Lecture 20 brock on euthanasia
- 2. Voluntary vs. Nonvoluntary Euthanasia Voluntary Euthanasia: Euthanasia with the patient’s consent. Active voluntary: Directly causing the patient’s death with their consent. Passive voluntary: Withholding or withdrawing life-sustaining treatment with the patient’s consent. Nonvoluntary Euthanasia: Euthanasia without the patient’s consent. Active nonvoluntary: Directly causing the patient’s death without their consent. Passive nonvoluntary: Withholding or withdrawing life-sustaining treatment without the patient’s consent. Remember: For any of these to be euthanasia, they must be done for the patient’s benefit.
- 3. Brock Thesis Voluntary active euthanasia is morally permissible and should be legal. It is supported by two values - autonomy (individual self- determination) and individual well-being - that also support a patient’s right to decide about life-sustaining treatment.
- 4. We value autonomy (individual self-determination) because we think that a person should make important decisions about how their life goes. • Must have a certain amount of competence to make these decisions. • Brock says that the value of self-determination extends to the time and manner of one’s death, since we are concerned about when and how we die. We value individual well-being. • Brock says that sometimes continued life is a burden for someone, not a benefit.
- 5. Two Kinds of Arguments Against Voluntary Active Euthanasia: 1) Moral Arguments 2) Public Policy Arguments
- 6. Moral Arguments Against Voluntary Active Euthanasia Moral arguments against voluntary active euthanasia agree with Brock that autonomy and individual well-being sometimes support voluntary active euthanasia. - But they claim that other moral considerations outweigh those values, making voluntary active euthanasia morally wrong. - Brock’s goal is to say that those arguments are flawed.
- 7. A Specific Moral Argument Against Voluntary Active Euthanasia Voluntary active euthanasia is morally wrong because it is the deliberate killing of an innocent person. Withdrawing life-sustaining treatment is morally permissible because it is just allowing to die. Brock’s Response has two parts: 1) Withdrawing life-sustaining treatment IS the deliberate killing of an innocent person. Analogy: the greedy son who removes his mother from a respirator kills his mother. 2) Because withdrawing life-sustaining treatment for humane reasons is deliberate killing and NOT morally wrong, we cannot conclude that voluntary active euthanasia is morally wrong just because it is deliberate killing.
- 8. Is killing worse than letting die? • Like Rachels, Brock says no. Brock’s example: Gravely ill patient rushed to emergency room and begins to develop respiratory failure. Version 1: Family alert doctors to patient’s wish not to placed on a respirator. Version 2: Family arrives late, respirator is removed, patient dies. According to Brock, Version 1 is letting die and Version 2 is killing, and there is no moral difference between these versions.
- 9. Potential Problem Potential Problem with Brock’s Responses: One could argue, contrary to Brock, that BOTH failing to give life-sustaining treatment (Version 1) AND withdrawing life-sustaining treatment (Version 2) are cases of letting die, and that letting die is less morally bad than killing.
- 10. What makes killing wrong? What makes killing wrong is that it “deprives a person of a valued future.” (p. 673) Note the connection to Marquis! But voluntary active euthanasia does not deprive a person of a valued future, and so it is not wrongful killing.
- 11. Policy Arguments FOR Voluntary Active Euthanasia Respects self-determination of competent patients who want it. Is reassuring for everyone else, that they won’t have to endure a protracted dying process if they don’t want to. Relieves physical pain and suffering. A quick death is more psychologically humane than a slow one.
- 12. Policy Arguments AGAINST Voluntary Active Euthanasia 1) It’s incompatible with physicians’ fundamental role as healers. Brock’s Response: That role should be guided by the values of patient self- determination and well-being. 2) It weakens society’s commitment to care for dying patients. Brock’s Response: There is no strong evidence for this claim. The right to forego life- sustaining treatment hasn’t affected society’s commitment to care for dying patients. 3) It threatens the current consensus in favor of allowing patients to refuse treatment. Brock’s Response: There is no strong evidence for this claim, and the current consensus is strong.
- 13. Policy Arguments AGAINST Voluntary Active Euthanasia 4) The option of voluntary active euthanasia may pressure more people to take it. One of Brock’s Responses: This concern would also apply to the option of withdrawing life-sustaining treatment, but there is no evidence that having this option is harmful in that case. 5) It might weaken the legal prohibition of homicide. Brock’s Response: It won’t because the patient chooses it. 6) There’s a slippery slope from the fully voluntary/permissible cases to the impermissible ones.
- 14. Slippery-slope Argument Slippery-slope argument: arguing that some action is wrong because doing it will lead to a chain of events and actions that will result in a disastrous outcome. Sometimes slippery-slope arguments work. When they don’t, they are fallacies. Slippery-Slope Fallacy: FALSELY arguing that some action is wrong because doing it will lead to a chain of events and actions that will result in a disastrous outcome. A slippery-slope fallacy occurs when the evidence for the alleged chain reaction is lacking.
- 15. Brock responds by proposing safeguards to stop the slippery slope: 1. Provide patient with all relevant information about condition, prognosis, and alternative treatments. 2. Ensure that the request for euthanasia is stable and enduring (waiting period) and fully voluntary. 3. Explore all reasonable alternatives. 4. Psychiatric evaluation.
- 16. Nonvoluntary Active Euthanasia The values of autonomy and individual well-being can support some cases of nonvoluntary active euthanasia as well – e.g., when the patient is incompetent and a surrogate makes the choice. This is just like how these values can support cases of nonvoluntary withdrawal of life-sustaining treatment. Brock: The important moral divide is not between active and passive euthanasia but between voluntary and nonvoluntary performances of either.