Phl 340 - Special Problems in Philosophy ASSISTED SUICIDE QUESTIONS FOR RESPONSES FROM INTENDING DEATH
1."Introduction" (Tom L. Beauchamp)Questions for Responses:
1. What is the difference between "killing" and "letting die?"
2. What are the essential features of the principle of double effect?
3. What is the alleged difference between "active" and "passive" euthanasia? Do you think there is a real difference between the two?2. "Intending Death: The Structure of the Problem and Proposed Solutions" (Allen Buchanan)
Questions for Responses:
1. Why is intentional killing a matter of public policy concern in the issue of physician-assisted suicide?
2. Is there any morally acceptable exception to the prohibition on intentional killing, particularly when dealing with physician-assisted suicide?3. Criteria That Make Intentional Killing Unjustified: Morally Unjustified Acts of Killing that have been Sometimes Declared Justified (Albert R. Jonsen)
Questions for Responses:
1. Is self-determination sufficient warrant for aid-in-dying, or must other considerations be added such as "physician," "patient," or "terminal condition?"
2. Does Jonsen think that the notion of intention help clarify the moral problems in the practice of physician-assisted suicide?4. What Makes Intentional Killing Unjustified? (Ruth Macklin)
Questions for Responses:
1. What are the criteria which Macklin identifies as making intentional killing unjustified?
2. Do you think that Macklin correctly applies the criteria to the medical context?5. Intention, Foresight, and Killing (Raymond G. Frey)
Questions for Responses:
1. What is the author's answer to the question of "whether one can withhold intending an action if one knows the outcome of the action and carries out the action?"
2. Does the notion of "control responsibility" help us clarify the causal connection between a physician's action and its resultant outcome?By now the question should have occurred to you that all this talk about "assisted suicide" presupposes some beliefs about suicide, viz., suicide is or is not a legitimate exercise of one's self-determination. (1) Do you have an opinion on that? Would the CHA's brief before the Supreme Court be helpful in forming your opinions about this matter? (2) Is your opinion based on religious grounds or . . .?(3) Do you know one article that you think states a sound argument on the legitimacy of sucide?
6. Causal Responsibility and Moral Culpability (Alisa L. Carse)
Questions for Responses:
1. Is there really a difference between being answerable for an action and being culpable for the action?
2. Is being causally responsible for an action a broader concept than being morally culpable for the action?By now you should have read the two Circuit Court Decisions (1996) on Physician-Assisted Suicide and the Supreme Court's decision (1997) and you can begin to formulate some critical responses to the analysis given by the Courts on the basis of the material you are reading in the essays in Intending Death. You may want to use the insights in some of the other readings on the reserve shelf to fine tune your insights.
7. Withdrawal of Treatment versus Killing of Patients (Baruch Brody)
Questions for Responses:
1. What do you think is the GENUINELY morally significant difference between withdrawing treatment from patients for whom the treatment will provide no benefit and killing patients who see the killing to be the best alternative?
2. Could the intention to relieve suffering be sufficient to justify killing in the same way that giving high levels of morphine with the intention of relieving suffering can be justified even though death is foreseen and inevitable? Think about terminal sedation here.8. The Right to Refuse Treatment (N. Ann Davis)
Questions for Responses:
1. Assess the reason for refusal of treatment on pp. 110 & 111. Which do you think are good reasons and "not-so-good" reasons? Are any of them so bad that treatment refusal should be eliminated in those cases? Why?
2. Should the rejection of the "suicide constraint" logically lead to an approval of assisted suicide?9. The Physician's Role In Killing and the Intentional Withdrawal of Treatment (Ronald E. Cranford)
Questions for Responses:
1. Are there some cases where the physician's obligation to relieve suffering and respect patient autonomy outweighs the duty to preserve life? Can you give some examples where this may be a consideration?
2. Are physical pain and suffering the same? How do you think they should be weighed in considerations about assisted suicide?10. The Place of Intention in the Moral Assessment of Assisted Suicide and Active Euthanasia (Edmund Pellegrino)
Questions for Responses:
1. Which do you think is more important in judging the morality of an action, the intention of the agent behind the action on the consequences on the action on the person being affected?
2. In what way does Pellegrino think that intending to kill is essentially a distortion of the "healing" relationship. Focus on duties of beneficence and the notion of "trust." Do you agree with him?11. Should Some Morally Acceptable Actions of Killing and Letting Die be Legally Prohibited and Punished? (Alexander Morgan Capron)
Questions for Responses:
1. Do you think that it would be possible to establish adequate safeguards so that physician-assisted suicide would not be abused if it were made legal?
2. Look at the major harms attached to physician-assisted suicide which are listed on page 110. Assess whether these are real possible harms or just unwarranted fears. If they are genuinely possible, what safeguards (in #1) could diminish the possibility of the harms?