Voluntary Active Euthanasia by Dan W. Brock

What does Brock argue in this paper?

The same two basic moral principles that support a patients right to make choices about life-sustaining treatment also support the permissibility of voluntary active euthanasia

the first principle is self determination and teh second is individual well being

What does Brock mean about Self Determination as it bears on euthanasia?

peoples interest in making important decisions about their lives for themselves according to their own values or conceptions of a good life, and in being left free to act on those decisions

Why does Brock say self determination is important?

it allows people to take responsibility for their lives for the kinds of persons they become

What does Brock say the right of self determination does not grant?

it doesn’t entitle patients to compel physicians to act contrary to their own moral or professional values. the physicians self determination should be respected as well

what is the first argument that Brock considers?

euthanasia is the deliberate killing of an innocent person

What is Brock’s ALS patient argument?

a patient terminally ill with ALS disease is completely respirator dependent with no hope of ever being weaned off. She has a greedy and hostile son who mistakenly believes that his mother will never decide to stop her life sustaining treatment and that even if she did her physician would not remove her

He’s afraid his inheritance will be dissipated by a long hospital bill and extubates her and she dies.

He says he didnt kill her he “merely allowed her to die".

Brock argues that there is an ethical difference between what the son did then what a physician would do.

What does Brock say the difference between killing and allowing to die is?

While both the physician and greedy son act in a manner that cause death, the son killed her while the physician let her die because the son unjustly caused her death

What does Brock say about killing and a persons future?

Wrongful killing deprives a person of a valued future, and of all the person wanted and planned to do in that future

The right to not be killed can be waved when the person makes a competent decision that continued life is no longer wanted or a good, but is instead worse than no further life at all

What are the potential good consequences of permitting euthanasia?

1. if permitted it would be possible to respect the self-determination of competent patients who want it, but now cannot get it because of its illegality

2. it benefits a much larger group (a majority people believe they should have a right to obtain euthanasia if they want it)

3. patients whose dying is filled with severe and unbelievable pain or suffering can end this with euthanasia

4. once death has been accepted, it is often more humane to end life quickly and peacefully, when that is what the patient wants

What are the potential bad consequences of permitting euthanasia?

1. permitting physicians to perform euthanasia would be incompatible with their fundamental moral and professional commitment as healers to care for patients and to protect life.

2. Permitting euthanasia would weaken society’s commitment to provide optimal care for dying patients

3. Permitting euthanasia is to threaten the progress made in securing the rights of patients or surrogates to decide about and to refuse life sustaining treatment

4. Making a new option or choice available to people can sometimes make them worse off, even if once they have the choice they go on to choose what is best for them

5. It might weaken the general legal prohibition of homocide

What does Brock say SHOULD be the moral center of medicine?

The commitment of respecting patients self determination and promoting their well being in guiding physicians actions as healers, comforters, and protectors of their patients lives. Thus, administering euthanasia when their patients make competent requests for it

What does Brock say about the argument that permitting euthanasia would weaken society’s commitment to provide optimal care for dying patients?

the same worry could have been directed at recognizing patients’ or surrogates’ rights to forgo life-sustaining treatment, yet there is no persuasive evidence that recognizing the right to refuse treatment has caused a serious erosion in the quality of care of dying patients. The second reason for skepticism about this worry is that only a very small proportion of deaths would occur from euthanasia if it were permitted. In the Netherlands, where euthanasia under specified circumstances is permitted by the courts, though not authorized by statute, the best estimate of the proportion of overall deaths that result from it is about 2 percent

Why does Brock discount the worry that permitting euthanasia would erode patients or surrogates rights to decide about life sustaining treatment?

The legal rights of competent patients and, to a lesser degree, surrogates of incompetent patients to decide about treatment are very firmly embedded in a long line of informed consent and life-sustaining treatment cases, and are not likely to  be eroded by a debate over, or even acceptance of, euthanasia.

What does Brock say about the argument that offering euthanasia can make a patient worse off by offering them a choice?

The effects of this should have already been seen since patients are offered life sustaining care, but there is no evidence of this

What does Brock say about the argument that permitting euthanasia would weaken the general legal prohibition of homicide?

Courts have not seen cases of stopping life support as killing, therefore euthanasia would not weaken the prohibition of homicide

What does Brock say about the slip into nonvoluntary active euthanasia?

There is reason to expect that legalization of voluntary active euthanasia might soon be followed by strong pressure to legalize some nonvoluntary euthanasia of incompetent patients unable to express their own wishes