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

By John Keown | Go to book overview

7
The slippery slope arguments

VAE in principle and in practice

The prohibition of VAE by the criminal laws of almost all countries and by the ethical codes of virtually all medical associations testifies to the historic and enduring appeal of the principle of the inviolability of human life. Many people continue to judge that it is wrong intentionally to take the life of another person, even if that person earnestly requests death to avoid pain and suffering. Many, therefore, continue to oppose VAE in principle.

But many do not. They believe that in principle, VAE (or at least PAS) is morally justifiable provided that the patient's request is free and informed, and that the patient is suffering from an illness resulting in unbearable suffering which can only be ended by terminating the patient's life. However, it does not follow that they also believe that the law should therefore be relaxed to permit VAE or PAS. Many such people oppose relaxation of the law because they believe it would result in (or would involve an unacceptable risk of resulting in) two undesirable consequences. The first is a slide from PAS to VAE and from VAE to NVAE and possibly even IVAE. The second is a slide from VAE as a last resort to its use as a standard and premature alternative to palliative care. In short, many of those who see nothing wrong with VAE in principle do not want the law to permit it in practice because they think it would be likely to result in a slide down a slippery slope from something they condone – ending patients' lives at their request as a last resort – to something they oppose – ending their lives without request or where less extreme alternatives exist. The slippery slope argument about what is likely to happen in practice has taken centre-stage in the contemporary debate. It therefore merits close consideration.

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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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