Class Note for PHIL 164 at UMass(12)
Class Note for PHIL 164 at UMass(12)
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This 2 page Class Notes was uploaded by an elite notetaker on Friday February 6, 2015. The Class Notes belongs to a course at University of Massachusetts taught by a professor in Fall. Since its upload, it has received 22 views.
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Date Created: 02/06/15
Medical Ethics 032609 Phil 1643 Spring 09 l Instructor Kiistoffer Ahlstrom leayrtmpyzarumamedu l httppeopleumassedukahlstro164 CARLA AND ESTHER Carla 47 years old married and with four daughters when an operation revealed a large malignant tumor on one of her ovaries After a round of chemotherapy her condition improved but about a year later the tumor had regrown This time chemotherapy didn t help Carla eventually ended up having to be administered morphine intravenously At this point she raised the question of euthanasia with her doctors Euthanasia could eventually be performed after it had been agreed to by a team of two doctors a nurse and one of the hospital s spiritual careigivers Esther A young woman divorced with one daughter Esther suffered from multiple sclerosis MS a disease of the nervous system that tends to be progressive and often terminates in complete paralysis Wanted to end her life but was told by the nursing home that this could not be done for religious reasons After extensive consultation with Esther her family and friends she was moved to a hospital in Delft The doctors at the hospital consulted further with the Roman Catholic chaplain as well as with a bioethicist and finally granted her wish CARING AND RESPECTING According to Dr Pieter Admiraal it is not only sometimes morally permissible for doctor s to perform active euthanai sia but even morally reqm39red by them to do so How so According to Admiraal a doctor has two duties Care A doctor needs to ensure the wellbeing of their patients to the greatest degree possible Respect A doctor needs to respect the autonomy of the patient The first principle is perhaps the one we most naturally associate with the job description of a doctor It is a duty of the doctor to do what she can to cure her patients and to relieve their pain or suffering But the second principle is just as present in a doctor s everyiday business For example a patient typically eg in the absence of court orders has the right to chose treatments and even to refuse treatment if they want to It is exactly in the interplay between these two principles that Dr Admiraal sees a role for euthanasia More speci cally consider the following principle A doctor is morally required to perform euthanasia on a patient given that a the doctor has gone as far as possi7 ble with respect to ensuring the wellbeing of the patient and relieving her pain and suffering yet 5 the patient still requests to have her life terminated That is the idea is that if the doctor has gone as far as she possibly can in respecting Care and the patient still asks to be killed the doctor needs to respect her wish in line with Respect Dr Admiraal s discussion of the above cases suggest that he would want to qualify this view somewhat More specifii cally he would not want it to be the case that just my request of the patient would need to be respected For one thing it would need to bepem39ilml and iimere Moreover he would not want the decision to fall entirely on the doctor but on a sufficiently diverse team of relevant practitioners More specifically the following seems to sum up his principle Admiraal s Principle A doctor is morally required to perform euthanasia on a patient given that a the doctor has gone as far as possible with respect to ensuring the wellbeing of the patient and relieving her pain and suffer ing yet 5 the patient still requestsipersistently and sincerelyito have her life terminated and a euthanasia is deemed the proper course of action by a team of two doctors a nurse and a spiritual careigiver TERAHNAL ILLNESS AND EUTHANASIA Notice that this principle doesn t require that the patient be terminally ill That s exactly how Dr Admiraal wants it He has two objections to invoking the notion of terminally ill in the context of euthanasia 1 I 71 one sense of leminal illness we are all leminal ill sinee we are all ma al Is this true It doesn t seem that it is The relevant notion of terminal illness involves two components a It is irreversible in the sense that there is no prospect of curing it 1 It is imminenl leiial in the sense that it will shorten the patients life Naturally mortality is irreversible in that it will lead to death However it is not imminently lethal 2 Maey li hllirealening diseases lemme leminal any enee we deeide no la lreal lliem For example palienls wm experieme respirai 100 failure are in ma al danger 1m la the exlenl Ilia lliey are kepl alive on a maeliine lliey are no leminal ill Respiratory failure may or may not be a terminal illness It is imminently lethal for sure but it need not be irrei versible lfit is however then the condition would be terminal whether or not we decided to try to maintain the life of the patientieenlra what Dr Admiraal says Consequently it does not seem that we have any reason to no talk about terminal illness in relation to euthanasia Why doesn t Dr Admiraal want to talk about it Because he takes it that it would rule out euthanasia in cases like Esther s However note that on the above understanding of terminal illness Esther is indeed terminally ill Moreover it might make sense to restrict euthanasia to terminally ill patients eg for the purpose of ruling out euthai nasia in the case of suicidal patients Suicidal patients may be considered to be suffering from something irreversible if their psychological condition does not respond to treatment and is not temporary However their condition is I m as suming not imminenl letval FOR DISCUSSION The Story A contemporary opied piece on the 1992 proposition 161 which was an attempt to legalize assisted suicide in the state of California Question Imagine that you were writing a report on this piece which in many ways is fairly typical of the public dis cussion of euthanasia In light of all the things we ve been talking about over the last couple ofweeks what kind kinds of questionsicritical as well as sympatheticiwould you raise about the piece
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