Euthanasia and End-of-Life Decisions
August 26, 2013
PowerPoint Presentations on Euthanasia
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. New York Review of Books.
March 27, 1997.
Reactions to the Supreme Court decisions
The Oregon Death with
The State of Washington Death with Dignity website
State-by-State Guide to Physician-Assisted Euthanasia Laws
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
Web Sites Relating to Euthanasia
- ProCon site on Euthanasia. An excellent starting point
- Resources on End-of-Life
Issues from the MacLean Center for Clinical Medical Ethics.
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."
- Patients Rights Council . A rich set of resources. The site features speakers who are generally strongly opposed to assisted suicide.
- 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
- CURE -- Citizens
United Resisting Euthanasia a grassroots advocacy network that defends
the rights of patients to receive medical treatment, particularly when care
- 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
- "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
Selected On-Line Full Text Articles Relating to Euthanasia and End-of-Life Decisions
Right to Choose Death? A
moral argument for the permissibility of euthanasia and physician-assisted
- Frances M. Kamm, The Boston Review, Summer, 1997.'
- "A Right to Self-Termination?"
- David Velleman, University of Michigan
at the Right Time: Reflections on Assisted and Unassisted Suicide"
- John Hardwig - from LaFollette, H., ed. Ethics in Practice (Blackwell, September 1996).
There a Duty to Die?"
- John Hardwig - Originally published in Hastings Center
the Sanctity of Life"
the Call of Duty. A Daughter Reflects on the Meaning of Her Mother's Suicide."
- Vivian Rothstein,
The Boston Review, Summer, 1997.
- Joan Didion, "The Case of Terri Schiavo." New York Review of Books (June, 2009).
A Bibliographical Survey of Selected Philosophical Literature on Euthanasia
Biliographical essays are drawn
from Lawrence M. Hinman, Contemporary Moral Issues,
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.
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.
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),
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.
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,
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,
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.
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