Ever since the debate concerning euthanasia was ignited, the distinction between active and passive euthanasia – or, letting die and killing – has been marked as one of its key issues. In this paper I will argue that a) the borderline between act and omission is an altogether blurry one, and it gets even vaguer when it comes to euthanasia, b) there is no morally significant difference between active and passive euthanasia, and c) if (...) there is any, it seems to favor active instead of passive euthanasia. Therefore, while the distinction between active and passive euthanasia might be meaningful in terms of description, if it is considered to be endowed with moral weight and used on purpose of justifying one type of euthanasia instead of the other, it becomes morally problematic and misleading. (shrink)

The researcher believes that James Rachels’s defense of active euthanasia deserves a critical and normative analysis because of its dehumanizing consequences. The researcher demonstrates that Rachels’s position is conceptually, theoretically, practically, and normatively unjustifiable. The researcher supports his position by three steps.

Euthanasia is one of the significant bioethical issues that has grown in complexity over time because of unprecedented developments in medicine, biotechnology, palliative care, and advanced medical technology. The issue is ethical and legal; new and old. To address this issue from the perspective of Islam, responses have emerged from various sections such as organizations of Muslim doctors, independent writers, fatwÉs, and above all from the Islamic jurisprudential bodies and Islamic medical code. œ”:In this chapter, euthanasia and its (...) types are explained. Active euthanasia is explained with related issues which come under it and ethical guidance from the main sources of Islamic jurisprudence is taken to understand Islamic ethical position on the issue. In a similar way, passive euthanasia is explained and the issues which come under it are explained and a detailed discourse is given in understanding the issues and how Islamic approach to medical treatment solves these issues. (shrink)

Sadly, there are people in very bad medical conditions who want to die. They are in pain, they are suffering, and they no longer find their quality of life to be at an acceptable level anymore. -/- When people like this are kept alive by machines or other medical treatments, can it be morally permissible to let them die? -/- Advocates of “passive euthanasia” argue that it can be. Their reasons, however, suggest that it can sometimes be not wrong (...) to actively kill some patients, i.e., that “active euthanasia” can be permissible also. This essay reviews these arguments. (shrink)

Kant has famously argued that human beings or persons, in virtue of their capacity for rational and autonomous choice and agency, possess dignity, which is an intrinsic, final, unconditional, inviolable, incomparable and irreplaceable value. This value, wherever found, commands respect and imposes rather strict moral constraints on our deliberations, intentions and actions. This paper deals with the question of whether, as some Kantians have recently argued, certain types of (physician-assisted) suicide and active euthanasia, most notably the intentional destruction (...) of the life of a terminally-ill, but rational and autonomous patient in order to prevent certain serious harms, such as enduring or recurring pain or the loss of the meaning in life, from befalling him really are inconsistent with respect for the patient’s human dignity. I focus on two independent, though interrelated explications of the rather vague initial idea that the patient (as well as the doctor), in intending and bringing about his death, treats his person or rational nature merely as a means and so denigrates his dignity: (i) that in doing what he is doing, he does not act for the sake of his person, but for the sake of something else; (ii) that, by trading his person for pain relief, he engages himself in an irrational and hence immoral exchange. After critically discussing some suggestions about how to understand this charge, I eventually find Kantian objections to suicide and (active) euthanasia, based on the idea of human dignity, less than compelling. For all the paper proves, suicide and (active) euthanasia may still be morally impermissible, but then this must be so for some other reason than the one given above. (shrink)

Euthanasia or mercy killing is, now a day, a major problem widely discussed in medical field. Medical professionals are facing dilemma to take decision regarding their incompetent patient while tend to do euthanasia. The dilemma is by nature moral i.e. whether it is morally permissible or not. In some countries of Europe and in some provinces of USA euthanasia is legally permitted fulfilling some conditions. It is claimed by Rachels that in our practical medical practice we do (...) euthanasia by forbidding patients from taking drugs. He concludes that if that type of euthanasia can be practiced in our society without any hesitation then why assisting euthanasia will not be permitted1. There are so many arguments both pro and con of euthanasia. But it is not the function of the current paper to discuss all the arguments. Philippa Foot in her article „Euthanasia‟ and J Velleman in his article titled as „A Right to Self-termination‟ discussed about the permissibility of euthanasia. The objective of the paper is to justify their arguments and then come to a conclusion regarding the permissibility of euthanasia. The focus will be given mainly on non- voluntary active and non-voluntary passive euthanasia. The method of discussion will be that an example will be given from Bangladesh and then the arguments provided by Foot and Velleman in their above mentioned papers will be discussed to justify the act of euthanasia on concerned patient. In the last section of the paper the situation of Bangladesh will also be considered for the permissibility of euthanasia i.e. whether the act of euthanasia can be permitted in our country considering the existing socio-cultural-religious practice. (shrink)

The article examines the so-called slippery slope argument (SSA) against the legalization of active voluntary euthanasia (AVE). According to the SSA, by legalizing AVE, the least morally controversial type of euthanasia, we will take the first step onto a slippery slope and inevitably end up in the moral abyss of widespread abuse and violations of the rights of the weakest and most vulnerable patients. In the first part of the paper, empirical evidence to the contrary is presented (...) and analyzed: None of the forecast regrettable trends can be elicited from the body of existing statistical data. Accordingly, we have no good reason to believe either that we already are, or are sooner or later going to be, sliding into a moral abyss. A related question is then considered: Would it not be wiser and safer to stick to the status quo and preserve the existing legal ban on AVE even if the risk of its abuse is uncertain and may well turn out to be relatively low? It is argued that such an appeal to precautionary reasoning fails to justify an outright legal ban on AVE for at least two reasons: (i) it grossly underestimates the hidden moral costs of current legal arrangements (competent terminal patients suffer both disrespect for their autonomous will and deprivation of the good of a timely death) and (ii) the ban is both too inefficient and disproportionate to qualify as a reasonable measure of precaution. (shrink)

The current impasse in the old debate about the morality of euthanasia is mainly due to the fact that the actual source of conflict has not been properly identified—or so I shall argue. I will first analyse the two different issues involved in the debate, which are sometimes confusingly mixed up, namely: (a) what is euthanasia?, and (b) why is euthanasia morally problematic? Considering documents by physicians, philosophers and the Roman Catholic Church, I will show that (a) (...) ‘euthanasia’ is defined by the intention to bring about a patient’s death, and (b) the distinction between what is intentional and what is not does not represent the morally problematic reason against euthanasia. Therefore, although the debate on euthanasia so far has mainly focussed on the distinctions ‘active /passive’ and ‘intentional /unintentional,’ I argue that neither constitutes the genuine source of the controversies. I will clarify what the source of controversies is, and outline the minimal requirement for an argument against euthanasia. (shrink)

Patient autonomy has a critical role in making decisions in medical practice and it is accepted by international conventions on health care and various national medical codes. However, pertaining to terminally ill patients, this right becomes very problematic in regards to end of life decisions. Utilitarian ethicists motivated by materialistic worldview and individualism have made patient autonomy based arguments for the permissibility of active euthanasia. An appraisal of pro-euthanasia arguments that include the best interest, golden rule, and (...) autonomy is made in this paper. The best interest and golden rule arguments are based on subjective moral judgment thus failing the universalization test. The argument from autonomy is unconvincing because of the confounded autonomy of the terminally ill patients. (shrink)

There are common concepts between euthanasia and suicide because euthanasia is historically connected with the discourse on suicide. In widespread literature on euthanasia there is confusion over the concepts and definitions. These definitions are analyzed in this paper and along with other conclusions and distinctions the researcher has substantially defended his definition of euthanasia. There are two different usages of the term euthanasia: a narrow construal of euthanasia and broad construal of euthanasia. Contrary (...) to other researches, the researcher agrees only with the narrow construal of euthanasia, i.e. active euthanasia. The researcher’s definition of euthanasia is: intentionally causing a terminally ill person’s death through an action performed by a physician. As a result, passive euthanasia is expunged from the definition of euthanasia. In addition to that, the definition excludes suicide, assisted suicide, and physician-assisted suicide. (shrink)

There has been much debate regarding the 'double-effect' of sedatives and analgesics administered at the end-of-life, and the possibility that health professionals using these drugs are performing 'slow euthanasia.' On the one hand analgesics and sedatives can do much to relieve suffering in the terminally ill. On the other hand, they can hasten death. According to a standard view, the administration of analgesics and sedatives amounts to euthanasia when the drugs are given with an intention to hasten death. (...) In this paper we report a small qualitative study based on interviews with 8 Australian general physicians regarding their understanding of intention in the context of questions about voluntary euthanasia, assisted suicide and particularly the use of analgesic and sedative infusions (including the possibility of voluntary or non-voluntary 'slow euthanasia'). We found a striking ambiguity and uncertainty regarding intentions amongst doctors interviewed. Some were explicit in describing a 'grey' area between palliation and euthanasia, or a continuum between the two. Not one of the respondents was consistent in distinguishing between a foreseen death and an intended death. A major theme was that 'slow euthanasia' may be more psychologically acceptable to doctors than active voluntary euthanasia by bolus injection, partly because the former would usually only result in a small loss of 'time' for patients already very close to death, but also because of the desirable ambiguities surrounding causation and intention when an infusion of analgesics and sedatives is used. The empirical and philosophical implications of these findings are discussed. (shrink)

This essay first introduces the moral sense theories of Francis Hutcheson, David Hume, and Adam Smith, and clarifies important differences between them. It then examines whether moral judgment based on the moral sense or moral sentiments varies according to one's metaphysical beliefs. For this, the essay mainly applies those theories to such issues as stem cell research, abortion, and active euthanasia. In all three theories, false religious beliefs can distort moral judgment. In Hutcheson's theory, answers to stem cell (...) research, abortion, and active euthanasia do not change according to the spectator's metaphysical beliefs. Yet answers to those issues can change according to the agent's metaphysical beliefs. Hume's theory cannot provide answers to stem cell research and abortion where the embryo or fetus is the receiver (the one affected by the agent's action) and to active euthanasia where the patient is unconscious. It may provide answers to abortion where the pregnant woman is the receiver and to active euthanasia where the patient is conscious. Yet the answers can vary depending on the woman's or the patient's metaphysical beliefs. Smith's theory can provide answers to stem cell research, abortion, and active euthanasia. But the answers can vary depending on the agent's metaphysical beliefs. These show that the moral sense or moral sentiments in those theories alone cannot identify appropriate morals. (shrink)

In 1975, The New England Journal of Medicine published James Rachels' article 'Active and Passive Euthanasia'. The argumentative method that Rachels introduced, the Bare Difference Argument (also known as the Contrast Strategy), became one of the most widely used tools in ethical reasoning. The argument, however, fails to show active euthanasia being morally permissible. It fails because Rachels takes the intuitions from the case where letting die is morally impermissible and applies the intuitions to cases where (...) letting die is morally permissible. While it is possible to create thought-experiments that are more analogous to euthanasia, in this respect, than Rachels' cases, they too are disanalogous to euthanasia with some of the relevant features. Creating the perfect analogy, however, would be a mistake too. Such a case would be too analogous; people would simply be divided on what kind of moral intuitions they would have. The problem thus highlights a methodological limit in philosophical bioethics and raises questions related to the roles of philosophical ethicists in the context of assisted dying. (shrink)

Science and technology are undergoing rapid development and progress. It is due to the increasing number of modern inventions. Among the technological discoveries that are very important are in the medical field. With modern medical equipment, the suffering of a patient can be reduced. But in reality, there are still some patients who have severe suffering. Patients who experience prolonged illness invites empathy from the family. To relieve his suffering, the family who could not bear to see his condition asked (...) the doctor to take actions that could shorten the patient's life, this kind of action in the medical world is known as euthanasia. This study aims to find out how the study of active euthanasia in the view of Christian law. This study is a literature review using an ethical-theological approach by studying books and scientific works related to the discussed problem. (shrink)

Pain medication is one of the responses to the mercy argument that utilitarian ethicists use for justifying active euthanasia on the grounds of prevention of cruelty and appeal to beneficence. The researcher reinforces the significance of pain medication in meeting this challenge and considers it the most preferred response among various other responses. It is because of its realism and effectiveness. In exploring the mechanism and considerations related to pain medication, the researcher briefly touches the Catholic ethical position (...) on the issue, a position that cannot be ignored in the development of contemporary bioethics. The researcher particularly deliberates on the contemporary Islamic discourse on the issue; by furthering the debate in line with the Islamic legal maxims and general guidance from the primary sources of Islamic law and ethics. The resolution on the issue is sought by synthesizing the views and legal maxims (al-Qawaid al-Fiqhiyyah) on the issue, which in conclusion provide justification for pain medication by considerably regarding pain as necessity and pressing need. However, such resolution allows pain medication to the limit and proportion that removes the pain and prohibits overdosing the patient with medication that may directly cause the death. (shrink)

Central elements of Roman Catholic treatment ethics include: 1) that rejection of treatment with the intent of hastening death (even for a good end) is ethically equivalent to active euthanasia with the same intent; 2) a distinction between morally obligatory “ordinary” treatment and morally optional “extraordinary treatment”; 3) that the quality of the patient’s life is not be a legitimate basis for rejecting treatment; and 4) that extraordinary treatment is not forbidden, but optional, and that it is the (...) patient or the patient’s legal surrogate–not the doctor– who has the right to choose or reject it. Despite these principles, even in a cultural climate fully sympathetic to Catholic treatment ethics, it is appropriate as a legal matter to maintain the doctrine of informed consent under which it is possible for patients or their surrogates to reject life-preserving treatment, including for unethical reasons. It is normally impossible to enforce in practice in the external forum a differentiation between rejection of treatment for ethically acceptable and ethically unacceptable reasons. By contrast, in cases of direct killing, such as assisting suicide, the intent to cause death is unmistakable (as opposed to accepting an increased risk of death as a foreseeable but unintended consequence of pursuing a good end). In a pluralistic society Catholic ethics cannot be legislatively enforced on the ground that they are compelled by Catholic teaching. However, the basic principles of Catholic treatment ethics may be justified based on logic and widely accepted norms of human equality independently of revelation or ecclesiastical authority. Particularly in protecting the right of individuals to choose and obtain life-saving medical treatment regardless of their “quality of life,” and in suicide prevention, secular law can and should be congruent with key aspects of Catholic health care ethics. (shrink)

Given the wide the range of legally available options for end-of-life care in recent decades: from aggressive, even experimental, treatment to active euthanasia, our ethical analysis struggles to keep pace with technology and law. In this essay I show that the principle of double effect (PDE) remains, and will continue to be, a useful tool for ethical analysis of end-of-life care. According to PDE, an agent may ethically perform an act that s/he foresees will have a significant bad (...) effect (e.g., death) in addition to a good effect (e.g., pain relief) only if s/he does not intend the bad effect, the act is not bad for reasons other than its causing the bad effect, and there is a proportionately serious reason to act. Following a brief explanation of PDE and preliminary considerations in favor of counting death as a bad effect, I analyze several end-of-life options in terms of the principle. I begin with those that enjoy significant consensus among proponents of PDE: active euthanasia, “passive euthanasia,” and palliative care. Then I consider the less-straightforward cases of drug provision, refusing food and water, and terminal sedation, arguing that participation in such actions is justifiable via PDE only under very limited conditions. (shrink)

Euthanasia and the duty to die have both been thoroughly discussed in the field of bioethics as morally justifiable practices within medical healthcare contexts. The existence of a narrow connection between both could also be established, for people having a duty to die should be allowed to actively hasten their death by the active means offered by euthanasia. Choosing the right time to end one’s own life is a decisive factor to retain autonomy at the end of (...) our lives. However, there is no definitive consensus on why physicians should be the ones performing the medical procedure to end a person’s life. The moral problems arising from such assertion are not to be taken lightly, for medical tradition has long regarded the duty not to kill, not to actively end a patient’s life, as the core moral obligation that gives meaning to the medical profession. Our concern is to question the moral justifiability of the arguments offered by physicians not to actively help patients die. (shrink)

The euthanasia literature typically discusses the difference between “active” and “passive” means of ending a patient’s life. Physician-assisted suicide differs from both active and passive forms of euthanasia insofar as the physician does not administer the means of suicide to the patient. Instead, she merely prescribes and dispenses them to the patient and lets the patient “do the rest” – if and when the patient chooses. One supposed advantage of this process is that it maximizes the (...) patient’s autonomy with respect to both her decision to die and the dying process itself. Still, despite this supposed advantage, Oregon is the only state to have legalized physician-assisted suicide. After summarizing the most important Supreme Court opinions on euthanasia (namely, Cruzan v. Director, Missouri Dep’t of Health; Vacco v. Quill; Washington v. Glucksberg; and Gonzales v. Oregon), this paper argues that while there are no strong ethical reasons against legalizing physician-assisted suicide, there are some very strong policy reasons for keeping it criminal in the other forty-nine states. (shrink)

[From Euthanasia to Infanticide] The paper revisits the recent controversy over Dr. Mitlőhner’s defense of infanticide, published in this journal. In section 1, I point out the weaknesses of Mitlőhner’s paper. In sections 2 and 3 I turn to the most sophisticated defense of infanticide on offer today, that of Peter Singer’s. Section 2 sums up Singer’s description of the medical practice as already having abandoned the traditional ethic of equal value of all human lives, which motivates ethical revisionism. (...) However, an explicit justification of a revision is necessary. This is the job of Singer’s Replacement Argument, examined in section 3. I argue that this justification of infanticide in completely impersonal terms fails. In section 4, I reject it in favor of Ronald Dworkin’s distinction between experiential interests, possessed by infants, and critical interests that develop later. Hence, neonatal euthanasia can sometimes be justified in terms of a newborn‘s own interests (presumably, to relieve its suffering), not in impersonal terms. The only exception is those infants that lack any capacity for cognitive activity whatsoever, and who thus lack even experiential interests. It is an open question whether their “life” differs from death, and whether by killing them we perform infanticide. (shrink)

James Rachels’s distinction between killing and letting die maintains that there is morally no difference between killing a terminally ill patient and letting him/her die. Therefore, active and passive euthanasia dichotomy is a distinction without a difference. Hence, if passive euthanasia is allowed, active euthanasia should be permitted too. The paper demonstrated that the distinction between killing and letting die is: (1) irrelevant to euthanasia(2) extraneous to the medical profession, and (3) methodologically degressive. Furthermore, (...) the paper demonstrated invalidity of the bare difference argument of Rachels based on the distinction because of four reasons: (1) irrelevance to American Medical Association’s statement; (2) differences between the cases such as intentionality, causality, and agency; (3) straw man fallacy, (4) and weak analogy. Therefore, the paper concluded that relating the distinction between killings and letting die to bioethics and euthanasia is unjustifiable. (shrink)

What I call medically enabled suicides have four distinctive features: 1. They are instigated by actions of a suicidal individual, actions she intends to result in a physiological condition that, absent lifesaving medical interventions, would be otherwise fatal to that individual. 2. These suicides are ‘completed’ due to medical personnel acting in accordance with recognized legal or ethical protocols requiring the withholding or withdrawal of care from patients (e.g., following an approved advance directive). 3. The suicidal individual acts purposefully to (...) ensure that medical personnel will act on these protocols. 4. These suicides do not involve medical personnel providing aid in dying in the standard sense, either through (a) active voluntary euthanasia, or (b) assistance by means of prescriptions, etc. -/- Regardless of how common medically enabled suicides are, they raise compelling questions at the interface of medicine and individual choice. After first clarifying the concept of medically enabled suicide and exploring some of the reasons why it might be attractive to suicidal individuals, I then investigate two apparent dilemmas that medically enabled suicides raise for medical care providers. The first alleges that medical care providers may not contribute to harming their patients, and so they may not contribute to their patients’ suicides. The second alleges that if care providers, as a matter of personal conscience, believe that suicide is wrong, then they may not be compelled to contribute to their patient’s acting wrongly by assenting to the wishes of a patient pursuing medically enabled suicide. Both dilemmas arise from the fact that while medical personnel are bound by widely accepted precepts of medical ethics to honor the competent wishes of their patients, medically enabled suicides entangle them in their patients’ suicidal plans in ways that result in their contributing to those suicides. I conclude that neither dilemma should be resolved in the direction of medical personnel having the right to refrain from involvement in medically enabled suicides. Thus, while we may find medically enabled suicide distasteful or exploitative, a strong case cannot be made that medical personnel refusing to involve themselves in such suicides is ethically permissible. (shrink)

Belgium has recently extended its euthanasia legislation to minors, making it the first legislation in the world that does not specify any age limit. I consider two strands in the opposition to this legislation. First, I identify five arguments in the public debate to the effect that euthanasia for minors is somehow worse than euthanasia for adults—viz. arguments from weightiness, capability of discernment, pressure, sensitivity and sufficient palliative care—and show that these arguments are wanting. Second, there is (...) another position in the public debate that wishes to keep the current age restriction on the books and have ethics boards exercise discretion in euthanasia decisions for minors. I interpret this position on the background of Velleman’s “Against the Right to Die” and show that, although costs remain substantial, it actually can provide some qualified support against extending euthanasia legislation to minors. (shrink)

Euthanasia and assisted suicide have proved to be very contentious topics in medical ethics. Some ethicists are particularly concerned that allowing physicians to carry out these procedures will undermine their professional obligations and threaten the very goals of medicine. However, I maintain that the fundamental goals of medicine not only do not preclude the practice of euthanasia and assisted suicide by physicians, but can in fact be seen to support these practices in some instances. I look at two (...) influential views of the goals of medicine, one based on the broad guiding principles of autonomy, beneficence and nonmaleficence, and the other focusing on several more concrete aims, concluding that both approaches can be seen to support euthanasia and assisted suicide. I then turn to the popular concern that allowing physicians to carry out euthanasia and assisted suicide will lead to widespread abuse. I argue that the possibility for abuse can be minimised if we make the patient's autonomous consent an essential requirement of the practice. (shrink)

Argues that considerations central to the justification of euthanizing humans do not readily extrapolate to the euthanasia of pets and companion animals; that the comparative account of death's badness can be successfully applied to such animals to ground the justification of their euthanasia and its timing; and proposes that companion animal guardians have authority to decide to euthanize such animals because of their epistemic standing regarding such animals' welfare.

The paper classifies euthanasia and discusses its typological presence in storytelling video games. It aims to illustrate the importance of experiencing simulated moral challenges in the context of gameworlds as a significantly influential, exponentially growing form of interactive media. In contrast to older works of art and media, such as film and literature, the difference should be emphasized in light of the player’s ability to make choices in video games. Although the influence of gameworld content depends on the player, (...) the experiences and knowledge gained from playing storytelling video games may influence the player’s problem-solving orientation in the landscape of difficult moral dilemmas they may encounter throughout their lives. (shrink)

Presenting the case against legalizing euthanasia, this paper refers mainly to two clinical facts. First that, in the majority of cases, a wish to die is a symptom of depression; and second, that depression affects rational decision making. Since a depressive individual is not fully competent, it is a mistake to resort to that individual's autonomy. One should recall that a subclinical depressive state is an object of treatment, and safeguards are necessary lest this state should be an object (...) of euthanasia or assisted suicide. (shrink)

The book attempts to conceptualize the “ancient” issues of human death and human mortality in connection to the timely and vital subject of euthanasia. This subject forces the meditation to actually consider those ideological, ethical, deontological, legal, and metaphysical frameworks which guide from the very beginning any kind of approach to this question. This conception – in dialogue with Heideggerian fundamental ontology and existential analytics – reveals that, on the one hand, the concepts and ethics of death are originally (...) determined by the ontology of death, and, on the other hand, that, on this account, the question of euthanasia can only be authentically discussed in the horizon of this ontology. It is only this that may reveal to whom dying – our dying – pertains, while it also reveals our relationship to euthanasia as a determined human potentiality or final possibility. Thus euthanasia is outlined in the analysis as the possibility of becoming a mortal on the one hand, while on the other hand it appears in relation to the particularities of its existential structure, which essentially differ from the existential and ontological structure of any other possibility of dying. This is why it should not be mixed up with, or mistaken for, any of these. (shrink)

Ong, Caroline In February 2014, the Belgian parliament passed an amendment to the Belgian Act on Euthanasia of May 28th, 2002 removing the age limit of those requesting euthanasia provided that they have discerning capabilities and their parents approve. After mentioning briefly the arguments against legalising euthanasia, this article questions the ethical validity of removing the age limit, as well as the presumption that ending lives prematurely allows people to die with dignity. Caring for people who are (...) vulnerable in their suffering is the proper goal of the healing professions, not terminating lives. (shrink)

Kemampuan memilih adalah ekspresi langsung dari kebebasan berkehendak. Namun, sebagai makhluk sosial yang bermartabat, secara teoritis manusia menerapkan banyak pembatasan perilaku pada dirinya untuk melindungi anak-anak dan mempertahankan lingkungan yang stabil agar dapat hidup bersama. Pembatasan ini diperkuat dengan hukum atau norma sosial yang dianut. Sebagai contoh, pembunuhan, pembakaran, dan perampokan termasuk kejahatan dengan konsekuensi hukuman yang berat secara hukum, sedangkan bentuk yang lebih ringan seperti kebohongan, kekerasan verbal, dan tidak menghargai/menghormati tidak dianggap penting secara kolektif. Singkatnya, banyak perilaku yang (...) secara teknis mungkin dilakukan namun tidak diterima secara sosial dalam berbagai tingkatan. Pada aspek ini, bunuh diri ada di area abu-abu. Kebanyakan negara di dunia tidak mencegah tindakan bunuh diri pada tingkat hukum. Bagaimanapun, bunuh diri sangat tidak dianggap dan dicegah secara aktif di hampir semua masyarakat. Persepsi kolektif terhadap bunuh diri di berbagai budaya relatif konsisten. Sebagai contoh, semua agama besar di dunia telah mengutuk bunuh diri melalui ajarannya [1]. Namun niatan bunuh diri juga sangat jelas individualis, dan perilaku terkait hal itu tergantung pada individu untuk memutuskan [2]. Oleh karena itu, salah satu masalah terbesar terkait euthanasia adalah aspek kebebasan memilih, di samping implikasi etik, komplikasi hukum, dan risiko eksploitasi. (shrink)

In the Netherlands and Belgium, it is lawful for voluntary euthanasia to be offered on the grounds of psychiatric suffering. A recent case that has sparked much debate is that of Aurelia Brouwers, who was helped to die in the Netherlands on account of her suffering from borderline personality disorder. It is sometimes claimed that whether or not a mentally ill person’s wish to die is valid hinges on whether or not that wish is a symptom of the person’s (...) mental disorder. This article addresses the philosophical problems raised by this claim, with a specific focus on the diagnosis of borderline personality disorder. After considering descriptivist and causal conceptualizations of mental disorder, I argue that the current approach to borderline personality disorder in psychiatry precludes the possibility of dissociating the wish to die from the disorder. I then examine the implications of this analysis for the question of whether or not the request for voluntary euthanasia in the case of borderline personality disorder can be considered valid. Ultimately, I conclude that the inability to dissociate the wish to die from the disorder does not invalidate the wish in the case of borderline personality disorder. (shrink)

I identify what appears to be a "glaring" inconsistency between what Joseph Raz says on euthanasia in a 2012 lecture and what he says on well-being within his most celebrated book, The Morality of Freedom. There also appears to be a subtler inconsistency between what he says and his endorsement of H.L.A. Hart’s opposition to a definitional project.

In most jurisdictions where euthanasia is legal, patients seeking euthanasia need to seek out the approval of their request from two clinicians (one of who is a psychiatrist). These doctors are required to assess whether euthanasia is ‘appropriate’ for the patient in question. In this paper I claim that doctors qua doctors are not qualified (or, at least, not typically) to evaluate suffering of an existential kind, and consequently they are not qualified to 'evaluate' the requests of (...) patients seeking euthanasia. Importantly, this argument is only focused on patients who are seeking euthanasia on account of acute suffering. To defend my central thesis, I discuss the limits of the professional expertise of clinicians, in addition to considering the nature of suffering experienced by patients requesting euthanasia (which is, typically, a combination of physiological, psychological and existential suffering). (shrink)

The practice of ‘management euthanasia’, in which zoos kill otherwise healthy surplus animals, is a controversial one. The debate over the permissibility of the practice tends to divide along two different views in animal ethics—animal rights and animal welfare. Traditionally, those arguments against the practice have come from the animal rights camp, who see it as a violation of the rights of the animal involved. Arguments in favour come from the animal welfare perspective, who argue that as the animal (...) does not suffer, there is no harm in the practice and it is justified by its potential benefits. Here, I argue that an expansion of the welfare view, encompassing longevity and opportunities for positive welfare, give stronger considerations against management euthanasia, which then require greater benefits to justify its use. (shrink)

Relying on euthanasia’s definitionally derived set of propositions to provide its purpose, claims, and benefit, we obtain the core concept. Nonetheless, given its core concept, euthanasia is demonstrated to provide no benefit to the animal to justify its use. Euthanasia 1) cannot possibly, and therefore does not, end unbearable suffering, 2) it fails to hasten death, and 3) it, therefore, provides no perceptible relief to the patient. These findings are significant because the argument’s validity does not permit (...) euthanasia to satisfy its definitionally derived purpose, claims, or benefit on logical grounds. In other words, the argument is that as a form of legalized assisted suicide, euthanasia is wrong but not in the way principled arguments would suggest. Additionally, irrespective of euthanasia actually doing what it claims, if it is allowed to be provisioned, then euthanasia will affect vulnerable populations exactly like nonprincipled arguments claim. Therefore, despite sharing aspects with each type of argument in the extant literature, my argument against euthanasia can be categorized as neither principled nor nonprincipled, which makes it significant because it may be the first of a new category of argument against the concept and practice to enter the discourse on euthanasia. As a corollary, since we prove that unbearable suffering logically entails death, when it is authentic signifying that death is imminent, because euthanasia’s only purpose is to end unbearable suffering by inducing death, euthanasia is completely obviated. (shrink)

In this paper, I defend the view that the requested euthanasia of adults is morally permissible and should be legalised; I use an argument from analogy which compares physician-assisted euthanasia with morally less ambiguous and, in my opinion, an acceptable instance of mercy killing. I also respond to several objections that either try to prove that the instance of mercy killing is not acceptable, or that there is a fundamental difference between these two cases of killing. Furthermore, in (...) the remainder of the paper I defend the moral permissibility and legalisation of euthanasia against several objections that appeared in local disputes on this issue, based on the concepts of the limits of freedom, the slippery slope, and the needlessness of euthanasia. (shrink)

Lawful euthanasia involves State endorsed termination of human life. Apart from a period of less than 9 months, in the Northern Territory, euthanasia has been illegal in Australia. Many of Australia’s parliaments have regularly considered introducing the practice and they continue to do so. In this context, this paper considers another type of State endorsed termination of human life: capital punishment. These took place in Australia from 1788 to 1967. The practice was abolished nationwide by 1985 and the (...) Commonwealth passed laws, in 2010, to prevent its reintroduction. This paper does not consider all of the arguments for or against euthanasia or capital punishment and nor does it argue that the two practices are identical. Instead, it argues that introducing euthanasia without careful consideration of the arguments and experiences of capital punishment would risk repetition of past mistakes. The paper considers whether introducing euthanasia would be inconsistent with arguments accepted as grounds for the abolition of capital punishment. It focuses, on the irrevocable argument. This is the argument that death is irrevocable and that the risk of an innocent person being executed should never be taken. The paper argues that, any criteria which might be adopted by the State as sufficient to justify euthanasia, would run the risk of people outside that criteria being euthanised. The paper argues that capital punishment and euthanasia each pose disproportionate risks to minority and vulnerable groups. The paper also argues that, the evidence of pain and suffering endured by the condemned in their execution require careful consideration in relation to arguments for euthanasia as a means to a quick and pain free “good death.” It considers the evidence that demonstrates that, like execution, euthanasia in practice can be slow and painful. The paper then argues that requiring health professional to administer lethal injections in acts of euthanasia would be inconsistent with the approach taken in Australia and the United States to the identification of those willing to administer the death penalty. The paper concludes that many of the key arguments which resulted in the abolition of the death penalty in Australia support the continued prohibition of euthanasia in Australia and ought to be addressed by proponents of change but its primary aim is to encourage further examination of the extent to which learnings relevant to the current euthanasia debate can be gained by examining the arguments and experience of capital punishment. (shrink)

Internalist approaches to epistemic justification are, though controversial, considered a live option in contemporary epistemology. Accordingly, if ‘active’ externalist approaches in the philosophy of mind—e.g. the extended cognition and extended mind theses—are _in principle_ incompatible with internalist approaches to justification in epistemology, then this will be an epistemological strike against, at least the _prima facie_ appeal of, active externalism. It is shown here however that, contrary to pretheoretical intuitions, neither the extended cognition _nor_ the extended mind theses are (...) in principle incompatible with two prominent versions of epistemic internalism—viz., accessibilism and mentalism. In fact, one possible diagnosis is that pretheoretical intuitions regarding the incompatibility of active externalism with epistemic internalism are symptomatic of a tacit yet incorrect identification of epistemic internalism with epistemic individualism. Thus, active externalism is not in principle incompatible with epistemic internalism per se and does not significantly restrict one’s options in epistemology. (shrink)

This chapter provides empirical evidence about everyday attitudes concerning euthanasia. These attitudes have important implications for some ethical arguments about euthanasia. Two experiments suggested that some different descriptions of euthanasia have modest effects on people’s moral permissibility judgments regarding euthanasia. Experiment 1 (N = 422) used two different types of materials (scenarios and scales) and found that describing euthanasia differently (‘euthanasia’, ‘aid in dying’, and ‘physician assisted suicide’) had modest effects (≈3 % of the (...) total variance) on permissibility judgments. These effects were largely replicated in Experiment 2 (N = 409). However, in Experiment 2, judgments about euthanasia’s moral permissibility were best predicted by the voluntariness of the treatment. Voluntariness was a stronger predictor than some demographic factors and some domain general elements of moral judgments. These results help inform some debates about the moral permissibility of euthanasia (e.g., the slippery slope argument) suggesting that some of the key premises of those arguments are unwarranted. (shrink)

Discussions over whether these natural kinds exist, what is the nature of their existence, and whether natural kinds are themselves natural kinds aim to not only characterize the kinds of things that exist in the world, but also what can knowledge of these categories provide. Although philosophically critical, much of the past discussions of natural kinds have often answered these questions in a way that is unresponsive to, or has actively avoided, discussions of the empirical use of natural kinds and (...) what I dub “activities of natural kinding” and “natural kinding practices”. The natural kinds of a particular discipline are those entities, events, mechanisms, processes, relationships, and concepts that delimit investigation within it—but we might reasonably ask: How are these natural kinds discovered?, How are they made?, Are they revisable?, and Where do they come from? A turn to natural kinding practices reveals a new set of questions open for investigation: How do natural kinds explain through practice?, What are natural kinding practices and classifications and why should we care?, What is the nature of natural kinds viewed as a set of activities?, and How do practice approaches to natural kinds shape and reconfigure scientific disciplines? Natural kinds have traditionally been discussed in terms of how they classify the contents of the world. The metaphysical project has been one which identifies essences, laws, sameness relations, fundamental properties, and clusters of family resemblances and how these map out the ontological space of the world. But actually how this is done has been less important in the discussion than the resultant categories that are produced. I aim to rectify these omissions and suggest a new metaphysical project investigating kinds in practice. (shrink)

Arguments concerning central issues of contemporary Medical Ethics often not only bear similarities, but also derive their sheer essence from notions which belong to the celebrated history of Ethics. Thus, argumentation pro euthanasia and assisted suicide which focus on the detainment of dignity and the ensuring of posthumous reputation on behalf of the moral agent is shown to echo stoic views on arête and the subordination of life to the primary human goal, namely the achievement of virtue. The progress (...) made in palliative care when seen alongside the — steadily increasing — requests for suicide, is indicative of the fact that, though pain now days can be effectively controlled, moral agents often consider the preservation of their life detrimental to the detainment of virtue or posthumous reputation. The stoic view is considered to justify elective death as a personal choice, but is deemed inadequate as well as inconsistent in the broader context of a coherent value theory. (shrink)

Several countries have legalized euthanasia on the basis of medically diagnosable suffering over the last decennial; the criteria to which they adhere differ. The topic of this article is euthanasia on the basis of existential suffering. This article presents a recent proposal to legalize euthanasia for people who experience such suffering and then discusses the issue of what the value of life may be, and whether the standard that life is normally something positive should be accepted. This (...) provides the foundation to answer the question of whether euthanasia on the basis of existential suffering should be allowed. (shrink)

Kant argued that the perceptual representations of space and time were templates for the perceived spatiotemporal ordering of objects, and common to all modalities. His idea is that these perceptual representations were specific to no modality, but prior to all—they are pre-modal, so to speak. In this paper, it is argued that active perception—purposeful interactive exploration of the environment by the senses—demands premodal representations of time and space.

The article examines from an historical perspective some of the key ideas used in contemporary bioethics debates both for and against the practices of assisted suicide and euthanasia. Key thinkers examined--spanning the Ancient, Medieval and Modern periods--include Plato, Aristotle, Augustine, Aquinas, Hume, Kant, and Mill. The article concludes with a synthesizing summary of key ideas that oppose or defend assisted suicide and euthanasia.

Spontaneous activity levels prior to stimulus presentation can determine how that stimulus will be perceived. It has also been proposed that such spontaneous activity, particularly in the default-mode network (DMN), is involved in self-related processing. We therefore hypothesised that pre-stimulus activity levels in the DMN predict whether a stimulus is judged as self-related or not. Method: Participants were presented in the MRI scanner with a white noise stimulus that they were instructed contained their name or another. They then had to (...) respond with which name they thought they heard. Regions where there was an activity level difference between self and other response trials two seconds prior to the stimulus being presented were identified. Results: Pre-stimulus activity levels were higher in the right temporoparietal junction (RTPJ), the right temporal pole (RTP), and the left superior temporal gyrus in trials where the participant responded that they heard their own name than trials where they responded that they heard another. Conclusion: Pre-stimulus spontaneous activity levels in particular brain regions, largely overlapping with the DMN, predict the subsequent judgement of stimuli as self-related. This extends our current knowledge of self-related processing and its apparent relationship with intrinsic brain activity in what can be termed a rest-self overlap. (shrink)

The following article is a contribution to the rich debate concerning happiness or fulfilment (eudaimonia) in Aristotle’s Nicomachean Ethics. It argues that eudaimonia is theōria in accordance with what Aristotle repeatedly says in Book X of the Nicomachean Ethics. However, happy life (eudaimōn bios) is a complex way of life which includes not only theoretical activity but also the exercising of other virtues including the so-called moral or social ones. The article shows that Aristotle differentiates between eudaimonia on the one (...) hand and the happy or fulfilled life (eudaimōn bios) on the other, and shows how this distinction clarifies Aristotle’s account of eudaimonia. (shrink)

People display recognizably characteristic behavioral patterns across time and situations, with a given degree of regularity. These patterns may justify the attribution of personality traits. It is arguably the commonsense view that the proper explanation of these behavioral regularities is given by intrinsic properties of the agent’s psychology. In this paper, I argue for an externalistic view of the causal basis of personality-characteristic behaviors. According to the externalistic view, the relevant behavioral regularities are better understood as the result of a (...) systematic interaction between features internal to the agent and environmental-situational factors. Moreover, if the premise is granted that people are typically able to exercise a certain degree of control over the environmental-situational conditions they find themselves in, the resulting picture is of active sort of externalism, as people may at times engage in selection and manipulation of environmental-situational conditions as a way of managing their own behavioral tendencies. (shrink)

Unless one embraces activities as foundational, understanding activities in mechanisms requires an account of the means by which entities in biological mechanisms engage in their activities—an account that does not merely explain activities in terms of more basic entities and activities. Recent biological research on molecular motors exemplifies such an account, one that explains activities in terms of free energy and constraints. After describing the characteristic “stepping” activities of these molecules and mapping the stages of those steps onto the stages (...) of the motors’ hydrolytic cycles, researchers pieced together from images of the molecules in different hydrolyzation states accounts of how the chemical energy in ATP is transformed in the constrained environments of the motors into the characteristic activities of the motors. We argue that New Mechanism’s standard set of analytic categories—entities, activities, and organization—should be expanded to include constraints and energetics. Not only is such an expansion required descriptively to capture research on molecular motors but, more importantly from a philosophical point of view, it enables a non-regressive account of activities in mechanisms. In other words, this expansion enables a philosophical account of mechanistic explanation that avoids a regress of entities and activities “all the way down.” Rather, mechanistic explanation bottoms out in constraints and energetics. (shrink)