism are morally permitted. (shrink)
The ethical problems surrounding voluntary assisted suicide remain formidable, and are unlikely to be resolved in pluralist societies. An examination of historical attitudes to suicide suggests that modernity has inherited a formidable complex of religious and moral attitudes to suicide, whether assisted or not. Advocates usually invoke the ending of intolerable suffering as one justification for euthanasia of this kind. This does not provide an adequate justification by itself, because there are (at least theoretically) methods which would (...) relieve suffering without causing the physical death of the suffering person. Carried to extremes, these methods would finish the life worth living, but leave a being which was technically alive. Such acts, however, would provide no moral escape, since they would create beings without meaning. Arguments seeking to justify ending the lives of others need some grounding in concepts of the meaning of a life. The euthanasia discourse therefore needs to take at least some account of the meaning we construct for our lives and the lives of others. (shrink)
In this article I defend a new definition of what it is to commit suicide:(D) A commits suicide by performing an act x if and only if A intends that he or she kill himself or herself by performing x (under the description ‘I kill myself’), and this intention is fully satisfied.The definition has some surprising implications: various real-life examples often referred to as ‘suicides’ (e.g. ‘suicide bombers’) may well turn out not to be suicides after all.1.
This paper evaluates the arguments against physician assisted suicide which contend that it violates the integrity of medicine and the physician-patient relation; i.e. that it contradicts the goal of seeking health and healing, violates an absolute prohibition against killing, and undermines the patient's trust in the physician. These arguments against physician assisted suicide (1) misuse notions of teleology and teleological explanation; (2) rely on inappropriate notions of "ideal medicine", for which death is a defeat; (3) turn on a (...) highly selective reading for the Hippocratic tradition; and (4) are unacceptably paternalistic. Keywords: Hippocratic ethics, integrity in medicine, physician assisted suicide, physician-patient relation CiteULike Connotea Del.icio.us What's this? (shrink)
Ethical issues surrounding the act of suicide are confounded by the difference between the complexity of suicide and the popular and professional clinical view of suicide. In elaborating these different views, it is shown that the dominant view of suicide as a manifestation of mental illness has a weak scientific base and limits our efforts at understanding the multi-faceted concept suicide. In particular, the rationality of those who kill themselves is examined. Finally, the right of (...) a person in our society to take his or her own life is supported; the state is shown to have no base for a compelling interest in preventing suicide. (shrink)
Since 1998, physician-assisted suicide has been legal in the American state of Oregon. In this paper, I defend Oregon’s physician-assisted suicide (PAS) law against two of the most common objections raised against it. First, I try to show that it is not intrinsically wrong for someone with a terminal disease to kill herself. Second, I try to show that it is not intrinsically wrong for physicians to assist someone with a terminal disease who has reasonable grounds for wanting (...) to kill herself. (shrink)
All too often in applied ethics debates, there is a danger that a lack of analytical clarity and precision in the use of key terms serves to cloud and confuse the real nature of the debate being undertaken. A particular area of concern in my analysis of the bioethics literature has been the uses to which the key terms "suicide," "assisted suicide," and "euthanasia" are put. The modest aim of this article is to render a contribution to the (...) applied ethics debate on these topics by seeking to delimit the scope and meaning of these terms. The criteria of specificity, non-arbitrariness, consistency (between various terms), and the avoidance of strong pejorative presuppositions, supply the main standards guiding my adoption of usages. (shrink)
In recent years, much has been learned about the strategic and organizational contexts of suicide attacks. However, motivations of the agents who commit them remain difficult to explain. In part this is because standard models of social learning as well as Durkheimian notions of sacrificial behavior are inadequate in the face of the actions of human bombers. In addition, the importance of organizational structures and practices in reinforcing commitment on the part of suicide recruits is an under-explored factor (...) in many analyses. This essay examines the potential applicability of evolutionary models of altruism to the understanding of commitment to suicide on the part of terrorist organizational recruits. Three evolutionary models of sacrificial behavior in nonhuman species and many categories of human behavior are explored cross-organizationally: reciprocity, inclusive fitness theory, and induced altruism. Reciprocal altruism is unlikely to be a major motivator in suicide attacks because the costs exhibited by attackers are too high to be adequately compensated. However, the role of evolved self-deception in perceptions of personal death, and thus of rewards in the afterlife, is potentially illuminating. Inclusive fitness theory can help explain the motivations of attackers because rewards to kin often are offered by organizations to suicide recruits. However, suicide bombers also often act out of revenge for the loss of or injury to relatives, and inclusive fitness theory generally, as well as more specific theoretical models of retaliatory aggression, may not adequately account for the bombers' actions. Predictions from induced altruism theory appear to be well supported because suicide terror organizations tend to be tightly structured around practices intended to maintain and reinforce commitment though the manipulation of kinship-recognition cues. (shrink)
The common consensus on suicide seems to be that even if taking one's life is permissible on some basis, it cannot be morally obligatory. In fact, one argument often used against Utilitarianism is that the principle sometimes requires individuals to sacrifice themselves for the benefit of others, as in the case of healthy individuals who can donate all their life saving organs to those in need of transplants.However, a plausible philosophical case can be built for morally obligatory suicide. (...) First, although not a standard interpretation, it seems clear Kant thought some crimes so morally repugnant that the moral agent should commit suicide rather than performing the former. Using this interpretation, I will strengthen and defend a Kantian argument for morally obligatory suicide in situations of crimina carnis contra naturum. (shrink)
A diagnosis of schizophrenia is often taken to denote a state of global irrationality within the psychiatric paradigm, wherein psychotic phenomena are seen to equate with a lack of mental capacity. However, the little research that has been undertaken on mental capacity in psychiatric patients shows that people with schizophrenia are more likely to experience isolated, rather than constitutive, irrationality and are therefore not necessarily globally incapacitated. Rational suicide has not been accepted as a valid choice for people with (...) schizophrenia due in part to a belief that characteristic irrationality prevents autonomous decision-making. Since people with schizophrenia are often seen to lack insight into the nature of their disorder, both psychiatric and ethical perspectives generally presume that suicidal acts result directly from mental illness itself and not from second-order desires. In this article, I challenge notions of global irrationality conferred by a diagnosis of schizophrenia and argue that, where delusional beliefs are unifocal, schizophrenia does not necessarily lead to a state of mental incapacity. I then attempt to show that people with schizophrenia can sometimes be rational with regard to suicide, where this decision stems from a realistic appraisal of psychological suffering. (shrink)
Suicide is a major problem in the United States, with the number of suicides annually exceeding the number of homicides by 10,000. Many studies have examined the relationship between media coverage of suicides and the suicide rate. This article reviews literature on imitative suicide and discusses implications of suicide stories on people in crisis. In addition, it explores the options for suicide coverage and gives suggestions for more ethical coverage that could save people's lives, rather (...) than reinforcing suicide as an option. (shrink)
The contributions of adolescent and parent perspectives to ethical planning of survey research on youth drug use and suicide behaviors are highlighted through an empirical examination of 322 7th-12th graders' and 160 parents' opinions on questions related to 4 ethical dimensions of survey research practice: (a)evaluating research risks and benefits, (b)establishing guardian permission requirements, (c)developing confidentiality and disclosure policies, and (d)using cash incentives for recruitment. Generational and ethnic variation in response to questionnaire items developed from discussions within adolescent and (...) parent focus groups are described. The article concludes with a discussion of the potential contributions and challenges of adolescent and parent perspectives for planning scientifically valid and ethically responsible youth risk survey research. (shrink)
Respect for autonomy is typically considered a key reason for allowing physician assisted suicide and euthanasia. However, several recent papers have claimed this to be grounded in a misconception of the normative relevance of autonomy. It has been argued that autonomy is properly conceived of as a value, and that this makes assisted suicide as well as euthanasia wrong, since they destroy the autonomy of the patient. This paper evaluates this line of reasoning by investigating the conception of (...) valuable autonomy. Starting off from the current debate in end-of-life care, two different interpretations of how autonomy is valuable is discussed. According to one interpretation, autonomy is a personal prudential value, which may provide a reason why euthanasia and assisted suicide might be against a patient’s best interests. According to a second interpretation, inspired by Kantian ethics, being autonomous is unconditionally valuable, which may imply a duty to preserve autonomy. We argue that both lines of reasoning have limitations when it comes to situations relevant for end-of life care. It is concluded that neither way of reasoning can be used to show that assisted suicide or euthanasia always is impermissible. (shrink)
It has been argued that, on Kantian grounds, pedophiles, rapists and murderers are morally obligated to take their own lives prior to committing a violent action that will end their moral agency. That is, to avoid destroying the agent's moral life by performing a morally suicidal action, the agent, while he still is a moral agent, should end his body's life. Although the cases of dementia and the morally reprehensible are vastly different, this Kantian interpretation might be useful in the (...) debate on the permissibility of suicide for those facing dementia's effects. If moral agents have a duty to act as moral agents, then those who will lose their moral identity as moral agents have an obligation to themselves to end their physical lives prior to losing their dignity as persons. (shrink)
Dutch euthanasia and physician-assisted suicide stand on the eve of important legal changes. In the summer of 1999, a new government bill concerning euthanasia and physician-assisted suicide was sent to Parliament for discussion. This bill legally embodies a ground for exemption from punishment for physicians who conduct euthanasia or physician-assisted suicide and comply with certain requirements. On November 28, 2000, the Dutch parliament approved an adapted version of this bill. Since the approval by the Dutch Senate can (...) be regarded as a formality, it is expected that the bill will come into force in the course of this year (2001). In this paper we discuss these new developments. (shrink)
Amongst the latest, and ever-changing, pathways of death and dying, “suicide tourism” presents distinctive ethical, legal and practical challenges. The international media report that citizens from across the world are travelling or seeking to travel to Switzerland, where they hope to be helped to die. In this paper I aim to explore three issues associated with this phenomenon: how to define “suicide tourism” and “assisted suicide tourism”, in which the suicidal individual is helped to travel to (...) take up the option of assisted dying; the (il)legality of assisted suicide tourism, particularly in the English legal system where there has been considerable recent activity; and the ethical dimensions of the practice. I will suggest that the suicide tourist—and specifically any accomplice thereof—risks springing a legal trap, but that there is good reason to prefer a more tolerant policy, premised on compromise and ethical pluralism. (shrink)
``What Does a Right to Physician-Assisted Suicide (PAS) Legallyentail?''''Much of the bioethics literature focuses on the morality ofPAS but ignores the legal implications of the conclusions thereby wrought. Specifically, what does a legal right toPAS entail both on the part of the physician and the patient? Iargue that we must begin by distinguishing a right to PAS qua``external'''' to a particular physician-patient relationship from a right to PAS qua ``internal'''' to a particular physician-patientrelationship. The former constitutes a negative claim (...) right inrem that prohibits outside interference with the exercise of aright to PAS while the latter can provide the patient witha positive claim right in personam to obligatory assistancefrom his physician. Importantly, I argue that the creation of sucha patient right, however, originates with the physician who may exercise an unqualified right of first refusal prior to promisingto help her patient commit suicide. In doing so, I hope to establishthat explicit physician promises of assistance in dying shouldbecome legally binding. As such, current PAS law in both theNetherlands and Oregon is in need of substantive modification. (shrink)
The experimental setup of the self-referential quantum measurement, jovially known as the ‘quantum suicide’ or the ‘quantum Russian roulette’ is analyzed from the point of view of the Principal Principle of David Lewis. It is shown that the apparent violation of this principle – relating objective probabilities and subjective chance – in this type of thought experiment is just an illusion due to the usage of some terms and concepts ill-defined in the quantum context. We conclude that even in (...) the case that Everett’s (or some other ‘no-collapse’) theory is a correct description of reality, we can coherently believe in equating subjective credence with objective chance in quantum-mechanical experiments. This is in agreement with results of the research on personal identity in the quantum context by Parfit and Tappenden. (shrink)
Camus’ central thesis in The Myth of Sisyphus is that suicide is not the proper response to, nor is it the solution of, the problem of absurdity. Yet many of his literary protagonists either commit suicide or are self-destructive in other ways. I argue that the protagonists that best live up to the characteristics of the absurd man that Camus outlines in the Myth uniformly either commit suicide or consent to their destruction by behaving in such a (...) manner as to invite death. It is my contention that this raises serious questions abuut the validity of Camus’ arguments that suicide is not the proper response to the recognition that life is absurd. (shrink)
The experimental setup of the self-referential quantum measurement, jovially known as the "quantum suicide" or the "quantum Russian roulette" is analyzed from the point of view of the Principal Principle of David Lewis. It is shown that the apparent violation of this principle---relating objective probabilities and subjective chance---in this type of thought experiment is just an illusion due to the usage of some terms and concepts ill-defined in the quantum context. We conclude that even in the case that Everett's (...) (or some other "no-collapse") theory is a correct description of reality, we can coherently believe in equating subjective credence with objective chance in quantum-mechanical experiments. This is in agreement with results of the research on personal identity in the quantum context by Parfit and Tappenden. (shrink)
In this paper I use William James's understanding of significance in life to show that for certain patients euthanasia and assisted suicide can be importantly meaningful acts that family, friends, and health care professionals must acknowledge and even, at times, aid in bringing to fruition. Dying with meaning is transformative. It reshapes the lives of others that are left behind, giving to their lives new groundings by engaging them in the meaning of dying for us. For the patient, dying (...) with meaning takes the seemingly formless void in the abyss of death and gives it a significant purpose in the last stages of life itself; it turns potential nothingness into actual significance. To the extent that we outsiders do not help the dying, we condemn terminally ill patients to a meaningless existence until they die. (shrink)
The article draws from a personal clinical experience of two suicides, not far removed from each other in time. The first patient was a 33-year-old intellectual suffering from depression with narcissistic traits but no psychotic elements, while the second patient was a 21-year-old student with a manifest psychotic episode behind him and with characteristics of post-psychotic depression at the time of suicide. The two suicides had very different impacts on the therapist: the first left open some “space” for reflection, (...) communication, and working-through, while the second closed such a “space,” leaving only a tiny door to the existential roots of human beings and suffering. The therapist was able to find some “shelter” by talking to supervisors, colleagues, and friends in the first case; in the second, the only possible “shelter” was glimpsed in the philosophy of groundlessness (Ungrund) of the Russian existentialist Nicolai Berdyaev. The personal experiences of the therapist, along with some theoretical interpretations of the after-effects of both suicides, are presented using a psychodynamic and existential–phenomenological understanding of the therapeutic relationship with a psychotic and a non-psychotic patient. The main dilemmas exposed by a patient’s suicide, especially if the patient suffers from psychosis, are difficult to deal with in the usual clinical settings and call for resources beyond it. The authors propose that these can be found in philosophical and theological insights. (shrink)
The relatively new practice of continuous sedation at the end of life (CS) is increasingly being debated in the clinical and ethical literature. This practice received much attention when a U.S. Supreme Court ruling noted that the availability of CS made legalization of physician-assisted suicide (PAS) unnecessary, as CS could alleviate even the most severe suffering. This view has been widely adopted. In this article, we perform an in-depth analysis of four versions of this ?argument of preferable alternative.? Our (...) goal is to determine the extent to which CS can be considered to be an alternative to PAS and to identify the grounds, if any, on which CS may be ethically preferable to PAS. (shrink)
A review of the literature was conducted to better understand the (potential) role of mental health professionals in physician-assisted suicide. Numerous studies indicate that depression is one of the most commonly encountered psychiatric illnesses in primary care settings. Yet, depression consistently goes undetected and undiagnosed by nonpsychiatrically trained primary care physicians. Noting the well-studied link between depression and suicide, it is necessary to question giving sole responsibility of assisting patients in making end-of-life treatment decisions to these physicians. Unfortunately, (...) the use of mental health consultation by these physicians is not a common occurrence. Greater involvement of mental health professionals in this emerging and debated area is advocated. Beyond describing mental health professionals' role in the assessment of patient competency or decision making capacity, other areas of potential involvement are described. A discussion of ethical principles relevant to this area follows, along with comments on the training necessary to adequately serve patient needs. (shrink)
When discussing the distinction between referential and attributive uses of definite descriptions, Keith Donnellan also mentions cases such as âSmithâs murderer is insaneâ, uttered in a scenario in which Smith committed suicide. In this essay, I defend a two-fold thesis: (i) the alleged intuition that utterances of âSmithâs murderer is insaneâ are true in the scenario in question is independent from the phenomenon of referential uses of definite description, and, most importantly, (ii) even if such intuition is granted semantic (...) relevance, the evidence it presents is compatible with a Russellian treatment of definite descriptions. I thus present a Russellian analysis of âSmithâs murderer is insaneâ which, when coupled with certain independently plausible hypotheses, explains the presumed intuition that certain utterances of this sentence are indeed true, at least as long as the intended individual is insane. (shrink)
To accept a notion of rational suicide, as many contemporary bioethicists now urge, first makes possible certain kinds of manipulation into suicide which do not occur in suicide-impermissive societies. This paper describes the two principal mechanisms by which an individual can be manipulated into choosing to kill himself or herself, though that individual would not have done so otherwise, and identifies circumstantial and ideological changes in contemporary society which may be associated with such manipulation now and in (...) the future. However, the author holds that this prospect is not grounds for rejecting the notion of rational suicide;it must be accepted on other moral grounds, but with a clear view of the risks it will bring. (shrink)
Where assistance in suicide is readily available to those dying of AIDS, as in the west coast gay communities of the United States and in the Netherlands, we must examine the different roles of physicians and friends (including lovers, spouses, family members, religious advisors, members of support groups, and intimate others) in helping a person with AIDS decide about and carry out suicide. This paper makes a central assumption: that where assistance in suicide is available, it is (...) the moral obligation of others to protect and enhance as much as possible the rationality of that choice. Four components are identified in a rational choice about suicide in AIDS – whether it is a choice for or against suicide. Phrased as questions a person with AIDS might ask him- or herself, they are: (1) "Is suicide an option I want to consider?" (2) "Shall I hold out for the chance of a cure?" (3) "How shall I time my suicide?" (4) "What weight shall I give to the welfare and interests of others?" Although physicians often make assertions relevant to (1), they are appropriately involved only in (3); and although friends or intimate partners often provide the patient with anecdotal information relevant to (3), they should be involved primarily in (1). In short, both physicians and friends often intervene in the wrong parts of choices made by a person with AIDS about suicide. Keywords: AIDS, assisted suicide, euthanasia, rationality, role of friends and physicians, timing CiteULike Connotea Del.icio.us What's this? (shrink)
Abstract In this paper I am concerned to address the question of voluntary or self?willed death from two distinct positions?a particular community's socio?religious practice (viz. Jaina sallekhan?) and as the matter stands in law (penal code, constitution, judicial wisdom, etc.) in India?in the light of the recent move by a bench of its apex court striking down the penal code section proscribing suicide. I also wish to draw out some implications of these deliberations for the beneficence of medical practice (...) and related bio?ethical ramifications in the Indian context. (shrink)
Some disability rights (DR) advocates oppose physician-assisted suicide (PAS) laws like Oregon’s on the grounds that they reflect ableist prejudice: how else can their limit on PAS eligibility to the terminally ill be explained? The paper answers this DR objection. It concedes that the limit in question cannot be defended on soft paternalist grounds, and offers a hard paternalist defense of it. The DR objection makes two mistakes: it overlooks the possibility of a hard paternalist defense of the limit, (...) and it confuses terminal illness, which is at best one type of disability, with disability itself. (shrink)
“Wrongful life” claims are made by persons born with a disease to the effect that they should not have been born. I ask whether we can say that if someone claims that he would have been better off if he were not born, he would be better off if he died. I examine the relationship between the following propositions:(1) It would have been better for me if I were not born.(2) My life (as a whole) is not worth living.(3) It (...) would be better for me if I died.(4) I desire to die.(5) I should commit suicide/ ask for euthanasia.If a person claims that he would have preferred not to be born, this normally implies that it would be better for him if he died. But this does not necessarily imply that he desires to die, or that he should commit suicide. (shrink)
Practices such as physician assisted suicide, even if legal, engender a range of moral conflicts to which many are oblivious. A recent proposal for physician assisted suicide provides an example by calling upon physicians opposed to suicide to refer patients to other, more sympathetic, physicians. However, the proposal does not address the moral concerns of those physicians for whom such referral would be morally objectionable. Keywords: collaboration, euthanasia, intrinsic evil, material cooperation, projects, referral, toleration CiteULike Connotea Del.icio.us (...) What's this? (shrink)
Rawls’s theory of justice is capable of providing an important contribution to the question of physician-assisted suicide (PAS). PAS should be guaranteed as a right to make decisions in accordance with the conception of the good the individual formulates as a rational being. This defense is supported, therefore, by a Kantian premise. But it is also possible to oppose this kind of proposal by relying on differentaspects of Kant’s theory, i.e. on some variant of the famous argument against (...) class='Hi'>suicide based on the means/end formulation of the categorical imperative. In this paper, I try to show that these attempts are not well founded, and that the Rawlsian appeal to the Kantian tradition divulges better perspectives. I also try to add considerations inspired by contextualist epistemology to the Rawlsian appeal to the burdens ofjudgment. (shrink)
Objectives: The aims of this study were to: (1) investigate patients’ views on euthanasia and physician-assisted suicide (PAS), and (2) examine the impact of question wording and patients’ own definitions on their responses. Design: Cross-sectional survey of consecutive patients with cancer. Setting: Newcastle (Australia) Mater Hospital Outpatients Clinic. Participants: Patients over 18 years of age, attending the clinic for follow-up consultation or treatment by a medical oncologist, radiation oncologist or haematologist. Main Outcome Measures: Face-to-face patient interviews were conducted examining (...) attitudes to euthanasia and PAS. Results: 236 patients with cancer (24% participation rate; 87% consent rate) were interviewed. Though the majority of participants supported the idea of euthanasia, patient views varied significantly according to question wording and their own understanding of the definition of euthanasia. Conclusions: Researchers need to be circumspect about framing and interpreting questions about support of ‘euthanasia’, as the term can mean different things to different people, and response may depend upon the specifics of the question asked. (shrink)
This article argues that Durkheim's theory of suicide is deficient because of its monocausal reasoning, its conception of suicide as an action without subjects, and its characterization of preliterate societies as harmonious, self-contained, and morphologically static. It shows that these deficiencies can be overcome by including cultural and social-psychological considerations in the analysis of suicide-specifically by including culture as a causal force in its own right and drawing links between social circumstances, cultural beliefs and values, and individual (...) dispositions. The authors make their case by analyzing ethnographic and quantitative data on the preliterate Guarani-Kaiowá of southwestern Brazil, one of the most suicide-prone groups in the world. (shrink)
The failure to locate a unifying psychological profile of suicide bombers should prompt moves to a more extended and interdisciplinary front, availing itself of insights from disciplines such as sociology, philosophy and history of ideas, as well as from psychology. This paper aims in that direction by exploring 'traditional' versus 'western liberal' conceptions of the self, with special emphasis on their possible pathologies; and by integrating those pathologies with insights from Durkheimian suicidology. It is hypothesised that suicide bombers (...) in the West are typically callow, malleable young men targeted by terror merchants, and that their suicide missions are, first and foremost, acts of deluded self-enhancement, which need to be understood against the backdrop of the western liberal conception of the self. Finally, some implications for moral education are suggested. (shrink)
The leaders of many prominent health and mental health organizations have issued policy statements about the appropriateness of members of their professions being involved in assisted suicide, whether assisted suicide is ever an acceptable option for people, and what roles a professional can or should play when a client is considering assisted suicide. This article argues that only the latter focus-providing suggestions about how a professional can assist a person considering hastening death-is appropriate for an organization whose (...) members are clinical practitioners rather than theorists. The former 2 positions, it is contended, are merely political posturing and are counterproductive to providing proper care to clients in need. (shrink)
Physician-Assisted Suicide: Views of Swiss Health Care Professionals Content Type Journal Article DOI 10.1007/s11673-010-9246-2 Authors Eliane Pfister, Institute of Biomedical Ethics, University of Zurich, CH-8032 Zurich, Switzerland Nikola Biller-Andorno, Institute of Biomedical Ethics, University of Zurich, CH-8032 Zurich, Switzerland Journal Journal of Bioethical Inquiry Online ISSN 1872-4353 Print ISSN 1176-7529 Journal Volume Volume 7 Journal Issue Volume 7, Number 3.
What are some of the most useful tools and techniques for teaching about suicide? How can this topic be used to deepen students’ understanding of Socrates and existentialism? Which concepts, skills, and exercises can facilitate student interest and insight? This essay will explore Socrates’ Apology as a means to teach analytical issues on suicide, Camus’s The Myth of Sisyphus to teach existentialist issues, and finally the cases of Kurt Cobain and Ludwig van Beethoven to teach the application of (...) existentialist issues. (shrink)
The general assumption that underlines Richard Posner’s argument in his book Not a Suicide Pact is that decisions concerning rights and security in the context of modern terrorism should be made by balancing competing interests. This assumption is obviously correct if one refers to the most rudimentary sense of balancing, namely, the idea that normative decisions should be made in light of the importance of the relevant values and considerations. However, Posner advocates a more specific conception of balancing, both (...) substantively and institutionally. Substantiality, he argues for balancing based on a consequential moral theory that rejects the ideas of deontological rights and particularly absolute or very weighty deontological rights. More specifically, it seems that Posner assumes a utilitarian theory that also rejects intrinsic concern for distributive justice. Institutionally, Posner argues that this method of reasoning should be adopted by judges when interpreting the constitution. These substantive and institutional background assumptions are of course controversial, but I do not dispute them in this Article. My critique concerns Posner’s conclusions based on these assumptions. Posner’s main claim is that given the magnitude of the danger of modern terrorism, even a small probability that an act of terror may occur justifies extreme anti-terror measures. While the general idea that even a slight risk of very serious harm justifies significant cost is plausible, I doubt Posner’s assumptions regarding the cost of various means of preventing these dangers, his claim that judicial review in this context should be very limited, and his suggestion of an absolute formal prohibition that is not strictly enforced in the context of measures such as interrogational torture. (shrink)
Leon Kass's often-cited essay, Death with Dignity and the Sanctity of Life, provides the basis for a case study in the rhetorical function of definition in debates concerning bioethics. The study examines the way a particular definition of human dignity is used to maintain an advantage of power in the debate over the morality of physician-assisted suicide. It also considers sources of human dignity that are deflected from attention by the rhetoric of Kass's formulation.
Is a Muslim still a Muslim when he crashes airplanes into the twin towers? Any serious theory of multiculturalism has to deny that Islam could ever come to justify suicide bombing and terrorism. My thesis is that none of the contemporary multicultural theories manages to do so, or at least not without collapsing into a Kantian conception of personal autonomy and, consequently, into some standard version of liberalism. Communitarianism, trying to demonstrate that fundamentalism has nothing to do with the (...) true and authentic Islam and that it does not take into account the pluralism prevailing in Islam, has to moralize Islam. A Humean position, which takes Islamic fundamentalism to be merely a pathology, the product of resentment and western neocolonialism, eventually could come to the conclusion that good and upright Muslims today cannot help but become suicide bombers. Liberal multiculturalism, considering identity to be a matter of choice, must suppose that an active agent with self-knowledge is by definition a responsible person with a moral identity. In conclusion, multiculturalism, in its effort to make the good identities prevail over the bad and the ugly identities, risks adopting some of the same righteous attitudes towards Islam as traditional liberalism. (shrink)
When the terms ?women? and ?violence? are used, it is usually in the context of women as victims and rarely as perpetrators of violence, and yet women do behave aggressively ? for instance, as female suicide bombers. An ethical analysis of this role, however, has tended to be somewhat overlooked, partly because of the gender stereotypes at play, with little (or spurious) focus on the agency and autonomy of the women. This has resulted in an incomplete understanding of the (...) unique ways in which societies treat female political aggressions, and the consequences of this for their agency. This paper seeks to redress these issues by evaluating two different societal portrayals of female suicide bombers; that of the ?scandalous subwoman? and the ?sublime superwoman?. It argues that violent women's agency is often distorted to extremes beyond that of their male counterparts, and that it is imperative to avoid misrepresenting them either as agentless victims (?subwomen?) or wholly agentic (?superwomen?) since, even in times of political instability, they can rarely be dichotomised in this binary way. (shrink)
The great majority of species that lived on this earth have gone extinct. These extinctions are often explained by invoking changes in the environment, to which the species has been unable to adapt. Evolutionary suicide is an alternative explanation to such extinctions. It is an evolutionary process in which a viable population adapts in such a way that it can no longer persist. In this paper different models, where evolutionary suicide occurs are discussed, and the theory behind the (...) phenomenon is reviewed. (shrink)
In this paper the author argues that a narrative approach to understanding assisted suicide has been compromised by the notion that all narratives must be both coherent and unified. He asks what we are to do with those narratives that cannot seem to cohere or be other than full of disunity? Is suicide the only way to make meaning out of suffering? He then proposes that the narrative found in the Gospel of Mark leads Christians to a life (...) in hope and compassion in spite of apparent incoherence and disunity and threats of abandonment and suffering. (shrink)
Gibson, Robin The concept of dying by euthanasia and indeed physician-assisted suicide is a highly emotive one. Assisted dying arouses intense feelings both in favour and against. The prospect of enduring a long drawn out dying process generates both fear and apprehension in both terminally ill and chronically ill patients. Many of them wish to choose the time and manner of their death. On the other side, passionate, mainly religious groups have campaigned long and hard to deny suffering people (...) assistance to die. As the law currently stands in Australia, there is a complete ban on both euthanasia and assistance in suicide. Even following a request by a patient, a medical practitioner who directly takes the life of his or her patient, can be charged with murder or manslaughter. Despite the repeal of laws that forbade committing or attempting to commit suicide, laws still exist which proscribe the provision of assistance to another to commit or attempt to commit suicide. (shrink)
In a letter of 1746, David Hume tells of the suicide of his kinsman Major Forbes. While Hume's account overtly presents the major's suicide as heroic, incorporating allusions to the Ajax of Sophocles and the lives of noble Romans such as Cato, the narrative context in which he places it, and the nature of narrative itself, call the wisdom of the act into question. In his essay ‘Of Suicide’, written a few years later, Hume largely avoids narrative (...) examples. However, the small number of historical cases to which he does allude, and an implied narrative of suicide that emerges from context he supplies in passing, diminish the rhetorical force of his argument. (shrink)
This paper argues that suicide is very important for Cicero’s articulation and defense of the philosophical life. Happiness, according to Cicero, is dependent upon a willingness to commit suicide. I explain why this is the case through a discussion of On Ends and the Tusculan Disputations. I conclude with some critical remarks about Cicero’s argument, with reference to book XIX of Augustine’s City of God.
"Active intervention" with suicidal callers to telephone crisis lines involves breaking confidentiality by dispatching emergency services, typically the police, to a suicidal person without that person's consent and sometimes without his or her knowledge.1 Those who oppose active intervention often refer to it as "nonvoluntary intervention." Active intervention is rapidly becoming the standard of practice for crisis centers and is required for certification by the American Association of Suicidology (AAS), the primary organization that certifies telephone crisis centers. A policy of (...) active intervention is also required for any crisis center affiliated with the Hope Line and the National Suicide Prevention Lifeline .. (shrink)
State statutes, case law, and professional codes of ethics in the mental health professions typically stress either a duty or the permissibility of disclosing confidential information in order to prevent clients from seriously harming themselves. These sources are intended to address cases where clients are deemed to be suffering from cognitive dysfunction for which paternalistic intervention, including involuntary hospitalization, is considered necessary to prevent self-destructive behavior.The counselor’s moral and legal responsibility is less apparent when mentally competent clients desire suicide (...) as release from irremediable suffering due to severe physical illness, and this desire is defensible within these clients’ value systems. This paper will explore moral and legal dimensions of a counselor’s decision not to intervene in such cases. The concept of permitted suicide will be introduced and defined, and guidelines for its application developed. (shrink)
This paper presents a new analysis of the logical structure of Hume’s attack on the theological objection to suicide. I suggest that Hume intends his reasoning in “Of Suicide” to generalize, covering not just suicide but any arbitrary action: his implied conclusion is that no human action can violate a duty to God. I contrast my reading with a series of recent interpretations, and argue that the various criticisms of Hume’s reasoning are based on a misunderstanding of (...) what he is about. Finally, I also show the integration of Hume’s discussion of suicide with his broader critique of attempts to generate moral conclusions by way of natural religion. (shrink)
A distinction is commonly drawn between continuous sedation until death and physician-assisted suicide/euthanasia. Only the latter is found to involve killing, whereas the former eludes such characterization. I argue that continuous sedation until death is equivalent to physician-assisted suicide/euthanasia in that both involve killing. This is established by first defining and clarifying palliative sedation therapies in general and continuous sedation until death in particular. A case study analysis and a look at current practices are provided. This is followed (...) by a defense of arguments in favor of definitions of death centering on higher brain (neocortical) functioning rather than on whole brain or cardiopulmonary functioning. It is then shown that continuous sedation until death simulates higher brain definitions of death by eliminating consciousness. Appeals to reversibility and double effect fail to establish any distinguishing characteristics between the simulation of death that occurs in continuous sedation until death and the death that occurs as a result of physician-assisted suicide/euthanasia. Concluding remarks clarify the moral ramifications of these findings. (shrink)
In an age of rapid advances inlife-prolonging treatment, patients and caregivers areincreasingly facing tensions in making end-of-lifedecisions. An examination of the history of healthcare in the United States reveals technological,economic, and medical factors that have contributed tothe problems of terminal care and consequently to themovement of assisted suicide. The movement has itsroots in at least two fundamental perceptions andexpectations. In the age of technological medicineenergized by the profit motive, dying comes at a highprice in suffering and in personal economic (...) loss. Thefailure to provide affordable resources for terminalcare is the result of the marketplace in health care. The medical profession has been painfully slow inresponding to the challenges of terminal care, mainlybecause of the pressures of the marketplace and lackof adequate training. This has occurred at a time ofrapid advances in life-sustaining treatment and ofexpanding public awareness of personal rights underthe law. Overly aggressive treatment in the finalstages of terminal illness has enhanced anxieties overa painfully prolonged and expensive dying. Thesefactors have promoted the movement to assistedsuicide. In the U.S. debate of the issues, ethiciststend to argue abstractly without examiningadequately the context of terminal care that is thehealth care system. It is a system in dire need of areform that will remove it from the marketplace. (shrink)
Brussen, Kerri Anne This paper is a brief history of suicide, euthanasia, and physician assisted suicide in the United States of America which aims to provide an understanding of the continued and persistent effort in the USA to legalise physician assisted suicide. Oregon and Washington State Dying with Dignity Laws are reviewed as examples of legalised physician assisted suicide.
This paper presents a new analysis of the logical structure of Hume’s attack on the theological objection to suicide. I suggest that Hume intends his reasoning in “Of Suicide” to generalize, covering not just suicide but any arbitrary action: his implied conclusion is that no human action can violate a duty to God. I contrast my reading with a series of recent interpretations, and argue that the various criticisms of Hume’s reasoning are based on a misunderstanding of (...) what he is about. Finally, I also show the integration of Hume’s discussion of suicide with his broader critique of attempts to generate moral conclusions by way of natural religion. (shrink)
In this paper I examine one line of argument against the claim that (some) suicide may be morally legitimate. This argument appeals to a putative moral principle that it is never licit to assault an innocent human life. I consider some related arguments in St. Augustine and St. Thomas, and I explore two possible senses of “innocent.” I argue that in one sense the putative moral principle is very implausible, and in neither sense is it true that all suicides (...) assault an innocent life. So this line of argument fails to establish the desired universal prohibition of suicide. (shrink)
In the United States, judicialrulings that unrealistically addressed the complexityof cases and demonstrated limited understanding ofprinciples, helped to create a legal quagmire whichlegislatures had to confront. Moreover, thelegislative response was often slow and inadequate interms of both the scope and clarity of the laws. However, since the 1970s, progress has been made onmany fronts, particularly in regard to advancedirectives dealing with end-of-life decisions. Thedebate over physician-assisted suicide has spawned arepetition of moral and legal arguments. Thoseagainst legalization have failed to (...) make a realisticappraisal of the dilemmas facing patients and theirfamilies in an age of technological medicine deliveredin the context of the marketplace. The underlyingproblem is a system in dire need of reform that willno longer treat health care as a commodity of themarketplace and provide universal health care. Terminal care as an integral part of health care willsubstantially benefit from such reforms because amajor obstacle to comprehensive palliative care is thecondition of the present system. (shrink)
(2013). The Distinction Between Completing a Suicide and Assisting One: Why Treating a Suicide Attempt Does Not Require Closing the “Window of Opportunity”. The American Journal of Bioethics: Vol. 13, No. 3, pp. 26-27. doi: 10.1080/15265161.2013.767077.