A time to kill: Ronald dworkin and the ethics of euthanasia

Res Publica

Volumn 2, Issue 1, 1996, Pages 31-61

  Miller, Bradley W ^a  

^a Barrister and Solicitor Bell Spagnuolo and Company   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; ASSISTED SUICIDE; BEHAVIOR; DEATH AND EUTHANASIA; ETHICAL THEORY; ETHICS; EUTHANASIA; FREEDOM; HOMICIDE; HUMAN; INDIVIDUALITY; INDUCED ABORTION; JURISPRUDENCE; LIVING WILL; MENTAL CAPACITY; MENTAL PATIENT; MORALITY; MOTIVATION; PERSISTENT VEGETATIVE STATE; PERSONAL AUTONOMY; PERSONHOOD; PHYSICIAN; POLICY; QUALITY OF LIFE; SOCIAL JUSTICE; SOCIOECONOMICS; VOLUNTARY EUTHANASIA;

DEATH AND EUTHANASIA;

ABORTION, INDUCED; ADVANCE DIRECTIVES; ETHICAL THEORY; ETHICS; EUTHANASIA; EUTHANASIA, ACTIVE, VOLUNTARY; FREEDOM; HOMICIDE; HUMANS; INDIVIDUALITY; INTENTION; JURISPRUDENCE; MENTAL COMPETENCY; MENTALLY DISABLED PERSONS; MORALS; MOTIVATION; PERSISTENT VEGETATIVE STATE; PERSONAL AUTONOMY; PERSONHOOD; PHYSICIANS; PUBLIC POLICY; QUALITY OF LIFE; SOCIAL JUSTICE; SUICIDE, ASSISTED; VALUE OF LIFE; WEDGE ARGUMENT;

EID: 0030308131     PISSN: 13564765     EISSN: 15728692     Source Type: Journal    
DOI: 10.1007/BF02335709     Document Type: Article

References (107)

1. See Rodriguezv. British Columbia (Attorney General) (1993) 107 D.L.R. (4th) 342; Airedale M/S Trust v. Bland [1993] 2 W.L.R. 316; and Cruzan v. Director Missouri Department of Health (1990)110 Supreme Court Reports 2841.
2. Increasingly, especially in the lower courts, our judges lack any significant education in moral philosophy. The leading Canadian political philosopher, the late George Grant, cautioned that "When society puts power into the hands of the courts, they had better be educated ... The more the justices quote philosophy or religious tradition the less they give the sense they understand what they are dealing with." ("The Triumph of the Will", in A Time to Choose Life: Women, Abortion and Human Rights, ed. lan Gentles (Stoddart: Toronto, 1990), 9-18, endnote 3 at p.213, as cited in lain Benson, "Medical and Legal Ethics: Objective Truth and Subjective Schooling", Focus 15/1 (1994), 12-23).
3. Rodrigufz, supra n.l, at 389.
4. R. Dworkin, Life's Dominion (London: Harper Collins, 1993).
5. Edward Keyserlingk, Sanctity of Life or Quality of Life (Study Paper, Law Reform Commission of Canada, Ottawa, DSS, 1979).
6. R.P. George, Making Men Moral: Civil Liberties and Public Morality (Oxford: Clarendon Press, 1992), 19.
7. On the role of tradition in general, see A. Maclntyre, Whose Justice? Which Rationality? (Notre Dame, Ind.: University of Notre Dame Press, 1988).
8. I do not provide any defence of natural law theory here, and I will attempt only a brief summary of some key concepts. By "natural law theory" I mean the particular restatement developed largely by John Finnis and Germain Grisez. References to works by Finnis, Grisez, Robert George and others should point the reader towards a satisfactory exposition and defence of this tradition.
9. Linacre Centre for Health Care Ethics, "Submission to the Select Committee of the House of Lords on Medical Ethics", in Euthanasia, Clinical Practice and the Law, ed. Luke Gormally (London: The Linacre Centre, 1994), 111-65, at 119.
10. Supra n.9.
11. In John Finnis' account these include life, knowledge, play, aesthetic experience, sociability (friendship), practical reasonableness, and "religion"; J.M. Finnis, Natural Law and Natural Rights (Oxford: Clarendon Press, 1980),ch. IV.
12. J.M. Finnis, "Natural Law and Legal Reasoning", in Natural Law Theory, ed. R. George (Oxford: Clarendon Press, 1992), 134-57, at 136.
13. Finnis argues for nine basic principles of practical reasonableness. They are: (1) have a harmonious set of orientations, purposes, and commitments; (2) do not leave out of account, or arbitrarily discount or exaggerate, any of the basic human goods; (3) do not leave out of account, or arbitrarily discount or exaggerate, the goodness of other people's participation in human goods (i.e. have no arbitrary preferences among persons); (4) do not give any particular project the significance which belongs only to a basic good; (5) do not abandon your commitments lightly; (6) do not waste opportunities through unnecessary inefficiency; (7) do not choose directly against a basic human good; (8 promote the common good of your communities; and (9) follow your conscience. See J.M. Finnis, Fundamentals of Ethics (Oxford: Oxford University Press, 1983), 75; supra n. 11, at ch. V.
14. "Natural Law and Legal Reasoning", supra n. 12, at 147.
15. This is to be distinguished from F.A. Hayek's epistemological point that it is not within our cognitive capacity to know and choose good, and therefore we can only refrain from doing wrong (see Z. Bankowski, "Ambiguities of the Rule of Law", in Issues of Law and Morality, ed. H. Jung (Berlin: Forum Verlag, 1991), 101-12, at 105). The point from practical reasonableness is that even if we do know how to do good, some possible instantiations of good will be mutually exclusive, and we must choose among them. Therefore some possible good will not be pursued. Given finite human ability, we cannot have moral absolutes requiring that all good be done. See J.M. Finnis, "Intention and side-effects", in Liability and Responsibility, ed. R.G. Frey and C.W. Morris (Cambridge: Cambridge University Press, 1991), 32-64, at 63.
16. Finnis, supra n. 12.
17. Supra n.6, at 8-9; also J.M. Finnis, Moral Absolutes (Washington, DC: The Catholic University of America Press, 1991), 43-44.
18. Finnis, supra n. 15, at 62.
19. Supra n. 18, at 62-4. Also supra n.6, at 17.
20. Finnis, supra n. 15, at 61.
21. The Linacre Centre, Report of a Working Party, "Euthanasia and Clinical Practice", in Gormally supra n.9, 1-107, at 48-50.
22. "Act so that you treat humanity, whether in your own person or in that of another, always as an end and never as a means only", cited in Finnis, supra n.13, at 121.
23. Finnis, supra n.15. Also, supra n.9, at 48-50.
24. Supra n.9, at 39.
25. Supra n.9 at 39-41. Also Finnis, Fundamentals of Ethics, supra n. 13, at 124-33.
26. Bland, supra n.l, at 367.
27. Rodriguez, supra n.l, and the Law Reform Commission of Canada, Euthanasia, Aiding Suicide and Cessation of Treatment, Working Paper 28 (Ottawa: DSS, 1982), at 33.
28. J.M. Finnis, "Bland: Crossing the Rubicon?", Law Quarterly Review 109 (1993), 329-37, at 333.
29. See N. Pace, "A Practitioner's Overview", an unpublished manuscript presented at the University of Glasgow, Conference on "Death, Dying and the Law", 3 September 1994, at p.3.
30. Supra n.9, at 63-64.
31. Supra n.4, at 101.
32. Supra n.4, at 68-69.
33. Supra n.4, at ch. III.
34. Supra n.4, at 69.
35. Supra n.4, at 92.
36. Supra n.4, at 84.
37. Supra n.4, at 84-89.
38. Supra n.9, at 84-89.
39. Supra n.4, at 89-94.
40. Supra n.4, at 93.
41. Supra n.4, at 215-216.
42. Supra n.4, at 28.
43. See Z. Bankowski, "Don't think about it?: Legalism and Legality", Rechtstheorie Beiheft 15 (1993), 45-54.
44. Supra n.43. Also, St. Thomas Aquinas, Summa Theologiae I-II q.96, a.2; George, supra n.6.
45. Although Dworkin's liberalism also allows for limited paternalism: see R. Dworkin, "The Right to Death", New York Review of Books, 31st January 1991, 14-17 at 17 n.6;
46. and R. Dworkin, "Foundations of Liberal Equality", in 1989 Tanner Lectures on Human Values (Salt Lake City: University of Utah Press, 1989), vol. II, cited in George, supra n.6, at 102.
47. Supra n.6, at 28-35.
48. Supra n.6, at 43.
49. Supra n.43, at 8.
50. Supra n.13, at 124.
51. Supra n. 12, at 145-48.
52. Supra n.U, at 148-50.
53. J.M. Finnis, "The 'Value of Human Life' and The Right to Death': Some Reflections on Cruzan and Ronald Dworkin", Southern Illinois University Law Journal 17 (1993), 559-571, at 567-70. This is not to suggest that emotions form no part of rational deliberation; see supra n.12, at 39-41 and supra n.6, at 9-10.
54. Supra n.4, at 213.
55. Supra n.9, at 121-23.
56. C.S. Lewis, Abolition of Man (New York: Macmillan, 1947), 60.
57. Supra n.55, at 59.
58. Supra n.9, at 122, note 8(2).
59. Supra n.4, at 80.
60. While Dworkin's contention that life can have no value is placed in the context of an autonomous request for death, the concept of the valueless life has necessary implications for involuntary euthanasia, as well as the creation of a moral climate which encourages people to make life terminating decisions (either in advance directives or contemporaneously) based on a vision which encourages them to feel worthless in themselves and a burden on society.
61. Supra n.4, at 230.
62. L. Gormally, "The Aged: non-persons, human dignity and justice", in The Dependent Elderly, ed. L. Gormally (Cambridge: Cambridge University Press, 1992), 181-88, at 184.
63. Supra n.9, at 123.
64. Supra n.9.
65. J.M. Finnis, "Economics, justice and the value of life: concluding remarks", in Gormally, supra n.6l, 189-98, at 193-96.
66. Supra n.6l, 189-98, at 193-6.
67. G.V. Bradley, "Life's Dominion: A Review Essay", Notre Dame Law Review 69 (1993), 329-91, at 374.
68. G. Grisez, "Should Nutrition and Hydration Be Provided to Permanently Unconscious and Other Mentally Disabled Persons?", Issues in Law and Medicine-4 (1989), 165-79, at 173.
69. "The Right to Death', supra n.45, at 17.
70. Supra n.67, at 174.
71. Supra n. 67, at 174.
72. Finnis, supra n.64, at 192-94.
73. Finnis, supra n.64, at 192-94.
74. On thé distinction between emotional reactions and the rational requirements of justice: "Neither solidarity nor justice can be maintained by reliance on sentiments of affection uninformed by recognition of duties of care to those who in the course of nature (because of immaturity and decline) are necessarily dependent and without a sense of responsibility for their own lives. The lives of many of us have depended at some stage on others recognising duties of care towards us, a recognition overriding any strong inclination to abandon care for us" (supra n.9, at 121 n.4).
75. Supra n.4, at ch. VII and VIII.
76. J. Boyle, "The American debate about artificial nutrition and hydration", in Gormally, supra n.6l, at 28-46.
77. Supra n.11 at 106-107.
78. Supra n.67, at 169.
79. Supra n.9, at 122.
80. And this is not simply to make the epistemological complaint that it is impossible to foresee the benefits and burdens that would occur as a result of each option. On incommensurability, see J. Raz, The Morality of Freedom (Oxford: Clarendon Press, 1986), ch. XIII;
81. also J.M. Finnis, J. Boyle, and G. Grisez, Nuclear Deterrence, Morality and Realism (Oxford: Clarendon Press, 1987), ch. IX.
82. Finnis, Grisez and Boyle, supra n.79, at 252.
83. Supra n.4, at 205.
84. Supra n.4, at 29.
85. Raz, supra n.79, at 370.
86. Supra n.4, at 224.
87. Supra n.4, at 224.
88. Supra n.6, at 129.
89. Supra n.4, at 202-206.
90. Supra n.4, at 202-206.
91. Supra n.4, at 228-29.
92. Fundamentals of Ethics, supra n.13, at 70-74.
93. Supra n.12, at 100.
94. Supra n.6, at 178.
95. Supra n.9, at 131.
96. Supra n.13, at 124.
97. J. Boyle, "The American debate about artificial nutrition and hydration", in Gormally, supra n.6l, 28-46, at 42.
98. Supra n.9, at 131-132.
99. Supra n.6, at 32.
100. Raz, supra n.79, at ch. 1.
101. Supra n.6, at 163-4.
102. J. Keown, "Some reflections on euthanasia in The Netherlands", in Gormally, supra n.61, 70-100, at 79.
103. Finnis, supra n. 12, at ch. VI.
104. Supra n.6, at 99.
105. For a fuller discussion of policy considerations, see Y. Kamisar, "Some Non-Religious Views Against Proposed 'Mercy-Killing' Legislation", Minnesota Law Review 42 (1958), 970-1039.
106. Supra n. 100, at 82.
107. B. Logue, "Physician-Assisted Suicide: A Social Science Perspective on International Trends (Summary)", unpublished manuscript presented at University of Glasgow Symposium on "Death, Dying and the Law", 3 September 1994, at 3-4.