Whether the law should permit voluntary euthanasia or physician-assisted suicide is one of the most vital questions facing all modern societies. Internationally, the main obstacle to legalisation has proved to be the objection that, even if they were morally acceptable in certain 'hard cases', voluntary euthanasia and physician-assisted suicide could not be effectively controlled; society would slide down a 'slippery slope' to the killing of patients who did not make a free and informed request, or for whom palliative (...) care would have offered an alternative. How cogent is this objection? This book provides the general reader with a lucid introduction to this central question in the debate, not least by reviewing the Dutch euthanasia experience. It will interest all in any country whether currently for or against legalisation, who wish to ensure that their opinions are better informed. (shrink)
Argues that considerations central to the justification of euthanizing humans do not readily extrapolate to the euthanasia of pets and companion animals; that the comparative account of death's badness can be successfully applied to such animals to ground the justification of their euthanasia and its timing; and proposes that companion animal guardians have authority to decide to euthanize such animals because of their epistemic standing regarding such animals' welfare.
Why do so many doctors have profound misgivings about the push to legalise euthanasia and assisted suicide? Ole Hartling uses his background as a physician, university professor and former president of the Danish Council of Ethics to introduce new elements into what can often be understood as an all too simple debate. Alive to the case that assisted dying can be driven by an unattainable yearning for control, Hartling concentrates on two fundamental questions: whether the answer to suffering is (...) to remove the sufferer, and whether self-determination in dying and death is an illusion. He draws on his own experience as a medical doctor to personalize the ethical arguments, share patients' narratives and make references to medical literature. Here is a sceptical stance towards euthanasia, one that is respectful to those who hold different opinions and well-informed about the details and nuances of different euthanasia practices. Written from a Scandinavian perspective, where respect for autonomy and high quality palliative care go hand in hand, Hartling's is a nuanced, valuable contribution to the arguments that surround a question doctors have faced since the birth of medicine. He shows us how the intentions of doing something good can sometimes lead to even greater dilemmas, opening us up to those situations where an inclination to end suffering by ending life is deeply conflicting both for the clinician and for any fellow human being. (shrink)
Margaret Otlowski investigates the complex and controversial issue of active voluntary euthanasia. She critically examines the criminal law prohibition of medically administered active voluntary euthanasia in common law jurisdictions, and carefully looks at the situation as handled in practice. The evidence of patient demands for active euthanasia and the willingness of some doctors to respond to patients' requests is explored, and an argument for reform of the law is made with reference to the position in the Netherlands (...) (where active voluntary euthanasia is now openly practiced). (shrink)
Euthanasia and assisted suicide have proved to be very contentious topics in medical ethics. Some ethicists are particularly concerned that allowing physicians to carry out these procedures will undermine their professional obligations and threaten the very goals of medicine. However, I maintain that the fundamental goals of medicine not only do not preclude the practice of euthanasia and assisted suicide by physicians, but can in fact be seen to support these practices in some instances. I look at two (...) influential views of the goals of medicine, one based on the broad guiding principles of autonomy, beneficence and nonmaleficence, and the other focusing on several more concrete aims, concluding that both approaches can be seen to support euthanasia and assisted suicide. I then turn to the popular concern that allowing physicians to carry out euthanasia and assisted suicide will lead to widespread abuse. I argue that the possibility for abuse can be minimised if we make the patient's autonomous consent an essential requirement of the practice. (shrink)
The Dutch rules governing neonatal euthanasia, known as the Groningen Protocol, require parental consent for severely disabled infants with poor prognoses to have their lives terminated. This paper questions whether parental consent should be dispositive in such cases, and argues that the potential suffering of the neonate or pediatric patient should be the decisive factor under such unfortunate circumstances.
Machine generated contents note: Table of Cases xi -- Table of legislation xv -- Introduction: Medicine Men, Outlaws and Voluntary Euthanasia 1 -- 1. To Kill or not to Kill; is that the Euthanasia Question? 9 -- Introduction-Why Euthanasia? 9 -- Dead or alive? 16 -- Euthanasia as Homicide 25 -- Euthanasia as Death with Dignity 29 -- 2. Euthanasia and Clinically assisted Death: from Caring to Killing? 35 -- Introduction 35 -- The Indefinite (...) Continuation of Palliative Treatment 38 -- Withholding or Withdrawing Treatment 44 -- The Principle of Double Effect 54 -- Physician Assisted Suicide 60 -- Mercy Killing 64 -- Conclusions 66 -- 3. Consent to Treatment but Not to Death 69 -- Introduction-Why Consent? 69 -- Without Consent 70 -- Killing and Consent 73 -- Valid Consent, Freely Given? 74 -- Old Enough to Consent 80 -- Deciding for Others 82 -- Conclusions-A Consent Too Far? 93 -- 4. Autonomy, Self-determination and Self-destruction 95 -- Introduction-Autonomous Choices 95 -- Choosing to Die-Suicide and Autonomy 100 -- Suicidal Intentions 107 -- Autonomous Clinical Discretion 110 -- Deciding to Live or Die-Whose Decision? 112 -- 5. Living Wills and the Will to Die 115 -- Introduction 115 -- I Know My Will 118 -- This is My Will 121 -- I Will Decide 128 -- Will My Will be Done? 134 -- Where There's a Will 137 -- Conclusions 143 -- 6. Is Euthanasia a Dignified Death? 145 -- Introduction-Why Dignity? 145 -- Needing Dignity 146 -- Finding Dignity 149 -- Achieving Dignity in Dying 151 -- Dignifying Death 157 -- 7. Conclusions: Dignified Life, Dignified Death and Dignified Law 165 -- Select Bibliography 175 -- Index 183. (shrink)
Sadly, there are people in very bad medical conditions who want to die. They are in pain, they are suffering, and they no longer find their quality of life to be at an acceptable level anymore. -/- When people like this are kept alive by machines or other medical treatments, can it be morally permissible to let them die? -/- Advocates of “passive euthanasia” argue that it can be. Their reasons, however, suggest that it can sometimes be not wrong (...) to actively kill some patients, i.e., that “active euthanasia” can be permissible also. This essay reviews these arguments. (shrink)
Authorising euthanasia and assisted suicide with advance euthanasia directives is permitted, yet debated, in the Netherlands. We focus on a recent controversial case in which a Dutch woman with Alzheimer’s disease was euthanised based on her AED. A Dutch euthanasia review committee found that the physician performing the euthanasia failed to follow due care requirements for euthanasia and assisted suicide. This case is notable because it is the first case to trigger a criminal investigation since (...) the 2002 Dutch euthanasia law was enacted. Thus far, only brief descriptions of the case have been reported in English language journals and media. We provide a detailed description of the case, review the main challenges of preparing and applying AEDs for persons with dementia and briefly assess the adequacy of the current oversight system governing AEDs. (shrink)
Ong, Caroline In February 2014, the Belgian parliament passed an amendment to the Belgian Act on Euthanasia of May 28th, 2002 removing the age limit of those requesting euthanasia provided that they have discerning capabilities and their parents approve. After mentioning briefly the arguments against legalising euthanasia, this article questions the ethical validity of removing the age limit, as well as the presumption that ending lives prematurely allows people to die with dignity. Caring for people who are (...) vulnerable in their suffering is the proper goal of the healing professions, not terminating lives. (shrink)
Belgium has recently extended its euthanasia legislation to minors, making it the first legislation in the world that does not specify any age limit. I consider two strands in the opposition to this legislation. First, I identify five arguments in the public debate to the effect that euthanasia for minors is somehow worse than euthanasia for adults—viz. arguments from weightiness, capability of discernment, pressure, sensitivity and sufficient palliative care—and show that these arguments are wanting. Second, there is (...) another position in the public debate that wishes to keep the current age restriction on the books and have ethics boards exercise discretion in euthanasia decisions for minors. I interpret this position on the background of Velleman’s “Against the Right to Die” and show that, although costs remain substantial, it actually can provide some qualified support against extending euthanasia legislation to minors. (shrink)
This two-volume set addresses key historical, scientific, legal, and philosophical issues surrounding euthanasia and assisted suicide in the United States as well as in other countries and cultures. * Addresses the extended history of debates regarding the ethical justifiability of assisted suicide and euthanasia * Analyzes assisted suicide and euthanasia in many cultural, philosophical, and religious traditions * Provides an interdisciplinary perspective on the subject, including coverage of topics such as the depictions of assisted dying in popular (...) culture, that enables a more complete understanding of this emotionally charged controversy * Spotlights the latest medical and scientific developments and examines the role of technology in the ethical debates on assisted dying. (shrink)
The objective of this paper is to understand from a sociological perspective how the moral question of euthanasia, framed as the “right to die”, emerges and is dealt with in society. It takes France and Germany as case studies, two countries in which euthanasia is prohibited and which have similar legislation on the issue. I presuppose that, and explore how, each society has its own specificities in terms of practical, social and political norms that affect the ways in (...) which they deal with these issues. The paper thus seeks to understand how requests for the “right to die” emerge in each society, through both the debate (analysis of daily newspapers, medical and philosophical literature, legal texts) and the practices (ethnographic work in three French and two German hospitals) that elucidate the phenomenon. It does so, however, without attempting to solve the moral question of euthanasia. In spite of the differences observed between these two countries, the central issue at stake in their respective debates is the question of the individual’s autonomy to choose the conditions in which he or she wishes to die; these conditions depend, amongst others, on the doctor-patient relationship, the organisation of end-of-life care in hospital settings, and more generally, on the way autonomy is defined and handled in the public debate. (shrink)
This paper re-evaluates euthanasia and assisted suicide from the perspective of eudaimonia, the ancient Greek conception of happiness across one’s whole life. It is argued that one cannot be said to have fully flourished or had a truly happy life if one’s death is preceded by a period of unbearable pain or suffering that one cannot avoid without assistance in ending one’s life. While death is to be accepted as part of life, it should not be left to nature (...) to dictate the way we die, and it is fundamentally unjust to grant people liberal latitude in how they live their lives while granting them little control over the conclusion of their life narratives. Three objections to this position are considered and rejected; the paper also offers an explanation of why we think killing can be a benefit. Ultimately, euthanasia may be necessary in some cases in order to achieve eudaimonia. (shrink)
The growing support for voluntary active euthanasia is evident in the recently approved Dutch Law on Termination of Life on Request. Indeed, the debate over legalized VAE has increased in European countries, the United States, and many other nations over the last several years. The proponents of VAE argue that when a patient judges that the burdens of living outweigh the benefits, euthanasia can be justified. If some adults suffer to such an extent that VAE is justified, then (...) one may conclude that some children suffer to this extent as well. In an attempt to alleviate the suffering of extremely ill neonates, the University Medical Center Groningen developed a protocol for neonatal euthanasia. In this article, I first present the ethical justifications for VAE and discuss how these arguments relate to euthanizing ill neonates. I then argue that, even if one accepts the justification for VAE in adults, neonatal euthanasia cannot be supported, primarily because physicians and parents can never accurately assess the suffering of children. I argue that without the testament of the patient herself as to the nature and magnitude of her suffering, physicians can never accurately weigh the benefits and burdens of a child’s life, and therefore any such system would condemn to death some children whose suffering is not unbearable. I conclude that because the primary duty of physicians is to never harm their patients, neonatal euthanasia cannot be supported. (shrink)
Thomasma and Graber, medical ethics theorists and clinical practitioners, present a definitive examination of the actions that fall under the aegis of euthanasia--the art of painlessly putting to death persons suffering from incurable conditions or diseases. They distinguish active euthanasia as an intentional act that causes death, while passive euthanasia is seen as an intentional act to avoid prolonging the dying process. They maintain that the distinction between these two modes of euthanasia depends not on motive, (...) but on means. The authors present a theoretical discussion of which forms are justified and unjustified, and explore, with the help of case studies, four main perspectives on the issue: those of the individual, the family, the medical profession, and society as a whole. ISBN 0-8264-0470-7: $24.95. (shrink)
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)
In a recent article, Henri Wijsbek discusses the 1991 Chabot “psychiatric euthanasia” case in the Netherlands, and argues that Chabot was justified in helping his patient to die. Dutch legislation at the time permitted physician assisted suicide when the patient’s condition is severe, hopeless, and unbearable. The Dutch Supreme Court agreed with Chabot that the patient met these criteria because of her justified depression, even though she was somatically healthy. Wijsbek argues that in this case, the patient’s integrity had (...) been undermined by recent events, and that this is the basis for taking her request seriously; it was unreasonable to expect that she could start again. In this paper, I do not challenge the Dutch euthanasia criteria in the case of somatic illness, but I argue that both Chabot and Wijsbek are wrong because we can never be sufficiently confident in cases of severe exogenous depression to assist the patient in her irreversible act. This is partly because of the essential difference between somatic and mental illness, and because of the possibility of therapy and other help. In addition, I argue that Wijsbek’s concept of integrity cannot do the work that he expects of it. Finally, I consider a 2011 position paper from the Royal Dutch Medical Association on euthanasia, and the implications it might have for Chabot-style cases in the future. (shrink)
The article examines the so-called slippery slope argument (SSA) against the legalization of active voluntary euthanasia (AVE). According to the SSA, by legalizing AVE, the least morally controversial type of euthanasia, we will take the first step onto a slippery slope and inevitably end up in the moral abyss of widespread abuse and violations of the rights of the weakest and most vulnerable patients. In the first part of the paper, empirical evidence to the contrary is presented and (...) analyzed: None of the forecasted regrettable trends can be elicited from the body of existing statistical data. Accordingly, we have no good reason to believe either that we already are, or are sooner or later going to be, sliding into a moral abyss. A related question is then considered: Would it not be wiser and safer to stick to the status quo and preserve the existing legal ban on AVE even if the risk of its abuse is uncertain and may well turn out to be relatively low? It is argued that such an appeal to precautionary reasoning fails to justify an outright legal ban on AVE for at least two reasons: (i) it grossly underestimates the hidden moral costs of current legal arrangements (competent terminal patients suffer both disrespect for their autonomous will and deprivation of the good of a timely death) and (ii) the ban is both too inefficient and disproportionate to qualify as a reasonable measure of precaution. (shrink)
The article examines the so-called slippery slope argument (SSA) against the legalization of active voluntary euthanasia (AVE). According to the SSA, by legalizing AVE, the least morally controversial type of euthanasia, we will take the first step onto a slippery slope and inevitably end up in the moral abyss of widespread abuse and violations of the rights of the weakest and most vulnerable patients. In the first part of the paper, empirical evidence to the contrary is presented and (...) analyzed: None of the forecast regrettable trends can be elicited from the body of existing statistical data. Accordingly, we have no good reason to believe either that we already are, or are sooner or later going to be, sliding into a moral abyss. A related question is then considered: Would it not be wiser and safer to stick to the status quo and preserve the existing legal ban on AVE even if the risk of its abuse is uncertain and may well turn out to be relatively low? It is argued that such an appeal to precautionary reasoning fails to justify an outright legal ban on AVE for at least two reasons: (i) it grossly underestimates the hidden moral costs of current legal arrangements (competent terminal patients suffer both disrespect for their autonomous will and deprivation of the good of a timely death) and (ii) the ban is both too inefficient and disproportionate to qualify as a reasonable measure of precaution. (shrink)
In discussions about the legalisation of active, voluntary euthanasia it is sometimes claimed that what should happen in a liberal society is that the two sides in the debate “agree to disagree”. This paper explores what is entailed by agreeing to disagree and shows that this is considerably more complicated than what is usually believed to be the case. Agreeing to disagree is philosophically problematic and will often lead to an unstable compromise.
The moral issues involved in doctors assisting patients to die with dignity are of absolutely central concern to the medical profession, ethicists, and the public at large. The debate is fuelled by cases that extend far beyond passive euthanasia to the active consideration of killing by physicians. The need for a sophisticated but lucid exposition of the two sides of the argument is now urgent. This book supplies that need. Two prominent philosophers, Gerald Dworkin and R. G. Frey present (...) the case for legalization of physician-assisted suicide. One of the best-known ethicists in the US, Sissela Bok, argues the case against. (shrink)
In this article we discuss the moral and legal aspects of causing the death of a terminal patient in the hope of extending their life in the future. We call this theoretical procedure cryothanasia. We argue that administering cryothanasia is ethically different from administering euthanasia. Consequently, objections to euthanasia should not apply to cryothanasia, and cryothanasia could also be considered a legal option where euthanasia is illegal.
Kant has famously argued that human beings or persons, in virtue of their capacity for rational and autonomous choice and agency, possess dignity, which is an intrinsic, final, unconditional, inviolable, incomparable and irreplaceable value. This value, wherever found, commands respect and imposes rather strict moral constraints on our deliberations, intentions and actions. This paper deals with the question of whether, as some Kantians have recently argued, certain types of (physician-assisted) suicide and active euthanasia, most notably the intentional destruction of (...) the life of a terminally-ill, but rational and autonomous patient in order to prevent certain serious harms, such as enduring or recurring pain or the loss of the meaning in life, from befalling him really are inconsistent with respect for the patient’s human dignity. I focus on two independent, though interrelated explications of the rather vague initial idea that the patient (as well as the doctor), in intending and bringing about his death, treats his person or rational nature merely as a means and so denigrates his dignity: (i) that in doing what he is doing, he does not act for the sake of his person, but for the sake of something else; (ii) that, by trading his person for pain relief, he engages himself in an irrational and hence immoral exchange. After critically discussing some suggestions about how to understand this charge, I eventually find Kantian objections to suicide and (active) euthanasia, based on the idea of human dignity, less than compelling. For all the paper proves, suicide and (active) euthanasia may still be morally impermissible, but then this must be so for some other reason than the one given above. (shrink)
Euthanasia is a popular subject that health care professionals, lawyers and theologians has dealt with for a long time. While it was an extreme and exceptional case to support and argue in favour of euthanasia among health care professionals and lay public, it becomes more and more common to see supporters of this act especially among health care professionals.In this article euthanasia is examined from different perspectives, and tried to draw a conclusion that may be helpful to (...) clarify our thinking on this issue. Throughout the article, the concept of ‘ownership’ and the popular bioethical principal ‘right to autonomy’ are also explored. It is mainly concluded that since the euthanasia is the termination of a human life, and violates the internal morality of medicine, it cannot be considered as a part of ‘good-doctoring’ before it is questioned and debated very closely by the concerned public, as well as health care professionals, lawyers, theologians and politicians. (shrink)
I identify what appears to be a "glaring" inconsistency between what Joseph Raz says on euthanasia in a 2012 lecture and what he says on well-being within his most celebrated book, The Morality of Freedom. There also appears to be a subtler inconsistency between what he says and his endorsement of H.L.A. Hart’s opposition to a definitional project.
In 2011, Frank Van Den Bleeken became the first detainee to request euthanasia under Belgium’s Euthanasia Act of 2002. This article investigates whether it would be lawful and morally permissible for a doctor to accede to this request. Though Van Den Bleeken has not been held accountable for the crimes he committed, he has been detained in an ordinary prison, without appropriate psychiatric care, for more than 30 years. It is first established that VDB’s euthanasia request plausibly (...) meets the relevant conditions of the Euthanasia Act and that, consequently, a doctor could lawfully fulfill it. Next, it is argued that autonomy-based reasons for euthanizing VDB outweigh complicity-based reasons against doing so, and that, therefore, it is also morally permissible for a doctor to carry out the euthanasia request. (shrink)
The book attempts to conceptualize the “ancient” issues of human death and human mortality in connection to the timely and vital subject of euthanasia. This subject forces the meditation to actually consider those ideological, ethical, deontological, legal, and metaphysical frameworks which guide from the very beginning any kind of approach to this question. This conception – in dialogue with Heideggerian fundamental ontology and existential analytics – reveals that, on the one hand, the concepts and ethics of death are originally (...) determined by the ontology of death, and, on the other hand, that, on this account, the question of euthanasia can only be authentically discussed in the horizon of this ontology. It is only this that may reveal to whom dying – our dying – pertains, while it also reveals our relationship to euthanasia as a determined human potentiality or final possibility. Thus euthanasia is outlined in the analysis as the possibility of becoming a mortal on the one hand, while on the other hand it appears in relation to the particularities of its existential structure, which essentially differ from the existential and ontological structure of any other possibility of dying. This is why it should not be mixed up with, or mistaken for, any of these. (shrink)
Presenting the case against legalizing euthanasia, this paper refers mainly to two clinical facts. First that, in the majority of cases, a wish to die is a symptom of depression; and second, that depression affects rational decision making. Since a depressive individual is not fully competent, it is a mistake to resort to that individual's autonomy. One should recall that a subclinical depressive state is an object of treatment, and safeguards are necessary lest this state should be an object (...) of euthanasia or assisted suicide. (shrink)
Euthanasia in China is gaining increasing acceptance among physicians, intellectuals, and even the people. This paper surveys current attitudes towards euthanasia and suggests why it should be legalized. Keywords: euthanasia, euthanasia in China CiteULike Connotea Del.icio.us What's this?
In the Netherlands, in 2002, euthanasia became a legitimate medical act, only allowed when the due care criteria and procedural requirements are met. Legally, an Advanced Euthanasia Directive can replace direct communication if a patient can no longer express his own wishes. In the past decade, an exponential number of persons with dementia share a euthanasia request with their physician. The impact this on physicians, and the consequent support needs, remained unknown. Our objective was to gain more (...) insight into the experiences and needs of Dutch general practitioners and elderly care physicians when handling a euthanasia request from a person with dementia. We performed a qualitative interview study. Participants were recruited via purposive sampling. The interviews were transcribed verbatim, and analyzed using the conventional thematic content analysis. Eleven general practitioners and elderly care physicians with a variety of experience and different attitudes towards euthanasia for PWD were included. Euthanasia requests appeared to have a major impact on physicians. Difficulties they experienced were related to timing, workload, pressure from and expectations of relatives, society’s negative view of dementia in combination with the ‘right to die’ view, the interpretation of the law and AEDs, ethical considerations, and communication with PWD and relatives. To deal with these difficulties, participants need support from colleagues and other professionals. Although elderly care physicians appreciated moral deliberation and support by chaplains, this was hardly mentioned by GPs. Euthanasia requests in dementia seem to place an ethically and emotionally heavy burden on Dutch GPs and elderly care physicians. The awareness of, and access to, existing and new support mechanisms needs further exploration. (shrink)
The present ethical advice tackles the question as to how caregivers in a Catholic mental health service can take care of psychiatric patients requesting euthanasia because of their unbearable mental suffering. The question arises because the Belgian act on euthanasia allows euthanasia under certain conditions, while the Roman Catholic Church forbids euthanasia in all circumstances. The ethical advice is based on the assessment of fundamental values: the inviolability of life, the patient’s autonomy, and the care relationship (...) between caregivers and patient. To integrate these values, caregivers should in a timely fashion make clear that life is inviolable, attentively respect the patient’s autonomy, and provide the best possible care relationship, including counseling for existential questions. If the request for euthanasia persists, the only sensible option is to refer the patient to another physician, guaranteeing the continuity of the care relationship. In the tension between the inviolability of life and the patient’s autonomy, the care relationship is the binding value. (shrink)
Euthanasia or mercy killing is, now a day, a major problem widely discussed in medical field. Medical professionals are facing dilemma to take decision regarding their incompetent patient while tend to do euthanasia. The dilemma is by nature moral i.e. whether it is morally permissible or not. In some countries of Europe and in some provinces of USA euthanasia is legally permitted fulfilling some conditions. It is claimed by Rachels that in our practical medical practice we do (...)euthanasia by forbidding patients from taking drugs. He concludes that if that type of euthanasia can be practiced in our society without any hesitation then why assisting euthanasia will not be permitted1. There are so many arguments both pro and con of euthanasia. But it is not the function of the current paper to discuss all the arguments. Philippa Foot in her article „Euthanasia‟ and J Velleman in his article titled as „A Right to Self-termination‟ discussed about the permissibility of euthanasia. The objective of the paper is to justify their arguments and then come to a conclusion regarding the permissibility of euthanasia. The focus will be given mainly on non- voluntary active and non-voluntary passive euthanasia. The method of discussion will be that an example will be given from Bangladesh and then the arguments provided by Foot and Velleman in their above mentioned papers will be discussed to justify the act of euthanasia on concerned patient. In the last section of the paper the situation of Bangladesh will also be considered for the permissibility of euthanasia i.e. whether the act of euthanasia can be permitted in our country considering the existing socio-cultural-religious practice. (shrink)
Dutch developments on euthanasia have drawn much attention over the years. Defenders and opponents have been telling very different stories about the practice of euthanasia and the frequency of cases, and the Dutch government has been struggling with the legal and moral problems involved. Concern about the procedures followed by physicians as well as questions on the “real” figures led the government to decide to organize an epidemiological study on the extent and the decision making. The results of (...) the study were published in November 1991. Interpretation of the data may lead to a final settlement of the debate on euthanasia and has inevitably led to a revival of the moral debate of the 1970s. For the moment it has been decided that euthanasia will remain officially illegal under the Penal Code. However, in cases where euthanasia does occur, Attorneys General will continue to check the procedures followed by physicians to ensure no abuses have occurred and to safeguard physicians against prosecution. In this contribution, we discuss the development and intertwinement of legal, medical, and moral aspects of euthanasia in The Netherlands and the effects of the empirical studies of 1991, both on definitions and procedures for medical decisions at the end of life. (shrink)
Definition of the problem: The Dutch policy regarding euthanasia has been causing amazement in other countries over and over again: Although euthanasia is illegal in the Netherlands, there are cases of euthanasia in which no criminal prosecution follows. The latter are regulated actively and in public by the Dutch authorities. In other countries certain cases of euthanasia are sometimes tolerated as well, however, there it is in most cases merely tacitly consented to. In contrast to these (...) countries, in the Netherlands it is declared in advance under which conditions physicians do not need to fear criminal prosecution of their illegal actions. How can this peculiar Dutch policy be explained?Arguments: The Dutch policy concerning euthanasia is a typical example of a policy of pragmatical tolerance. This societal phenomenon is typically Dutch and can best be explained from a historical perspective.Conclusion: The historical roots of this policy of pragmatical tolerance can be found in the Dutch republic of the 17th century, where two dominant and sometimes rather opposite societal forces influenced the Dutch mentality and policy. The merchants wanted peace and freedom through a policy of tolerance, exemptions and compromises. The calvinists, on the other hand, strove for normative regulation of all human behaviour corresponding to their rigid moral standards. These two forces constituted the Dutch policy of pragmatical tolerance: on the one hand certain criminal acts remained unpunished, on the other hand certain conditions for immunity from criminal prosecution were formulated in advance and in public by the authorities. As such the practice of tolerance of illegal deeds was normatively regulated. This typically Dutch form of tolerance still exerts an important influence on the present policy of euthanasia in the Netherlands. (shrink)
Definition of the problem: Concerning the debate on euthanasia, a widely held position is that it should be accepted in its so-called passive and indirect form, while so-called active euthanasia should be rejected. The problem, now, is that at least some of the usual arguments to defend this view are invalid. Arguments: Three kinds of failures are examinded: First, if taken seriously, some of the arguments against active euthanasia undermine the accepted passive and indirect forms, too. For (...) example, this is the case concerning the claim that the patient's decision can be manipulated. Second, the rejection of active euthanasia partly rests on empirical data unsuited for this task. Euthanasia in The Netherlands as evidence for the so-called slippery slopes is presented as an example. Third, some of the objections against active euthanasia rest on assumptions that contradict our empirical knowledge, e.g. in the field of motives of patients asking for euthanasia. Conclusion: Those who want to defend the view mentioned above have to present more conclusive arguments. (shrink)
For euthanasia the case is deceptively easy to make. When the suffering of others is ended by death we often feel relief. Commonly we accept that animals must sometimes, as the saying goes, be 'put out of their misery'. And, while most people who advocate euthanasia do not rely simply on our revulsion from suffering as though there were no other considerations, the public appeal of their view probably does rest largely on it.
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)
The lack of consensus in American society regarding the permissibility of assisted suicide and euthanasia is due in large part to a failure to address the nature of the human person involved in the ethical act itself. For Karol Wojtyla, philosopher and Pope, ethical action finds meaning only in an authentic understanding of the person; but it is through acting ( actus humanus ) alone that the human person reveals himself. Knowing what the person ought to be cannot be (...) divorced from what he ought to do; forWojtyla, the structure of the ethical “do” – the act itself – comes first. The current paper will focus on four arguments used to justify assisted suicide and euthanasia: (1) the argument from autonomy, (2) the argument from compassion, (3) the argument from the evil of suffering, and (4) the argument from the loss of dignity. It will seek to answer each claim from the perspective of Karol Wojtyla's philosophical anthropology. Much of this will come from his defining work in pure philosophy, The Acting Person (1969). The final part of the paper will suggest some positive solutions to the stalemate over the euthanasia debate, again drawn from Wojtyla's idea of human fulfillment through participation with the other, and with the community itself. (shrink)
Euthanasia and assisted suicide have been legally possible in the Netherlands since 2001, provided that statutory due care criteria are met, including: voluntary and well-considered request; unbearable suffering without prospect of improvement; informing the patient; lack of a reasonable alternative; independent second physician’s opinion. ‘Unbearable suffering’ must have a medical basis, either somatic or psychiatric, but there is no requirement of limited life expectancy. All EAS cases must be reported and are scrutinised by regional review committees. The purpose of (...) this study was to investigate whether any particular difficulties arise when the EAS due care criteria are applied to patients with an intellectual disability and/or autism spectrum disorder. The 416 case summaries available on the RTE website were searched for intellectual disability and autism spectrum disorder. Direct content analysis was used on these nine cases. Assessment of decisional capacity was mentioned in eight cases, but few details given; in two cases, there had been uncertainty or disagreement about capacity. Two patients had progressive somatic conditions. For most, suffering was due to an inability to cope with changing circumstances or increasing dependency; in several cases, suffering was described in terms of characteristics of living with an autism spectrum disorder, rather than an acquired medical condition. Some physicians struggled to understand the patient’s perspective. Treatment refusal was a common theme, leading physicians to conclude that EAS was the only remaining option. There was a lack of detail on social circumstances and how patients were informed about their prognosis. Autonomy and decisional capacity are highly complex for patients with intellectual disabilities and difficult to assess; capacity tests in these cases did not appear sufficiently stringent. Assessment of suffering is particularly difficult for patients who have experienced life-long disability. The sometimes brief time frames and limited number of physician-patient meetings may not be sufficient to make a decision as serious as EAS. The Dutch EAS due care criteria are not easily applied to people with intellectual disabilities and/or autism spectrum disorder, and do not appear to act as adequate safeguards. (shrink)