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PH258 – Medical Ethics. Agenda. CLASSIC CASES, Chapter 1 – Requests to Die: Elizabeth Bouvia and Larry McAfee CLASSIC CASES, Chapter 2 – Comas: Karen Quinlan, Nancy Cruzan, and Terri Schiavo. Requests to Die: Elizabeth Bouvia and Larry McAfee. - PowerPoint PPT Presentation
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PH258 – Medical EthicsPH258 – Medical Ethics
AgendaAgenda
CLASSIC CASES, Chapter 1 – Requests to Die: Elizabeth Bouvia and Larry McAfee
CLASSIC CASES, Chapter 2 – Comas: Karen Quinlan, Nancy Cruzan, and Terri Schiavo
Requests to Die: Elizabeth Bouvia and Requests to Die: Elizabeth Bouvia and Larry McAfeeLarry McAfee
Elizabeth Bouvia – totally paralyzed from cerebral palsy; no use of legs; partial use of one arm; mentally competent
Requested to die in hospital Initially denied – Chicken Little
argument
Chicken Little Defense
If Elizabeth Bouvia is given right to terminate her life, then other disabled people might also ask for this option
Later given the right to terminate her life
Changed her mind
Five years before the Nancy Cruzan US Supreme Court decision, Bouvia won right to terminate her life.
Elizabeth Bouvia case – show effects of long-standing abuse of people with disabilities
Larry Mcafee – paralyzed from a motorcycle accident
Requested to dieIn 1989, he won the right to
terminationYet he decided to live.Bouvia and Mcaffee given three
options:Become a burden to one’s
family
Exist in a large public health
care facility
Kill oneself
Dax Cowart – burns over 2/3 of his body
Requested to terminateInitially refused.Later given right to terminationYet he decided to live.
Adaption effect (p. 16)
Historical Views of SuicideHistorical Views of Suicide
Ancient Greek Plato Aristotle
Stoic View Seneca Marcus
Aurelius
Judaic and Christian Views of Suicide
Old Testament – suicide of Saul – 1st king of Israel by prophet Samuel – routed Philistines and others – later usurped Samuel – accused of stealing war booty and not killing a captured king of the Amalekites – was later routed by Philistine forces – 3 sons killed in battle – committed suicide – body was recovered through daring raid from his soldiers – buried with honor
New Testament – suicide of Judas Iscariot
Conflicting accountsGospel of Matthew – betrays Jesus – later
returned the 30 silver coins – hanged himself
Acts of the Apostles – keeps the money – buys a farm – falls down in the field – disemboweled
Gospel of Judas – not part of Bible – Jesus asks Judas to hand him over
St. Augustine - against suicide
St. Thomas Aquinas – suicide – a sin
No chance for repentance Life is gift from God Robs children of their parents Unnatural
Private
killings
Killings endorsed
by God
Not OK OK
Michel de Montaine - “If we have learned how to live properly and calmly, we will know how to die in the same manner.”
Baruch Spinoza – “A free man, that is to say, a man who lives according the dictates of reason alone, is not led by the fear of death.”
John Donne – “When the [terminal] disease would not reduces us, [God] sent a second and worse affliction, ignorant and torturing physicians.”
David Hume – favors suicide– if someone’s health is failing, letting
it happen is following causal lawsAudacious to think our life – or death –
influences the vast universeTo kill oneself is only to stop doing
good
Immanuel Kant - against suicideSuicide cannot be universalized – ‘Act
so that your action becomes a universal law.’ (categorical imperative)
Suicide does not treat another (in this case, oneself) as an end – ‘Treat each person as an end in himself, never merely as a means.’
Immanual Kant (continued)Suicide is a form of disrespect to
oneself. This could lead to disrespect others.
Humans as ‘sentinels on earth’ – we are God’s property
John Stuart Mill“Over himself, over his own body and
mind, the individual is sovereign.”
Self-regarding actions Other-regarding actions
Total freedom Limited freedom
Autonomy Vs. Government-Paternalism
What qualifies as a suicide?
People with a terminal illness
People fully competent and without a terminal illness
Forgoing treatment Kill themselves
Not suicide Suicide
Elizabeth Bouvia, Larry McAfee, Dax Cowart:
Assisted suicide
Autonomy Paternalism
Empowerment Prejudice
Rule of Rescue operative
http://www.npr.org/2011/06/16/137217016/the-nation-keeping-the-right-to-die-alive
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