Assisted Suicide

Objective Altruism is arguably the quintessential moral trait, involving willingness to benefit others and unwillingness to harm them. In this study, I explored how altruism and other personality variables relate to acceptance of euthanasia. In addition, I investigated the role of culture in attitudes to subcategorical distinctions of euthanasia.Methods 190 Iranian students completed the Attitude Towards Euthanasia scale, the HEXACO Personality Inventory-Revised, and an interest in religion measure.Results Higher scores on altruism, Honesty–Humility, Agreeableness, Conscientiousness and religiousness were associated with viewing (...) euthanasia as unacceptable. As expected, altruism explained unique variance in euthanasia attitude beyond gender, religiosity and broad personality factors.Conclusions Cultural and individual differences should be taken into consideration in moral psychology research and end-of-life decision-making. (shrink)

Aim To study the views of people in a largely Muslim country, Kuwait, of the acceptability of a life-ending action such as physician-assisted suicide (PAS). Method 330 Kuwaiti university students judged the acceptability of PAS in 36 scenarios composed of all combinations of four factors: the patient's age (35, 60 or 85 years); the level of incurability of the illness (completely incurable vs extremely difficult to cure); the type of suffering (extreme physical pain or complete dependence) and the extent to (...) which the patient requests a life-ending procedure, euthanasia or PAS (no request, some form of request, repeated requests). In all scenarios, the patients were women who were receiving the best possible care. The ratings were subjected to cluster analysis and analyses of variance. Results Five clusters were found. For 44%, PAS was always very unacceptable, no matter what the circumstances. For 23%, it was unacceptable, but less so if the patient was older or requested it repeatedly. For 16%, it was unacceptable if the patient was young but was acceptable if the patient was elderly. For 5%, it was unacceptable if the patient had extreme pain but was acceptable if completely dependent. For 11%, it was unacceptable if the patient did not request it but acceptable if she did. Conclusion The majority of the Kuwaiti university students opposed PAS either categorically or with a slight variation according to circumstances. Nonetheless, a minority approved of PAS in some cases, particularly when the patient was elderly. (shrink)

The purpose of this article is to develop a conception of death with dignity and to examine whether it is vulnerable to the sort of criticisms that have been made of other conceptions. In this conception “death” is taken to apply to the process of dying; “dignity” is taken to be something that attaches to people because of their personal qualities. In particular, someone lives with dignity if they live well (in accordance with reason, as Aristotle would see it). It (...) follows that health care professionals cannot confer on patients either dignity or death with dignity. They can, however, attempt to ensure that the patient dies without indignity. Indignities are affronts to human dignity, and include such things as serious pain and the exclusion of patients from involvement in decisions about their lives and deaths. This fairly modest conception of death with dignity avoids the traps of being overly subjective or of viewing the sick and helpless as “undignified”. (shrink)

This paper presents my personal convictions, as an Evangelical, regarding the absolute impropriety of doctor-assisted suicide for Christians. They have been “bought with a price” and are owned by Another. Hence, they must always strive to glorify God in their bodies, both in life and in death. Although they crave the well-being of temporal health, when they are ill seek healing or relief, and may well recoil even from the thought of suffering and dying, they should realize that their values (...) and priorities must be rooted in biblical truths and that their well-being is eternal and not temporal, spiritual and not material. As Christians, their attitudes and responses to suffering and dying must be molded by the reality that their Creator and Sovereign will cause all things to work together for their good and that their Lord has called them into a fellowship of His suffering in which they are sustained by dependence upon Him. Hence, for Christians to take their lives in order to escape from the trials and testings ordained by Him would be a failure of love and a breach of trust. (shrink)

A detailed review of the 2013 Festschrift for John Finnis.

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 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)

Attitudes to questions of whether physician-assisted dying should be legalised in the UK, reflect one of the greatest challenges to moral stance in health care for both individuals and professional bodies, not least as indicated by public opinion. However, public opinion is a seductively deceptive notion, seemingly readily identifiable but in practice multifarious. At best, consensus regarding public opinion and assisted dying is illusory, sometimes transient and what is relevant in this matter is a comprehension of both majority (popular) opinion (...) and vocal dissent, but which do not them selves have a simple relationship with Parliamentary attitudes and legislation. Arguably, an increasingly important consideration to take account of is the influence of increasing population diversity. (shrink)

The purpose of the present study is to determine if physician-assisted suicide is ever morally justified and, if so, under what conditions. We begin with a brief introduction of the current debate surrounding the issue of physician-assisted suicide. Chapter One is devoted to establishing the sufficient conditions for an act to constitute suicide. We argue that some acts which are considered to be praiseworthy are in fact acts of suicide. We also argue that some medical practices which are currently considered (...) to be both morally and legally acceptable involve an act of suicide. In order to support our argument, Chapter Two is devoted to establishing the necessary and sufficient conditions for euthanasia. The connection between physician-assisted suicide and euthanasia is made insofar as we find that physician-assisted suicide is a type of voluntary euthanasia. Our search for an answer to the moral justification of physician-assisted suicide is now broadened to include all forms of voluntary euthanasia. Chapter Three is directed toward an investigation of the commonly held distinction between active and passive euthanasia. We also examine the distinction between ordinary and extraordinary means of medical treatment and the distinction between killing and letting die which is supported by the principle of double effect. It is argued that none of the foregoing distinctions merit the moral standing that has been attributed to them. We conclude that there is no morally significant difference between active and passive euthanasia, either both are morally justified or neither is. In Chapter Four, we consider four major types of arguments against voluntary euthanasia and conclude that none of these arguments show that voluntary euthanasia is morally unjustified. Finally, Chapter Five focuses on two arguments most often found in defense of voluntary euthanasia: the mercy argument and the argument from the right to death. We dismiss the mercy argument as insufficient to support the justification for voluntary euthanasia but find acceptable the argument from a right to death. We conclude that voluntary euthanasia in all its forms is morally justified in those cases in which the agent is convinced that the patient's request is both fixed and rational. (shrink)

Medicine is a science, and healing, an art. The right mix of a scientist and an artist is essential in a good physician. Clinical detachment is the balance between the scientist and the human. Good physicians are born; however, it is possible to cultivate the qualities. Gaining the patient's confidence is an art; a sense of humor can greatly help. Give a child respect and he becomes your friend. Death is inevitable, but a physician can help make it less agonizing. (...) A good physician is a philosopher, aware of the beauty of life, of his limitations and conscious of the power that controls us. (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.

Objective: To explore the relationship between the presentation of suffering and support for euthanasia in the British news media.Method: Data was retrieved by searching the British newspaper database LexisNexis from 1996 to 2000. Twenty-nine articles covering three cases of family assisted suicide were found. Presentations of suffering were analysed employing Heidegger’s distinction between technological ordering and poetic revealing.Findings: With few exceptions, the press constructed the complex terrain of FAS as an orderly or orderable performance. This was enabled by containing the (...) contradictions of FAS through a number of journalistic strategies: treating degenerative dying as an aberrant condition, smoothing over botched attempts, locating the object of ethical evaluation in persons, not contexts, abbreviating the decision making process, constructing community consensus and marginalising opposing views.Conclusion: The findings of this study support the view that news reporting of FAS is not neutral or inconsequential. In particular, those reports presenting FAS as an orderly, rational performance were biased in favor of technical solutions by way of the legalisation of euthanasia and/or the involvement of medical professionals. In contrast, while news reports sensitive to contradiction did not necessarily oppose euthanasia, they were less inclined to overtly support technical solutions, recognising the importance of a trial to address the complexity of FAS. (shrink)

Disamina delle principali posizioni etiche a proposito di eutanasia e suicidio assistito.

In the present article the concept of the right to die will be analyzed in English and American literature between 1990 and 1994.

The problem of self-determination in the dying process confronts a dilemma regarding clients’ desire to know and not to know. Ambivalence and guilt make “free choice” problematic in choosing the way to die. Telling dying clients the “whole truth” about their condition is an art or skill. The question of a meaningful death raises questions that philosophical analysis can help clarify.

This paper considers the problems that arise when death, which is a philosophically difficult concept, is incorporated into healthcare metrics, such as the quality-adjusted life year (QALY). These problems relate closely to the debate over euthanasia and assisted suicide because negative QALY scores can be taken to mean that patients would be ‘better off dead’. There is confusion in the literature about the meaning of 0 QALY, which is supposed to act as an ‘anchor’ for the surveyed preferences on which (...) QALYs are based. In the context of the debate over euthanasia, the QALY assumes an ability to make meaningful comparisons between life-states and death. Not only is this assumption questionable, but the ethical debate is much more broad than the question of whether death is preferable to a state of living. QALYs are derived from preferences about health states, so do not necessarily reflect preferences about events (eg, dying) or actions (eg, killing). This paper presents a new kind of problem for the QALY. As it stands, the QALY provides confused and unreliable information when it reports zero or negative values, and faces further problems when it appears to recommend death. This should preclude its use in the debate over euthanasia and assisted suicide. These problems only apply where the QALY involves or seems to involve a comparison between life-states and death, and are not relevant to the more general discussion of the use of QALYs as a tool for comparing the benefits derived from treatment options. (shrink)

Background: Debates over legalisation of physician-assisted suicide or euthanasia often warn of a “slippery slope”, predicting abuse of people in vulnerable groups. To assess this concern, the authors examined data from Oregon and the Netherlands, the two principal jurisdictions in which physician-assisted dying is legal and data have been collected over a substantial period.Methods: The data from Oregon comprised all annual and cumulative Department of Human Services reports 1998–2006 and three independent studies; the data from the Netherlands comprised all four (...) government-commissioned nationwide studies of end-of-life decision making and specialised studies. Evidence of any disproportionate impact on 10 groups of potentially vulnerable patients was sought.Results: Rates of assisted dying in Oregon and in the Netherlands showed no evidence of heightened risk for the elderly, women, the uninsured , people with low educational status, the poor, the physically disabled or chronically ill, minors, people with psychiatric illnesses including depression, or racial or ethnic minorities, compared with background populations. The only group with a heightened risk was people with AIDS. While extralegal cases were not the focus of this study, none have been uncovered in Oregon; among extralegal cases in the Netherlands, there was no evidence of higher rates in vulnerable groups.Conclusions: Where assisted dying is already legal, there is no current evidence for the claim that legalised PAS or euthanasia will have disproportionate impact on patients in vulnerable groups. Those who received physician-assisted dying in the jurisdictions studied appeared to enjoy comparative social, economic, educational, professional and other privileges. (shrink)