Euthanasia II: Callahan

Callaghan

•Euthanasia debate represents “three important turning points in Western thought”

•Legitimate conditions under which one person may kill another

•Meaning and limits of self-determination

•Goal of medicine

•Proponents of legalizing euthanasia push us the wrong way at each of these turning points

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•Acceptance of voluntary active euthanasia would sanction “consenting adult killing” – waive right to life

– but we’ve always tried to limit the circumstances under which one human being can kill another

•Meaning and limits of self-determination

–Focus on autonomy permits individuals to ask others to help them to pursue their own good, even at risk of the common good

–Traditionally, we limit pursuit of individual good

•Medicine should be used to aid individuals in achieving their view of the good life

–Definition of “health”

Four arguments for euthanasia

1. Moral claim – individual self-determination

2. Moral irrelevance of distinction between killing and letting die

3. Lack of evidence for bad consequences

4. Compatibility of euthanasia and medical practice

Self-determination

•Euthanasia requires that we ask someone else to help us achieve self-determination – this makes euthanasia a social one, not an individual one

•Source of “moral warrant” for physician’s agreement to euthanasia?

–Waiving right to life

–Parallels with slavery, dueling

–Requirement of independent moral grounds

Killing vs. letting die

•Brock, Rachels deny moral distinction between active and passive euthanasia

•Callahan: this denial involves “confusing causality with culpability”

–Causality: direct physical cause of death

–Culpability: attribution of moral responsibility

•Malpractice, unauthorized cessation of treatment are killing in an “expanded sense of the term”

•Also, denial of distinction will result in:

–Physicians holding themselves responsible for all patient deaths (including when they involve cessation of futile treatment)

–Belief that in all cases of futile treatment, a quick death from euthanasia is preferable

Calculating Consequences

•Those who argue against bad consequences of allowing euthanasia say that predictions of these consequences are unfounded and overly speculative

•Callahan argues that certain consequences would occur:

–Inevitability of abuse of the law

–Difficulty of writing and enforcing the law

–“Inherent slipperiness” of moral reasons for permitting euthanasia

•Two arguments for permitting euthanasia (self-determination and claims upon mercy of others to relieve suffering) “contain within them the ingredients for abuse

•Arguments usually used together, but separately they lead to problems

Euthanasia and medical practice

•These arguments claim that euthanasia/assisted suicide are compatible with the aims of medicine

•But the judgment that a life is no longer worth living is outside of the scope of health

•Aims of medicine should be to:

–Relieve pain

–Allay anxiety and uncertainty

–Be a comforting presence