Euthanasia, Ethics, and Public Policy: An Argument against Legalisation

By John Keown | Go to book overview

1
'Voluntary euthanasia'

'Voluntary'

Campaigners for relaxation of the law typically stress that they are campaigning only for V AE –voluntary active euthanasia. VAE is generally understood to mean euthanasia at the request of the patient,1 and this is how it will be used in this book. VAE can be contrasted with 'non-voluntary' active euthanasia (NVAE), that is, euthanasia performed on those who do not have the mental ability to request euthanasia (such as babies or adults with advanced dementia) or those who, though competent, are not given the opportunity to consent to it. Finally, euthanasia against the wishes of a competent patient is often referred to as 'involuntary' euthanasia (IVAE).

Some commentators lump together the last two categories and classify all euthanasia without request as 'involuntary'. Others (including the author) think that it is preferable to keep the two categories distinct, not least because it helps to avoid unnecessary confusion.


'Euthanasia'

Given the absence of any universally agreed definition of 'euthanasia' it is vital to be clear about how the word is being used in any particular context. The cost of not doing so is confusion. For example, if an opinion pollster asks people whether they support 'euthanasia', and the pollster understands the word to mean one thing (such as giving patients a lethal injection) while the people polled think it means another (such as withdrawing a life-prolonging treatment which the patient has asked to be withdrawn because it is too burdensome), the results of the poll will be worthless. Similarly, if two people are discussing whether 'euthanasia'

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Or at least with the consent of the patient. Euthanasia would still be voluntary even if the doctor (or someone else) suggested it to the patient and the patient agreed.

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Euthanasia, Ethics, and Public Policy: An Argument against Legalisation
Table of contents

Table of contents

  • Title Page *
  • Contents vii
  • Preface xi
  • Foreword xiii
  • Acknowledgments xv
  • Table of Cases xvi
  • Abbreviations xviii
  • Introduction 1
  • Part I - Definitions 7
  • 1 - 'Voluntary Euthanasia' 9
  • 2 - Intended V. Foreseen Life-Shortening 18
  • 3 - 'Physician-Assisted Suicide' 31
  • Part II - The Ethical Debate: Human Life, Autonomy, Legal Hypocrisy, and the Slippery Slope 37
  • 4 - The Value of Human Life 39
  • 5 - The Value of Autonomy 52
  • 6 - Legal Hypocrisy? 58
  • 7 - The Slippery Slope Arguments 70
  • Part III - The Dutch Experience: Controlling Vae? Condoning Nvae? 81
  • 8 - The Guidelines 83
  • 9 - The First Survey: the Incidence of 'Euthanasia' 91
  • 10 - Breach of the Guidelines 103
  • 11 - The Slide Towards Nvae 115
  • 12 - The Second Survey 125
  • 13 - The Dutch in Denial? 136
  • Part IV - Australia and the United States 151
  • 14 - The Northern Territory: Rotti 153
  • 15 - Oregon: the Death with Dignity Act 167
  • Part V - Expert Opinion 181
  • 16 - Expert Committees 183
  • 17 - Supreme Courts 191
  • 18 - Medical Associations 208
  • Part VI - Passive Euthanasia: Withholding/withdrawing Treatment and Tube-Feeding with Intent to Kill 215
  • 19 - The Tony Bland Case 217
  • 20 - Beyond Bland: the Bma Guidance on Withholding/withdrawing Medical Treatment 239
  • 21 - The Winterton Bill 260
  • Conclusions 273
  • Afterword: the Diane Pretty Case 282
  • Bibliography 292
  • Index 303
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