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1 Voluntarily Assisted Suicide and Euthanasia Soazig Le Bihan - University of Montana.
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Transcript of 1 Voluntarily Assisted Suicide and Euthanasia Soazig Le Bihan - University of Montana.
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Voluntarily Assisted Suicide Voluntarily Assisted Suicide
and Euthanasia and Euthanasia
Soazig Le Bihan - University of Montana
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IntroductionIntroduction
Why should we care?
- Our death
- Aging Society
Discussion
- When to stop?
- Definitions
- Doctors
- Decisions
What this class is about
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OutlineOutline
Introduction
Important Distinctions
The argument from autonomy and its critics
The utilitarian argument and its refinement
Slippery Slopes and the Pandora Box: Fears vs. Reality
Conclusion
A controversial distinction: Active vs. Passive Euthanasia
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OutlineOutline
Introduction
Important DistinctionsImportant Distinctions
The argument from autonomy and its critics
The utilitarian argument and its refinement
Slippery Slopes and the Pandora Box: Fears vs. Reality
Conclusion
A controversial distinction: Active vs. Passive Euthanasia
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Important DistinctionsImportant Distinctions
Voluntary / Non-voluntary / Involuntary
Involuntary: against the patient’s will – nobody defends it!
Non-voluntary: the current desire of the patient is unknown because she is physically or mentally unable to express it
Voluntary: in agreement with the patient’s will
Assisted Suicide /Euthanasia
Assisted Suicide: the person kills herself with a medication prescribed by a doctor
Euthanasia: the doctor administrates herself the medication
We will focus on the morality of Voluntary Assisted Suicide (VAS) and Voluntary
Euthanasia.
We will focus on the morality of Voluntary Assisted Suicide (VAS) and Voluntary
Euthanasia.
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OutlineOutline
Introduction
Important Distinctions
A controversial distinction: Active vs. Passive Euthanasia
The argument from autonomy and its criticsThe argument from autonomy and its critics
The utilitarian argument and its refinement
Slippery Slopes and the Pandora Box: Fears vs. Reality
Conclusion
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The argument from autonomy The argument from autonomy
The argument from autonomy:
P1: Each individual’s autonomy ought to be respected
P2: Denying someone the right to assisted suicide amounts to disrespect her autonomy
CC: Nobody should be denied the right to assisted suicide
Is this a tenable argument? Is this a tenable argument?
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The argument from autonomy The argument from autonomy ProblemsProblems
The argument from autonomy is not the best argument!
The argument from autonomy is not the best argument!
Doerflinger:
The argument is self-contradictory because life is a necessary condition for the exercise of one’s autonomy.
“Suicide is not the ultimate exercise of freedom but its ultimate self-contradiction”
Voluntary vs Non Voluntary
The argument from autonomy only works for voluntary assisted suicide and euthanasia
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The Argument from AutonomyThe Argument from AutonomyConclusionConclusion
1. The argument from autonomy2. Problems: (a) Suicide in the name of autonomy is self-
contradictory(b) Could only work for voluntary cases
1. The argument from autonomy2. Problems: (a) Suicide in the name of autonomy is self-
contradictory(b) Could only work for voluntary cases
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OutlineOutline
Introduction
Important Distinctions
The argument from autonomy and its critics
The utilitarian argument and its refinementThe utilitarian argument and its refinement
Slippery Slopes and the Pandora Box: Fears vs. Reality
Conclusion
A controversial distinction: Active vs. Passive Euthanasia
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The Utilitarian ArgumentThe Utilitarian Argument
The utilitarian argument:
P1: A given action is right if and only if it serves to increase the amount of happiness/ decrease the amount of misery
P2: Euthanasia for suffering patients with terminal illnesses decreases the amount of misery
CC: Euthanasia for suffering patients with terminal illnesses is right
Is this a tenable argument? Is this a tenable argument?
Advantage: the argument applies to Voluntary assisted suicide, voluntary and non-voluntary euthanasia.
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The Utilitarian ArgumentThe Utilitarian ArgumentProblemsProblems
General Problem for Utilitarianism:
Utility vs. Rights
The Problem applied to Euthanasia:
It seems that the utilitarian argument could be used to justify involuntary euthanasia – against the will
Which is of course unacceptable !
The Utilitarian Argument is not acceptable as it is.
The Utilitarian Argument is not acceptable as it is.
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The Utilitarian ArgumentThe Utilitarian ArgumentRefined by RachelsRefined by Rachels
The utilitarian argument:
P1: A given action is right if and only if it serves to increase the amount of happiness/ decrease the amount of misery
P2: Euthanasia for suffering patients with terminal illnesses decreases the amount of misery
CC: Euthanasia for suffering patients with terminal illnesses is right
The utilitarian argument as refined by Rachels is tenable!
The utilitarian argument as refined by Rachels is tenable!
and violates no one’s rights
and violates no one’s rights
Refined:
Refined:
and in many cases violates no one’s rights
and in many cases violates no one’s rights
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The Utilitarian ArgumentThe Utilitarian ArgumentConclusionConclusion
1. The argument from mercy: applies to VAS and euthanasia
2. Problem: Conflict with Rights3. Solution: Refined argument from mercy
1. The argument from mercy: applies to VAS and euthanasia
2. Problem: Conflict with Rights3. Solution: Refined argument from mercy
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OutlineOutline
Introduction
Important Distinctions
A controversial distinction: Active vs. Passive Euthanasia
A controversial distinction: Active vs. Passive Euthanasia
The argument from autonomy and its critics
The utilitarian argument and its refinement
Slippery Slopes and the Pandora Box: Fears vs. Reality
Conclusion
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Active vs. Passive EuthanasiaActive vs. Passive Euthanasia
The distinction: Killing vs. Letting die
Accepted in the US: AMA 1973
“The intentional termination of the life of one human being by another -mercy killing - is contrary to that for which the medical profession stands and is contrary to the policy of the American Medical Association.
The cessation of the employment of extraordinary means to prolong the life of the body when there is irrefutable evidence that biological death is imminent is the decision of the patient and/or his immediate family. The advice and judgment of the physician should be freely available to the patient and/or his immediate family.”
Does this make moral sense? Does this make moral sense?
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Active vs. Passive EuthanasiaActive vs. Passive EuthanasiaPb 1: Is the distinction morally relevant?Pb 1: Is the distinction morally relevant?
Moral Responsibility: Is “passive” euthanasia really passive?
- Rachels’ example: Jones and Smith and their cousin in the bathtub – Is Jones’ any less responsible than Smith is of his cousin’s death?
- Withhold food and fluids? grand ma, infant
- Withhold medication? diabetic
The Distinction is not morally relevant: passive and active euthanasia involve the same moral
responsibility
The Distinction is not morally relevant: passive and active euthanasia involve the same moral
responsibility
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Active vs. Passive Euthanasia Active vs. Passive Euthanasia Pb 2: Which is morally preferable?Pb 2: Which is morally preferable?Example from Rachels: infants with Down Syndrome
“I can understand why some people are opposed to all euthanasia and insist that such infants must be allowed to live. I think I can also understand why other people favor destroying these babies quickly and painlessly. But why should anyone favor letting “dehydration and infection wither a tiny being over hours and days”? The doctrine that says that a baby may be allowed to dehydrate and wither, but may not be given lethal injection that would end his life without suffering, seems so patently cruel as to require no further refutation.” (Rachels)
In some cases, active euthanasia seems morally preferable
In some cases, active euthanasia seems morally preferable
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Active vs. Passive Euthanasia Active vs. Passive Euthanasia Pb 3: ArbitrarinessPb 3: Arbitrariness
The problem: passive euthanasia:
(a) One agrees that it would be better that the unnecessary suffering ends
(b) But one waits until a separate health problem “allows” for a quicker death – a chancy event
Rachels’ argument:
- Either (a) is true, and then our moral action should not depend on irrelevant circumstances
- Or (a) is false, and then, not to treat the patient in (b) is wrong
Passive Euthanasia makes our action depend on arbitrary factors
Passive Euthanasia makes our action depend on arbitrary factors
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Active vs. Passive Euthanasia Active vs. Passive Euthanasia ConclusionConclusion
1. A distinction generally accepted by physicians2. Problems: (a) The distinction is not morally relevant – no
less responsible in the case of passive euthanasia
(b) Active euthanasia seems morally preferable in some cases
(c) Passive euthanasia makes our action depend on arbitrary factors
1. A distinction generally accepted by physicians2. Problems: (a) The distinction is not morally relevant – no
less responsible in the case of passive euthanasia
(b) Active euthanasia seems morally preferable in some cases
(c) Passive euthanasia makes our action depend on arbitrary factors
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OutlineOutline
Introduction
Important Distinctions
A controversial distinction: Active vs. Passive Euthanasia
The argument from autonomy and its critics
The utilitarian argument and its refinement
Slippery Slopes and the Pandora BoxSlippery Slopes and the Pandora Box
Conclusion
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Slippery Slopes Slippery Slopes Fears and RealityFears and Reality
Slippery Slopes: Beware!
Doerflinger’s slippery slopes:
Subtle coercion, economic incentives, substituted judgment, prejudice against people with disabilities etc.
The Facts: Oregon’s Death with Dignity Act
- Conditions to be eligible
- Conditions to receive the prescription
- Results?
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Number of qualifying people: ~ 80,000!
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OutlineOutline
Introduction
Important Distinctions
A controversial distinction: Active vs. Passive Euthanasia
The argument from autonomy and its critics
The utilitarian argument and its refinement
Slippery Slopes and the Pandora Box: Fears vs. Reality
ConclusionConclusion
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ConclusionConclusion
Argument from autonomy: limited and arguably self-contradictory
Utilitarian Argument: refinement protecting rights
Passive vs Active Euthanasia: distinction not morally acceptable
Slippery Slopes: not supported by available evidence
Fundamental divide: absolute rules vs about serving everyone’s best interest
Argument from autonomy: limited and arguably self-contradictory
Utilitarian Argument: refinement protecting rights
Passive vs Active Euthanasia: distinction not morally acceptable
Slippery Slopes: not supported by available evidence
Fundamental divide: absolute rules vs about serving everyone’s best interest