Killing and Allowing to Die: Another Look

Journal of Law, Medicine and Ethics

Volumn 26, Issue 1, 1998, Pages 55-64

  Sulmasy, Daniel P ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

ACTIVE EUTHANASIA; ANALYTICAL APPROACH; ARTICLE; ASSISTED SUICIDE; BEHAVIOR; DEATH AND EUTHANASIA; DECISION MAKING; ETHICS; EUTHANASIA; HOMICIDE; HUMAN; LANGUAGE; LEGAL ASPECT; MEDICAL ETHICS; MORALITY; PHILOSOPHY; POLICY; SOCIOECONOMICS; TREATMENT WITHDRAWAL; UNITED STATES;

ANALYTICAL APPROACH; DEATH AND EUTHANASIA;

DECISION MAKING; DOUBLE EFFECT; ETHICS; EUTHANASIA; EUTHANASIA, ACTIVE; HOMICIDE; HUMANS; INTENTION; LANGUAGE; MORAL OBLIGATIONS; MORALS; PHILOSOPHY, MEDICAL; PUBLIC POLICY; SUICIDE, ASSISTED; UNITED STATES; VALUE OF LIFE; WEDGE ARGUMENT; WITHHOLDING TREATMENT;

EID: 0032008877     PISSN: 10731105     EISSN: None     Source Type: Journal    
DOI: 10.1111/j.1748-720X.1998.tb01906.x     Document Type: Article

References (56)

1. Washington v. Glucksberg, 117 S. Ct. 2258 (1997); and Vacco v. Quill, 117 S. Ct. 2293 (1997).
2. Quill v. Vacco, 80 F.3d. 716 (2d Cir. 1996).
3. R. Dworkin et al., "Assisted Suicide: The Philosopher's Brief," New York Review of Books, Mar. 27, 1997, at 41-47.
4. See, for example, J. Rachels, The End of Life: Euthanasia and Morality (New York: Oxford University Press, 1986); D. Brock, "Voluntary Active Euthanasia," Hastings Center Report, 22, no. 2 (1992): 10-22; H. Kuhse, The Sanctity of Life Principle in Medicine: A Critique (Oxford: Clarendon Press, 1987); H. Brody, "Assisted Death - A Compassionate Response to Medical Failure," N. Engl. J. Med., 327 (1992): 1384-88; E.H. Lowey, "Healing and Killing, Harming and Not Harming," Journal of Clinical Ethics, 3 (1992): 29-34; and D. Meier, "Physician-Assisted Dying: Theory and Reality," Journal of Clinical Ethics, 3 (1992): 35-37.
5. See, for example, J. Rachels, The End of Life: Euthanasia and Morality (New York: Oxford University Press, 1986); D. Brock, "Voluntary Active Euthanasia," Hastings Center Report, 22, no. 2 (1992): 10-22; H. Kuhse, The Sanctity of Life Principle in Medicine: A Critique (Oxford: Clarendon Press, 1987); H. Brody, "Assisted Death - A Compassionate Response to Medical Failure," N. Engl. J. Med., 327 (1992): 1384-88; E.H. Lowey, "Healing and Killing, Harming and Not Harming," Journal of Clinical Ethics, 3 (1992): 29-34; and D. Meier, "Physician-Assisted Dying: Theory and Reality," Journal of Clinical Ethics, 3 (1992): 35-37.
6. See, for example, J. Rachels, The End of Life: Euthanasia and Morality (New York: Oxford University Press, 1986); D. Brock, "Voluntary Active Euthanasia," Hastings Center Report, 22, no. 2 (1992): 10-22; H. Kuhse, The Sanctity of Life Principle in Medicine: A Critique (Oxford: Clarendon Press, 1987); H. Brody, "Assisted Death - A Compassionate Response to Medical Failure," N. Engl. J. Med., 327 (1992): 1384-88; E.H. Lowey, "Healing and Killing, Harming and Not Harming," Journal of Clinical Ethics, 3 (1992): 29-34; and D. Meier, "Physician-Assisted Dying: Theory and Reality," Journal of Clinical Ethics, 3 (1992): 35-37.
7. See, for example, J. Rachels, The End of Life: Euthanasia and Morality (New York: Oxford University Press, 1986); D. Brock, "Voluntary Active Euthanasia," Hastings Center Report, 22, no. 2 (1992): 10-22; H. Kuhse, The Sanctity of Life Principle in Medicine: A Critique (Oxford: Clarendon Press, 1987); H. Brody, "Assisted Death - A Compassionate Response to Medical Failure," N. Engl. J. Med., 327 (1992): 1384-88; E.H. Lowey, "Healing and Killing, Harming and Not Harming," Journal of Clinical Ethics, 3 (1992): 29-34; and D. Meier, "Physician-Assisted Dying: Theory and Reality," Journal of Clinical Ethics, 3 (1992): 35-37.
8. See, for example, J. Rachels, The End of Life: Euthanasia and Morality (New York: Oxford University Press, 1986); D. Brock, "Voluntary Active Euthanasia," Hastings Center Report, 22, no. 2 (1992): 10-22; H. Kuhse, The Sanctity of Life Principle in Medicine: A Critique (Oxford: Clarendon Press, 1987); H. Brody, "Assisted Death - A Compassionate Response to Medical Failure," N. Engl. J. Med., 327 (1992): 1384-88; E.H. Lowey, "Healing and Killing, Harming and Not Harming," Journal of Clinical Ethics, 3 (1992): 29-34; and D. Meier, "Physician-Assisted Dying: Theory and Reality," Journal of Clinical Ethics, 3 (1992): 35-37.
9. See, for example, J. Rachels, The End of Life: Euthanasia and Morality (New York: Oxford University Press, 1986); D. Brock, "Voluntary Active Euthanasia," Hastings Center Report, 22, no. 2 (1992): 10-22; H. Kuhse, The Sanctity of Life Principle in Medicine: A Critique (Oxford: Clarendon Press, 1987); H. Brody, "Assisted Death - A Compassionate Response to Medical Failure," N. Engl. J. Med., 327 (1992): 1384-88; E.H. Lowey, "Healing and Killing, Harming and Not Harming," Journal of Clinical Ethics, 3 (1992): 29-34; and D. Meier, "Physician-Assisted Dying: Theory and Reality," Journal of Clinical Ethics, 3 (1992): 35-37.
10. See Brock, supra note 4, at 12.
11. See, for example, T.E. Quill, R. Dresser, and D.W. Brock, "The Rule of Double Effect - A Critique of Its Role in End-of-Life Decision Making," N. Engl. J. Med., 337 (1997): 1768-71; T.E. Quill, B. Lo, and D.W. Brock, "Palliative Options of Last Resort: A Comparison of Voluntarily Stopping Eating and Drinking, Terminal Sedation, Physician-Assisted Suicide, and Voluntary Active Euthanasia," JAMA, 278 (1997): 2099-104; D. Orentlicher, "The Supreme Court and Physician-Assisted Suicide: Rejecting Assisted Suicide but Embracing Euthanasia," N. Engl. J. Med., 337 (1997): 1236-40; and M.A. Lee et al., "Legalizing Physician-Assisted Suicide - Views of Physicians in Oregon," N. Engl. J. Med., 334 (1996): 310-15.
12. See, for example, T.E. Quill, R. Dresser, and D.W. Brock, "The Rule of Double Effect - A Critique of Its Role in End-of- Life Decision Making," N. Engl. J. Med., 337 (1997): 1768-71; T.E. Quill, B. Lo, and D.W. Brock, "Palliative Options of Last Resort: A Comparison of Voluntarily Stopping Eating and Drinking, Terminal Sedation, Physician-Assisted Suicide, and Voluntary Active Euthanasia," JAMA, 278 (1997): 2099-104; D. Orentlicher, "The Supreme Court and Physician-Assisted Suicide: Rejecting Assisted Suicide but Embracing Euthanasia," N. Engl. J. Med., 337 (1997): 1236-40; and M.A. Lee et al., "Legalizing Physician-Assisted Suicide - Views of Physicians in Oregon," N. Engl. J. Med., 334 (1996): 310-15.
13. See, for example, T.E. Quill, R. Dresser, and D.W. Brock, "The Rule of Double Effect - A Critique of Its Role in End-of- Life Decision Making," N. Engl. J. Med., 337 (1997): 1768-71; T.E. Quill, B. Lo, and D.W. Brock, "Palliative Options of Last Resort: A Comparison of Voluntarily Stopping Eating and Drinking, Terminal Sedation, Physician-Assisted Suicide, and Voluntary Active Euthanasia," JAMA, 278 (1997): 2099-104; D. Orentlicher, "The Supreme Court and Physician-Assisted Suicide: Rejecting Assisted Suicide but Embracing Euthanasia," N. Engl. J. Med., 337 (1997): 1236-40; and M.A. Lee et al., "Legalizing Physician-Assisted Suicide - Views of Physicians in Oregon," N. Engl. J. Med., 334 (1996): 310-15.
14. See, for example, T.E. Quill, R. Dresser, and D.W. Brock, "The Rule of Double Effect - A Critique of Its Role in End-of- Life Decision Making," N. Engl. J. Med., 337 (1997): 1768-71; T.E. Quill, B. Lo, and D.W. Brock, "Palliative Options of Last Resort: A Comparison of Voluntarily Stopping Eating and Drinking, Terminal Sedation, Physician-Assisted Suicide, and Voluntary Active Euthanasia," JAMA, 278 (1997): 2099-104; D. Orentlicher, "The Supreme Court and Physician-Assisted Suicide: Rejecting Assisted Suicide but Embracing Euthanasia," N. Engl. J. Med., 337 (1997): 1236-40; and M.A. Lee et al., "Legalizing Physician-Assisted Suicide - Views of Physicians in Oregon," N. Engl. J. Med., 334 (1996): 310-15.
15. See J.S. Cohen et al., "Attitudes Towards Assisted Suicide and Euthanasia Among Physicians in Washington State," N. Engl. J. Med., 331 (1994): 89-94; R.S. Shapiro et al., "Willingness to Perform Euthanasia: A Survey of Physician Attitudes," Archives of Internal Medicine, 154 (1994): 575-84; and J.G. Bachman et al., "Attitudes of Michigan Physicians and the Public Toward Legalized Physician-Assisted Suicide and Voluntary Euthanasia," N. Engl. J. Med., 334 (1996): 303-09.
16. See J.S. Cohen et al., "Attitudes Towards Assisted Suicide and Euthanasia Among Physicians in Washington State," N. Engl. J. Med., 331 (1994): 89-94; R.S. Shapiro et al., "Willingness to Perform Euthanasia: A Survey of Physician Attitudes," Archives of Internal Medicine, 154 (1994): 575-84; and J.G. Bachman et al., "Attitudes of Michigan Physicians and the Public Toward Legalized Physician-Assisted Suicide and Voluntary Euthanasia," N. Engl. J. Med., 334 (1996): 303-09.
17. See J.S. Cohen et al., "Attitudes Towards Assisted Suicide and Euthanasia Among Physicians in Washington State," N. Engl. J. Med., 331 (1994): 89-94; R.S. Shapiro et al., "Willingness to Perform Euthanasia: A Survey of Physician Attitudes," Archives of Internal Medicine, 154 (1994): 575-84; and J.G. Bachman et al., "Attitudes of Michigan Physicians and the Public Toward Legalized Physician-Assisted Suicide and Voluntary Euthanasia," N. Engl. J. Med., 334 (1996): 303-09.
18. See Hippocrates, "The Hippocratic Oath: Text, Translation, and Interpretation," in O. Temkin and C.L. Temkin, eds., and L. Edelstein, trans., Ancient Medicine: Selected Papers of Ludwig Edelstein (Baltimore: Johns Hopkins University Press, 1967): 3-63.
19. See Hippocrates, "The Art," in W.H.S. Jones, trans., Hippocrates II (Cambridge: Harvard University Press, 1972): 193.
20. See S. Waxman, "The Dutch Way of Death," Washington Post, Jan. 31, 1995, at B1, B3.
21. See P.J. van der Maas et al., "Euthanasia and Other Medical Decisions Concerning the End of Life," Lancet, 338 (1991): 669-74.
22. See R.J. van der Maas et al., "Euthanasia, Physician-Assisted Suicide, and Other Medical Practices Involving the End of Life in the Netherlands: 1990-1995," N. Engl. J. Med., 335 (1996): 1699-705.
23. See "Departing Prosecutor Charges Dr. Kevorkian in 10 Deaths," American Medical News, Nov. 18, 1996, at 71.
24. See D. Gianelli, "Euthanasia Measures Fail, But Backers Vow Renewed Push," American Medical News, Nov. 20/30, 1992, at 42-43.
25. See T. Eagan, "In Oregon, Opening a New Front in the World of Medicine," New York Times, Nov. 6, 1997, at A26.
26. Lee v. Oregon, No. 95-35804, 1997 WL 80783 (9th Cir. Feb. 27, 1997).
27. See B. Steinbock and A. Norcross, eds., Killing and Letting Die (New York: Fordham University Press, 2nd ed., 1994); and D.P. Sulmasy, Killing and Allowing to Die (1995) Ph.D. dissertation, Georgetown University (on file with UMI Dissertation Services No. 9608827).
28. See B. Steinbock and A. Norcross, eds., Killing and Letting Die (New York: Fordham University Press, 2nd ed., 1994); and D.P. Sulmasy, Killing and Allowing to Die (1995) Ph.D. dissertation, Georgetown University (on file with UMI Dissertation Services No. 9608827).
29. T.L. Beauchamp, "Introduction," in Intending Death: The Ethics of Assisted Suicide and Euthanasia (Upper Saddle River: Prentice Hall, 1996): at 7.
30. Rachels, supra note 4, at 112.
31. See Brock, supra note 4.
32. See W. Gaylin et al., "Doctors Must Not Kill," JAMA, 259 (1988): 2139-40.
33. See Beauchamp, supra note 18, at 7.
34. See J. Bennett, "Whatever the Consequences," Analysis, 26 (1966): 83-102.
35. See id.
36. Some suggest that the patient in physician-assisted suicide is acting in self-defense, but this is a specious argument. In claiming self-defense, one is justified in killing another person only if that person threatens one's existence. Cancer or AIDS may be threats to my existence, and I am justified in defending my existence against these illnesses. But it is at best awkward to claim that I can justify killing myself because I am a threat to myself.
37. See J.D. Sapira, The Art and Science of Bedside Diagnosis (Baltimore: Urban and Schwartzenberg, 1990): at 130.
38. See D.P. Sulmasy, "Managed Care and Managed Death," Archives of Internal Medicine, 155 (1995): 133-36.
39. See, for example, T.E. Quill, "The Ambiguity of Clinical Intentions," N. Engl. J. Med., 329 (1993): 1039-40; and H. Brody, "Causing, Intending, and Assisting Death," Journal of Clinical Ethics, 4 (1993): 112-17.
40. See, for example, T.E. Quill, "The Ambiguity of Clinical Intentions," N. Engl. J. Med., 329 (1993): 1039-40; and H. Brody, "Causing, Intending, and Assisting Death," Journal of Clinical Ethics, 4 (1993): 112-17.
41. See, for example, A. Donagan, Choice: The Essential Element in Human Action (London: Routledge and Kegan Paul, 1989): at 40-41, 51; M. Brand, Intending and Acting (Cambridge: MIT Press, 1984): at 94-97, 122-26; M. Bratman, Intention, Plans, and Practical Reason (Cambridge: Harvard University Press, 1987): at 1-22, 37, 60, 141; J. Searle, Intentionality: An Essay in the Philosophy of Mind (New York: Cambridge University Press, 1983): at 7-10, 35-36, 103-05; and D. Gustafsen, Intention and Agency (Dordrecht: D. Reidel, 1986): at 44, 68.
42. See, for example, A. Donagan, Choice: The Essential Element in Human Action (London: Routledge and Kegan Paul, 1989): at 40-41, 51; M. Brand, Intending and Acting (Cambridge: MIT Press, 1984): at 94-97, 122-26; M. Bratman, Intention, Plans, and Practical Reason (Cambridge: Harvard University Press, 1987): at 1-22, 37, 60, 141; J. Searle, Intentionality: An Essay in the Philosophy of Mind (New York: Cambridge University Press, 1983): at 7-10, 35-36, 103-05; and D. Gustafsen, Intention and Agency (Dordrecht: D. Reidel, 1986): at 44, 68.
43. See, for example, A. Donagan, Choice: The Essential Element in Human Action (London: Routledge and Kegan Paul, 1989): at 40-41, 51; M. Brand, Intending and Acting (Cambridge: MIT Press, 1984): at 94-97, 122-26; M. Bratman, Intention, Plans, and Practical Reason (Cambridge: Harvard University Press, 1987): at 1-22, 37, 60, 141; J. Searle, Intentionality: An Essay in the Philosophy of Mind (New York: Cambridge University Press, 1983): at 7-10, 35-36, 103-05; and D. Gustafsen, Intention and Agency (Dordrecht: D. Reidel, 1986): at 44, 68.
44. See, for example, A. Donagan, Choice: The Essential Element in Human Action (London: Routledge and Kegan Paul, 1989): at 40-41, 51; M. Brand, Intending and Acting (Cambridge: MIT Press, 1984): at 94-97, 122-26; M. Bratman, Intention, Plans, and Practical Reason (Cambridge: Harvard University Press, 1987): at 1-22, 37, 60, 141; J. Searle, Intentionality: An Essay in the Philosophy of Mind (New York: Cambridge University Press, 1983): at 7-10, 35-36, 103-05; and D. Gustafsen, Intention and Agency (Dordrecht: D. Reidel, 1986): at 44, 68.
45. See, for example, A. Donagan, Choice: The Essential Element in Human Action (London: Routledge and Kegan Paul, 1989): at 40-41, 51; M. Brand, Intending and Acting (Cambridge: MIT Press, 1984): at 94-97, 122-26; M. Bratman, Intention, Plans, and Practical Reason (Cambridge: Harvard University Press, 1987): at 1-22, 37, 60, 141; J. Searle, Intentionality: An Essay in the Philosophy of Mind (New York: Cambridge University Press, 1983): at 7-10, 35-36, 103-05; and D. Gustafsen, Intention and Agency (Dordrecht: D. Reidel, 1986): at 44, 68.
46. See Bratman, id. at 4-5, 110.
47. See B. Steinbock, "The Intentional Termination of Life," in Steinbock and Norcross, supra note 17, at 120-30.
48. See B. Gert, J.L. Bernat, and R.P. Mogielnicki, "Distinguishing Between Patients' Refusals and Requests," Hastings Center Report, 24, no. 4 (1994): 13-15.
49. See M.C. Kaveny, "Assisted Suicide, Euthanasia, and the Law," Theological Studies, 58 (1997): 124-48.
50. See Dworkin et al., supra note 3; and Quill, Dresser, and Brock, supra note 6.
51. This was the view of Peter Abelard, but few others have based their evaluation of the morality of actions solely on intentions.
52. See D. Callahan, "When Self-Determination Runs Amok," Hastings Center Report, 22, no. 2 (1992): 52-55.
53. See D.P. Sulmasy, "Death and Human Dignity," Linacre Quarterly, 61 (Dec. 1994): 27-36.
54. I. Kant, "The Metaphysics of Morals, Part II: The Metaphysical Principles of Virtue," in J.W. Ellington, trans., Kant: Ethical Philosophy (Indianapolis: Hackett, 1983): at 127, Ak 462.
55. See P.A. Singer and M. Siegler, "Euthanasia: A Critique," N. Engl. J. Med., 322 (1990): 1881-83.
56. See B.J.F. Lonergan, "Common Sense as Intellectual," in Insight: A Study of Human Understanding (San Francisco: Harper and Row, 1958): 173-81.