In March 2021, the Spanish Congress approved the law regulating euthanasia, that regulates both euthanasia and physician-assisted suicide (PAS). In this article, we analyse the Spanish law regulating euthanasia and PAS, comparing it with the rest of the European laws on euthanasia and PAS (Netherlands, Belgium and Luxembourg). Identified strengths of the Spanish law, with respect to other norms, are that it is a law with many safeguards, which broadly recognises professionals’ right to conscientious objection and (...) the specification that it makes on the prior comprehensive care of the patient, including the approach to care dependency. Regarding its shortcomings, the law does not differentiate well between euthanasia and PAS; it barely assigns a role to the healthcare team as a whole (similar to other regulations); it does not clarify the functions of the different professionals involved; it does not detail the specific composition and duration of theevaluation commission; it has not been accompanied by a prior or simultaneous regulation of palliative care; and, lastly, the period of time to implement the law is too short. (shrink)

Ever since the debate concerning euthanasia was ignited, the distinction between active and passive euthanasia – or, letting die and killing – has been marked as one of its key issues. In this paper I will argue that a) the borderline between act and omission is an altogether blurry one, and it gets even vaguer when it comes to euthanasia, b) there is no morally significant difference between active and passive euthanasia, and c) if there is (...) any, it seems to favor active instead of passive euthanasia. Therefore, while the distinction between active and passive euthanasia might be meaningful in terms of description, if it is considered to be endowed with moral weight and used on purpose of justifying one type of euthanasia instead of the other, it becomes morally problematic and misleading. (shrink)

Historically, the preconditions for the emergence of bioethics in China. were political reforms and their applications. The Hanzhong Euthanasia Case and the publication of Qiu Ren-zong's academic work Bioethics played a significant role in the development of bioethics in China. Other contributory factors include the establishment of the Chinese Society of Medical Ethics/Chinese Medical Association (C.M.A), the publication of the Journal of Chinese Medical Ethics, and the teaching and education of bioethics in China. Major achievements of bioethics in China (...) include the establishment of ethics committee and ethics review system, active international communication and cooperation among the academic circles, and the successful management of the 8th World Congress of Bioethics in Beijing in 2006. Chinese bioethics focus on native Chinese realities and conditions, absorb the international research achievements in relevant fields, and combine international ideas with traditional Chinese doctrines. Admittedly, there are still some aspects to be improved, yet bioethics has attracted a lot of attention from the core leadership in China and has gained sound financial support, which augers well for its further development. This article also briefly introduces the development of bioethics in Hong Kong and Taiwan, China. (shrink)

Those are the words of Pope John Paul II, speaking in March 2004 to an international congress held in Rome. The conference was on "Life-sustaining Treatments and Vegetative State: Scientific Advances and Ethical Dilemmas," and it was organized by the World Federation of Catholic Medical Associations and the Pontifical Academy for Life. The pope was able to cut through all the ethical dilemmas. Although he acknowledged that a patient in a persistent vegetative state, or PVS, "shows no evident sign of (...) selfawareness or of awareness of the environment, and seems unable to interact with others or to react to specific stimuli," he said that they should be kept alive indefinitely. Such patients, he insisted, "retain their human dignity in all its fullness" and "the loving gaze of God the Father continues to fall upon them." For this reason, he said, it is obligatory to continue to provide them with food and water, even if this can only be done through a tube. The pope added that to withdraw the tube, knowing that it will lead to the death of the patient, is "euthanasia by omission.". (shrink)

The notion of "relevance" in philosophy is ultimately determined by a notion of "utility" that has been present in American culture from very early on. In Democracy in America, Tocqueville stated that "Democratic nations... prefer the useful to the beautiful, and... require that the beautiful should be useful". Today, the issues of utility and relevance are motivations for a congress which threatens to drastically cut funding for humanities programs around the country. At a time when employment in the academy is (...) sporadic at best, how might one respond philosophically in light of the current congressional threat? John Lachs responds by criticizing what he calls, "the professionalization of philosophy". Rather than focusing inquiries on the problems and concerns of everyday life, philosophers "linger over abstract details of technique". Ultimately, Lachs' concern is that such hyperspecialization will only alienate the practice of philosophy from the rest of society: "so long as philosophers talk about philosophical texts to other philosophers in a mysterious philosophical language, they cannot keep faith with their mission. Isolated and irrelevant, we will become the butt of jokes, and our departments will be marked... for eradication". In contrast to such "professionalization," Lachs provides us with a book of essays that are "united by the belief that philosophical reflection can yield results and by the desire to harness them to the service of improving life". Lest the reader too quickly assume the facile distinction between "history of philosophy" and "original philosophy," it must be noted that Lachs brings a wealth of knowledge regarding historical figures to bear on the problems which he addresses. One finds Aristotle, Hegel, Mill, James, Peirce, Santayana, Dewey and others, all being invoked in the interest of elucidating and understanding issues such as dogmatism, violence, alienation, technology, education, law, and euthanasia Lachs' overriding concern, however, is that of "mediating relations" "in which individuals perform actions on behalf of others". While such relations may be necessary in order to allow people to perform specialized societal roles more efficiently, they also separate people from the other specialized roles in which they do not take part. The unfortunate consequence is that most people do not have "even an elementary understanding of social life, economic reality, the interplay of activity and happiness, or the structure and needs of our bodies," because "the mediated world denies them the opportunity to learn by direct experience". Relevant philosophy must clear away the abstract and specialized language, which alienates the normal reader and draws philosophers away from learning by direct experience. It is not surprising, therefore, that Lachs' prose is extremely clear and accessible. Such prose works exceptionally well in "Life And Death", where Lachs engages the difficult questions regarding the constitution of a human life, the viewing of death as "a natural and appropriate end to a satisfying life", and the termination of the "lives" of beings who--like the hydroencephalic child --cannot develop into actual human beings, but remain only as "human forms". Whether one agrees with Lachs' positions on these issues or not, his straightforward and unmediated prose bespeaks a courage which is admirable. (shrink)

The case of nonvoluntary euthanasia shows that the current definition of euthanasia must be more accurately determined. Euthanasia refers necessarily to the ending of life due to serious illness which must be expanded to include the lack of any capacity to give sense to life. A person in this latter position would be under lasting and unbearable suffering, perhaps unconscious, and incapable of leading her own life. The ethics of euthanasia must take these considerations into account. (...) The will does not found the ethical decision. This is based instead on the reasonableness of continuing life under these circumstances. Voluntary euthanasia, as well as nonvoluntary, is founded on the right that every person who suffers under these conditions has to put an end to her life. It is understood that this is the only way to escape from such misfortune when life does not make sense any longer. The topic of euthanasia has a political dimension that is associated with the contemporary practice of medicine and the defense of human rights in our society. At the foundational level, euthanasis is unitary; the distinction between voluntary and nonvoluntary establishes only further precision, not a fundamental one. (shrink)

The distinction between killing and letting die has been a controversial element in arguments about the morality of euthanasia and physician-assisted suicide. The killing/letting die distinction is based on causation of death. However, a number of causal factors come into play in any death; it is impossible to state a complete cause of death. I argue that John Mackie’s analysis of causation in terms of ‘inus factors,’ insufficient but nonredundant parts of unnecessary but sufficient conditions, helps us to see (...) that moral responsibility for death cannot rest on causation alone. In specifying the cause of death, some factors can be considered alternatively as either causal factors or merely parts of the presupposed background conditions. If a factor is moved from the background field into the causal field, the result is a changed background field. Comparisons of cases of killing and letting die often do just this; hence, the cases depend on different presuppositions and the causation cannot be directly compared. Moral judgments determine how to apportion factors to the causal and background fields. (shrink)

Helping people to die may involve killing and/or alleviation of pain in a dying person. A dual commitment to the avoidance of killing and the alleviation of pain raises the question of whether these two ways of helping people are always compatible. This paper addresses the question through use of sources in classical American pragmatism and contemporary bioethics. First, I apply Charles Peirce’s notion of pragmatism to the concept of killing through consideration of the empirical consequences of alternative interpretations. James (...) Rachels’ account of the distinction between active and passive euthanasia is critiqued in this analysis. Second, I examine what it means to relieve pain by relating Jane Addams’ concept of maternal nurturance to an ethic of care and opposition to killing. Utilizing these concepts, I apply William James’ notion of pragmatism as a method of mediating or straddling different theoretical approaches to resolve the apparent incompatibility between pain relief and the avoidance of killing. To address social concerns raised by the practice of helping people to die, I propose a corrective insight of Addams, along with John Dewey, about the role of the philosopher as social critic. Thus understood, pragmatism is a means of avoiding abuses that may occur in the process. I conclude that so long as permissive practices are restrained sufficiently to avoid injustices, it is morally both possible and desirable to resist killing while relieving pain. (shrink)

A genuine bioethics would be fiercely devoted to human life (bios) and would express that devotion by articulating as well as advocating moral virtues that rigorously protect that value against the temptation to see life in purely instrumental terms. In my view, no genuine bioethics exists today. In what follows, I will question two fundamental assumptions often presumed in discussions of euthanasia and assisted suicide. These are (i) the agent does will her victim (i.e., her putative beneficiary) some significant (...) human good, e.g., relief from pain, escape from becoming a burden to loved ones, a dignified death, or simply self-determination; (ii) in purposely helping someone to kill herself or in killing her for her own good, the agent wills her no serious harm. Put differently, I question the assumption of ‘mercy’ in so-called ‘mercy-killing’. (shrink)

The advancement in the field of medical science and technology has made the issue of euthanasia more relevant and important for the present day society to discuss. Life saving machines and drugs are helping the patients who become incapable of leading their lives independently and to live artificially with thehelp of these life prolonging machines and medicines. But today it is possible to prolong their life, which may be full of pain and suffering. This suffering of the 'person' forces (...) us to think as to how far we are morally justified to help such patients to go on living a useless, helpless and painful life. Isn't it obligatory on us to relieve them of their pain? Such issues have made the concept of ‘euthanasia’, which involves 'good death', an important one. One should take a utilitarianpoint of view in analyzing the concept of euthanasia. One should keep the interests and benefit of people in mind. When one decides that a particular case is a case of euthanasia, then not only the 'net benefit' of the patient should be borne in mind, but also the 'general benefit of the society and individuals looking after the patient should be taken into consideration. (shrink)

In her introduction to this collection, Tymieniecka presents her phenomenology of life - the leitmotif of the three-volume anniversary publication of Analecta Husserliana - as something that stands out from preceding historical attempts to investigate life in an 'integral' or 'scientific' way. After an incubation lasting throughout the 2000 years of Occidental philosophy, this scientific phenomenology/philosophy of life at last uncovers the entire area of the 'inner workings of Nature', exposing the way in which the 'sufficient reason' and the 'ground' (...) of beingness as such crystallise out of the 'onto poietic' process. This onto-poietic process, continuing as it does in the human creative condition, also reveals the authentic genius of the works of the human spirit. This new and original philosophy, free of fallacious simplifications, speculations and reductionism, opens up a basic starting point for all philosophy. Life, 'the theme of our times', at last receives a profound philosophical treatment. (shrink)

Wild Ideas is a collection of essays that brings a fresh and refreshing perspective to the wilderness paradoxically at the center of our civilization.

orbit and far beyond it. Indeed, the immense, painstaking, indefatigable and ever-improving effort of Husserl to find ever-deeper and more reliable foundations for the philosophical enterprise (as well as his constant critical re-thinking and perfecting of the approach and so called "method" in order to perform this task and thus cover in this source-excavation an ever more far-reaching groundwork) stands out and maintains itself as an inepuisable reservoir for philosophical reflec tion in which all the above-mentioned work has either its (...) core or its source. In fact, in his undertaking to re-think the entire philosophical enterprise as such and to recreate philosophy upon what he sought to be at least a satisfactorily legitimated basis, Husserl, through his already systematised and "authorized" work, and his courses, and later on in his spontaneous reflection (which did not find its way into a definitive corpus but was nevertheless sufficiently coherent with his previously established body of thought to be considered a continuation of it), uncovers perspectives upon the universe of man and projects their new philosophical thematisation that brings together all the attempts by philosophers (e. g., Merleau-Ponty, who drew upon this material and found there his own inspiration) who succeeded him with foundational intentions; it also gives a core of philosophical ideas and insights for the youngergenerationofphilosophers today. (shrink)

This collection is the final volume of a four book survey of the state of phenomenology fifty years after the death of Edmund Husserl. Its publication represents a landmark in the comprehensive treatment of contemporary phenomenology in all its vastness and richness. The diversity of the issues raised here is dazzling, but the main themes of Husserl's thought are all either explicitly treated, or else they underlie the ingenious approaches found here. Time, historicity, intentionality, eidos, meaning, possibility/reality, and teleology are (...) the main concerns of this collection devoted to studies in aesthetics, metaphysics and literary interpretation, written by such authors as, among others, R. Cobb-Stevens, C. Moreno Marquez, J. Swiecimski, Sitansu Ray and M. Kronegger. These original studies of phenomenological aesthetics and literary theory by scholars from all parts of the world were gathered by the World Institute for Advanced Phenomenological Research and Learn ing during the year 1988/89 during its assessment of the phenomeno logical movement, fifty years after Husserl's death. IX A -T. Tymieniecka (ed.), Analecta Husserliana, Vol. XXXVII, ix. (shrink)

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In 1993, Professor of Jurisprudence, Ronald Dworkin of Oxford University and Professor of Law at New York University, delivered the Georgetown Law Center’s thirteenth Annual Philip A. Hart Memorial Lecture: "Life’s Dominion: An Argument About Abortion and Euthanasia." Dworkin is Professor of Philosophy and Frank Henry Sommer Professor of Law at New York University. He received B.A. degrees from both Harvard College and Oxford University, and an LL.B. from Harvard Law School and clerked for Judge Learned Hand. He was (...) associated with a law firm in New York (Sullivan and Cromwell) and was a professor of law at Yale University Law School from 1962-1969. He has been Professor of Jurisprudence at Oxford and Fellow of University College since 1969. He has a joint appointment at Oxford and at NYU where he is a professor both in the Law School and the Philosophy Department. He is a Fellow of the British Academy and a member of the American Academy of Arts and Sciences. Professor Dworkin is the author of many articles in philosophical and legal journals as well as articles on legal and political topics in the New York Review of Books. He has written Taking Rights Seriously (1977), A Matter of Principle (1985), Law’s Empire (1986), Philosophical Issues in Senile Dementia (1987), A Bill of Rights for Britain (1990), Life’s Dominion (1993), and Freedom’s Law (1996). (shrink)

BackgroundIn the Netherlands, patients have the legal right to make a request for euthanasia to their physician. However, it is not clear what it means in a moral sense for a physician to receive a request for euthanasia. The aim of this study is to explore the moral values of physicians regarding requests for euthanasia. MethodsSemi-structured interviews were conducted with nine primary healthcare physicians involved in decision-making about euthanasia. The data were inductively analyzed which lead to (...) the emergence of themes, one of which was about values regarding end-of-life decisions.ResultsFour clusters of values related to euthanasia requests are described: values related to 1) the patient; 2) the family; 3) the physician; and 4) life and death. The data show that the participants value patient autonomy as a necessary but not sufficient condition for meeting a euthanasia request. A good relationship with the patient and the family are important. For the physician, the values physician autonomy, responsibility, understanding the patient and relief of suffering play a role. Life as an intrinsic good and a peaceful death are also important values.ConclusionThis study shows that next to patient autonomy and the relationship with the patient and the family, it is important for the participants to act in accordance with their professional values and to do justice to values related to life and death. The awareness of going against the intrinsic value of life is crucial, even if performing euthanasia may result in a feeling of relief or gratitude afterwards. (shrink)

While some countries are moving toward legalization, euthanasia is still criticized on various fronts. Most importantly, it is considered a violation of the medical ethics principle of non-maleficence, because it actively seeks a patient’s death. But, medical ethicists should consider an ethical alternative to euthanasia. In this article, we defend cryocide as one such alternative. Under this procedure, with the consent of terminally-ill patients, their clinical death is induced, in order to prevent the further advance of their brain’s (...) deterioration. Their body is then cryogenically preserved, in the hope that in the future, there will be a technology to reanimate it. This prospect is ethically distinct from euthanasia if a different criterion of death is assumed. In the information-theoretic criterion of death, a person is not considered dead when brain and cardiopulmonary functions cease, but rather, when information constituting psychology and memory is lost. (shrink)

Issues such as abortion, embryo research and euthanasia have been discussed exhaustively from the standpoint of Western philosophy and religion, but so far the voice of Buddhism has been little heard in the debate. Although widely respected for its benevolent and humanistic values, Buddhism has not so far shown how its ethical principles can be applied in a consistent manner to contemporary moral dilemmas. Drawing on both ancient and modern sources, this book sets out the basis of a Buddhist (...) response to the major ethical questions posed by modern medicine. (shrink)

Objectives: To discover what factors affect lay people’s judgments of the acceptability of physician assisted suicide and euthanasia and how these factors interact.Design: Participants rated the acceptability of either physician assisted suicide or euthanasia for 72 patient vignettes with a five factor design—that is, all combinations of patient’s age ; curability of illness ; degree of suffering ; patient’s mental status , and extent of patient’s requests for the procedure .Participants: Convenience sample of 66 young adults, 62 middle (...) aged adults, and 66 older adults living in western France.Main measurements: In accordance with the functional theory of cognition of N H Anderson, main effects, and interactions among patient factors and participants’ characteristics were investigated by means of both graphs and ANOVA.Results: Patient requests were the most potent determinant of acceptability. Euthanasia was generally less acceptable than physician assisted suicide, but this difference disappeared when requests were repetitive. As their own age increased, participants placed more weight on patient age as a criterion of acceptability.Conclusions: People’s judgments concur with legislation to require a repetition of patients’ requests for a life ending act. Younger people, who frequently are decision makers for elderly relatives, place less emphasis on patient’s age itself than do older people. (shrink)

Slippery slope arguments appear regularly whenever morally contested social change is proposed. Such arguments assume that all or some consequences which could possibly flow from permitting a particular practice are morally unacceptable.Typically, “slippery slope” arguments claim that endorsing some premise, doing some action or adopting some policy will lead to some definite outcome that is generally judged to be wrong or bad. The “slope” is “slippery” because there are claimed to be no plausible halting points between the initial commitment to (...) a premise, action, or policy and the resultant bad outcome. The desire to avoid such projected future consequences provides adequate reasons for not taking the first step.Thus the legalization of abortion in limited circumstances is asserted to lead down the slippery slope towards abortion on demand and even infanticide; and the legalization of assisted suicide to lead inexorably to the acceptance of voluntary euthanasia and subsequently to the sanctioning of the practice of nonvoluntary euthanasia – even involuntary euthanasia of “undesirable” individuals. (shrink)

ObjectivesIn 2015, the Province of Quebec, Canada passed a law that allowed voluntary active euthanasia. Palliative care stakeholders in Canada have been largely opposed to euthanasia, yet there is little research about their views. The research question guiding this study was the following: How do palliative care physicians in Quebec position themselves regarding the practice of VAE in the context of the new provincial legislation?MethodsWe used interpretive description, an inductive methodology to answer research questions about clinical practice. A (...) total of 18 palliative care physicians participated in semistructured interviews at two university-affiliated hospitals in Quebec.ResultsParticipants positioned themselves in opposition to euthanasia. Their justifications were framed within their professional commitment to not hasten death, which sat in tension with the value of patients’ autonomy to choose how to die. Participants described VAE as unacceptable if it impeded opportunities to evaluate and alleviate suffering. Further, they contested government rhetoric that positioned VAE as a way to improve end-of-life care. Participants felt that VAE would diminish the potential of palliative care to relieve suffering. Dilemmas were apparent in their narratives, about reconciling respect for patient autonomy with broader palliative care values, and the value of accompanying and not abandoning patients who make requests for VAE while being committed to neither prolonging nor hastening death.ConclusionsThis study provides insight into nuanced positions of experienced palliative care physicians in Quebec and confirms expected tensions between an important stakeholder and the practice of VAE as guided by the new legislation. (shrink)

The purpose here is to cast doubt on some utilitarian non‐rights‐based arguments that are generally thought to be decisive objections to voluntary and non‐voluntary euthanasia. The aim is not to prove that euthanasia is morally vindicated (although I think rights‐based arguments can do this) but rather to contend that such arguments, far from being decisively anti‐euthanasia, can be made to point equally in the opposite direction.

In 2002, I wrote an editorial in this Journal arguing that it was time to review the structure and function of ethics committees in the USA, Australia and the UK.1 This followed the deaths of Ellen Roche and Jesse Gelsinger, which were at least in significant part due to the poor functioning of research ethics committees in the USA.2 In the case of Ellen Roche, it was the failure to require a systematic review of the existing literature which led to (...) her death. Iain Chalmers and I had previously documented in 1996 the failure of ethics committees to require systematic review.3 In 1998, at the time of revising the previous guidelines and forming the first Australian National Statement on Research Ethics, I made a public submission to the Australian Health Ethics Committee arguing that the new guidelines for RECs should include a person with skills in conducting systematic reviews of the literature and that the requirement to have a religious representative on the committee be replaced with the requirement to have an ethicist. Neither of these changes was made. I argued, ‘It is time to ask whether institutional RECs should be abandoned in favour of expert committees that cover many institutions—suprainstitutional specialist committees. Supraregional specialist ethics committees could specialise—for example, in genetic research, cancer clinical trials, dermatology, respiratory physiology and each of the specialist areas of medical research. An example of such a committee is provided by the Thoracic Society of Australia and New Zealand research ethics committee, which reviews multicentre trials of respiratory drugs’.4 Around that time, I was involved ‘at the coal face’ as Chair of the Department of Human Services Ethics Committee in Victoria. In a public presentation, I arguedThere are two philosophical views of what ethics review is. On the …. (shrink)