lecture videos for Phil 321 sp26

EUTHANASIA AND PHYSICIAN ASSISTED SUICIDE

Definitions

Euthanasia is the willful or indirect or direct painless ending of a life to get rid of incurable and persistent suffering. In this lecture, we will debate strictly about people who are basically terminally ill, in a vegetative state or brain dead. A doctor can directly bring death to their patient by doing something to bring it (e.g., giving medicine). Indirectly bringing death to a patient obviously involves allowing the patient to die by not doing something to prevent it.

It's also important to keep in mind physician assisted suicide. As you probably guessed, the doctor, in this case, helps the patients die.

Active euthanasia is directly causing the death and a passive ethanasia is allowing someone to die without stopping it.

Active voluntary (ethanasia?) involves directly killing the patient after receiving consent from the patient. Active non-voluntary… is directly causing the death without the patient's consent. Passive voluntary… is withdrawing life sustaining resources with the patient’s consent. Passive non-voluntary… is withdrawing life sustaining resources without the patient’s consent.

Euthanasia vs. physician-assisted suicide

The American medical association has prohibited physician assistant suicide and classified it as unethical and inconsistent with physicians role to enhance healing and preserve life. Survey says, however, that many doctors agree with using physician-assisted suicide. Additionally, over 70 percent of adults believe this should be legal for incurable diseases with severe pain and terminal illnesses.

Meaning of death

A person not breathing or heartbeat stopping is a traditional view of death. This is traditional because modern medicine has given us the ability to keep someone's breathing and heartbeat to continue even if someone is kind of brain dead. As a result, instead of the traditional view, you have is called the whole brain view well all brain functions cease but saying “all brain functions” makes it very similar to the traditional view. So, they then came up with a further improvement called the hybrid view that says when the higher parts of their brain that is responsible for consciousness shuts down, they're dead.

What justifies euthanasia: self-determination

The same thing that justifies abortion in the last module is the same thing that justifies euthanasia: the moral right of autonomy as self-determination; choosing to die could be the top five to 10 most important decisions will make in our lives so it obviously seems that people have a right to decide whether they want to live or not. Moreover, this idea is not exactly supporting things like suicide. The goal is to think about cases where someone's kind of brain dead or even dead as a whole, they should have the rights to decide if they want to live or not. REMEMBER! The right to Liberty and the right to a claim are two different concepts: for instance, what if you had a right to a million dollars that I own. That would put me under the duty to give you that money. On the other hand, your freedom of speech has no correlation to duty. It is just your right to have freedom of speech.

Beneficence

Another huge argument for active euthanasia: if we can relieve the severe suffering of someone else without a major cost to ourselves, then we have a duty to do so.

Is there any difference between active and passive euthanasia

There's a lot of people who believe that passive euthanasia is allowed, not active. Arguing against this, James Rachel Wright created the no difference thesis: he believed that active euthanasia is okay sometimes especially if the results is expected to be good (e.g., ending someone's suffering).

Other arguments

Allowing euthanasia would lead to a slippery slope or abuse where even though the patient does not consent to diane, their doctors or families would intentionally create conditions that bring about that death.

NOTE! The goal of this lecture is to not agree with one out of all the arguments mentioned so far. In other words, the goal is to take note of these arguments and make up your mind which one is the optimal way to be.

Lastly, can we get a different result from utilitarianism? Because, based on classical utilitarianism, euthanasia is allowed; based on preference utilitarian, euthanasia is allowed; based on rule utilitarian, euthanasia may not be allowed because of the slippery slope argument.

THE PHILOSOPHERS’ BRIEF

Background

In 1997, in a couple of Supreme Court cases (Vacco v. Quill and Washington v. Glucksberg), six prominent philosophers (Ronald Dworkin, Thomas Nagel, Robert Nozick, John Rawls, Thomas Scanlon, and Judith Jarvis Thompson) presented this amicus brief, urging that states see the right in assisted suicide. In other words, these are pretty much the top six powerful philosophers trying to make a point and also trying to persuade a legal group that's not necessarily a group for moral philosophy.

Notice the strategy

So, they're not using any kind of wisdom or moral values, not saying that, “this is what utilitarianism suggests, so we should do it like this.” or “this is what Emmanuel Khan says. So…” They're not presenting anything that their audience is not already agreeing with which is the key. Additionally, they're not supporting euthanasia (or the request to die) except in some cases where it meets all the regulations (once all the rules are satisfied or t’s crossed and i’s dotted). There is, on the other hand, a typical objection that someone does bring to the debate: if euthanasia is allowed, somewhere down the line there will be abuse with this law. If so, the issue can be solved in the revision of the regulations.

Argument (grounded in the due process clause of the 14th amendment)

Under this clause, autonomy is important but it's not the main point and this clause is somethin we all can agree to: individuals must be permitted to make decisions for themselves, from their own faith, conscience and convictions. Moreover, death is the most significant events of our lives and everyone's view on it shouldn't be imposed on others who reject it. However, the state preventing someone committing euthanasia is, in fact, imposed in some people's views about death which violates the 14th amendment

Analogy to abortion (Casey)

Because of the Planned Parenthood v. Casey in 1992, the autonomy argument for the right to abortion occured (in addition to the circumstances like the great burden that's an unwanted child brings that warrant this argument). This is similar to the Judy Thomson argument but Thomson’s argument focused on the effect of abortion to the victim themself. The Planned Parenthood case focus on what decision should the victim make based on the sake of other people. The simple response to this was: even though this case was not the catalyst to what drove the current judgment on abortion, if abortion can receive support from the courts, then so can euthanasia.

Analogy to the right against unwanted invasions (Cruzan)

We will now look at another notable case: Cruzan v. The director of Missouri Department of Health. Here, the Supreme Court kind of recognizes the rights of patients to refuse treatment; supporting people's right to refuse unwanted bodily invasion. Here, the state is requiring that in some cases (e.g., driving while intoxicated), individuals are required to accept unwarranted invasion of their body to respect people's underlying preferences (preferences that are consistent with the preferences of others). NOTE! Not allowing euthanasia to happen across the board, is the same as saying there is no right to die in any circumstances whatsoever and this goes against the spirit of liberty which is supposed to be protected by cases like the Cruzan case.

Abuses/risks

The following information is a look at their responses to some of the last set of objections. Abuse can come from family members, doctors, etc. and the risks is correlated to mostly misdiagnoses. First thing to remember is that all throughout this conversation, the strategy has been focused on analogies.

So, the first response to this is that the same type of risk here also applies to the rights against bodily invasions; obviously, if we permit a sort of right against bodily invasion, then there will be some sort of risk involved; and some circumstances, it would be lethal or risky for people to refuse treatment. If those risks don't undercut the value of autonomy here, it appears that those risks shouldn't undercut the value of autonomy there (an analogy)

Second, it doesn't matter how we formulate the laws, rules and regulations, risk of mistakes will still be unavoidable.

Undue influence would be where the abuse would come in. Undue influence is just not a misdiagnosis, it would be more like a person who is sick ends up under the wrong influence (influence that makes you deviate from your own deep values). The response to this is a recommendation of stringent regulations to constraint cases of undue influence to filter out the good influence from the bad influence. As a whole, when people are caught in situations where they have to suffer unbearable pain and they listen to others and become influenced wrongly is the objective response to undue influence