Ending Life. Ethics and the Way We Die

Ethics & Medicine, Spring 2006 | Go to article overview

Ending Life. Ethics and the Way We Die


Ending Life. Ethics and the Way We Die. Margaret Pabst Battin. New York: Oxford University Press, 2005 ISBN 0-19-514027-3; 344 PP., PAPERBACK, NO PRICE QUOTED

The author is Distinguished Professor of Philosophy and Adjunct Professor of Internal Medicine, Division of Medical Ethics, at the University of Utah and this book is a sequel to her 1994 The Least Worst Death. It is an eclectic but almost always interesting collection of her writings around "Ending Life: The Way We Do It, the Way We Could Do It", as she titles her Introduction.

One quote could summarize her theme. She describes "the Stoic/Christian divide about the individual's role in his or her own death: whether one's role should be as far as possible active, self-assertive, and responsible and may include ending one's own life-or, on the other hand, acceptant, obedient, and passive in the sense of being patient, where 'allowing to die' is the most active step that should be taken."

The descriptions, discussions and debates that follow make her position clear. Indeed, she (presumably) chose for the front cover Rubens' 1615 painting Death of Seneca, a grisly reminder of that Roman Stoic philosopher and statesman who died in 65 AD when Nero ordered him to commit suicide and he obligingly opened his veins.

Part I, "Dilemmas about Dying", begins with a useful historical review that ends with an unconvincing plea for a consensus on "Can the Dispute over Physician-Assisted Suicide Be Resolved?" We are either going to have doctors killing patients legally or we are not. There is no middle ground. Chapter 2 uses the Netherlands, the U.S., and Germany to illustrate three different approaches to dying, and makes a generally fair critique, though discussion is not about 'if but 'how' we intervene to end life. A chapter on the rationality of physician-assisted suicide in AIDS contains useful insights, and I disagree totally with her conclusion to the question "Is a physician ever obligated to help a patient die?" A short case consultation seems out of place, and Part I ends with a lengthy piece of creative fiction she wrote in 1981 but has never published previously. Interestingly, while as a philosopher her assumption is always that autonomy trumps (almost) everything, it is here and in another fictional piece that she records a genuine ambivalence about what ending life would mean in practice. …

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