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A Level - Ethics > Euthanasia > Flashcards

Flashcards in Euthanasia Deck (46)
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1
Q

suicide

assisted suicide

A

Suicide - when a person dies as a direct result of his or her own voluntary action.
Assisted Suicide - when a person dies as a direct result of his or her own voluntary action but with the help of another person. Different to voluntary euthanasia in that their condition does not have to be life threatening and they may have many reasons to want to die.

2
Q

active

passive euth

A

active - giving something

passive - taking something away

3
Q

voluntary
non voluntary
involuntary

A

Voluntary euthanasia - when another person at their request and with their consent directly causes a person’s death.

Involuntary euthanasia - where someone provides the mean to end someone else’s life where there is an expressed wish not to. E.g. Hitler used this on mentally disabled/Jews.
• Involuntary euthanasia is ‘like a child’s visit to the dentist, it is imposed for ‘his or her own good’ but against his or her wishes’ - Mel Thompson, Ethics

Non-voluntary euthanasia - when a person’s life is ended without their consent, but with the consent of someone representing their interests. E.g. a doctor may decide a person in a persistent vegetative state should have his/her life sustaining treatment removed.

4
Q

law

A

• Suicide was legalised in 1961 in the UK.
• One of the clauses specified assisted suicide should remain illegal, with euthanasia falling into that category.
• Passive euthanasia is only allowed in PVS situations, must be accompanied by legal proceedings.
• Legal to use the ‘law of double effect’.
o E.g. a cancer sufferer. They may be prescribed high doses of morphine to get rid of the pain, but the side effect may be hastened death.
• Hippocratic Oath is one of major reason why euthanasia is illegal:
o ‘I will give no deadly medicines to anyone if asked, nor suggest any such counsel’
o Must be taken by all doctors, euthanasia deemed a potential destruction of Dr/Patient relationship.

5
Q

self determination/autonomy - diane pretty

A

o Paralysed neck down with motor neurone disease, asked doctors to aid her in her suicide.
o Lawyers presented the case based on right to self-determination.
o Argued under the Human Rights Act, 1998.
o Case taken to European Court of Human Rights, they concluded that although the law recognises the right to life, it does not consider in its corollary the right to die.

6
Q

self determination - baby charlotte

A

• Baby Charlotte, 2005
o Born prematurely with severe brain damage.
o High Court ordered the doctors to not resuscitate her if she fell into a coma as they claimed her underlying condition did not justify the medical assistance she was being given to stay alive.
o Suggests a limit to the idea that life is sacred.

7
Q

slippery slope argument

A

John Haldane and Alasdair MacIntyre, who argue:
• Supporters of the Bill slide between a condition of actual unbearable suffering and merely the fear of the suffering etc.
• If quality of life is grounds for euthanasia for those who request it, this could be extended to those who don’t request it e.g. Hitler and the mentally disabled.
• Many in euthanasia-legalised countries die against their wishes and purely due to pressure they feel etc. How do we prevent this?

8
Q

criticisms of slippery slope argument

A
  • Helga Kuhse challenged the slippery slope argument, stating that it is used by scaremongers to support the complete ban of euthanasia.
  • The most frequently used example to support the slippery slope argument is that of the Nazi practice of euthanasia during the Holocaust as a form of eugenics to ‘improve society.
  • Kuhse argues that ‘the motivation behind these killings was neither mercy nor respect for autonomy; it was, rather, radical prejudice and the belief that the racial purity of the Volk required the elimination of certain individuals and groups’.
  • She also states that there is a ‘social experiment’ going on in the Netherlands concerning active, voluntary euthanasia and that there is ‘no evidence’ this has sent the Dutch society down a ‘slippery slope’.
9
Q

sanctity of life - origins

A

• Based on the idea that there is a supreme value to human life.
• Religious origins of Sanctity of Life
o Genesis 1:27 – Imago dei
• Human features set us apart from other creatures, we possess similar aspects to God e.g. ability to love, sentient ability.
• We are rational beings.
• Incarnation reaffirms the intrinsic value of every human life in its relationship with God.

o Old Testament
• Highlights specialness in humanity
• God makes covenants with mankind, giving human obligation. Gives us divine purpose and design, distinguishes human.
• Genesis highlights human’ dominion over creation

10
Q

sanctity of life - xian thinkers and JC

A

• Lactanius (240-320AD) said God has made humankind as a sacred animal and so human kind has dignity.

o Creation and Jesus
• Teachings about God’s purpose in creating the world as well as purpose of Jesus coming to die for humanity highlights worth of humanity.

11
Q

strong sanctity of life - life is set apart from god and is a gift from god

A

• Life is set apart by God
o Imago dei and sensus divinitatis
o Genesis 1:27
• Life is a gift from God an is on loan to humans
o God should determine when life ends as he is the author of life
o Job 1:21(‘naked I came from my mother’s womb, and naked shall I return there’)
o Accepting euthanasia is to undermine sanctity of life by developing a ‘culture of death’ (Pope John Paul II)

12
Q

strong sanctity of life - bible

A

• Should always respect innocent life
o No murder is against 10 Commandments and social glue.
o Deuteronomy 30:19-20 commands us to ‘choose life’
• Life must be loved and protected
o Parable of Good Samaritan (Luke 10:29-37) shows we must protect all humans.
• 1 Corinthians 6:19 - Refers to the body as a temple of the Holy Spirit.

13
Q

weak sanctity of life - bible

A

• No one has a duty to endure a life of extreme pain
• Life is a gift not a burden
o Humans are owners of God’s gift of life; it is up to them as good stewards of this life (Genesis 1:28) to decide when to end it.

14
Q

weak sanctity of life - singer

A
  • We put down animals that are in pain, why are humans different? (Singer)
  • The value of human life depends on a person’s ability to have desires/preferences, not a soul etc. (Singer and John Locke)
15
Q

weak sanctity of life - random

A
  • Killing a person out of love is not morally equivalent to murder.
  • Murder implies an ulterior motive, euthanasia can imply kindness so is not the same and not always wrong.
  • It does not take any consideration of the quality of the person’s life.
  • It seems cruel and against the idea of a God of love to force a person in PVS to continue ‘living’
  • It is only due to the rise in technological advances that we have been able to keep such people alive
  • It is hard to uphold SofL when we cannot truly call someone in PVS alive.
  • Double effect arguably goes against sanctity of life, as does DNRs, war (including holy wars) and suicide.
16
Q

singer - quality of life, 5 principles

A

• Human life does not have intrinsic value; it is only valuable when it has usage/qualities attached to it.
• Peter Singer outlines 5 quality of life principles to replace SofL
1. Recognise that the worth of human life varies (not intrinsic)
2. Take responsibility for the consequences of your decision
3. Respect a person’s desire to live/die (autonomy)
4. Bring children into the world only if they are wanted
5. Do not discriminate on the basis of species (all sentient beings)

17
Q

factors that lead to QofL argument

A
o	Fear
•	Fear of death
•	Fear of loss of control
•	Fear of loss of body use/speech
o	Dignity
•	Reliant on others for everyday personal things
o	Control
•	Having none
•	Being taken advantage of
•	Wanting control over death itself
o	Burden
•	Guilt
•	Everyone looking after you
•	Drain on people and resources
18
Q

quality of life - personhood: greeks

A

• Zoe – spiritual life
• Psuche – psychological life
• Bios – physical life
seeking to distinguish between human bodies which are alive despite having lost key features of humanity and those who have them and thus, whose life should be preserved

19
Q

quality of life - personhood: glover

A

o Jonathan Glover argues being alive is not sufficient for life to be valuable.
• Supports non-voluntary euthanasia for PVS patients.
• However…
• What about cases such as brain damage and Alzheimer’s? Limited consciousness, should they be euthanasia?

20
Q

quality of life - personhood: locke

A
  • A person is someone who has an ability to think and reflect
  • May rule out people in PVS
  • Sentience includes the principle of reciprocity, should be able to give and take in a relationship
21
Q

quality of life - personhood: selling and fletcher

A
  • A person is one who is able to relate to other and has moral standing (Selling)
  • Fletcher includes a variety of characteristics such as self control and self awareness
22
Q

quality of life - autonomy: JS Mill

A
  • Developed the liberal principle.
  • Individuals should have full autonomy in matters that do not concern others.
  • ‘His independence is, of right, absolute. Over himself, over his body and mind, the individual is sovereign’.
23
Q

quality of life - autonomy: kung

A

• ‘As a Christian and theologian, I am convinced that the all-merciful God, who has given men and women freedom and responsibility for their lives, has also left to dying people the responsibility for making a conscientious decision about the manner and time of their deaths’.

i. e. - we have free will, should be able to decide death
- god has given us freedom and responsibility for our own lives inc. conscientious decision about manner and time of deaths

24
Q

criticisms of quality of life

A
  • It does not accept the special nature of humanity
  • It is a relativist concept and we all have different ideas about what constitutes a good QofL. Could lead to slippery slope argument. If you allow euthanasia for people in PVS etc. then surely you could use it for disabled people?
  • QofL can vary day to day. Cannot be sure how one will cope with an illness.
  • People may feel pressured to request an early death.
  • Some argue that doctors should not ‘play God’
  • Could ruin Dr/Patient relationship.
25
Q

consequentialism

A
  • Reject the distinction made by deontologists between acts and omissions.
  • The acts and omissions principle distinguishes between willing to do x and omitting to do x. They believe failing to give a patient life-preserving drugs and allowing him to die is morally equivalent to giving a patient drugs which hasten death if both actions have the same outcome of the death of the patient.
  • Whilst they claim to just judge the outcome, they do assume there are some significant non-consequential factors e.g. the duties of the doctor to be responsible for its patients.
26
Q

double effect

A

• A person may morally perform an act that will produce good and evil if:
o The action in itself from the outset is good
o The good effect and not the evil is intended
o The good effect is not produced by means of the evil effect
o There is proportionately good reason to permit the evil effect

27
Q

double effect e.g. jodie and mary

A

o Doctors wanted to save the life of Jodie, a morally good action.
o The death of Mary was a bad consequence of saving Jodie but it was not the means; it was a foreseen but unintended by-product of saving Jodie.
o The doctors intended to save the life of Jodie; it was not to kill Mary.
o Saving the life of Jodie is morally as significant as the death of Mary.

28
Q

double effect vs consequentialism: purity of intention

A

C: • An evil act is an evil act, no matter what the intention.
• Deceit can degrade an apparent act of kindness e.g. child visiting grandparent because he wants to vs. has to.

DE • A good intention can justify an act.

29
Q

double effect vs consequentialism: arbitrariness

A

C • Argue against deontological viewpoint by stating life is not that simple.

DE • Distinguish between intended foreseen effects and unintended foreseen effects.
• It is logically possible to have prior intentions.

30
Q

double effect vs consequentialism: ordinary vs. extraordinary means

A

C • View deontologist argument as leading to more suffering and loss of dignity over what ‘extraordinary’ means.

DE • Believe that it is wrong to directly kill.

31
Q

double effect vs consequentialism: proportionality and rofl

A

C • If prolonging life brings about disproportionate suffering, then surely the deontologist should permit direct killing?

DE • Argue that outcomes are important, but that the consequentialist underestimates the importance of means the very subjective nature of quality-adjusted life year (takes into account the quantity and quality of life generated by healthcare interventions). Who decided what constitutes a worthwhile life?

32
Q

natural law and euth: 4 types of law and 5 primary precepts

A
•	4 Types of Law
o	Eternal law 
o	Divine law – scripture and revelation against euthanasia 
o	Natural law 
o	Human law 

• 5 Primary Precepts
o Ordered society → slippery slope. Can lead to euthanasia on demand. Pressures, confusion over duty of doctor
o Preserve life - Focus for euthanasia. Augustine and Aquinas argue suicide is a failure of one’s duty to protect innocent life. (H, is bad quality of life a life at all?)
o Reproduce
o Education
o Worship God, euth is worshipping yourself

33
Q

overall natural law and euth

A

• NL is focused on doing morally good actions and avoiding evil, means it is deontological.
• By doing this, you will fulfil God’s plan and purpose.
o Primary precepts are all in line with divine law and the purpose of human life as part of God’s plan.
o Catholics believe the purpose is to live a loving life. Euthanasia ends the possibility of love and pursuing any other precepts, it rejects God.

use of reason will mean that human laws cannot allow euthanasia. euthanasia is an apparent good, not a real good

34
Q

RCC on euth

A

o Euthanasia is wrong, life is sacred and gift from God, ‘which they are called upon to preserve and make fruitful’ (Declaration on Euthanasia, 1980)
o ‘Such an action on the part of a person is to be considered as a rejection of God’s sovereignty and loving plan’ (Declaration on Euthanasia, 1980)
o Deem euthanasia an apparent good/short term good, does not lead to flourishing as it only considers the individual, not the society as Aquinas emphasised. Slippery slope can lead to undermine order in society and value of human life (eudaimonia is aim for society).
o Make a distinction between killing and letting die in exceptional circumstances when treatment is futile. Burdensome treatment should not be offered at the end of a person’s futile life.

• Everyone has a duty to lead his or her life in accordance with God’s plan. (Sacred Congregation for the Doctrine of the Faith, Vatican 1980)

35
Q

criticism of RCC on euth

A
  • NL assumes human life has reason and the higher capacities associated with human life.
  • If someone is brain dead/in a permanent coma, they are no longer able to fulfil their purpose and no longer have defining characteristics of personhood.
  • What is difference between active euth and letting someone die? James Rachels highlights how ‘the decision to let a patient die is subject to moral appraisal in the same way that a decision to kill him would be subject to moral appraisal’.
  • However… euthanasia could stop another person from pursuing their purpose…
36
Q

NL on ruth: interior vs exterior

A

o Acting in a good way for the wrong reason is to perform a good exterior act but a bad interior act.
o E.g. helping an old lady cross the road (good exterior act) to impress someone (bad interior act) is wrong.
o It should be done out of charity, not for the sake of admiration of others.

37
Q

NL on euth: double effect

A

o Intention is not to kill
o Aim is to end life, means good death/mercy killing
o It may have good secondary implications of relief of suffering but we must focus on the intention.
o Palliative care involves double effect. The primary purpose is palliative care but the secondary effect is shortening life.

38
Q

SE and euth, general

A
  • Fletcher served as the president of the Euthanasia Society of America from 1974-76.
  • Combines consequentialist ideas and the weak sanctity of life principle.
  • There will be some occasions where euthanasia is wrong because it is not the most loving thing to do and others when it is compassionate and just.
  • Fletcher refers to euthanasia as death control, like birth control, and saw it as a matter of dignity. His views are based on autonomy, rejects NL approach to medical care.
  • ‘Indeed, to justify one, suicide or mercy killing, is to justify the other’ – (Fletcher, Humanhood: Essays in Biomedical Ethics)
39
Q

SE and euth: factors that shape view

A
  1. Rejects legalistic approach to moral-decision making. All about the experience of the person involved and all those affected in that situation – links to QofL.
  2. Agape – unconditional love in the service of others e.g. Simon Binner and Diane Pretty case.
40
Q

SE and euth: human criteria

A

• Fletcher identifies positive human criteria to judge if a human is a purpose:
o Minimal intelligence – IQ of 20/40
o Self awareness and self control
o Sense of the passage of time – future/past
o Concern for others
o Communication
o Control of existence
o Curiosity
o The possibility of change
o However… what does it mean for the mentally ill?

41
Q

SE and euth: working principles

A

o Pragmatism
• Must examine each case according to its merits, no intrinsic laws which prohibit euthanasia
• Unjustifiable to use limited resources to keep a terminally ill patient alive at the expense of other parents’ welfare
o Relativism
• No absolutes, must apply agape to each case, judge according to love and compassion.
• Weak sanctity of life – life is given to us to use wisely
o Positivism
• There is no law which states life must be preserved at all costs, laws invented by humans.
• Want to treat one another humanely, may involve allowing someone to die (passive euth) or helping them shorten their life (voluntary active euth)
o Personalism
• Must respect people’s autonomy and integrity
• Humanity is more significant than mere biological existence
• ‘It is harder to justify letting someone die a slow and ugly death, dehumanised than it is to justify helping him escape from such misery’.

42
Q

quality of life: personhood - Mary Anne warren

A
  • feel pain and consciousness
  • ability to reason
  • act beyond instinct
  • complex communication
  • sense of self
43
Q

self determination/autonomy - Simon binner

A

Binner, 57, was diagnosed with aggressive motor neurone disease in January 2015
His wife was against euthanasia, but Binner chose to end his life at a clinic in Basel, Switzerland, in October 2015.

I won’t join any campaign or celebrate his “choice”. But I will not condemn anyone for making the same one. - his wife

44
Q

e.g. tony nicklinson

A

he 58-year-old was paralysed from the neck down after suffering a stroke in 2005 and described his life as a “living nightmare”.
He lost his High Court case to allow doctors to end his life. “I am saddened that the law wants to condemn me to a life of increasing indignity and misery.”
Mr Nicklinson’s family solicitor said that he refused food and consequently, died.

45
Q

criticisms of current law

A

o However…
• Could chemo not be deemed deadly medicine?
• Increasing demand for the legalisation of euthanasia in the UK
o Works efficiently in several Scandinavian countries
o In a poll in 2007, 82% of the GB population agreed euthanasia should be legalised.

46
Q

which theories do you apply to euthanasia

A

situation ethics

natural law