Ending a Life

1. Ending a Life

2. Physician-Assisted Suicide Questions to be answered (in the order listed): 1) Is suicide ever morally permissible? If so, under what conditions? 2) Is assisted suicide ever morally permissible? If so, under what conditions? 3) Is physician assisted suicide ever morally permissible? If so, under what conditions?

3. Physician-Assisted Suicide • 4) Should physician assisted suicide be made: • A) Legal • B) Illegal • or, C) Should the law remain neutral?

4. Physician-Assisted Suicide • If suicide is morally permissible, under what conditions? • Unrelievable pain and suffering? • Terminal illness? • Permission/support of others? • Loss of control or dignity? • All of the above? • Another distinction: refusing, withdrawing, or withholdings treatment is not necessarily suicide.

5. Suicide • 1) Suicide • NO: Violates the sanctity of life • Life is a gift from God, we can't give it back • Suicide goes against natural law • Suicide is a violation of the categorical imperative (Kant) • Life is a condition for happiness; it shouldn't be taken away (Utilitarian)

6. Suicide • 1) Suicide • NO (cont.): • Rule in favor of suicide might lead to general happiness in the short run but in the long run it could be abused • Suicide is always the result of mental incompetence • Suicide is a violation of commitments to others

7. Suicide • 1) Suicide • YES: Autonomy and freedom can be expressed in the way that we live and in the way that we die (Kant and Utilitarians, i.e. autonomy and general happiness permit suicide) • Individuals determine the quality of their lives and when they are no longer worth living • There is such a thing as rational suicide • An expression of the right to control what happens to one's body

8. Assisted Suicide • 2) Assisted Suicide • NO: Suicide is Wrong • YES: Sometimes it is permissible when the person can't do it alone or without assistance

9. Physician-Assisted Suicide • 3) Physician-Assisted Suicide • NO: Suicide is Wrong • Suicide goes against the moral tradition of medicine, e.g. Hippocrates • Physicians must not kill but always seek to cure • Physician-assisted suicide will destroy the trust of patients

10. Physician-Assisted Suicide • 3) Physician-Assisted Suicide (cont.) • YES: Assisting is helping patients to the very end, duty of fidelity • Assisting assures patients of their own freedom and dignity • Physician assisting assures a quality death

11. Legalization • 4) Legalization • NO: Suicide is Wrong • Will be abused • Slippery slope • Managed care will lead to abuses • Dutch experience

12. Legalization • 4) Legalization (cont.) • YES: We can legally refuse treatment which is life-supporting, this is a logical extension • Protects doctors from charges of abuse • Enhances the doctor-patient relationship • Each state should be allowed to determine • Oregon is a model

13. The Debate • The "Push" on the Debate • 1) Beliefs about end of life conditions • 2) Beliefs about the cost of 1) • 3) Beliefs about the management of pain and suffering • A) Among physicians • B) Among laypersons • 4) Beliefs about the meaning of suffering