Rational suicide, assisted suicide, and indirect legal paternalism (original) (raw)
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Assisted suicide, suffering and the meaning of a life
Theoretical Medicine and Bioethics, 1999
The ethical problems surrounding voluntary assisted suicide remain formidable, and are unlikely to be resolved in pluralist societies. An examination of historical attitudes to suicide suggests that modernity has inherited a formidable complex of religious and moral attitudes to suicide, whether assisted or not. Advocates usually invoke the ending of intolerable suffering as one justification for euthanasia of this kind. This does not provide an adequate justification by itself, because there are (at least theoretically) methods which would relieve suffering without causing the physical death of the suffering person. Carried to extremes, these methods would finish the life worth living, but leave a being which was technically alive. Such acts, however, would provide no moral escape, since they would create beings without meaning. Arguments seeking to justify ending the lives of others need some grounding in concepts of the meaning of a life. The euthanasia discourse therefore needs to take at least some account of the meaning we construct for our lives and the lives of others.
University of California, Davis law review, 1989
To express the national concern over the growing problem of suicide, on October 7, 1987, House Concurrent Resolution 194 was introduced expressing, as such, "the sense of the Congress that efforts to allow people to assist others to commit suicide and efforts to promote suicide as a rational solution to certain problems should be opposed." H.R. Con. Res. 194, 100th Cong., 1st Sess. (1987). Joseph Cardinal Bernardin of Chicagoin a letter to all congressional membersadvocated passage of the Resolution and the condemnation of those efforts by right-todie advocates to legalize acts of assisted suicide. Bernardin Condemns Legal Assisted [Vol. 22:275 Suicide or Self-Determination? suicide from an accidental or natural death, particularly among the elderly, precise data is scarce. 7 Indeed, most experts are of the opinion that suicide is under-reported. 8 Under-reporting occurs primarily because attending physicians and involved families often cooperate in disguising or ignoring the less-than-obvious suicides to avoid any social stigma from attaching to the surviving relatives. 9 Suicide may be defined "as doing something which results in one's death, either from the intention of ending one's life or the intention to bring about some other state of affairs (such as relief from pain) which one thinks it certain or highly probable can be achieved only by means of death or will produce death." 1 0 Since death is a necessary element of suicide, reflexive descriptions of death are important to allow a full understanding of the very term, suicide. Thus, one description would be simply that one has killed herself; another would be that one has let herself be killed. Additionally, one might perform a suicide by deliberately, with premediation, taking her own life, or by ordering an agent to accomplish the act, thereby getting herself killed. By falling into a pool and refusing to swim to save herself, an individual could let herself be killed. She could even kill herself by provoking a physical confrontation while offering little resistance and defense, thereby letting herself be killed. Thus, for a suicide to occur the deceased must kill herself, get killed, or let herself be killed." As can be seen, suicide as a form of behavior has developed its own particular praxis. Voluntary euthanasia has been variously described as "assisted suicide,12 or "within the knife's edge between suicide and murder."' 3 Sui
One of the most frequently used arguments for the legalization of assisted suicide and euthanasia is that assisted suicide and euthanasia are rooted in a right to personal autonomy. Thus, in its decision challenging the Criminal Code of Canada’s prohibition of aiding or abetting a person to commit suicide, the Canadian Supreme Court declared that people’s decision to end their own lives when faced with a “grievous and irremediable medical condition is a matter critical to their dignity and autonomy.” In line with the Court’s emphasis on autonomy, the preamble to Bill C-14, the law enacted by Canadian Parliament permitting assisted suicide and euthanasia in Canada, opens with a recognition of the “autonomy of persons who have a grievous and irremediable medical condition that causes enduring and intolerable suffering and who wish to seek medical assistance in dying.” The purpose of this paper is to refute the libertarian notion of autonomy that is enshrined in Carter and C-14 and that underlies their justification for assisted suicide and euthanasia. This notion is a fundamentally libertarian one. It is rooted in a doctrine of liberty which regards each person as free to do what/she wants provided he/she does not interfere with another’s freedom to do what he/she wants. Individual autonomy is therefore an absolute, and a person’s actions are subject to no higher measure than his/her own desires. To refute this erroneous understanding of autonomy, we first point out that it does not correspond to the concrete reality of our existence as social beings. Second, we show that the doctrine of autonomy as including the right to kill oneself logically leads to the erosion of all limits on assisted suicide and euthanasia. Third, we manifest that the exaltation of autonomy to the level of an absolute actually undermines autonomy because true autonomy, rather than being an end in itself, is directed toward the good. Fourth, we show that assisted suicide and euthanasia are not acts of true autonomy because they are opposed to three goods in particular: the good of the patient's own existence, the common good, and the divine good.
Why Do People Want to Die? The Meaning of Life from the Perspective of Euthanasia
Royal Society of Philosophy Supplements, 2022
One way to examine the enigmatic meaningfulness of human life is to ask under which conditions persons ask in earnest for assistance to die, either through euthanasia or physician assisted suicide. The counterpart of intolerable suffering must consist in some form of, however minimal, flourishing that makes people want to go on with their lives, disregarding other reasons to reject assisted dying that have more to do with religious prohibitions. To learn more about why persons want to hasten death during the last days, weeks or months of their lives, what kinds of suffering they fear and what they hold to be the main reasons to carry on or not carry on living, the paper offers some examples from a book written by the physician Uwe-Christian Arnold. He has helped hundreds of persons in Germany to die with the aid of sedative drugs the last 25 years, despite the professional societies and codes in Germany that prohibit such actions. The paper discusses various examples from Arnold’s book and makes use of them to better understand not only why people sometimes want to die but what made their lives meaningful before they reached this final decision.
Choosing death: the moral status of suicide
Psychiatric Bulletin, 1996
Our moral conception of suicide is examined. It is argued that a neutral definition of suicide is difficult to achieve and that how we treat the question of suicide shows what value we place on the sanctity of life or on life as a means to other ends. The case is made that autonomy, the principle of self-governance, has acquired special importance in the modem world to the detriment of other ethical principles such as beneficence.
The Ethical and Legal Desirability of Physician Assisted Suicide and Active Voluntary Euthanasia
The question of whether a framework legalising physician assisted dying ought to be adopted in the UK engages conflicting ethical ideologies towards the value of life and the rights of individuals. Currently the law in the UK prohibits ‘mercy killing’, absolutely on the grounds of murder, irrespective of permission or good will . The law surrounding assisted suicide is however enshrined in Statute as a particular offence. The Suicide Act 1961 criminalises “an act capable of encouraging or assisting the suicide or attempted suicide of another person” . This law is unique in that it renders an accessory liable to conviction when the principal individual does not themselves commit a criminal offence . However, following a number of high profile cases involving individuals with debilitating illnesses who wished assistance in committing suicide and a growing public consensus on the desirability of pro-assistance legislation , Parliament is reviewing Lord Falconer’s ‘Assisted Dying Bill’ which aims to legalise the practice in limited circumstances. In this essay it will be asserted that the ethical desirability of legalising physician assisted suicide (PAS) and active voluntary suicide (AVE) rests upon the value of life and the ethics of suicide itself. Consequently, before any consideration of the ethics on legislation can be accurately made it must first be shown whether suicide itself can be ethically justified. This essay will address this issue by considering the conflicting ethical concepts of the inherent sanctity of life and theories on the importance of autonomy and self-determination. Upon concluding that it is indeed the latter aspects of human life that give it value, it will be argued that an ethical continuum exists that allows for the extrapolation of the ethical justifiability of suicide to PAS and AVE.
Suicide, Euthanasia and Human Dignity
Acta Analytica, 2001
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 reccuring 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.
The Logical Link Between Voluntary and Non-Voluntary Euthanasia
Cambridge Law Journal, 2022
The logical "slippery slope" argument is of key relevance to the ongoing debate about "assisted dying". The argument runs that if the principle of respect for autonomy and the principle of beneficence justify voluntary euthanasia, then the principle of beneficence justifies non-voluntary euthanasia. Several prominent scholars of medical law and medical ethics have either rejected or at least not accepted the argument, including Gerald Dworkin and Raymond Frey; Margaret Battin; Hallvard Lillehammer; Stephen Smith; Robert Young; Emily Jackson; and Steven Daskal. This paper analyses their reasoning and finds it wanting. It concludes that the logical argument stands unrebutted and merits much greater attention.