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Outline of lectures on euthanasia

Killing vs. letting die:

  •     either may 'cause' death
  •     either may be wrong
  •     question is what are the obligations of the physician:  in what circumstances is it wrong for him to kill or to let die?

    •         Callahan:  sometimes let die, never kill
            Rachels:  sometimes more cruel to let die

    Voluntary euthanasia

  •     should we help the person who wishes to be killed/let die?

    •         Is consent enough?
                consider:  rationality of person, impulsiveness of decision
            What conditions justify our helping a person to die?
                bad haircut ....  pain/terminal illness .... none
                difficulty of drawing a principled line

    Involuntary euthanasia

  •     Patient too young, incapacitated, unconscious
  •     What can justify involuntary euthanasia?

    •         Patient may not be either suffering or dying
            "Irreversible" coma sometimes reversed (but typically not)
            permanent vegetative state:  already dead?
            Burden on family
                can burdens on family ever justify euthanasia?

    Social implications

  •     Is it done simply to make medical care cheaper?  Where would this stop?
  •     If euthanasia is made legal, will there be undue pressure on patients to consent?
  •     Do physicians in fact make the decision, because patients will tend to follow their advice?
  •     Easier for physicians to end life than treat pain and discomfort?
  •     Would permitting euthanasia mean that pain relief, better ways of treating illnesses would be ignored?
  •     Would it be applied selectively to poor and minorities?  handicapped?

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