2012年4月7日 星期六

Killing vs Letting Die, another hypothetical case

I just read something on the internet in which part of the discussion talks about James Rachels' idea on killing and letting die, and one of the example used seems to be less extreme as the inheritance one we learned in class but nevertheless the first case involves letting die and the second case involves killing. So is case (ii) morally worse than case (i)? Will this example make the two less different to you?

Cases 

§     (i) A unconscious patient will almost certainly die unless paced on a respirator. His family explain he has expressed a clear desire not to be placed on one. He is treated according to those wishes and dies.

§     (ii) Case i, but the man is placed on the respirator before his family arrive. After his wishes are explained, he is removed from the respirator and dies.



 Original from:
 http://www.ucs.mun.ca/~alatus/2803-Winter03/Lecture8Euthanasia.htm

5 則留言:

  1. 作者已經移除這則留言。

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  2. Try to view it from the angle of Hospital Authority.

    1. In both cases, they will not be regarded as euthanasia.
    2. Case I is "Withhold Treatment".
    3. Case II is "Withdraw Treatment".
    4. It is ethical and legally acceptable to withhold or withdraw
    life-sustaining treatment.
    5. There are no legal or necessary morally relevant
    differences between withholding and withdrawing treatment.

    Ref: http://www.ha.org.hk/haho/ho/cc/clinicalethicreport_eng_graphic.pdf

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  3. Maybe I should try to add some more details:

    (1) "Withholding treatment" may be regarded as "passive" without an act of providing the respirator. There is no evidence of "active euthanasia", but there may be a case of "passive euthanasia" because such non-action is fulfilling the wish or instruction of the patient but indirectly via the explanation of the patient's family.

    (2)"Withdrawing treatment" may be regarded as "active" with an act of omission by taking away the respirator. The outcome is expected and predictable death of the patient. This is not "passive" but whether it may become a case for "active euthanasia" depends on arguments:

    (I) FOR no case for "active euthanasia"
    (a) The act is not the direct cause of the patient's death. Only the disease or "fate" should be the direct cause.
    (b) The decision on withdrawing treatment is made by the patient's family, not by the medical team

    (II) AGAINST no case for "active euthanasia"
    (a) There is patient's wish and instruction indirectly via the patient's family.
    (b) An act of withdrawing treatment is undeniable. The effect of withdrawal- immediately fatal, or a certain time lapse before death, may support or weaken the prosecutor's argument.

    About point (4) and (5)in CS's response, I would like to point out that J. Rachel and a few other critics unfortunately do not analyze different situations of "letting die" and "killing with intent" with a strong legal mind. Their abilities to distinguish cases appear rather weak.

    My advice is: it is definitely unsafe and proven invalid already by some scholars that withholding and withdrawing treatments are similar without significant moral differences. I prefer to let classmates do their own research rather than listing out my findings.

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    1. My point (4) and (5) are direct quotes of the document referred, namely "HA Guidelines on Life-sustaining Treatment in the Terminally Ill". So those are HA's views, not James Rachels'.

      The embarrassing arguments are that HA is doing withhold & withdraw treatments which are in certain sense similar to euthanasia (no matter passive or active), but they strongly regard those as not anything related to euthanasia.

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  4. I think both cases are letting die, not killing. Both cases involved removing of the supportive equipment but not taking active measures to end his life.

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