slides class 2020

1. Euthanasia

2. Callahan Thesis
Voluntary active euthanasia is morally wrong
and should be illegal. It is not supported by the
value of autonomy (individual self-
determination),will lead to bad consequences,
and moves medicine beyond its proper role.

3. Three Moral Turning Points
Accepting voluntary active euthanasia would permit:
1. a form of “consenting adult killing.”
2. self-determination at the cost of the good of the
community.
3. the medical profession serving the individualistic pursuit of
happiness and well-being, rather than just promoting and
preserving health.

4. Callahan then explains four categories
of arguments in favor of voluntary
active euthanasia and responds to
each.

5. 1. Self-Determination
Argument for Voluntary Active Euthanasia:
People should be allowed to decide according to their own values how
to conduct their lives, including how and when to die.
Callahan’s Response: Euthanasia is not just about self-determination
because it involves another person. It is a mutual decision between two
people.
 No plausible argument why it should be permissible to give someone
the right to kill you.
 It is against human dignity.
 Analogies to slavery, dueling.

6. Evaluating Callahan on 1)
It is true that it is morally wrong, in normal circumstances, to kill
someone even with that person’s permission, or to make
someone your slave even with that person’s permission.
But might voluntary active euthanasia be different, since the
person is suffering and will die anyway?

7. 2. Killing and Allowing to Die
Argument for Voluntary Active Euthanasia:
There is no moral difference between killing and letting die. (cf. Rachels, Brock)
 Callahan’s Response: This argument confuses causality and culpability.
 Causality=physical or metaphysical responsibility
 Culpability=moral responsibility
 C: The disease causes death, not the physician who stops treatment. (cf. healthy and sick
person)
 C: When a doctor should not have stopped treatment, we say the doctor “kills” in an
expanded sense of the term, to point out that the doctor is morally responsible for the
death, even though the cause of the death is the disease.

8. Evaluating Callahan on 2)
What would Callahan say about Brock’s greedy son case?
The greedy son kills his mother in the extended sense.
The disease actually kills his mother, but he is morally
responsible for that happening.
The doctor who rightly withholds treatment, unlike the
greedy son, only lets the patient die.

9. Evaluating Callahan on 2)
But notice that what causes the death is both the doctor’s action
and the disease.
 After all, in explaining the cause of death, a person would state
both factors, as the doctor’s action is part of the causal chain.
That is the same for the greedy son.
 Does that mean that both the doctor and the disease together
kill the patient? Or that the doctor uses the disease to kill the
patient?

10. 3. Calculating Consequences
Argument for Voluntary Active Euthanasia:
It is unlikely to lead to bad consequences.
Callahan’s Response:
 The experience of other countries suggests that the law will be abused.
 The confidentiality of the doctor-patient relationship makes such abuse easier.
 If there’s a right of self-determination to choose euthanasia to relieve suffering, then
 why limit it to relieving suffering?
 why limit it to the mentally competent?

11. Evaluating Callahan on 3)
It makes sense to allow limits on self-determination
when it comes to death, such as when the suffering is
extreme and the person is going to die anyway.
Can’t laws permitting withdrawing treatment also be
abused? (cf. Brock)

12. 4. Euthanasia &
Medical Practice
Argument for Voluntary Active Euthanasia:
Euthanasia is compatible with the aims of medicine.
 Callahan’s response:
 Voluntary active euthanasia moves medicine beyond its proper role
of promoting and preserving health and into issues about human
happiness and well being and what lives are worth living.

13. Evaluating Callahan on 4)
Even if doctors can’t always know perfectly, don’t we have
some idea about what diseases could produce unbearable
suffering and when a patient experiences that sort of
suffering?
And don’t we think unbearable suffering might make life not
worth living, such that it is reasonable for a patient to think
that their life is no longer worth living?