The debate around euthanasia is a tricky topic from the perspective of both patients and doctors. Should it be allowed, and if so, when is it appropriate to practice? Should doctors be held to moral standards when practicing euthanasia, and if so, which ones? Is killing a patient any different than letting a patient die? Daniel Callahan has responded to philosophers such as James Rachels in his article, “When Self-Determination Runs Amok,” and insists that recognizing the moral distinction between killing and letting die is crucial in evaluating whether euthanasia is permissible. Callahan discusses how euthanasia should not be permitted under any circumstances based on three important turning points in western thought. He uses this as grounds to establish two “slippery slopes” that result from allowing euthanasia: a logical one, which focuses on the morality of the issue, and a causal one, which addresses the legality of the issue. He uses both of these slopes as justification for the banning of euthanasia. But, Callahan has a serious amount of moral abstraction in the grounds he sets the slippery slope argument on, as well as in the argument itself. As we will see, there are situations that I and another philosopher, John Lachs, suggest that undermine the limited moral standards that Callahan has assumed should be held, and the slippery slopes may prove to not always be so slippery.
Daniel Callahan is concerned with accepting the moral consequences of Rachels’s argument. He presents an argument against the practice of euthanasia stemming from three turning points in western thought. The discussion begins with the “killing versus letting die” distinction. Contrary to some beliefs on the matter, Callahan says that there is a moral difference between killing and letting die, and to overlook this difference would conflate causality and culpability. Callahan writes, “to say that a doctor ‘kills’ a patient by allowing [death] to happen should only be understood as a moral judgment about the licitness of his omission…it is the underlying disease that brings death when treatment is omitted…” (383). This leads to two disturbing possibilities: health care practitioners are morally and physically responsible for the deaths of their patients and every time life-prolonging treatment proves ineffective, a quick and direct killing will be logical. Next, he turns to the role of self-determination, claiming that it does not follow from the fact that you have a right to self-determination that someone else can permissibly kill you. If everyone has a right to life, then others have a duty to protect this right. So then how can others assist in killing you if they have a contradictory duty to help preserve your life? One of Callahan’s replies is that if one is a slave, her will and moral responsibility are turned over to someone else, and this turning over of her rights is morally wrong. But what about in cases like surgery where a patient is under the knife? Would that not be morally impermissible in any other context? If such rights are not transferable in a moral way then the other person cannot do anything more than what we’ve requested of them (i.e. perform surgery). Lastly Callahan address the doctor’s role in euthanasia, presenting a second obstacle: to act responsibly, the doctor has to concur in the decision of the patient because deference is not responsible, but the doctor ought not act on their own values either. This requires only that the doctor make decisions based on the patient’s values and not their own, and it may not require the doctor to suspend their own value judgments in the evaluation of someone else’s values. In considering these three turning points in Western thought, Callahan believes that “proponents of euthanasia push us in the wrong direction” (381) and that two inevitable slippery slopes will arise as consequences. One slippery slope is causal...
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