1. Euthanasia and Physician Assisted Suicide
Week Four Seminar
HU245 Ethics

2. Last Week Discussion Board Position Paragraphs
Be careful to edit your papers well.
I should have these graded this weekend.
How do think the assignment turned out? Easy, hard? To short?

3. This Week
Discussion Board
Based on a Case Study
Two Threads

4. Active vs. Passive Euthanasia
Active euthanasia occurs in those
instances in which someone takes active
means, such as a lethal injection, to bring
about someone’s death; the patient is killed by a direct action of the physician.
Passive euthanasia occurs in those
instances in which someone simply
refuses to intervene in order to prevent
someone’s death.

5. Ordinary vs. Extraordinary Means
Ordinary means: these are typically taken to be morally obligatory. For example, antibiotics to cure an infection.
Extraordinary means: these are typically seen as morally optional. These types of measures may place undo burden on the patient. For example, keeping a brain-dead person on a respirator.

6. Voluntary, Nonvoluntary, and Involuntary Euthanasia
Voluntary: patient chooses to be put
to death
Nonvoluntary: patient is unable to make a choice at all
Involuntary: patient chooses not to be
put to death, but is anyway

7. Assisted vs. Unassisted Euthanasia
Many patients who want to die are unable to do so without assistance. Some who are able to assist themselves commit suicide with guns, etc. Given that this issue frequently arises, we are faced, as a society with a moral problem.

8. Current Legal Status
Only two states, Oregon and Washington, allow for any type of physician assisted suicide.
Euthanasia is never legal in any state.
Some European nations have some types of legalized euthanasia such as The Netherlands.

9. Arguments for PAS and Euthansia
(1) Mercy: better to end it painlessly and quickly than painfully and slowly
(2) Utility: suffering is ended and the high cost of medical care is averted;
(3) Autonomy: the “right to die;” this is an issue of privacy

10. Arguments Against Legalized Euthanasia
(1) There is a moral difference between killing and letting die. The intentions of the agent matter.
Slippery Slope: could lead to devaluation of human life. It is a short step from passive to active Euthanasia and from voluntary to involuntary euthanasia.
Vulnerable Populations: elderly, poor, disabled could be pressured to choose death.
Medical Costs: Many may choose death to avoid high healthcare costs for themselves or their families. 40% of medical expenses occur in the last month of a person’s life.
Potential for abuse.

11. Ethical Theories to Consider
Utilitarianism: what would result in the best good for the most people?
Kantian Rights: if we have a duty to respect persons, then those people have related rights. Conversely, if they have a right, than others have a duty to uphold that right.

12. The Deontologist The Head of the Local Hemlock Society:
“I support active euthanasia…one of the fundamental principles, or rights, that Western societies have affirmed for centuries is the right of individual autonomy and self- determination…”
Scott Rae, “Moral Choices,” 78.

13. The Ethical Egoist 80 year old with terminal cancer:
“All this moral discussion of euthanasia really bothers me. You see, for me it all boils down to the fact that I am the patient and what I want should be the thing that counts. It’s my interests that really matter here, not whether the euthanasia violates the Hippocratic Oath, or the 5th Commandment, or what consequences allowing euthanasia produces for society…”
Scott Rae, “Moral Choices,” 77.

14. The Utilitarian A Physician who specializes in Oncology
“In most cases, I , too, support active euthanasia, but for still different reasons than we have heard so far. I hold that it is not necessary principle that determine right and wrong, but the consequences produced by the actions in question…It would relieve the patient of needless suffering, stop the family’s anxiety about their loved one’s condition, end a needless drain of the family’s financial resources, and allow everyone involved to get on with their lives…”
Scott Rae, “Moral Choices,” 78

15. Seminar Question One!
Should a law be passed making it legal for physicians to honor requests like Will's to have his morphine pump reprogrammed? 
Is it moral for a physicians to perform such actions? Can you think of some ways someone who is generally against PAS might justify a case like this? (Hint: think about Aquinas’ Principle of Double-Effect that I mentioned during the Abortion seminar last week)

16. Seminar Question One Continued
Are there any predictable social harms that would ensue from the legalization of euthanasia and assisted suicide? If so, how serious are these negative consequences?

17. Seminar Question Two
What is hospice, and what role do they play in palliative care?   Might this be a viable option in Will's situation?