Abstract
Two insights motivate proponents of euthanasia. One is that pain and all the other assaults upon human autonomy attendant upon disease can be so severe that it can be more humane to kill than to prolong dying or even to cure. The second insight is that our lives are preeminently our own to do with and terminate as we will. Some may wish to challenge these insights-they were certainly controversial at other times and places1-but neither the traditional nor the contemporary philosophical debate on euthanasia has focused on them. Although euthanasiasts sometimes act as if this were the issue, antieuthanasiasts by and large concede the point and take the issue to turn not on the moral propriety of isolated acts of mercy killing (on the proverbial desert island), but on the propriety of accepting euthanasia as part of public morality, sanctioned by law. The antieuthanasiasts’ point is that, just as the mere immorality of an act does not suffice to justify making it illegal (which is why there are no statutes proscribing nastiness), so too the mere humaneness and decency of an act does not suffice to provide a warrant for its legality. For laws regulate not individual acts but social practices; and practices, by nature, are iterative; and extensive iteration necessarily transforms the improbable consequences of individual acts into virtual certainties.
One dies just as it comes; one dies the death that belongs to the disease one has (for since one has come to know all diseases, one knows too that the different lethal terminations belong to the diseases and not to the people; and the sick person has so to speak nothing to do). R. M. Rilke The Notebooks of Malte Laurids Brigge
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Notes and References
S.E. Sprott, The English Debate On Suicide (Open Court, 1961).
Minnesota Law Review 42 (1958) No. 6, May 1958; reprinted in T. Beauchamp and L. Walters, eds., Contemporary Issues in Bioethics Dickenson, 1978), pp. 308–317.
Minnesota Law Review Vol 43, No. 1(1948); reprinted in Beauchamp and Walters, pp. 318–328 (ref. 2).
Beauchamp and Walters, p. 309.
Beauchamp and Walters, p. 318.
Beauchamp and Walters, p. 322.
Beauchamp and Walters, p. 322.
Anthony Flew “The Principle of Euthanasia,” in A. B. Downing, Euthanasia and The Right to Die (Nash, 1969).
Marvin Kohl, The Morality of Killing (Atlantic Highlands, NJ: Humanities Press, 1974); Beneficent Euthanasia (Buffalo: Prometheus, 1975).
O. Ruth Russell, Freedom To Die (New York: Human Sciences Press, 1975).
See, for example, James Rachels, “Killing and Starving to Death,” Philosophy 54, 1979, 159–171. This article contains Rachels’ most recent and most sophisticated version of the argument. Rachels’ original argument on the subject, “Euthanasia, Killing and Letting Die” was published in John Ladd’s excellent anthology EthicalIssues Relating to Life and Death (Oxford: Oxford University Press, 1979), 146–163. A condensed version appeared in the New England Journal of Medicine 292, January 1974, 78–80. The latter version has been much anthologized and is available in Bonnie Steinbock’s Killing and Letting Die (Englewood Cliffs, NJ: Prentice Hall, 1980), and Ethical Issues in Death and Dying edited by Tom Beauchamp and Seymour Perlin and also published by Prentice Hall, 1978. Singer’s work is in his Practical Ethics (Cambridge: Cambridge University Press, 1979). Tooley’s argument is in Steinbock, pp. 56–62.
Philippa Foot takes this line in “The Problem of Abortion and the Doctrine of Double Effect,” Oxford Review 5, 1977, and in “Euthanasia”, Philosophy and Public Affairs 6, 1977, 85–112. Foot’s work is explored at some length by Nancy Davis in the Steinbock anthology, pp. 172–214, and by Bruce Russell, “The Relative Strictness of Negative and Positive Rights,” American Philosophical Quarterly 14, 2 April 1977, (also in Steinbock), “Still A Live Issue,” Philosophy and Public Affairs 7, 1978, 278–281 and “The Presumption of Taking Life as Compared to That Against Failing to Save,” Journal of Medicine and Philosophy 4, 3, 1979. Russell’s interlocuter and antagonist on these issues is Richard Trammell, “Saving Life and Taking Life,” Journal of Philosophy LXXII, 5, March 13, 1975, 131–137, “Tooley’s Moral Symmetry Principle,” Philosophy and Public Affairs 5, 1976, 305–313, “The Non-Equivalence of Saving Life and Taking Life” and “The Presumption Against Taking Life,” both in the Journal of Medicine and Philosophy 4, 1979 and 3, 1978, pp. 53–67, respectively. See also Tooley’s article in Ladd, pp. 63–93 and Judith Thomson’s “Killing, Letting Die, and The Trolley Problem,” The Monist 59, 1976, 204–217.
Tom Beauchamp, “A Reply to Rachels On Active and Passive Euthanasia,” in Beauchamp and Perlin, pp. 246–259.
Bonnie Steinbock, “The Intentional Termination of Life,” Ethics in Science and Medicine 6, 1, 1979, 59–64, also in Steinbock, pp. 69–77.
In “Killing and Starving to Death,” Philosophy 54, 1979, pp. 165–166, Rachels develops some formally sufficient conditions for “moral equivalence”. Michael Tooley, who also used this argument, presents a different theory of moral equivalence in “An Irrelevant Consideration: Killing Versus Letting Die” in Steinbock, pp. 56–62.
Peter Singer, Practical Ethics (Cambridge: Cambridge University Press, 1979), 152–153.
Beauchamp and Walters, p. 309.
John Freeman “Ethics and The Decision Making Process for Defective Children,” in David Roy Medical Wisdom and Ethics in the Treatment of Severly Defective Newborn and Young Children (Eden Press, 1978) p. 32.
Roy, pp. 28–29.
“Euthanasia, Killing and Letting Die”, Ladd, p. 150.
M. T. Rabkin et al., “Orders Not to Resuscitate,” New England Journal of Medicine 259, 1976, pp. 365, 366.
G. Tagge et al., “Relationship of Critical Care to Prognosis in Critically Ill Patients,” Critical Care Medicine 2, 2, March-April 1974, 61–63. See also M. Kirchner, “How Far to Go Prolonging Life: One Hospital’s System,” Medical Economics 1976, 12 July 1976, 69–75. See also G. Tagge, “Critical Care: A Classification System for ICU Patients,” The Hospital Medical Staff 5, 2, February 1976, 1–6. Variants of this protocol have been published by Massachusetts General Hospital (Boston) and by Presbyterian University Hospital (Pittsburgh). See, Clinical Care Committee, Massachusetts General Hospital, “Optimum Care for Hopelessly Ill Patients,” New England Journal of Medicine 295, 7, August 12, 1976, 362–364; Ake Grenvik et al., “Cessation of Therapy in Terminal Illness and Brain Death,” Critical Care Medicine 6, 4, July-August 1978, 284–291.
As quoted by Rachels in Ladd, p. 149, Steinbock, p. 63, New England Journal 292, January 1975, p. 78.
JAMA Aug 1, 1980, 244, 5; p. 506.
Steinbock, p. 66–67.
Ake Grenvik et al., “Cessation of Therapy in Terminal Illness and Brain Death, Critical Care Medicine 6, 4, July-August 1978, pp. 284–291.
These figures are projections from the data in the US Department of Health Education and Welfare’s publication Hospital Health US 1979. In 1977, 36.8 million discharges excluding newborns from all short stay hospitals (p. 129) and 1,303,100 were in nursing homes (p. 131). Figures for longterm stay hospitals, and psychiatric hospitals were not available. If all excluded groups are counted, it is reasonable to assume that well over forty million people were hospitalized for some period of time in the US in 1977. According to the Statistical Abstracts the estimated population of the US in 1977 was 216,900,000. At a conservative estimate, therefore, a North American population of 300,000,000 would generate 50,000,000 hospitalized in a given year.
Practical Ethics 144–145.
New England Journal of Medicine 292, 16, April 17, 1975, pp. 863–864. Rachels replies on 866, 867. By the way, Singer cites this correspondence in Practical Ethics p. 228.
Ibid. 866, 867.
Stuart Alsop, “The Right To Die With Dignity,” Good Housekeeping 179, 2, p. 69, 130, 132, August 1974, quote from p. 132.
“Terminal Care: Issues and Alternatives,” Ryder and D. Ross, Public Health Reports 92, 1, January-February, 1977. See also C. Saunders, “The Challenge of Terminal Care” in Symington and Carter, Scientific Foundations of Oncology (London: Heinemann, 1975). See also The Hospice Movement by S. Stoddard, (New York: Stein and Day, 1978).
On Dying Well Church Information Office, London, 1975.
Ibid. p. 47.
Jan. 14, 1982, 306, 2 pp. 98–99.
David Sudnow, Passing On (Englewood Cliffs, NJ: Prentice Hall, 1967), p. 89.
Ibid. p. 91.
Ibid. p. 83.
Ibid. pp. 82–83.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1983 Springer Science+Business Media New York
About this chapter
Cite this chapter
Baker, R. (1983). On Euthanasia. In: Humber, J.M., Almeder, R.F. (eds) Biomedical Ethics Reviews · 1983. Biomedical Ethics Reviews. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-439-9_1
Download citation
DOI: https://doi.org/10.1007/978-1-59259-439-9_1
Publisher Name: Humana Press, Totowa, NJ
Print ISBN: 978-1-4757-4632-7
Online ISBN: 978-1-59259-439-9
eBook Packages: Springer Book Archive