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

By John Keown | Go to book overview

2
Intended v. foreseen life-shortening

Distinguishing intention from foresight

In both ordinary language and human experience intention is different from mere foresight.Aiming to bring about a consequence is not the same as simple awareness that it may or will occur. The difference between the two states of mind is easily illustrated. There can, first, be foresight without intention. To take an example given by the former Law Lord, Lord Goff: when Montgomery ordered his troops to invade France on D-Day, he foresaw that many of them would be killed but he obviously did not intend that any of them should be killed.1 Again, the tipsy guest at the wedding reception who drinks too much of the free-flowing fizz foresees the inevitable hangover but hardly intends it. The discomfort of having a tooth extracted by the dentist is always foreseen, never intended.

Conversely, there can be intention without foresight. An assassin may intend to shoot a political leader who is giving a speech hundreds of yards away without foreseeing that the bullet will find its mark. I can intend to make you interested in this sentence without foreseeing that you will be. You can buy a ticket intending to win the lottery without foreseeing that you will.


Moral difference

No less importantly, whether a bad consequence is intended or merely foreseen can make a major difference to the morality of one's conduct. Consider the actions of two dentists, the kindly Mr Fill and the cruel Mr Drill. Mr Fill drills out decay in your tooth and fills the cavity, in accordance with good dental practice, even though both you and Mr Fill foresee that you will suffer some pain. The following week Mr Drill drills

____________________
1
Lord Goff, 'The Mental Element in the Crime of Murder' (1988) 104 LQR 30 at 44.

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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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