Today's Agenda

• Legal and constitutional framework

• Active/passive euthanasia debate (James Rachels)

• Practical challenges and slippery slopes (John Arras)

• Current policy landscape

• Central Questions: scope of moral consideration, nature/extent of obligations to others

Defining Euthanasia

• Euthanasia: "Good Death" or "Gentle Death"

• Deliberate ending of life for an individual's good

• Main Arguments:

  • Mercy-based: Relief from suffering

  • Autonomy-based: Right to control one's death

• Distinction: Moral permissibility vs. legal permissibility

Types of Euthanasia

• Active vs. Passive:

  • Active: Doctor takes action (e.g., lethal injection)

  • Passive: Withholding/withdrawing treatment

• Voluntary vs. Involuntary vs. Non-Voluntary:

  • Voluntary: Explicit request

  • Involuntary: Explicit wish against euthanasia

  • Non-Voluntary: No capacity to express wishes

Legal Background

• Bouvia v. Superior Court (1986): Right to refuse treatment

• Cruzan v. Missouri (1990): Clear and convincing evidence for incompetence required

• Vacco v. Quill (1997): Different treatments for refusal and PAS due to causation distinction

• Washington v. Glucksberg (1997): State interest in protecting vulnerable groups

Euthanasia vs. Suicide Debate

• Suicide defined vs. euthanasia as choice of how to die

• Argument on life value: Instrumental vs. intrinsic value

• Rachels’ Argument: No moral difference between killing and letting die; focuses on intention and outcome rather than action

Arras’s Perspective on PAS

• Empirical worries regarding real-world policy applications

• Arguments for euthanasia:

  • Mercy and autonomy

  • Respect for individual choice

• Slippery slope arguments:

  • Type 1: Logical extension of policy

  • Type 2: Abuse potential

Challenges and Policy Recommendations

• Ensure true voluntariness of requests

• Improve palliative care to prevent requests for PAS

• Implement reliable monitoring to prevent abuses

• Address systemic inequalities in healthcare access

Oregon Death with Dignity Act (1997)

• Criteria for eligibility and safeguards in place

• Trends in data: increasing acceptance and use

Current Legal Status in the United States

• VSED and passive euthanasia widely accepted

• PAS legal in certain states; illegal elsewhere

• Active voluntary euthanasia illegal nationwide

Key Philosophical Tensions

• Autonomy vs. protection of vulnerable

• Intention vs. action in moral considerations

• Individual rights vs. social consequences

• Ideal vs. non-ideal moral theories and policies