By Dr Wong Wee Nam
“You will not mistake my meaning or suppose that I depreciate one of the great humane studies if I say that we cannot learn law by learning law. If it is to be anything more than just a technique it is to be so much more than itself; a part of history, a part of economics and sociology, a part of ethics and a philosophy of life.”
– Lord Radcliffe, The Law and Its Compass
Writing in a recent issue of the Singapore Academy of Law Journal, National University of Singapore law professor Stanley Yeo and DPP Toh Puay San had proposed that a terminally-ill patient be legally allowed to kill himself with the assistance of his doctor.
They even crafted a piece of draft legislation on this.
The article could have been just a piece of academic musing or it could have been a controversial kite flown to test the winds of public opinion. Whatever it is, a piece of legislation such as this would be an ill-conceived one.
Unlike strict liability, eg, traffic laws, where no moral issues are involved and hence do not need an input from society, the question of euthanasia and physician-assisted suicide is a very complex one. This is not just a medical problem but a moral and ethico-legal problem that has far-reaching effects on the moral fabric of society. Thus the question is: how much feedback have the authors received from the community before they penned the article?
Yes, law sometimes needs to be changed, but it needs to take into consideration human values and societal mores. Lord Simonds in Shaw v Director of Public Prosecutions said, “The law must be related to the changing standards of life, not yielding to every shifting impulse of the popular will but having regard to fundamental assessments of human values and the purposes of society.”
He also said that the moral welfare of the State must also be conserved and protected: “In the sphere of criminal law I entertain no doubt that there remains in the courts of law a residual power to enforce the supreme and fundamental purpose of the law, to conserve not only the safety and order but also the moral welfare of the State and that it is their duty to guard it against attack which may be more insidious because they are novel and unprepared for.”
Thus any law on euthanasia without consultation with the community must end up as a flimsy piece of work.
What is Euthanasia?
We all live in a civilised society where there is general moral prohibition against killing.
Unfortunately there are now some people who find that active euthanasia and physician-assisted suicide is an attractive proposition. This is because medical interventions have, in many cases, made dying very unpleasant. People who have experienced the dying of an aged parent, relative or friend under such circumstances would naturally want death to come quickly and painlessly. It appears to be more compassionate that way.
However, active euthanasia and physician-assisted suicide is not compassionate killing. It is just a way of reducing demands on the compassion of the care-givers.
It is actually nothing more than a perverse way of managing suffering. We are merely trying to solve the problem of suffering by knocking out the sufferer.
The danger of active euthanasia and physician-assisted suicide is that once we accept killing, it just becomes a little easier the second time, and each time thereafter, until it becomes routine and mechanical, totally devoid of compassion.
The Slippery Slope
What then comes next? We will then start using pain, disability, suffering and, worse still, age and economic status to assess the worth of a human life and as reasons for the doctor to end his patient’s life. I hope this is not what Prof Yeo and DPP Toh have in mind when they said, “The rapidly ageing population calls for much more to be done than just the provision of advance medical directives and improved palliative care by the Government.”
Imagine how you would feel when you are old, poor, disabled, sick and an economic burden to have a doctor telling you to get off his uncaring face!
Once human lives become a commodity to be disposed off when it becomes too expensive to maintain, the rot of materialism will set in and the caring ethos of medicine will disappear.
In such circumstances, how are we to safeguard against tendencies to take the easy way out and the possibility of subtle coercion to put pressure on the patient to die?
The real danger of such physician-assisted suicide legislation is that it is the thin edge of the wedge towards a society in which the aged, the handicapped, the mentally deficient and the chronic sick will be faced with a duty to die so that they will not be a burden to society.
Is Assisted Suicide Morally Right?
It is obvious that allowing terminally-ill patients to end their suffering by killing themselves is morally wrong. Even the authors of the report appear to think so. Otherwise why would they want the suicide to be physician-assisted instead of allowing anyone else to do it?
This is because assisted suicide is not a morally correct thing to do and thus the suicide must be medicalised to make it morally right. Making suicide a medical condition and turning it into a medical problem would assuage the guilt of the loved ones. Without medicalisation anyone else would loathe to take on the role of the executioner knowing that it is morally not the right thing to do.
Even then this will not make euthanasia any more psychologically comforting. Ask anyone who has put a pet dog to sleep.
Impact on Medicine
The most humanitarian function of medicine is the relief of suffering and helping patients cope with their physical disabilities.
Active euthanasia and physician-assisted suicide, therefore, runs counter to the traditions of medicine and to the training, inclinations and intuitions of doctors and nurses who care for dying patients. Allowing active euthanasia and physician-assisted suicide will give the doctor the taint of an executioner. It will relieve the community of its obligation to provide good care.
If our doctors start to be pre-occupied with whether a case should be killed or not, then they have stopped doctoring. Instead of being dispensers of care our doctors will become dispensers of death.
Impact on Society
A community needs its aged and dependent, its sick and its dying because they show us the virtues of humility, courage, and patience — just as much as the community needs the virtues of justice and love shown by doctors, nurses and families, and they can only do so with the presence of the aged, sick and dying.
Thus the ability to invoke love, devotion, sacrifice and care is one contribution of the handicapped, sick and dying to the humanity. (To understand this better, readers should read “Soft Sift in an hourglass” by Dr Rosalie Shaw)
Once we have active euthanasia and physician-assisted suicide, human lives would be in danger of becoming commodities to be disposed off when they becomes too expensive to maintain. Would the lives of the terminally ill, the senile, the permanently unconscious, the retarded, the incurable, the chronic sick and even the aged then have any value?
Care of the Terminally-Ill
The challenge in the care of the terminally-ill is not to assist them to die but to make euthanasia unnecessary. It is to find ways to improve the comfort and quality of life for them and not hurrying to dispatch them on their way.
Hospices, for example, by alleviating patients’ pain and comforting them, allow the dying to live as fully and painlessly as possible until death. They also help to relieve the burden on the caregivers and help them to cope.
The palliative care that they provide has made it less common for patients to ask for euthanasia and physician-assisted suicide.
Though there are still many conflicts to resolve and a wide range of issues to be addressed, there is no need to end life prematurely and to try to control death.
The Meaning of Dying
Dying used to be an occasion. Death was a significant part of life. In the past, it was a public ceremony showing the living how to die with dignity. The dying person is surrounded by his loved ones and not isolated in a ward attached to machines and have tubes inserted into all his orifices.
Euthanasia and physician-assisted suicide seems to allow a merciful end to suffering and dying, but what it actually does is to increasingly isolate the rest of us from death’s significance to life. It will make us more likely to abandon the aged and the dying in order to make life easier for us. In the end, it will make us poorer as human beings.
We must, therefore, be careful not to allow the momentum of the right-to-die call to push us over the slippery slope so that the call for the right to die may eventually become a demand for the duty to die.
Conclusion
It was reported that the two authors had also argued that “it is realistic to assert that even with their prohibition, acts of PAS are being conducted in secret.”
In April 2009, Health Minister Khaw Boon Wan made it very clear that “euthanasia, which means helping the patient to commit suicide, is not what Ministry of Health (MOH) is promoting” and that MOH is actually “promoting palliative care for the terminally ill so that they, and their family members, will be able to cope with terminal illness with the least pain and being cared for in the most appropriate setting, which usually means the home they live in.”
With such a clear stand from the Minister, it is hard to believe our doctors can be so reckless as to conduct acts of PAS in secret. Maybe the authors know something that the Minister and the medical fraternity do not?
I always believe that law must have a human face. Thirty-five years ago, when I was studying law, I came across these words of Walter Scott, a lawyer himself, from his novel Guy Mannering and they have stayed with me: “A lawyer without history or literature is a mechanic, a mere working mason; if he possesses some knowledge of these, he may venture to call himself an architect.”
Materialism and selfishness have eroded our soul and made us a less caring society; let us not add on to it by allowing the killing of the dying.
__________________________
References
1. Lord Lloyd of Hampstead Introduction to Jurisprudence
2. L. A. Hart Concept of Law
3. Daniel Callahan Setting Limits – the medical goal in an ageing society
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Take those doctors who perform secret PAS to task!
Assisted suicide is justifiable in some cases, but in sinkapore it is used as an excuse to lower medical costs and free up more space in hospitals. Patients that might have a chance of surviving have been put down like dogs, all in the name of saving money so that medical resources are freed for foreign medical tourists.
“Once human lives become a commodity to be disposed off when it becomes too expensive to maintain…”
But that’s how the gahmen thinks of its people!
Hence the push for MPA, citing morality in order to push the responsibility of elderly care to children, and so on. Because by the time you’re 70, your use as an economic commodity is exhausted. The gahmen no longer has any use for you. Rather than burdening itself with economically unproductive people who still require caring, just conveniently push the responsibility to children and private charities.
I say PAP, cut the hypocrisy and just allow euthanasia in Singapore. That would be entirely consistent with your stand on “human capital”.
Dr Wong,
“However, active euthanasia and physician-assisted suicide is not compassionate killing. It is just a way of reducing demands on the compassion of the care-givers.”
“It is actually nothing more than a perverse way of managing suffering. We are merely trying to solve the problem of suffering by knocking out the sufferer.”
No, these are sweeping generalisations which I do not agree. There are many different issues and situations to consider and think about hat makes this a issue a very complex than your simplistic views
The latest ST Forum letter by Dr Wong Wee Nam:
Mar 30, 2010
Euthanasia not the answer…
I REFER to recent discussions on euthanasia and physician-assisted suicide.
Modern medical interventions have, in many cases, made dying very unpleasant. People who have experienced the death of an aged parent, relative or friend in such circumstances will naturally want death to come quickly and painlessly. It appears more compassionate that way.
But is euthanasia the way to solve the problem of suffering by knocking out the sufferer?
The danger of active euthanasia and physician-assisted suicide is that once we accept killing, it becomes a little easier the second time, and each time thereafter, until it becomes routine and mechanical, devoid of compassion.
Once human lives become a commodity to be disposed of when they are too expensive to maintain, the caring ethos of medicine will disappear.
It is obvious that allowing terminally ill patients to end their suffering by killing themselves brings a lot of guilt and affects the conscience of loved ones. This is because deep inside us, we feel that assisted suicide is not morally correct.
When we term it ‘physician-assisted suicide’, we are merely trying to make suicide a medical condition and turn it into a medical problem. By making the doctor the ‘executioner’, we make the act seem morally right and assuage the guilt of loved ones and the conscience of everyone.
The electric chair would similarly relieve the patient of his suffering in a quick and painless way. Why aren’t we proposing ‘electric chair-assisted suicide’? Aren’t we moral hypocrites by trying to medicalise suicide?
A community needs its aged and dependent, its sick and its dying, because they show us the virtues of humility, courage and patience – just as much as the community needs the virtues of justice and love shown by doctors, nurses and families, and they can do so only with the presence of the aged, the sick and the dying.
Once we allow active euthanasia and physician-assisted suicide, human lives will be in danger of becoming commodities to be disposed of when they become too expensive to maintain. Would the lives of the terminally ill, the senile, the permanently unconscious, the retarded, the incurable, the chronic sick and even the aged then have any value?
The challenge in the care of the terminally ill is not hurrying to dispatch them on their way but to make euthanasia unnecessary.
We need to train more caregivers in palliative care to make it less likely for patients to ask for euthanasia and physician-assisted suicide, and to find ways to improve the comfort and quality of life of the dying.
Euthanasia and physician-assisted suicide seem to allow a merciful end to suffering and dying, but what they actually do is increasingly isolate the rest of us from death’s significance to life. In the end, it will make us poorer as human beings.
We must, therefore, be careful not to allow the momentum of the right-to-die call to push us down the slippery slope so the call for the right to die may eventually become a demand for the duty to die.
Dr Wong Wee Nam
Micheal Crichton (the novelist) said, “Historically, the claim of consensus has been the first refuge of scoundrels; it is a way to avoid debate by claiming that the matter is already settled.”
I would add that ‘so is the slippery slope’. Except that it avoids debate by claiming that the matter WILL happen as he FORETOLD. Suddenly, one can look into the future and be certain that things will happen as he predicted. Is he now God?
To me, Dr Wong’s whole argument is premised on the proverbial Slippery Slope.
One ST Forum poster say it the best:
So far, I have not seen any proponents of assisted suicide rejecting safeguards against abuse or ignored all impact /implication /considerations if and when this option is legalised. However, many opponents simply use the “slippery slope” argument to outright reject the motion for assised suicide only for those who need it.
A most disingenuously argued piece, filled with unsubstantiated assumptions, reductionistic assertions, and weasel words. If we would like to have a debate, it is a good idea not to start misrepresenting the issues in question.
“Thus any law on euthanasia without consultation with the community must end up as a flimsy piece of work.”
Dr Wong criticises the Professor Stanley Yeo and DPP Toh Puay San’s work on this ground. This is a valid criticism, fair enough. The problem is with how Dr Wong establishes that a “consultation” needs to take place, and then proceeds to illustrate in the rest of the article how the debate is already a done deal. It amounts to saying: “Please consult, but I know better than most of you, so please be informed that there is really only one outcome that should prevail.” This is perhaps the biggest travesty in this entire article.
“Imagine how you would feel when you are old, poor, disabled, sick and an economic burden to have a doctor telling you to get off his uncaring face!”
The slippery slope is often employed as some kind of ultima ratio in all sorts of debates. But it is often lazy and – as often utilised by scare tacticians – consists of speculation veering into worse-case scenarios. The above statement is one such scenario – but one that has little grounding in reality.
“It is obvious that allowing terminally-ill patients to end their suffering by killing themselves is morally wrong.”
No elaboration as to how it is obvious. The underlying assumption here is that Dr Wong’s moral standards are more sound than those of euthanasia proponents. Since the key battleground in a euthanasia debate is its morality, this statement amounts to a tautological argument – it assumes the outcome that it wants to prove, hence it is proven. Plain circular logic.
“The most humanitarian function of medicine is the relief of suffering and helping patients cope with their physical disabilities.”
Conveniently ignoring that this very same platform of humanitarian motive can be used to argue for the case of euthanasia – in instances where existing medical technology has proven inadequate in meeting these goals.
“Euthanasia and physician-assisted suicide seems to allow a merciful end to suffering and dying, but what it actually does is to increasingly isolate the rest of us from death’s significance to life. It will make us more likely to abandon the aged and the dying in order to make life easier for us. In the end, it will make us poorer as human beings.”
Another worse-case scenario – ever the convenient argument to make since you don’t have to prove it, or even explain it. The first sentence is another vague assertion, conveniently left unelaborated. It is not clarified as to how euthanasia creates this isolation “from death’s significance to life”. What is this significance, and how does euthanasia prevent its appreciation?
Another problem with this one is that it obfuscates and misrepresents the stand of euthanasia proponents. There is a spectrum of opinion on both sides, but it is safe to say that what many proponents are asking for is a right for the patient to choose – not the family and friends. This particular slippery slope argument doesn’t hold water if the decision to die is not placed in the hands of caregivers – hence Dr Wong’s apparent tactic is to pretend that it is.
Readers who would like to get a better grounding on the various arguments put forth for and against euthanasia are better off reading this: http://www.bbc.co.uk/ethics/euthanasia/
Our lives belong to someone else, so its a crime and sin to take one’s live asisted or non-assisted. It is even morally wrong to even discuss this issue in the first place.
If a dying patient jumps down and kills himself, we say he shouldn’t do it.
If the state provides an electric chair to do a clean and neat job, we will howl in protest.
Come to think of it, if any of the pro-death supporters were asked to posion their loved ones, how many would have the conscience to do it (unless you want to get inheritance fast or you want to save on medical bills)?
This is the moral of the story.
as far as i am concerned..my instructions is simple clear and congsise..
pull out the 13amp plug..even teach my nephew how to pull out the 13amp plug legaLLEE…
you might want to know how?… that for me to know and you peeps to guess…
few weeks ago i also posted a thread regardin the dyin issue on another thread…
1 pro pap supporter claimed i was tryin to dramatise the 102 auntie who lived on my upstairs..demandin i take the action myself since the doctor is not allowed to…
i rebuke..but my postin never got thru..under moderation so to speak…
i says maybe i should suffocate her with a pillow and endup bein charged for manslaughter under the singapoor shotpants matas law…which is very very common for our clean efficient policemen here.. 1 law for the pap government..1 law for peasants liked us…
Spiegel,
Thanks for the bbc link. The oregon approach seems to be a good start. Certainly, having the number of people who backed out is a good sign.
Spiegel,
Ultimately the Straits Times has a word limit, so Dr Wong might not have been able to write all that he wanted to write, given the complexity of the issue.
(1) Nope, you are misrepresenting Dr Wong. What Dr Wong is seeking to establish is that because human values and societal mores are necessary in a debate on euthanasia, omitting them (the way the govt is doing) results in a very skewed picture, or a “flimsy piece of work”. No “travesty” of any kind of logic here.
He then seeks to explain why he thinks values and societal mores are necessary components of the debate – no travesty again.
(2) If you were a little more observant, you might have realised that “get off his uncaring face” is an allusion to Wee Shu Min (remember her?). Also, very sadly, this is the kind of attitude we do have nowadays from doctors working in public hospitals, even without Euthanasia. I know; my grandfather had such a doctor, and he was suffering from cancer.
(3) I would take that Dr Wong didn’t have enough words to elaborate his point. Although, in honesty, would you actually argue that any kind of suicide is a good thing? What I see you doing here is making an argument from ignorance. (“I do not know how patients killing themselves can be a bad thing, therefore it is a good thing.”)
And of course, there is the Straits Times’ word limit.
(4) Except that the euthanasia proponents’ argument amounts to a false dilemma. The two horns of the dilemma are: Letting the patient suffer continuously for a prolonged period of time; and ending the patient’s life early. The solution to the dilemma – which the opponents of euthanasia propose – is to allow the patient to die naturally, and improve palliative care to ease the process.
Palliative care is not simply about providing painkillers and other forms of chemical medication; it is about preparing the patient (and loved ones) to move on, to let go so to speak.
Opponents of euthanasia are often falsely portrayed as people who revel in suffering of the patient and his/her loved ones. What they really want is medication to reduce pain for a sufficient period of time to allow the “letting go” to occur.
This strategy of reducing palliative care to chemicals and machines is merely a strawman argument.
(5) Ironically, you have helped illustrate Dr Wong’s point very well.
Removing the choice of the “family and friends” formally is a synthetic solution. The “removed” family and friends can still exert social pressure. If you can still remember primary-school mother-tongue lessons about the family who made their aged eat from wooden bowls while they dined in finery. Switch the wooden bowls with contracts for “mercy-killing” and you will see what point Dr Wong is getting at.
Also, this emphasis on the patient is an example of crass individualism. Remember, the other side of “nobody owes us a living” is “we don’t need to care for anyone else but ourselves”. By putting the sole onus on the patient, you discount the responsibility of the family, friends, government and the medical establishment for their influence on the patient’s decisions.
Essentially, you are permitting the MOH to do a HOTA for “Living Wills”. Even something as simple as organ donation is wrought with complexities; how much more what is essentially a trade in death?
And lastly, you forgot that the physician (and the hospital he/she is working for) is not a neutral party either. Sadly, the reality is that hospitals nowadays are also profit-driven enterprises that seek to cut costs when possible. And as Dr Wong points out, promoting euthanasia is a great way for hospitals to cut costs. And it is very hard to put “limits” and “safeguards” on this because the hospital can simply claim that it “cares for the patient’s welfare”.
Arix (@UK,
Dr Wong’s article is for The Online Citizen, and I quoted from that. There is no “Straits Times word limit”.
“What Dr Wong is seeking to establish is that because human values and societal mores are necessary in a debate on euthanasia, omitting them (the way the govt is doing) results in a very skewed picture, or a “flimsy piece of work”
If that was the case, the first segment would have sufficed. My point is that Dr Wong made that valid point about the need to include wider societal considerations, but then proceed to discuss those considerations and presenting them as established facts. Arix, if you read my post carefully, you will note that I did not say there was a travesty of logic in this part – that would come later.
” If you were a little more observant, you might have realised that “get off his uncaring face” is an allusion to Wee Shu Min (remember her?)”
I am well aware of Wee Shu Min and understand the reference to her infamous rant, but that has nothing to do with the point I was making. The point remains – Dr Wong is positing a slippery slope argument, which is easy to make, veers into speculative worse-case scenarios and never properly substantiated. The slippery slope in this particular case is that Dr Wong assumes that doctors will naturally care less about their their patients welfare if they are legally allowed to, perhaps become eager to have them die as well – this is a worse-case scenario that easy to make and difficult to prove.
“I would take that Dr Wong didn’t have enough words to elaborate his point.”
Once again, there is no word limit.
“Although, in honesty, would you actually argue that any kind of suicide is a good thing? What I see you doing here is making an argument from ignorance.”
I hope you are aware of the irony here – your argument is tautological, you assume the case you are trying to prove i.e. “all suicide is unacceptable and wrong, even in the case of the terminally ill”, and take that as a starting point.
If that’s the case, what’s the point of a debate then? The whole point of the euthanasia debate is that some believe that suicide is permissible in specific instances, that it can be moral and be the right thing to do in specific circumstances. I’m not trying to pick a position on the euthanasia here – I’m merely pointing out the logical fallacies and sleight of hands employed.
Finally, there are plenty of people who do argue that suicide in the very precise, specific circumstances is morally acceptable. Once again, I refer you to – http://www.bbc.co.uk/ethics/euthanasia/.
The writer has way too many sweeping personal emotive assumptions on this subject, which has been thoroughly studied (perhaps not here). A frustrating read of a weak slippery slope argument. I’m glad a few here have already addressed the article’s problem.
While I cannot fault the writer’s well intentions, I question his lack of thorough research, data, objectivity and understanding on the subject.
Poor article. Sorry.
Spiegel,
Firstly, apologies. I saw a previous post relating to a letter written by Dr Wong to the ST, and mistakenly hastily assumed that it was identical to this article, because it shared similar texts. That having been said, there is no formal word limit for articles on TOC, but there is an informal limit. I wrote a couple of pieces for TOC before, so I can attest to that. Although, if any editor is around, the editor might like to clarify this issue.
(1) I don’t actually see where Dr Wong implies that the matter is a “done deal”. What he is doing is arguing for the moral case against euthanasia. Admittedly, his treatment of the pro-camp is not particularly thorough, but then he is writing for a blog, not an academic journal.
His structure of the argument is establishing the necessity of consulting societal mores and human values first, and then outlining what he thinks these are and arguing how euthanasia and euthanasia laws violate these.
Although, I give it to you, the structure of his argument is not very clear.
(4) Actually, no. It is tacitly acknowledged on both sides that suicide – in the full sense – is a bad thing. What the pro-euthanasia camp is arguing is that euthanasia and PAS should be legalised because both are not suicide.
Suicide is inherently morally problematic because the person committing suicide has devalued his/her own humanity before ending his/her life. The whole point of the “death with dignity” slogan is to prove the converse.
But if you are talking about sleight-of-hand, then I would say that “Physician-Assisted Suicide” is a very good example of sleight-of-hand with terminology. What the term has done is shorn the word “suicide” of its moral connotations, and limited its meaning to the mechanical component, or as Dr Wong would call it, the “materialistic” component.
In fact, I would argue that while the anti-euthanasia camp has been consistent, the pro-camp has been playing word games. Euthanasia was first associated with “mercy killing”. The problem? “Killing” doesn’t seem to sit well with “mercy”. So they changed it to “Physician-Assisted Suicide”. “Physician” adds in the professional element which is supposed to bring neutrality in principle, thus blunting the implicature of “suicide”. But for a while, because “suicide” was problematic as well, they shifted the discussion to talking about “Living Wills”, a genius sleight-of-hand to make people forget that they are talking about death. The same thing could be said for “End-of-life issues”.
aft) Incidentally, you haven’t responded to my argument on palliative care and the structure of society.
Arix (@UK),
“It is tacitly acknowledged on both sides that suicide – in the full sense – is a bad thing.”
Is there another sense? Without adorning it with unnecessary semantics, suicide simply means “the intentional killing of oneself”. The motive for doing so is irrelevant in the definition of the term.
The crux of the euthanasia debate is this – are there any circumstances under which we can accept the act of suicide as being morally sound and compassionate? Those who support euthanasia essentially claim that there are, and go on to specify those circumstances – but of course there isn’t a cut and dry consensus amongst proponents on what they are. On the other hand, opponents essentially argue that there aren’t any exceptions to the rule.
The opponents take what is fundamentally a deontological ethical position – to define an act as inherently immoral, regardless of circumstance and consequence. The proponents are taking a utilitarian position – circumstances and consequences matter in judging the morality of an act.
This is the basic framework of the debate – I would say your characterisation of it is incorrect.
“What the pro-euthanasia camp is arguing is that euthanasia and PAS should be legalised because both are not suicide.”
No, that is what you are characterising them to be arguing. Their position, fundamentally, is that there are conditions under which suicide is acceptable and perhaps even the morally right thing to do. There may be instances where proponents use semantic games to make their case, but that is not their basic position.
This debate is not far off from that over abortion – in the sense that the fundamental moral arguments driving both sides are similar. There is a very good interview of Mike Huckabee by Jon Stewart, which unlike most other interviews on American television doesn’t descend into a shouting match or facile point scoring exercise. There are three parts, starting with – http://www.thedailyshow.com/watch/thu-june-18-2009/mike-huckabee-extended-interview-pt–1
Part 2 is perhaps the best part – http://www.thedailyshow.com/watch/thu-june-18-2009/mike-huckabee-extended-interview-pt–2
“But if you are talking about sleight-of-hand, then I would say that “Physician-Assisted Suicide” is a very good example of sleight-of-hand with terminology. What the term has done is shorn the word “suicide” of its moral connotations, and limited its meaning to the mechanical component, or as Dr Wong would call it, the “materialistic” component.”
By ascribing an inherent moral component to the phenomenon of suicide, you are taking a deontological ethical position. Proponents take a utilitarian position – i.e. there is no inherent immorality to suicide, in most instances to commit suicide is immoral, yet in specific cases it is not.
This is not a problem of sleight-of-hand. It is actually more of a moral philosophical problem.
Labelling it PAS if anything clarifies exactly what kind of suicide is being discussed – instances where terminally ill patients wish to end their lives with the aid of a doctor. Or in the case of euthanasia, the House of Lords Select Committee on Medical Ethics defines euthanasia as “a deliberate intervention undertaken with the express intention of ending a life, to relieve intractable suffering.”
In both cases, the definitions clarify the precise nature of the suicide and helps to frame the circumstance and consequence of the act. This is in fact central to a utilitarian approach to ethics – since their point is that the morality of an act is to be judge on why it is done and what its results are.
“In fact, I would argue that while the anti-euthanasia camp has been consistent, the pro-camp has been playing word games.”
Perhaps that’s true, but that is the political aspect of it – how politicians and activists try to package their beliefs and policies into something palatable. But as I’ve noted above – if you consider what proponents are doing to be semantic games, then the other side can also argue that opponents of euthanasia are also playing semantic games by ascribing by default precise moral connotations and implications to the term ‘suicide’, when there is no consensus on it in the first place.
“Incidentally, you haven’t responded to my argument on palliative care and the structure of society.”
That’s not what I was interested in when I commented on Dr Wong’s piece. Rather I was pointing out the disingenuity in his piece, rather than rebutting anti-euthanasia arguments with pro-euthanasia arguments.
On the influence of family and doctors, Dr Wong seems to suggest that if euthanasia is legalised, family and friends would be able to pressure people into killing themselves, acting on a purely economic calculus. That is plausible, but it is also employed as a reductionist scare tactic – it is framed in a manner as if to say it will happen, and there’s nothing we can do about it. Proponents will argue that safeguards can be introduced to ensure such influences are mitigated, such as the Oregon approach.
In the Jon Stewart/Mike Huckabee interview, they come to a middle ground of sorts – despite the fundamental divide between arguments of both sides of the abortion debate, there are steps that can be taken – proper sex education for example – to ensure that in the real world, abortion rates can come down, and reduce the loss of life. In the same vein, good palliative care can be that middle ground in the euthanasia debate, helping to reduce the number of people who would turn to suicide. And indeed, the Oregon example seems to vindicate such an approach.
Spiegel,
(1-4) You asked me if there is another sense, and then went on in your post to describe the existence of different senses. Regardless of normative ethical conditions, there are two distinct metaethical conceptions of suicide that we can use. The first is the naturalistic conception of suicide, which reduces suicide to the set of physical actions undertaken to end the mechanics of life-processes. The second is the non-physical conception of suicide, which puts it the emotional conditions of the person committing suicide into the picture.
The proponents of Euthanasia use the naturalistic conception, while opponents use the non-physical conception. I concede that it is possible that some opponents use the naturalistic conception, or that some proponents use the non-physical conception, but not all do.
Incidentally, Deonotology is not the only normative position opponents take; some take Divine Command Theory as well.
And also incidentally, you yourself have assumed the naturalistic conception of suicide.
(5) My point is that they are playing semantic games with the word “suicide”.
(6) If your characterization is really Deontology versus Utilitarianism, then I don’t think that you are correct. A strong argument for abortion lies on the human rights of the mother, and that is grounded in deontological concerns.
Perhaps Stewart argues on Utilitarian grounds, but that doesn’t mean all supporters do. The central question over abortion is a deontological debate over the status of the embryo and fetus.
(9) To do a brief <em>reductio ad absurdum</em>: Under only the definition provided by the House of Lords, if a patient told the doctor to strangle him because he is in much pain, then that would fit the definition provided, since “intractable” is really a very subjective term.
(11) Semantic Games are associated with the fallacy known as shifting of the goalposts. By sticking to a fixed definition of suicide, the opponents are not playing a semantic game. They have specified their semantics and have stuck to it throughout the debate.
(13) I have been studying the atheist-theist debate, and one of the atheist arguments that struck me was Anthony Flew’s “Death by a Thousand Qualifications” argument. The essence of the argument was that if Theists need to make several exceptions for God to ensure the validity of their case, then their case does not stand.
I don’t agree with this argument used against religion. However, I think it can be applied to proponents of euthanasia. The more qualifications or safeguards the pro-Euthanasia person has to put up to make Euthanasia defensible, or to prevent “abuse”, the less plausibility the pro-Euthanasia camp’s case is.
In fact, the “safeguards” argument is the weakest argument anyone could use for any argument over policy. Whenever one uses a “safeguards” argument, you are conceding moral ground to your opponent. Anyhow, for any list of safeguards, really inventive or really desperate people can find a loophole.
This article lacks the many elements that lend to the progress of social evolution on this planet. This is nothing but the same old, worn out, fear-mongering rhetoric that is based on the premise that a doctor knows what is best for a patient and a patient must always be subject to the will of the doctor.
Experience is the best teacher & I have that experience. I lost my beloved twin sons, Nick and Drew Loving, to two different terminal diseases. One received a physician assisted death and the other did not. The opposite of a physician assisted death (good death) is medical tyranny.
This doctor has sold his soul to the foreign devils of western medicine. Visit me on facebook to read the articles I post and take a look at my website to learn more about this basic human right.
Arix (@UK),
“The first is the naturalistic conception of suicide, which reduces suicide to the set of physical actions undertaken to end the mechanics of life-processes. The second is the non-physical conception of suicide, which puts it the emotional conditions of the person committing suicide into the picture.”
“The proponents of Euthanasia use the naturalistic conception, while opponents use the non-physical conception. I concede that it is possible that some opponents use the naturalistic conception, or that some proponents use the non-physical conception, but not all do.”
The first part of this statement is a false characterisation, as you concede. Proponents make pro-euthanasia arguments that can and do operate from both conceptions of suicide – hence this dichotomy is not useful. Are you saying that those who argue for euthanasia do not consider emotional aspects of the act of suicide and the condition of the person committing suicide? That is the false caricature the anti-euthanasia camp would like to paint of the proponents.
Divine Command Theory is a fundamentally unsound concept, which in any case shouldn’t be used in the formulation of secular policy.
“My point is that they are playing semantic games with the word “suicide”.”
And my response to that was that both sides do play “semantic games”, if you consider what proponents to be doing as a semantic game. However suicide is defined, mechanically or emotionally, the fundamental disagreement on euthanasia is still whether it is moral. And arguments can be advanced from both sides using both definitions of suicide as you put forth.
Proponents, unlike opponents, are not a singular, monolithic group. By assuming them to be a monolithic group, you read the use of different definitions as playing with semantics. I would argue that it is largely a case of various proponents with their respective positions on the debate setting out to define their case.
To do a brief reductio ad absurdum: Under only the definition provided by the House of Lords, if a patient told the doctor to strangle him because he is in much pain, then that would fit the definition provided, since “intractable” is really a very subjective term.
The proponents’ work is to define what that “intractable” is – defining the specific circumstance in which suicide is morally acceptable. It is a matter of debate, and it is tricky, and much is at stake. But that is essentially what proponents are working at.
“By sticking to a fixed definition of suicide, the opponents are not playing a semantic game. They have specified their semantics and have stuck to it throughout the debate.”
I don’t think there is a semantic game in the sense that they are moving goalposts. The crux of the debate remains the same – can suicide, however it is defined, be moral under specific circumstances? Creating terms like PAS is not a semantic game, neither is it moving the goalposts. It is a step in defining what the goalposts are and where it stands.
Proponents, by the very nature of their position, have to be debating and refining what they deign to be acceptable circumstances where suicide is morally right.
On the spectrum of positions taken on the euthanasia debate, opponents sit on one polar end – no circumstances exist where suicide is acceptable. On the polar opposite end, where suicide is totally acceptable, I don’t think many if anyone sits there. But standing anywhere else on the spectrum apart from the opponents’ end would be to take a proponent’s position. Creating and refining definitions is a necessary exercise by proponents – it isn’t shifting goalposts but deciding where they stand, refining exactly what circumstances that society can accept suicide as a moral choice.
The Stewart/Huckabee example is not meant to be direct comparison of the qualitative aspects of the abortion/euthanasia debates – its content, however, shows that there is much common ground between both sides of such debates. Whether each side would like to step away from talking points and actually work something out, is for them to decide.
“The more qualifications or safeguards the pro-Euthanasia person has to put up to make Euthanasia defensible, or to prevent “abuse”, the less plausibility the pro-Euthanasia camp’s case is. In fact, the “safeguards” argument is the weakest argument anyone could use for any argument over policy. Whenever one uses a “safeguards” argument, you are conceding moral ground to your opponent.”
How is this the case? You already assume the immorality of euthanasia – another tautology. You’re essentially claiming that euthanasia is immoral, and proponents claim to be able to make it moral by introducing safeguards. This is why in your mind they are “conceding moral ground” – that by having to fiddle and search for appropriate and moral safeguards, they are betraying the moral vacuousness of their position.
On the other hand, proponents will argue that the current legal status quo is immoral, and allowing euthanasia with safeguards is the more moral choice. From a proponent’s POV, the desire to introduce safeguards is founded on the desire to eliminate potential loopholes in their proposals and allow a more moral approach to medicine. They see the status quo as immoral, but concede that the alternative they propose can also be abused – hence the need for safeguards.
This isn’t a zero-sum debate, but you are framing it that way. But then again, that’s how opponents have to frame it anyway. There is middle ground to be found here, just like how Stewart/Huckabee came close to one.
The argument you are making here is essentially a cop-out. By characterising safeguards as goalpost-shifting or unprincipled or relativistic, you opt to avoid the difficulties in refining and debating safeguards in favour of a clear-cut position. The clear-cut position is just that – precise. But whether that position is moral is open to question, and indeed that is what proponents are challenging.
Arix
Perhaps Stewart argues on Utilitarian grounds, but that doesn’t mean all supporters do. The central question over abortion is a deontological debate over the status of the embryo and fetus.
How did you go from speculating what grounds people argue from, to suddenly reaching a conclusion of what the ‘central question’ is?
(9) To do a brief reductio ad absurdum: Under only the definition provided by the House of Lords, if a patient told the doctor to strangle him because he is in much pain, then that would fit the definition provided, since “intractable” is really a very subjective term.
Well, if anything, your example certainly is absurd. Your example highlighted the absurdity of the method of intervention (asking doctor to strangle), and yet you then based this on the subjectivity of ‘intractable’? How are they connected?
By sticking to a fixed definition of suicide, the opponents are not playing a semantic game.
Nope. They are too. Semantics is not just about fixed or moving definitions. It is also about clear and defined ones too. The ‘fixed’ definition used by the opponents is very broad.
It’d be like atheists fixing the definition of Christianity to be a religion that features Jesus, totally disregarding the various denominations. They’d then argue, mormonism = Chirstian = bad religion. Is this not a semantic argument?
Organ Trading/Assisted Suicides. Everything points to a future direction where the poor should die earlier and the rich sustain their lives longer. Although AS is still not casted in stone, the mere talk of it already betrays the real possibility.
Adam
Mar 31, 2010 11:08
Everything points to a future direction where the poor should die earlier and the rich sustain their lives longer.
Actually, to me, the direction is about making what was previously only accessible to the rich, possible for the poor. e.g the Rich can afford to go other countries to get organs and/or suicide. Now the poor (or simply those less rich) can do so too.
Spiegel,
(1) No, I conceded that there are a few exceptions, but that most go along the line that I described. I read through the page on BBC that you provided the link for. I do not think that the anti-euthanasia camp is off-mark, the way you say it is. The definition provided for suicide after all is the naturalistic definition. The way the pro-camp succeeds is by creating a false dichotomy between the mechanics of suicide and the emotional environment for suicide.
To put it simply, a person who is happy will not want to die. And if a person is unhappy, should the first thing to do be to kill that person, or to make the person happy again? The pro-camp wants the former; the anti-camp wants the latter.
(2) Let’s let the philosophers – and all, not just your cherry-picked favourites – decide on the merits of Divine Command Theory. Your atheistic prejudices against specific philosophical positions do not determine their truth. And please, no more red herring of “secularism”. I suspect also, that your “fundamentally unsound concept” is a strawman, and not the real, more advanced versions of the Divine Command Theory that are being put forth by modern philosophers.
(And yes, I know that Der Spiegel reeks of anti-religious content.)
(3) The traditionally-accepted emotional aspect of suicide is the despair and hopelessness of the person committing suicide. The anti-camp is trying to emphasize this, while the pro-camp is trying to argue this away. But of course, the only way such an argument can proceed is by first constraining the definition of suicide to the mechanical definition.
(4) I said that they start out from the same meta-ethical position; you were arguing that they start out from the same normative ethical position (Utilitarianism). So you were the one making them look more monolithic.
Anyhow, even for each normative position, there can be various aspects of the case to be arguing from, so neither side will be monolithic in its arguments even if they used both the same meta-ethical position and Normative ethical position.
My point was: each camp uses one meta-ethical position (naturalism or non-naturalism), but at least two normative ethical positions (deontology/Divine Command Theory and Utilitarianism). So I endorse a more pluriform set-up than you do.
In my view, neither the proponents or the opponents are monolithic.
Anyhow, the degree of monolithism or pluriformity does not determine the relative merits of each side’s case, so it is irrelevant to the debate.
(6) Yes, I agree. But I would ask two questions, which I feel that the pro-camp has not answered adequately. Firstly, is there really such a thing as a fully intractable situation, irresolvable by natural means? Secondly, if there was such an intractable situation, is it not better to prevent it from occurring, then to seek a cure for it through euthanasia (which isn’t so much a cure, as an involuntary – at point of service – termination)? Is not prevention better than cure?
Usually, if people are struggling to live, they want to live for some reason. So perhaps, the better solution – one with less moral controversy – would be to resolve this “unfinished business” and let the struggle (and pain) stop. But wait … isn’t that the Palliative Care Argument on the anti-side, or the core of it anyway?
(7) Physical circumstances. Because the emotional circumstances are the same for all suicides : trauma before and during the act. Unfortunately, the pro-camp would shoot themselves in the foot socially if they tried to argue that allowing a person to experience trauma could be morally justified under specific circumstances.
Each successive pseudonym chosen for euthanasia shows an attempt to try and cut out the trauma from the equation. There is not trauma in “mercy killing”, because of the “mercy”; there is no trauma in “Physician-Assisted Suicide” because of the physician; there is no trauma in “Living Wills” because it is after all a Will; and so on and so forth. The focus of the definition has shifted from the act (“killing”) to the person doing the act (“physician”) to the approval of the act (“Will”). This is over and above any arguments made in support of the act itself. This shift in definition is what I am identifying as a shifting-of-the-goalposts fallacy.
Regardless of the internal debates amongst the various proponents over details, this is the external face they present to the public when they argue against opponents.
(7-9) I too believe that there is a middle ground on these debates, but one tilted over to the anti-side. Abortion is more complex, because there are two individuals involved: the mother and the baby. In Euthanasia, there is only one patient involved.
(10) I wouldn’t be so dumb as to do what you accuse me of doing. I am saying that when the pro-camp says that “yep, we agree that safeguards must be installed to prevent the possible bads of the policy”, they are acknowledging the existence of “possible bads”. The more the safeguards, the more the possible bads whose existence is being acknowledged, if implicitly. And this is essentially signalling to the opponents: “Yes, we agree that these possible bads exist”. And when you agree with your opponents, you are conceding ground to them. Since the euthanasia debate is an ethical/moral debate, thus the pro-camp is conceding ethical/moral ground to the anti-camp each time a “safeguards” argument is raised.
I am making a deductive claim, not a tautological argument.
(11) So, you are arguing that the debate on the pro-side is “Good-vs-evil” as opposed to “Lesser of Two Evils”?
(12) Even though I am indeed an opponent of euthanasia, this does not make your argument any less of an ad hominem attack.
(13) You mischaracterized my argument. I aimed to point out 2 deficiences in the pro-case:
A. Shifting-The-Goalposts with the definition of Euthanasia.
B. Death by a Thousand Qualifications/Safeguards. (“Everyone is a true Scotsman” Fallacy/ Reverse of “No True Scotsman”)
You equivocated these two separate arguments, and then accused me of copping-out. With the result that you spent more time on red-herrings, like Divine Command Theory, or the “fundamental topic of the euthanasia debate”, which I agree with you on already.
What do call one who likes to use big words to impress when that oneself doesn’t even know the meaning of those big words and that he/she impressed no one but himself/herself?
How long does it take for a deluded to know his/her delusion or incompetence?
Tiring thread.
Arix (@UK),
Divine Command Theory may be internally coherent (or not). Insofar as it is relevant to this debate (i.e. allowing religious doctrine to govern public policy making), it should not factored in. Secularism a red herring? Since we are dealing with a matter of public policy, I’m not sure how you can posit the discussion of secularism as being a tactic of distraction. In a secular society, policy formulation should not consider, much less favour, a philosophical position that postulates a god as a final arbiter. Whose god do we listen to? Which holy book should be subscribed to? Who is allowed to interpret it?
“To put it simply, a person who is happy will not want to die. And if a person is unhappy, should the first thing to do be to kill that person, or to make the person happy again? The pro-camp wants the former; the anti-camp wants the latter.”
And once again you are caricaturising the proponents’ position as one that has no regard for the sanctity of life. That is the same thing that the anti-abortionists are trying to portray of pro-abortionists. Euthanasia proponents respect the sanctity of life, but in different way from opponents – this involves a belief in the idea that life in some situations should not be prolonged to the detriment of the person. What situations this should encompass is open to debate.
I think proponents do ask for good palliative care to be provided. The Oregon approach to euthanasia apparently shows that 45% of people given good palliative care changed their minds about seeking death. The difference between the two positions is not – proponents say let’s kill them, and opponents saying no. The difference is opponents saying “let’s give them the best care we can and never let them kill themselves,” whereas proponents are saying, “let’s give them the best care we can, and if that is still not good enough, and they still want to end their lives, they should be allowed to.”
You argue that proponents must necessarily take a naturalistic definition of suicide, but why so? You seem to base your argument on a caricaturised depiction of proponents’ position on euthanasia.
“The traditionally-accepted emotional aspect of suicide is the despair and hopelessness of the person committing suicide. The anti-camp is trying to emphasize this, while the pro-camp is trying to argue this away.”
I disagree. Rather, both sides would take this same position – i.e. recognise that suicide is driven by despair and hopelessness. The difference between the two sides is what can be done about this condition. Opponents would say that this despair and hopelessness can be ameliorated with good care, counselling and support. Proponents would argue that despair and hopelessness in some cases cannot be ameliorated despite the best possible efforts made by doctors and family, due to the nature of the ailment, the unavailability or inadequacy of treatment etc.
“I am saying that when the pro-camp says that “yep, we agree that safeguards must be installed to prevent the possible bads of the policy”, they are acknowledging the existence of “possible bads”.”
You are proving my point exactly. The only way you can posit the proposal of safeguards as sign of concession of moral ground in favour of the opponents camp is to have an implicit assumption that the opponents’ position is inherently moral.
The reason why there is even this debate over euthanasia is because there is a disagreement over what is the moral thing to do when a terminally-ill patient expresses a desire to die. The proponents of euthanasia will say that banning euthanasia is immoral, and the opponents the reverse. When proponents offer safeguards, they understand the “possible bads” and are trying to mitigate them. But opponents insist there are no “possible bads” in their position, and thus from their perspective, any acknowledge of “possible bads” from the other side is a “victory”. But it isn’t. This is only because the opponents refuse to consider the possibility of their position being immoral, and therefore there is no safeguards to make, nor grounds to concede.
You are not making a deductive claim here. If you were really making a deductive claim, the only things you can logically deduce from the proponents’ offering of safeguards are the follows: a) unmitigated euthanasia is acknowledged by proponents to be less moral/immoral (which in fact is a default position taken by both sides). b) proponents think that the more moral/moral position to take on the issue is to allow euthanasia with safeguards, and that they consider the opponents’ position is less moral/immoral.
The moment you extend this to a claim that the opponents’ position is more moral than the proponents one is the moment of fallacy. You are making an unqualified normative judgement from a positive statement. It is not a logical consequence of the fact that proponents proposing safeguards that the anti-euthanasia position is more moral. The proponent’s position is not that of unmitigated euthanasia – i.e. it is not a zero-sum game, and the proponents are not actually conceding anything.
For them to be conceding, their starting point would have to be that of unmitigated euthanasia. But what they are really saying euthanasia with safeguards is more moral than banning euthanasia completely – that is their starting position.
You can disagree whether the euthanasia with safeguards is actually moral or not – if you engage the proponents on this point, then they will have to defend their position. Just as you have to argue your position that a ban on euthanasia is more moral/or the only moral position.
You seem to characterise safeguards as some kind of external add-on to a proponents’ position, but that is not the case. Safeguards are integral to the proponents’ position.
So, you are arguing that the debate on the pro-side is “Good-vs-evil” as opposed to “Lesser of Two Evils”?
It could be both. Depends on who is framing it and how.
The opponents side is probably more likely to make use of the “good v evil” spectrum – in fact it is probably by default that they would use that rhetoric, since their position is defined as “good” and without any moral deficiency.
You mischaracterized my argument. I aimed to point out 2 deficiences in the pro-case:
A. Shifting-The-Goalposts with the definition of Euthanasia.
B. Death by a Thousand Qualifications/Safeguards. (“Everyone is a true Scotsman” Fallacy/ Reverse of “No True Scotsman”)
A) Euthanasia is actually clearly-defined. I think what you mean is “shifting-the-goalposts with what proponents consider to be a politically expedient label for their proposals on how euthanasia may be implemented as policy”. In any case, this “shifting the goalposts” bears only a tangential relevance to the debate on the morality of euthanasia. It is more a matter of political point scoring and PR management with the use of semantics than actually a indicator of deficiency in arguments.
B) Your Death-by-a-thousand-qualifications/No True Scotsman fallacy critique is claiming:
- Proponents assert that euthanasia with safeguards is moral.
- Opponents come up with an instance where euthanasia with safeguard A doesn’t work
- Proponents respond with euthanasia with safeguard B
- Opponents come up with an instance where euthanasia with safeguard B doesn’t work
- Repeat the above
- “Euthanasia with safeguards is moral” becomes so eroded by qualifications that it is no longer a valid assertion
But proponents are not claiming something as general as “euthanasia with safeguards is moral”. To be precise, they are claiming either “euthanasia with safeguards can be moral”, or “euthanasia with the appropriate safeguards is moral”. By this reckoning, the qualifications are no longer falsifications of the proponents’ hypothesis, but a process by which to prove their hypothesis. A deliberative process for discovering exactly what safeguards are workable – by eliminating those that do not.
Your critique is a flawed way to proceed with the euthanasia debate, as I’ve explained above. It removes the anti-euthanasia position from the equation – its claim to morality is not examined. What you are doing is claiming a free ride for the anti-euthanasia position. Like I’ve explained – this argument posits the euthanasia debate as a zero-sum game.
If you view the positions taken in the euthanasia debate over a spectrum, for example: [Opponents of any euthanasia --- Proponents of euthanasia with safeguards (which is also a spectrum by itself) --- Proponents of unmitigated euthanasia], then your zero-sum logic cannot be applied. The debate seeks to locate the point along this spectrum which is most moral/the only moral position to take. Falsifying one point on this spectrum doesn’t mean one end is more moral than the other, it only means that one point is deemed less moral than the rest along the spectrum.
In any case, this line of critique rather misses the point. Let me illustrate. If the same argument is applied to the opponents, this is what it might look like:
- Opponents assert that all forms of euthanasia are immoral
- Proponents come up with instance A where denying euthanasia violates moral principles
- Opponents respond by saying those principles are flawed and hence reject the proponents claims
- Proponents come up with instance B where denying euthanasia violates moral principles
- Opponents respond by saying those principles are flawed and hence reject the proponents claims
- Ad infinitum
As this should illustrate, the real battleground is over moral principles itself. Whose version of morality should triumph in the formulation of public policy. I would suggest that the opponents position – being inherently absolute and totalising – is unsuited for application in societies that aspire to be pluralistic. The proponents position is better suited (I would not venture to say ideal, for nothing is) for adoption in a pluralistic society, as it would not preclude adherence to an opponents’ position. People who subscribe to moral principles that inform the opponents position will still be able to stay true to those principles themselves, without preventing people who do not subscribe to those principles from adhering to their own moral compass.
Arix
To put it simply, a person who is happy will not want to die. And if a person is unhappy, should the first thing to do be to kill that person, or to make the person happy again? The pro-camp wants the former; the anti-camp wants the latter.
1. Killing is not the FIRST thing the pro-camp wants to do. They want it as a LAST resort if happiness is impossible. In any case, this is not simply about depression regardless of cause (i.e unhappy because no money doesn’t count). It’s about T E R M I N A L illnesses and un-treatable pain.
2. Anti-camp couldn’t care less about making the person happy, as long as their moral sensibilities are not offended.
Firstly, is there really such a thing as a fully intractable situation, irresolvable by natural means?
What do you mean by ‘situation’? Are you trying to conflate the issue to beyond terminal illnesses?
In any case, AGE (and thus illness due to it) seems to be intractable. Unless of course, you can ‘naturally’ rejuvenate’ their body back to 18 yrs old.
Secondly, if there was such an intractable situation, is it not better to prevent it from occurring, then to seek a cure for it through euthanasia (which isn’t so much a cure, as an involuntary – at point of service – termination)? Is not prevention better than cure?
So.. you claim that there are cures for terminal illnesses (intractable situation)?
If people are suffering from pain (from terminal illnesses) despite under doctor’s care, the doctors are willfully making them suffer as if they get off on it? Why else would they not ‘cure’ the pain then?
For those who are terminally ill but want to end their lives sooner and those who are advocates for it should not push for legalization of Euthanasia or PAS.Instead there is another way to kill yourselves:apply the don’t ask,don’t tell policy.
There are some long-winded people and short-sighted ideas being presented. The trouble is people are looking at an imaginary image of death in their minds. Make no mistake, dying people do not need to KILL themselves, they need to DIE.
When someone who is dying receives assistance from a physician, that dying person is Not killing himself, he is not SUICIDING ! He is dying, he is receiving help with the DYING PROCESS.
Don’t ask, don’t tell? Boy you must be young! Why should any government force a dying person to go out into the garage to put a shotgun barrel in their mouth so they can blow their head off – just because they happen to be dying of an intractable terminal condition.
Is that how you want your mother to die????
Dear Carol loving,
Honestly,if my mother chooses to kill herself sooner, I would rather see my mother using a shot gun or swallowing a bottle of sleeping pills .Why should anyone demands to enact a particular law to suit your wish to commit suicide.I believe that the body belongs to my mother and she has the rights to do anything to it without any government intervention.Let her be judged in the after life..Remember that feminist slogan ‘Mr body my rights and nobody business’?
Carol (31 Mar post),
(1) Errr … but the doctor has influence on the patient in all cases. There is no case where the patient is fully independent of the doctor, not even in the decision for PAS.
(2) Sad to hear that indeed, but perhaps – to be more objective – the “medical tyranny” your son experienced was because somehow or the other, you (or the hospital) failed to provide the requisite level of emotional support for him. Might not be your fault at all; I would think that most Western and Westernized countries have lost that ability, after becoming over dependent on industrialized childcare services.
(3) I know of a “right to life”. “Right to death” sounds a bit twisted, though.
Carol (3 April post),
(1) Indeed. And when people feel ready to die, they will. So if they are struggling on trying to live, there is something emotionally amiss which needs to be dealt with.
An artificial death is simply evading what ought to be done.
(2) LOL, there is technically no such thing as a “dying process”; you are either alive or dead. When you are “dying”, you are still alive. When you are dead … you are dead.
(3) And what is the difference between that and a legal injection or a deliberate drug overdose? All are used as forms of capital punishment.
lobo76,
(1) Honestly, do you think that is how Dignitas works? (Recall my earlier example of the French woman) “last resort” doesn’t mean “after the doctor has tried everything”; it means “when the doctor decides that nothing else should be done”. Or when the patient decides that himself/herself.
(2) That is an extremely-prejudiced view of the anti-camp. There are many people in the anti-camp also who have had relatives and close friends die of terminal illness. If you remember the Terri Schiavo case in the USA, the conflict was not between relatives and strangers. It was between two groups of relatives.
As I said before, my grandfather died of terminal bone marrow cancer.
(3-5) A TERMINAL illness is physically intractable; I am not as stupid to deny that. What I am contending is whether the pain can ever reach an absolutely intractable stage, especially EMOTIONAL pain. Once the person has let go of all the emotional pain, the person will just die naturally, since there is nothing need be left to fight for.
(6) Doctors are not the only people caring for the patient; although they are the only one who make the medical prescriptions.
Arix (@UK),
“What I am contending is whether the pain can ever reach an absolutely intractable stage, especially EMOTIONAL pain.”
How do you propose to know that it can’t?
Spiegel,
Your counter-argument is an Argument from Ignorance, but I’ll answer it anw.
“Intractable” implies “irreversible” and “excessive”.
For physical pain, there is always painkillers which can reduce any kind of pain, although they may not remove the pain completely. They can thus “reverse” some of the pain, removing the “Excess”.
For emotional pain, there is depression medication and counselling which can be applied at any time during the period. The point will be to grant the patient the chance to express this pain, so that he/she can let go. No matter how difficult, there is always a way to get through to the person, if you are willing. So emotional pain is certainly “reversible”. Given a consistent and constant degree of heartfelt dialogue (which admittedly is hard for many people today), the pain would not reach the “excessive” level. If it does, we need to sack the counsellor.
Arix (@UK),
“Your counter-argument is an Argument from Ignorance, but I’ll answer it anw.”
It wasn’t a counter-argument. It was a genuine question. Because I don’t think it’s possible to empirically test such a claim.
“For emotional pain, there is depression medication and counselling which can be applied at any time during the period…No matter how difficult, there is always a way to get through to the person, if you are willing.”
This is a untestable claim, founded from a normative position on the issue. How do you empirically test the absolute effectiveness of treatment and counselling? Correct me if I’m wrong, but the point you are making is counselling and treament will always work. If it doesn’t, it’s because we haven’t tried hard enough. Does that sound familiar to you? It’s the No True Scotsman fallacy.
Incidentally, I note that you have declined to answer my earlier response to your arguments.
Spiegel,
(1) Okay, point taken.
(2) You can analytically test it, at least. No, I am saying that there is always a method of counselling that will work in each situation, not that every method of counselling will always work. The latter is a No True Scotsman Fallacy, as you rightly point out; the former isn’t.
My argument is that “there is always a way to get through to the person”, not that “all ways are equally effective in getting through to the person”.
(3) I have been having technical problems with TOC. But I am going to answer your post in a while.
Happy Easter!
Arix (@UK),
“You can analytically test it, at least.”
How do you do that?
“No, I am saying that there is always a method of counselling that will work in each situation, not that every method of counselling will always work. The latter is a No True Scotsman Fallacy, as you rightly point out; the former isn’t. My argument is that “there is always a way to get through to the person”, not that “all ways are equally effective in getting through to the person”.”
This doesn’t deal with the problem still. How do you know if you can definitely find a way to deal with any kind of emotional pain. To say that “there will always be a way to get through to the person” is the same as saying “treatment will always work, as long as you find the right one”.
Claiming this means – if a patient fails to respond a treatment A, try treatment B, and so on, because eventually we will find a treatment that works. If you haven’t found an effective treatment, you haven’t tried hard enough to find it, because the assertion is it is always possible to find one.
This claim is self-perpetuating, and in this form cannot be tested or falsified. Even if all known treatment is exhausted, such a claim can still be made, and no one can falsify it – there is always something else you haven’t tried yet. But there is no way of knowing that the untried treatment will work or not. A workable treatment may eventually be found, or it may never be found – there’s no way of knowing.
In essence, your argument is a universal claim that by its nature cannot be tested.
In terms of how it applies in practice – it doesn’t really illuminate anything. Both sides will still argue you should try everything in your power and knowledge to treat and ameliorate the patient’s pain. The difference between the two positions still resides at the point where treatment is exhausted – what do you do next?
Proponents say there is the last and least desirable option, and it should be allowed. You are saying there is no need to take the last option, because effective treatment is always possible.
Spiegel (1 Apr post)(part 1),
(1) There are religious consciences and non-religious consciences. I don’t see why the latter should be privileged over the former in the public square. Undemocratic, much?
(2) Honestly, I spent a paragraph describing Divine Command Theory, and you are still giving me the “inconsistent holy books” argument? Second-Order DCT has nothing to do with specific holy books.
(3) I am not caricaturising anybody; you have chosen to throw in a term that I did not mention at all. Your accusation of me is only valid provided that the assumption that I am using a non-naturalistic definition of “killing” is true. But I am using the naturalistic definition, so your accusation is off-the-mark.
Incidentally, you have been caricaturising the anti-camp all along. You have been caricaturising this debate as a debate between the “Enlightened” pro-camp and the “Moralistic” (“barbaric”) anti-camp. Perhaps, you didn’t realize that most members of the anti-camp – including yours truly – have come to our positions after considering the state of our healthcare system. Or perhaps you neglected to note that many such people also have had relatives who died of terminal illnesses?
A slippery slope argument is not a good argument, though not always invalid. An ad hominem is an equally bad argument, but always invalid.
Spiegel (1 Apr post) (part 2),
(4) I went to your link, but don’t remember seeing that figure. Anyhow, that isn’t the way the debate seems to be portrayed, at least in the media. It seems to be more like:-
Pro-camp: Care includes letting the person kill himself/herself.
Anti-camp: Care does not include letting the person kill himself/herself.
Even on this thread, we have Carol who is expressing what I have just described as the Pro-camp’s view.
(5) You actually proved it yourself, when you replied to my definition of the Pro-Camp’s position and anti-Camp’s position.
Or perhaps, you didn’t get the crux of the matter. The issue with euthanasia is the legitimacy of active intervention to end a person’s life.
Outside the hospital, if Kate asked Bob to slit her wrist with a kitchen knife, and Bob did so, Bob would be charged with third-degree murder, or at least manslaughter. That is regardless of whether Kate volunteered for the slitting. The other term for this is “Assisted Suicide”.
The same thing for doctors who over-prescribe medicines.
But now, the pro-euthanists are arguing that this kind of action is valid in certain circumstances. If they argued using the traditional “loaded” (non-naturalistic) version, their argument is self-contradictory. So therefore, they reduce the meaning to the “unloaded” (naturalistic) version, so that they have some ground to make an argument.
(6) You seem confused. In case you forgot, we are talking about “Physician-Assisted Suicide”. There is an ethical problem with suicide itself, but that is not the main concern of the debate. To put it crudely, using the analogy in the previous paragraph, The issue is not whether Kate should be permitted to stab herself with a knife in an “intractable” condition. It is whether Dr Bob should be allowed to provide the knife to Kate when she asks for it (or in some cases, stab her himself).
The pro-camp makes the a priori assumption that Assisted Suicide is acceptable in some cases, and proceeds to argue who should be permitted to assist.
The anti-camp challenges the notion that Assisted Suicide can ever be justified, and attempts to shift the focus back onto “assisted”.
Spiegel (1 Apr post) (part 3),
(7-10) You misread my argument. The morality of the proponents’ argument is an a postieri logical result of the situation, not an a priori assumption before the argument. I have no such fallacy in my argument. To present it in logical form:-
[P1] If the situation is a debate, the type of grounds in the debate is the type of the topic of the debate.
[P2] The type of topic of the euthanasia debate is morality.
[C1] Therefore, the type of grounds in the euthanasia debate is moral grounds.
[P1] [C1]
[P2] The proponents of the Euthanasia debate cede grounds to the opponents whenever they invoke safeguards.
[C2] Thus, the proponents of the Euthanasia debate cede moral grounds to the opponents during the debate.
The type of topic is a positive/ descriptive element, not a normative element. Incidentally, ceding ground is a negative action, not a positive action; so perhaps it changes the absolute morality of the pro-position; but not necessarily the relative morality.
(11) Apart from caricaturising the anti-camp (yet again), you have failed to answer my question.
I asked you how the pro-side would characterise it, not how the anti-side would characterise it. (You are guilty of outgroup homogenity bias.)
(12) In logic, there is meaning and implicature. In political point-scoring, you alter the implicature (shifting the goal-posts) even if you don’t alter the meaning, so the “live” definition changes. And since this is a public-square debate and not an academic debate, such tactics have an effect on which argument the public <i>feels</i> to be more convincing.
(13) Your two statements have different meanings, and the second presumes the first. In other words, by restricting the debate to what constitutes “appropriate” safeguards, the proponents are begging the question of whether there is something inherently wrong with the act of Euthanasia itself. And they protect themselves – like you do – with a poisoning-the-well fallacy, by dismissing their opponents as “moralistic”.
(14) Of course I miss out the opponent’s position. My purpose so far is to critique the proposition’s position, not to compare the opponent’s position with the proposition’s position. My point here is to argue about the flaws that exist in the proposition’s argument even before the opposition is considered.
(15) *Sigh* This debate is a public policy debate, so whatever action will be taken will be “totalising” because it will be enforced by the government. The proponent’s position is no less totalising than the opponent’s. The opponent’s is “totalising” on the patient; the proponent’s is “totalising” on the doctor.
Besides, you are implicitly equivocating “pluralistic”. There are many ways to be pluralistic; pluralism in morality is only one of them. At any rate, if we adopted absolute pluralism in morality, then law ceases to have any function, because it can no longer set a “right” or “wrong”.
Let me give you a situation:-
Kate, the proponent, subscribes to the proponent’s position. Bob, her doctor, subscribes to the opponent’s position. In that case, who should prevail in your “pluralistic” society? One of their “moral compass” necessarily has to be sacrificed, or else there will be gridlock.
Spiegel (5 Apr post),
Because the patient is reaching out to you/carers for comfort. The patient is not setting up a barrier; the patient is trying to break down the barrier. Understanding the source of the pain isn’t important; what is important is allowing it to be spent.
Stop thinking of “treatment” in the medical sense; I am not calling for a psychoanalysis of the patient. All I am saying is let the patient express all that pain and then let go.
As I told you earlier, “treatment” in my sense is not about “curing” it; it is about at most reducing it.
So My Argument is:-
If A tells you A wants to die, ask A why he/she wants to die. Let A spew everything out, then tell A to let everything go, and die. Simple. No medication; no legal tussle; no complicated moral dilemma over suicide. problem solved.
Do this instead of:-
If A tells you A wants to die, say, Great! Now I just need to find that doctor with the lethal injection!
As simple as pie. Or Easter cake.
Fred, we all have the right to die with the help of a physician because it is a physician’s duty to assist his patient. The long arm of the law is the problem and that long arm is attached to religious fanatics and politicians who sold their souls for power.
What we have today is medical tyranny, and our forefathers said this would happen if we did not put medical freedom in the constitution.
Dr. Kevorkian helped my son dying from Lou Gehrig’s syndrome, thank god! his twin brother never received a gram of compassion on his death bed.
The LAW has no business in DEATH when DEATH is inevitable. And, doctors need to reexamine their role in medicine, stop acting blindly at the end of a puppet string.
Good Death for All! carol
I think you people are expressing yourselves like children over an issue that is beyond your ability to comprehend.
One of you laughed at the idea of the “dying process” & that makes me think all of you need to go through RN nursing school and work a few years on the floor!
Boy, would you all be singing another tune.
good bye, hope you have a good death when your time comes OR you can cling to your ego projected “arguments” and suffer like you never believed possible.
Arix (@UK),
“There are religious consciences and non-religious consciences. I don’t see why the latter should be privileged over the former in the public square. Undemocratic, much?”
This is not about privileging. It’s about taking the position that allows plurality. It’s as simple as that. Au contraire, it is the fundamental basis for a pluralistic democracy. Separation of Church and State – simple principle.
“Honestly, I spent a paragraph describing Divine Command Theory, and you are still giving me the “inconsistent holy books” argument? Second-Order DCT has nothing to do with specific holy books.”
Now then, explain how DCT will come into play in the euthanasia debate – i.e. how it becomes relevant. If it does not involve the interpretation of any religious text, and therefore no such practical interpretive issues, I will concede.
“You have been caricaturising this debate as a debate between the “Enlightened” pro-camp and the “Moralistic” (“barbaric”) anti-camp.”
I have no idea where you detect ad hominem attacks – perhaps from what you perceive to be misrepresentations of your arguments. In any case, that is not my intention. But it is very gracious of you to return fire with what you seem to define as ad hominem attacks.
Just because I say you are taking a flawed position that caricaturises the pro-camp doesn’t mean I’m saying everyone opponent is. Reading too much, no? Unless you reckon to be representative of everyone on your side?
Arix (@UK),
” I went to your link, but don’t remember seeing that figure. Anyhow, that isn’t the way the debate seems to be portrayed, at least in the media. It seems to be more like:- Pro-camp: Care includes letting the person kill himself/herself.
Anti-camp: Care does not include letting the person kill himself/herself.”
http://www.bbc.co.uk/ethics/euthanasia/infavour/infavour_1.shtml
Under Oregon Approach – “One survey showed that 45% of patients who were given good palliative care changed their mind about euthanasia.”
That is exactly the position I was explaining wasn’t it? Not sure what the issue is here, unless you consider “care including the right to choose death” meaning that you can choose it right off the bat. But I don’t think that’s where the euthanasia debate is headed, and that’s certainly not how it’s done in places where it is legal.
“But now, the pro-euthanists are arguing that this kind of action is valid in certain circumstances. If they argued using the traditional “loaded” (non-naturalistic) version, their argument is self-contradictory. So therefore, they reduce the meaning to the “unloaded” (naturalistic) version, so that they have some ground to make an argument.”
This point is still not very clear. Can you explain why a non-naturalistic definition cannot be used? How is it contradictory?
“The pro-camp makes the a priori assumption that Assisted Suicide is acceptable in some cases, and proceeds to argue who should be permitted to assist. The anti-camp challenges the notion that Assisted Suicide can ever be justified, and attempts to shift the focus back onto “assisted”.“
How is it the case that the anti-camp does not make a similar a priori assumption in the reverse? I.e. under no circumstances is it justified to commit suicide or take someone else’s life?
Arix (@UK),
“[P2] The proponents of the Euthanasia debate cede grounds to the opponents whenever they invoke safeguards.
[C2] Thus, the proponents of the Euthanasia debate cede moral grounds to the opponents during the debate.”
You have not dealt with my points at all. Your argument has an a priori assumption built into it – that the euthanasia proponents start from a polar opposite position where unfettered euthanasia is their starting point.
How is saying safeguards are necessary a concession of moral ground in a debate?
Let me put it to you in another way. When I say we in the following, I mean it in a general way representative of most of society as a whole.
We agree that killing another person is bad, but not necessarily immoral or morally unacceptable. We as a society differentiate between the different types of killing.
Homicide, or killing another person with the intention of doing so, is bad, but under specific circumstances we accept it as a moral thing to do.
Murder – which is a form of homicide – is universally condemned.
But we accept and allow our police officers and soldiers to commit homicide under the right circumstances – justifiable homicide. What are the right circumstances? Usually instances where it is necessary to save and preserve life and property. How do we make sure our police officers and soldiers only kill when these circumstances are in place – and therefore ensure that their killing is morally acceptable, perhaps even the moral thing to do? We introduce safeguards – good training, rules of engagement, legal guidelines, punishment to deter and stop abuse, etc. But no one makes an argument to say, look at all these guidelines and safeguards, they are conceding moral ground. Of course not, there is no moral ground to concede – homicide is already regarded as a usually bad thing, and in most circumstances, immoral.
No one disputes that wanton euthanasia is bad. This is an accepted position – there is no moral ground to concede. When proponents come in to say, we think in some circumstances euthanasia is morally acceptable, perhaps even the moral thing to do, the next logical steps would be to define those circumstances. Then the next would be to introduce safeguards to minimise straying from those circumstances.
Now, if you can explain how is the introduction of safeguards a concession of moral grounds, unless you frame it in a zero-sum style debate between two polar opposites?
“In other words, by restricting the debate to what constitutes “appropriate” safeguards, the proponents are begging the question of whether there is something inherently wrong with the act of Euthanasia itself.”
As I’ve illustrated above, the inherent problems are accepted. Just as they are in homicide. Safeguards are not moral concessions – they are the practical manifestations of moral boundaries.
Arix (@UK),
“The proponent’s position is no less totalising than the opponent’s. The opponent’s is “totalising” on the patient; the proponent’s is “totalising” on the doctor.”
Your argument is that the totalising comes from the legal coverage. What I’m saying is that the law banning euthanasia perpetuates the “totalising” quality of beliefs of opponents of euthanasia.
If euthanasia is legalised, this contrarian belief system is not able to impose itself on the patient because there is choice afforded to him or her now. But those who still adhere to the idea that suicide and euthanasia is wrong, they can choose not to die by a human hand and live out their lives however they wished.
As for physicians, granted the issues are far more complex. Doctors ought not to be able to deny the patients a legal decision they want to make for themselves, and then issues of how that affects their professional judgement etc would arise. But fundamentally, if euthanasia was allowed physicians still have a choice which they can exercise. They are not obliged to work palliative care for terminally-ill patients.
Where there is a ban, choice is denied to some people. Where there isn’t, choice is freely available. How is this a problem?
“Besides, you are implicitly equivocating “pluralistic”. There are many ways to be pluralistic; pluralism in morality is only one of them. At any rate, if we adopted absolute pluralism in morality, then law ceases to have any function, because it can no longer set a “right” or “wrong”.”
But we do live in a society that practices “plurality in morality”. For example, we have Syariah courts for Muslims. It doesn’t triumph the law of the land, but it is still an alternative legal system catering to a group of people whose beliefs may not necessarily align those of others in the same society.
And we are not dealing with extreme plurality or absolute relativism here. The point of a workable plurality is to find the point where it is most satisfactory to all in the society – a common denominator where no one’s moral sensibilities are restricted.
Let me give you a situation:-
Kate, the proponent, subscribes to the proponent’s position. Bob, her doctor, subscribes to the opponent’s position. In that case, who should prevail in your “pluralistic” society? One of their “moral compass” necessarily has to be sacrificed, or else there will be gridlock.”
This may in fact be the ideal situation, in theory, for the patient. The doctor who subscribes to an opponent’s position will want to provide the best possible palliative care, and remove the emotional pain. The patient thus gets his or her best shot at ameliorating the pain. If that fails, and all treatment is exhausted – and in theory, you’d think they would indeed by exhausted by a doctor who would refuse to let the patient kill him or herself – it would come down to choice between either moral belief system.
We come to a problem that is often encountered in the abortion debate, and is described as pro-life and pro-choice (although this dichotomy is misleading as it suggests that pro-choice people have a less than favourable attitude towards life).
We return to principle of plurality. Banning euthanasia necessarily means the patient is denied choice. Legalising euthanasia does not necessarily mean the physician is denied choice – and in fact – it also allows him or her choice. He or she can choose to follow his or her moral compass – if they don’t want to be in a position where they may have to administer euthanasia, then don’t put themselves in one.
Arix (@UK),
“If A tells you A wants to die, ask A why he/she wants to die. Let A spew everything out, then tell A to let everything go, and die. Simple. No medication; no legal tussle; no complicated moral dilemma over suicide. problem solved.”
This is a gross simplification of the conditions of terminal illnesses. If this is exactly your argument, you are being irresponsibly reductionist.
Carol,
I am trying to be nice here. I believe “helping a patient to die” is not a part of the Hippocratic oath which all doctors are supposed to sign up to, law or no-law?
And yes, I admit that “dying process” is a colloquialism that we often use, but it is not a technically conceptually-accurate term.
Honestly, I have a question to ask you: Why did you have to rely on Dr Lou? Whatever Dr Lou did, couldn’t you do it yourself. So who is doing “ego projection” here? (Incidentally. do you even know the technical meaning of “ego projection”?)
And what are you doing, vindictively cursing everybody who disagrees with you. Which incidentally is an Ad Bacculum Fallacy.
Man Lady, I think you need to go for some serious grief counselling.
Arix (@UK),
In the midst of your condescension, you might have missed the fact that she mentioned a Dr Kevorkian helping her son with his Lou Gehrig’s disease – which is a motor neurone disease.