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Euthanasia and End-of-Life Decisions
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Multimedia Resources on Euthanasia
- Lawrence M. Hinman
-
Euthanasia: The Basic Distinctions - RealVideo/PowerPoint combined
University of San Diego June, 2003
- "Ethical Issues in End-of-Life Decisions: A Guide to Understanding Differences."
- Euthanasia
"The
Slippery Slope Argument in Euthanasia" - Flash presentation.
- Rita Marker, J.D.
Thomas Beauchamp Ph.D.
- Larry Schneiderman, M.D.
Sue Rubin, Ph.D.
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.
Court Decisions
-
Cruzan v. Director, Missouri Department of Health
(Date Argued: December
6, 1989; Date Decided: June 25, 1990, 5-4)
- US Ninth Circuit Court of Appeals. Compassion
in Dying v. State of Washington. 1995. Opinion by Judge John Noonan.
- Compassion in Dying v. State of Washington, 1996.
- Quill v. Vacco. Second Circuit
Court of Appeals. Argued: September 1, 1995 Decided: April 2, 1996
- Appeal of Compassion in Dying v. State of
Washington and Quill v. Vacco to Supreme Court
- Quill v. Vacco. Supreme Court Decision.
- WASHINGTON et al. v. GLUCKSBERG et al.
-
Assisted Suicide. Philosophers Brief: The Brief by Ronald Dworkin, Thomas Nagel, Robert
Nozick, John Rawls, Thomas Scanlon, and Judith Jarvis Thomson.
- Join a discussion of "Assisted Suicide: The Brief by Dworkin
et al.," in Ethics Forums.
- Read an exchange between Ronald Dworkin and Michael McConnell
in Slate's Dispatches
and Dialogues on the Brief by Dworkin et al.
- J. Bottum, "Debriefing
the Philosophers," First Things, June/July
1997, 26-30.
- Amicus Brief before
the Supreme Court filed by the Project on Death in America, Open Society
Institute.
- Amicus Brief by
Bioethics Professors George Annas et al.
- Amicus Brief of
Not Dead Yet and American Disabled
- Amicus Brief of ACLU
et al.
- Amicus Brief
of National
Hospice Organization
- Reactions to the Supreme 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
- Resources on End-of-Life
Issues from the MacLean Center for Clinical Medical Ethics.
- Euthanasia.com.
Information on euthanasia, right-to-die, mercy killing, living wills, etc.
"On this Web site we will provide information on the issue of euthanasia
in the modern world. We are committed to the fundamental belief that the direct
killing of another person is wrong. We have deep sympathy for those people
who are suffering."
- Compassion in Dying. Website
of the organization that "brought two landmark legal challenges to achieve
Constitutional protection for personal liberty and dignity at the end of life."
Includes extensive links to materials on both the Washington case and the
Quill case.
- CURE -- Citizens
United Resisting Euthanasia a grassroots advocacy network that defends
the rights of patients to receive medical treatment, particularly when care
is critical.
- ERGO! Information Center,
The Euthanasia Research and Guidance Organization maintains a site with extensive
bibliography, court decisions, and links.
- ERGO!'s Euthanasia World Directory
includes links, bibliography, and extensive coverage of recent news articles.
- The Ohio Right to Life Page
on Euthanasia
- "Euthanasia: The
Debate Continues", a philosophical debate between Bob Lane and Richard
Dunstan on the morality of euthanasia
- Scottish Voluntary Euthanasia
Society Homepage. Voluntary Euthanasia Society of Scotland. Excellent
set of resources.
- The WEBster: Death and Dying.
An extensive list of resources related to death, dying, and grief.
- Death in American Reader.
This is a regularly-updated listing of new articles dealing with end-of-life
decisions.
Search the Web for information on Euthanasia
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.
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
- Living
High & Letting Die
- Peter
Unger The on-line version of this excellent book contains five of the
seven chapters of the print version. One of the most valuable on-line resources on this issue.
- "A
Right to Choose Death? A
moral argument for the permissibility of euthanasia and physician-assisted
suicide"
- Frances M. Kamm, The Boston Review, Summer, 1997.'
- "Internet
Encyclopedia of Philosophy: Euthanasia"
- "Dying
at the Right Time: Reflections on Assisted and Unassisted Suicide"
- John Hardwig - from LaFollette, H., ed. Ethics in Practice (Blackwell, September 1996).
- "Is
There a Duty to Die?"
- John Hardwig - Originally published in Hastings Center
Report
- "Against
the Sanctity of Life"
- "Beyond
the Call of Duty. A Daughter Reflects on the Meaning of Her Mother's Suicide."
- Vivian Rothstein,
The Boston Review, Summer, 1997.
- "Voluntary
Euthanasia,"
- "Active
Voluntary Euthanasia."
-
"Euthanasia: The Debate Continues."
- Bob Lane and Richard Dunstan - Full text available for
downloading.
- "Euthanasia
and assisted suicide in persons with Acquired Immunodeficiency Syndrome or
Human Immunodeficiency Virus,"
- Russel Ogden, Simon Fraser University, Masters
Thesis 1994
- Reporter Douglas Todd of the Vancouver Sun, had to spend several
weeks convincing Russel Ogden that his master's thesis about 29 people
who had helped loved ones with AIDS kill themselves should be publicized.
When Todd's story was finally published, the timing proved to be remarkably
coincidental - the story ran the same day Sue Rodriguez of Victoria died
in an assisted suicide.
Ogden, a Simon Fraser University criminology student, was called before
Vancouver coroner Larry Campbell but refused to reveal his sources; he
was eventually cleared of any wrongdoing. "A fascinating glimpse
into the AIDS underworld," said the judges.
- "
A Christian Response to Euthanasia,"
- Dr. H. Robert C. Pankratz and Dr. Richard M. Welsh, U-Turn.
A Bibliographical Survey of Selected Philosophical Literature on Euthanasia
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
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