Callahan: When Self-Determination Runs Amok

Question 1

Debate reflects a much larger set of issues in Western though:

Answer 1

3 important turning points

Question 2

3 Important Turning Points

Answer 2

1. a new category of killing: between consenting adults
2. self-determination is expanded at the expense of the community good
3. medicine is now about helping individuals attain their private vision of the good life, not just resorting health and relieving pain

Question 3

argument 1

Answer 3

self-determination and well-being

Question 4

argument 1: self-determination and well-being

Answer 4

1. self-determination arguments for euthanasia assume we own our life and we can waive our rights to it. What justification is there for this? (compare to voluntary slavery or dueling)
2. well-being: no way to “objectively” measure suffering. 3 people with the same condition might respond differently (so by allowing the patient to decide when suffering is too great, the doctor will be “treating the patient’s values”
3. the decision to take a life through mercy killing is social and not private

Question 5

Argument 2

Answer 5

killing/allowing to die

Question 6

argument 2: killing/allowing to die

Answer 6

1. don’t confuse causality and culpability
   - stopping treatment can ONLY bring about death if the disease will kill
   - a lethal injection kills both a healthy and a sick person
   - turning off a machine does not kill a healthy person

Question 7

argument 2 continued

Answer 7

responsibility judgments are human constructs

Question 8

argument 2 continued: responsibility judgments are human constructs

Answer 8

1. natural causes of death different from human actions guided by rules
2. “the only deaths that human beings invented are those that come from direct killing - when, with a lethal injection, we both cause death and are morally responsible for it. in the case of omissions, we do not cause death even if we may be judged morally responsible for it”
3. we have decided some commissions are killing and some are letting die. contrast doc who omits treatment they should with doc who respects request for unwanted treatment
4. one good part of the distinction is that it helps free doctors from the burden of having that power

Question 9

argument 3

Answer 9

consequences

Question 10

argument 3: consequences

Answer 10

1. laws are difficult to write and enforce. abuse is likely anytime you get laws with some open-ended interpretation (the case of Holland)
2. the patient/doctor relationship is very private so safeguards won’t work well
3. beneficence and autonomy are two reasons given, but why restrict mercy killing to both?
   - why not allow autonomy to decide?
   - why not allow beneficence to justify killing suffering incompetents?

Question 11

argument 4

Answer 11

medical practice

Question 12

argument 4: medical practice

Answer 12

1. the purpose of medical practice should be technical: relieving human suffering and healing diseases
2. medicine can’t well answer questions about life’s meaning and quality
3. why?: doctors are not specifically qualified to answer these questions
4. try to set out this argument to see how strong it is