Ethics Updates

 



Euthanasia and End-of-Life Decisions


Multimedia Resources on Euthanasia





Online Surveys



Internet Resources on Euthanasia

The Web offers extensive resources on euthanasia, including court decisions, legislation, basic documents, statistical information, web sites dedicated to euthanasia issues, and a set of resources on the dying rooms in Chinese orphanages. Icon of Surpeme Court

Court Decisions

Legislative Information

The Oregon Death with Dignity Act

California proposed legislation: California Compassionate Choice Act

Search Thomas, the legislative search engine of Congress. - recent and current (including pending) legislation on abortion (including late term abortions),

Other Basic Documents Relating to Euthanasia

Statistical Information

  • What do Americans think about euthanasia? Click here to read a very interesting longitudinal study by Michael C. Kearl of Trinity Univesity.

Web Sites Relating to Euthanasia





Search the Web for information on Euthanasia

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NPR's "Talk of the Nation"

Hour Two: Kevorkian Guilty.   Date:  March 29, 1999.  Host:  Lynn Neary.  Guests: Don Gonyea, 
NPR Correspondent who's been covering the Kevorkian Trial; Jay Kantor, Medical Ethicist, New York University Medical Center, Author, Medical Ethics for Physicians in Training (Plenum,1989); Faye Girsh, Executive Director, National Hemlock Society (Denver, CO); Diane Coleman, President and Founder, Not Dead Yet, Executive Director, Progress Center for Independent Living.  Description:  On March 29, 1999, Dr. Jack Kevorkian was found guilty of second-degree murder for ending the life of a terminally ill man. The case was brought to trial after a videotape of the death was broadcast on network television. Kevorkian had been charged with first degree murder, but the second-degree conviction could still bring a life sentence. The retired pathologist had previously been acquitted in three assisted-suicide cases, and a fourth case ended in a mistrial. Join guest host Lynn Neary and guests for a look at the Kevorkian verdict and what it portends for assisted suicide and the law. (NPR Description)

Hour One: Suicide .  Date:  December 7, 1999.  Host:  Brooke Gladstone.  Description:  The rate of suicide among young people has tripled in the past half century, and among ten to fourteen year olds, the rate has doubled since 1980. This year, the Surgeon General declared suicide a serious public health threat, and called for much more education and prevention. Join Brooke Gladstone and guests to discuss suicide -- why it's becoming more of a problem, and what can be done to prevent it, on the next Talk of the Nation. (NPR Description)

Death and Dying Series.   Host: Ray Suarez. Guests: Linda Wertheimer, NPR Host, All Things Considered; Patricia Neighmond, NPR Senior Correspondent, covers health policy issues; Howard Berkes, NPR Senior Correspondent (on-leave as a Nieman Fellow at Harvard University).  Description:  Though it's an experience we all share ...talking about the end of life can be difficult. This week on All Things Considered, NPR News began a year-long series exploring death in America. Ray Suarez will be joined by Linda Werthheimer and other NPR reporters working on the project to discuss attitudes about death, grief and care for the dying.

Death around the Globe. Host: Ray Suarez. Guests: Nigel Barley,   Author, Grave Matters: A Lively History of Death Around the World (Henry Holt, 1997), Director, Museum of Mankind for the British Museum Author, The Duke of Puddledock, The Innocent Anthropologist; Barbara Koenig, Executive Director, Stanford University Center for Biomedical Ethics, Medical Anthropologist.  Description: Every culture defines and reacts to death differently: in Nigeria the bereaved laugh and dance for the elderly and in Melanesia, the living step into the shoes of the deceased. Join Ray Suarez for a look at how different cultures experience and interpret death, and how their versions compare to America's Western view.

Our Parents' Keepers .   Host: Ray Suarez. Guests: Donna Cohen, Professor and Chairman, Dept. of Aging & Mental Health, Univ. of South Florida, Co-author, Caring for Your Aging Parents (Tarcher/Putnam, 1995); Joan Gruber, Certified financial planner specializing in the "mature market," Author, Your Money: It's a Family Affair (Odenwald Press, 1996); Lisa Gwyther, Director, Family Support Program, Education director, Joseph & Kathleen Bryan Alzheimer's Disease Research Center at Duke University.  Description: They took care of YOU for about 18 years -- now the tables are turning. Caring for aging parents is becoming a defining life issue for many Americans. In addition to the medical, legal and financial issues, the shift in balance of the parent-child relationship creates an emotional hurdle. Join Ray Suarez and guests for a look at the complex issues adult-children face when we become our parents' keepers...on the next Talk of the Nation, from NPR News.

Physician-Assisted Suicide Debate . Host: Ray Suarez. Guests: Dr. Ira Bylock, Director, Robert Wood Johnson Foundation National Program to improve end of life care, Director, Palliative Care Service, Missoula, Montana, Research Professor, Dept of Philosophy, University of Montana; Professor Margaret Battin, Department of Philosophy, University of Utah. Date: March 10, 1997.

Physician-Assisted Suicide . Host: Ray Suarez. Guest: Dr. Herbert Hendin, Author of Seduced by Death: Doctors, Patients, and the Dutch Cure (Norton, 1996) Executive Director of the American Suicide Foundation, Professor of Psychiatry, New York Medical College. Date: January 8, 1997.

Euthanasia . Host: Ray Suarez. Guest: Dr. Stephen Jamison, Author: Final Acts of Love: Families, Friends, and Assisted Dying (San Francisco, CA: Tarcher, 1995). Date: February 21, 1996.

 





Hugh LaFollette's "Ideas and Issues"

RealAudio

  • The Duty to Die
       Interview with John Hardwig, Philosophy Department, East Tennessee State University. April 12, 1998.




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All Things Considered

The End of Life: Explaining Death in America

In conjunction with the All Things Considered series on " The End of Life: Explaining Death in America," NPR has developed a web site devoted to this topic.   It is excellent, with superb graphics (see the home page graphic to the left) and the content to match.  The transcripts of the programs will be available on the site after the programs have been broadcast.  There is also an excellent supporting bibliography and a selection of readings as well as a list of resources relating to end of life issues.  Finally, and perhaps most movingly, there is a discussion forum, entitled "Tell Your Story," which provides an opportunity for individuals to share their experiences relating to the end of life, often for those whom they love.   All in all, this is the Web at its best.

Critique of the Double Effect
Monday, December 11th All Things Considered
NPR's Elizabeth Arnold moderates a discussion between Dr. Timothy Quill, Professor of Medicine and Psychiatry at the University of Rochester School of Medicine and Dentistry, and Dr. Daniel Salmasey, Director of the Center for Clinical Bioethics and Associate Professor of Medicine at the Georgetown University Medical Center.





Statistical Information





On-Line Full Text Articles Relating to Euthanasia





A Bibliographical Survey of Selected Philosophical Literature on Euthanasia Hinman, Ethics: A Pluralistic Approach to Moral Theory

Biliographical essays are drawn from Lawrence M. Hinman, Contemporary Moral Issues, 2nd Edition

Journals

In addition to the standard journals in ethics mentioned in Chapter One, see The Hastings Center Reports, The Journal of Medicine and Philosophy, Bioethics, and The Kennedy Institute of Ethics Journal.

Anthologies

There are several very helpful anthologies that deal with euthanasia. Beneficent Euthanasia, edited by Marvin Kohl (Buffalo: Prometheus Books, 1975) contains a very good range of pieces; Ethical Issues Relating to Life and Death, edited by John Ladd (New York: Oxford University Press, 1979); Euthanasia: The Moral Issues, edited by Robert M. Baird and Stuart E. Rosenbaum (Buffalo: Prometheus Books, 1989) contains a nice balance of philosophical and popular pieces; Euthanasia: Opposing Viewpoints, edited by Carol Wekesser (San Diego: Greenhaven Press, 1995) also contains a good balance of philosophical and popular pieces, all in relatively short segments. Also see, Voluntary Euthanasia, edited by A. B. Downing and Barbara Smoker (London: Peter Owen, 1986), which includes a number of important essays, including an exchange between Yale Kamisar and Glanville Williams; and The Dilemmas of Euthanasia, edited by J. A. Behnke and Sissela Bok (New York, 1975); and Suicide and Euthanasia, edited by Baruch Brody (Dordrecht: Kluwer).. On the distinction between killing and letting die, see Killing and Letting Die, edited by Bonnie Steinbock and Alastair Norcross, 2nd edition (New York: Fordham University Press, 1994), which contains virtually all the major essays on this topic; it also contains an excellent bibliography.

Review Articles

For an excellent survey of the philosophical issues (and a very helpful annotated bibliography), see Marvin Kohl, "Euthanasia," Encyclopedia of Ethics, edited by Lawrence C. Becker and Charlotte B. Becker (New York: Garland, 1992), pp. 335-39.

Journal Articles

The distinction between active and passive euthanasia was seriously question in our selection from James Rachels, "Active and Passive Euthanasia," New England Journal of Medicine, Vol. 292, No. 2 (January 9, 1975), pp. 78-80. Rachels position has been criticized by a number of philosophers, including Tom L. Beauchamp, "A Reply to Rachels on Active and Passive Euthanasia," in Social Ethics, First Edition, edited by Thomas A. Mappes and Jane S. Zembaty (New York: McGraw-Hall, 1977), pp. 67-76; Thomas D. Sullivan, "Active and Passive Euthanasia: An Impertinent Distinction?", in Social Ethics, Fourth Edition, edited by Thomas A. Mappes and Jane S. Zembaty (New York: McGraw-Hall, 1992), pp. 115-21; Rachels' reply to Sullivan in variously reprinted, including in Mappes and Zembaty's Social Ethics, Fourth Edition, pp. 121-31. Also see Bonnie Steinbock, "The Intentional Termination of Life," Ethics in Science and Medicine, Vol. 6, No. 1 (1979), pp. 59-64.

Among the important philosophical essays, see Philippa Foot, "Euthanasia," reprinted in her Virtues and Vices (Berkeley: University of California Press, 1978), pp. 33-61; Judith Jarvis Thomson's "Killing, Letting Die, and the Trolley Problem," and "The Trolley Problem," reprinted in her Rights, Restitution, and Risk, edited by William Parent (Cambridge: Harvard University Press, 1986), pp. 78- 93, 94-116; in "Euthanasia: A Christian View," Philosophic Exchange, Vol. 2, No. 2 (1975), pp. 43-52, R. M. Hare develops a version of the Golden Rule argument against euthanasia.

Books

Among the philosophical books devoted primarily to euthanasia and decisions at the end of life, see especially James Rachels, The End of Life: The Morality of Euthanasia (New York : Oxford University Press, 1986); Fred Feldman, Confrontations with the Reaper: A Philosophical Study of the Nature and Value of Death (New York: Oxford University Press, 1992); Jay F. Rosenberg, Thinking Clearly about Death (Englewood Cliffs, N.J.: Prentice-Hall, 1983); Marvin Kohl, The Morality of Killing: Sanctity of Life, Abortion, and Euthanasia (New York, Humanities Press, 1974); Kenneth L. Vaux, Death Ethics: Religious and Cultural Values in Prolonging and Ending Life (Philadelphia: Trinity Press International, 1992); Daniel Callahan, Setting Limits. Medical Goals in an Aging Society (New York: Simon and Schuster, 1987); and Margaret Battin, The Least Worst Death: Essays in Bioethics on the End of Life (New York: Oxford, 1994).

Among the more popular literature on euthanasia, see Derek Humphrey's Final Exit: the Practicalities of Self-deliverance and Assisted Suicide for the Dying (Eugene, Ore.: Hemlock Society, 1991). Perhaps the most (in)famous public figure in this area is Jack Kevorkian; see Prescription& endashMedicide : the Goodness of Planned Death (Buffalo, N.Y.: Prometheus Books, 1991). For a much more moderate voice, see C. Everett Koop, The Right to Live, the Right to Die (Wheaton, Ill.: Tyndale House Publishers, 1976). In Death and Dignity. Making Choices and Taking Charge (New York: W. W. Norton, 1993), Timothy E. Quill, M.D. argues, at least in part on the basis of his experience as a hospice director, in favor of physician-assisted euthanasia; for an interesting contrast, see Euthanasia Is Not the Answer: A Hospice Physician's View, by David Cundiff. (Totowa, N.J.: Humana Press, 1992)

On the Nazi euthanasia program, see most recently Michael Burleigh's Death and Deliverance (Cambridge: Cambridge University Press, 1994) as well as Robert Jay Lifton's The Nazi Doctors (New York: Basic Books, 1986).

Suicide

There are a number of excellent anthologies of selections dealing solely with the issue of suicide. These include: On Suicide, Introduction by Robert Coles, edited by John Miller (San Francisco: Chronicle Books, 1992); and Essays in Self-Destruction, edited by Edwin S. Shneidman (New York: J. Aronson, 1967). For a more strictly philosophical approach, see the anthologies Suicide, the Philosophical Issues, edited by M. Pabst Battin and David J. Mayo (New York: St. Martin's Press, 1980) and Suicide: Right or Wrong?, edited by John Donnelly (Buffalo: Prometheus Press, 1990) for excellent selections of philosophical works on suicide.

A. Alvarez's The Savage God: A Study of Suicide (New York, Random House, 1972) is a classic study. On the effects of depression, see especially William Styron, Darkness Visible (New York: Random House, 1990).

Among contemporary philosophical approaches to suicide, see the interesting contrast between the Kantian approach of Thomas E. Hill, Jr., "Self-Regarding Suicide: A Modified Kantian View," Autonomy and Self-Respect (Cambridge: Cambridge University Press, 1991), pp. 85-103 and the utilitarian perspective of Richard Brandt, "The Morality and Rationality of Suicide," in his Morality, Utilitarianism, and Rights (Cambridge: Cambridge University Press, 1992), pp. 315-35. For an excellent longer study, see Margaret Pabst Battin, Ethical Issues in Suicide (Englewood Cliffs, N.J.: Prentice-Hall, 1982).





Recent Popular Literature on Euthanasia

"On the Border of Life." - Darcy Frey New York Times Magazine, July 9, 1995, Section 6, pp. 22 ff. This is a very interesting example of what some contemporary moral philosophers have called "thick" moral descriptions. It is an empathetic and insightful account of the decision-making process that occurs when a woman goes into labor during the 23 week of pregnancy at the Brigham and Women's Hospital in Boston. The fetus at this point is on the very edge of viability. Attempts to save it are clearly extraordinary, costly, and fraught with danger. The chances that the infant may be severely compromised are high. This article provides an excellent account of the many factors that come into play in making the decision to attempt to save the infant. The discussion of a number of important moral issues can be generated from this article, including:

  • who should make such decisions about employing extraordinary means to save such infants?
  • what role should costs play in such decisions?
  • to what extent has technology created new moral issues?

"Baby's Death in '92 Still Being Fought," - Frank Bruni New York Times, March 9, 1996 (A-6). This is a very interesting article about an extremely disturbing case where life support equipment for 3 year old Brianne Rideout was turned off against the family's wishes and without a court order. The Rideouts are a strongly Christian, African-American family with comparatively little experience in dealing with medical bureaucracies. Their insurance coverage was also reaching its limit. The case raises a number of unsettling questions about religious freedom, racism, patient advocacy, and financial considerations.

"Man Who Aided Suicide to Go to Prison," - Pam BelluckNew York Times, March 16, 1996. Interesting article about George Delury, who helped his wife kill herself. During the trial, his diary revealed motives that were far from altruistic. He will be sentenced to six months.

"Ruling Sharpens Debate on 'Right to Die." - Tamar Lewin New York Times, March 8, 1996, p. A8. An excellent article about the possible implications of the 9th Circuit Court of Appeals decision affirming the right to die and permitting physician-assisted suicide.

"Mother's Last Request. A Not So Fond Farewell." - B. J. Nelson Harper's (Volume 292, No. 1750) March 1, 1996, pp. 35 ff. An autobiographical account of a son's assistance in his mother's euthanasia.

"Why the Courts Are Dead Wrong." - Stephen L. Carter The New York Times Magazine, July 21, 1996. A strong critique of the claim that there is a constitutionally-based right to die.

"A New Pro-Life Movement in the Making," - Paul Wilkes The New York Times Magazine, July 21, 1996. An interesting and surprisingly sympathetic portrait of a number of those who are opposed to physician-assisted suicide, including Daniel Callahan, Yale Kamisar, Herbert Hendin, and Kathleen Foley.





Suggestions for Discussion Questions and Term Paper Topics

Insurance Companies and Sustaining Life

  • Imagine that you are a vice-president of a major health insurance group. You are asked to develop a policy detailing the point at which your insurance company will cease to support efforts to keep a patient alive. Specify the rationale for your decisions.

Physicians' Special Responsibilities

  • Some who are faced with terminal illnesses turn to physicians for assistance in dying. What special responsibilities do physicians have in this regard? Do they have any special obligation to their own patients simply because they are their own patients? Do they have any special obligations as physicians not to do anything that would end life? Click on the highlighted text for the various versions of the Hippocratic Oath