Is it worse to kill someone than to let someone die? It seems obvious to common sense that it is worse. We allow people to die, for example, when we fail to contribute money to famine-relief efforts; but even if we feel somewhat guilty, we do not consider ourselves murderers. Nor do we feel like accessories to murder when we fail to give blood, sign an organ-donor card, or do any of the other things that could save (...) lives. Common sense tells us that, while we may not kill people, our duty to give them aid is much more limited. Some philosophers, however, have argued that common sense is wrong about this. They have defended the Equivalence Thesis, which says that killing and letting die are equally bad. This is a more specific version of the idea that there is no moral difference between making something happen and allowing it to happen. The Equivalence Thesis is a radical conception that would require changes in our ordinary moral beliefs. If it is true, then obviously our duty to give aid is much stronger than we commonly assume. But our views about other matters, such as euthanasia, will also be affected. Many people believe that “passive euthanasia”--allowing terminal patients to die, rather than pointlessly prolonging their lives--is sometimes permissible; but they also believe that killing patients is always wrong. If the Equivalence Thesis is true, this combination of beliefs is inconsistent. The idea behind the Equivalence Thesis is not that every individual case of letting die is equally as bad as every individual case of killing. Obviously, if we compare an ordinary murder--say, a man killing his wife out of jealousy--with the actions of a physician who humanely permits a suffering patient to die, the murder is much worse. Rather, the idea is that the difference between killing and letting die does not itself make a difference to the moral assessment of the actions. Other factors may still be important. (shrink)

BackgroundEuthanasia can be thought of as being either active or passive; but the precise definition of “passive euthanasia” is not always clear. Though all passive euthanasia involves the withholding of life-sustaining treatment, there would appear to be some disagreement about whether all such withholding should be seen as passive euthanasia.Main textAt the core of the disagreement is the question of the importance of an intention to bring about death: must one intend to (...) bring about the death of the patient in order for withholding treatment to count as passive euthanasia, as some sources would indicate, or does withholding in which death is merely foreseen belong to that category? We may expect that this unclarity would be important in medical practice, in law, and in policy. The idea that withholding life-sustaining treatment is passive euthanasia is traced to James Rachels’s arguments, which lend themselves to the claim that passive euthanasia does not require intention to end life. Yet the argument here is that Rachels’s arguments are flawed, and we have good reasons to think that intention is important in understanding the moral nature of actions. As such, we should reject any understanding of passive euthanasia that does not pay attention to intent.Short conclusionJames Rachels’s work on active and passive euthanasia has been immensely influential; but this is an influence that we ought to resist. (shrink)

In their account of passive euthanasia, Garrard and Wilkinson present arguments that might lead one to overlook significant moral differences between killing and letting die. To kill is not the same as to let die. Similarly, there are significant differences between active and passive euthanasia. Our moral duties differ with regard to them. We are, in general, obliged to refrain from killing each and everyone. We do not have a similar obligation to try to prevent (...) each and everyone from dying. In any case, to be morally obliged to persist in trying to prevent their deaths would be different from being morally obliged to refrain from killing all other people even if we had both obligations. (shrink)

I argue that ‘classical liberalism’ does not sanction any easy permissiveness about suicide and active euthanasia. I will use liberal arguments to argue that the distinction between active and passive euthanasia is real and that assisted suicide is, at the very least, deeply troubling when viewed from an authentic liberal perspective. The usual argument for active euthanasia is a utilitarian, not a liberal argument, as recent calls to eliminate the conscientious objection rights of (...) doctors who refuse participation in such procedures plainly demonstrate. The paper focuses on arguments in the public sphere (such as those articulated by James Rachels). (shrink)

ABSTRACT It is commonly assumed that the view that passive euthanasia is morally preferable to active euthanasia is an implication of the view that killing someone is worse than merely letting her die, and that it is held by its proponents on this ground. Accordingly, attempts to discredit the former often take the form of attempted refutations of the latter. In the present paper, it is argued that such attempts are misguided, since the former (...) view is not in fact implied by the latter. (shrink)

The view that voluntary active euthanasia and physician-assisted suicide should be made available for terminal patients only is typically warranted by reference to the risks that the procedures are seen to involve. Though they would appear to involve similar risks, the commonly endorsed end-of-life practices referred to as passive euthanasia are available also for non-terminal patients. In this article, I assess whether there is good reason to believe that the risks in question would be bigger in (...) the case of voluntary active euthanasia and physician-assisted suicide than in that of passive euthanasia. I propose that there is not. On that basis, I suggest that limiting access to voluntary active euthanasia and physician-assisted suicide to terminal patients only is not consistent with accepting the existing practices of passive euthanasia. (shrink)

Belgium has recently extended its euthanasia legislation to minors, making it the first legislation in the world that does not specify any age limit. I consider two strands in the opposition to this legislation. First, I identify five arguments in the public debate to the effect that euthanasia for minors is somehow worse than euthanasia for adults—viz. arguments from weightiness, capability of discernment, pressure, sensitivity and sufficient palliative care—and show that these arguments are wanting. Second, (...) there is another position in the public debate that wishes to keep the current age restriction on the books and have ethics boards exercise discretion in euthanasia decisions for minors. I interpret this position on the background of Velleman’s “Against the Right to Die” and show that, although costs remain substantial, it actually can provide some qualified support against extending euthanasia legislation to minors. (shrink)

This paper is divided into three sections. The first presents some examples of the killing/letting die distinction. The second draws a further distinction between what I call negative and positive cases of acting or refraining. Here I argue that the moral significance of the acting/refraining distinction is different for positive and for negative cases. In the third section I apply the above distinction to euthanasia, and argue that mercy killing should be regarded as analogous to positive rather than (...) negative cases. On the basis of this, I then support active rather than passive euthanasia. (shrink)

In his meditation on Emerson's self-reliance, George Kateb argues that Emerson's entrance into antislavery politics, particularly his calls for collective mobilization, constitutes a “deviation from his theory of self-reliance, not its transformation.” Though Emerson often imagines a self-reliance that can lead to action, his descriptions of the fundamental attitude of the self towards the world suggest passivity, attention, and waiting. Because he rules out logical or teleological sources for inspiration, his conception of self-reliance is fundamentally at odds with progressivist narratives (...) of history. His sense of “entranced waiting” flirts with an anarchic potentiality that he must reject in order to call for social solidarity and progressive action against slavery. In “Bartleby, the Scrivener,” Melville takes the radical outsidedness of self-reliance to its conclusion, transforming Emersonian waiting into Bartleby's catatonic stillness. Emerson's waiting for inspiration becomes the copyist's quiet demand that his employer wait with him rather than use charitable actions to free himself from the burden Bartleby imposes. Bartleby obstructs the lawyer's ideas of improvement as well as his conception of himself as a moral agent in a world of moral possibility. Simone Weil provides a similar version of a quietist waiting with. To an ungenerous “active searching” she opposes a fundamental generosity, a “waiting or attentive and faithful immobility” through which one is able to recognize “that the sufferer exists.” For Weil, as for Melville, there is no passage from such a recognition to a conception of history as progress. The sufferer is not a problem to be solved within a narrative of social improvement but the source of an unlimited and impossible obligation. (shrink)

Many studies show a developmental advantage for transitive sentences with familiar verbs over those with novel verbs. It might be that once familiar verbs become entrenched in particular constructions, they would be more difficult to understand (than would novel verbs) in non-prototypical constructions. We provide support for this hypothesis investigating German children using a forced-choice pointing paradigm with reversed agent-patient roles. We tested active transitive verbs in study 1. The 2-year olds were better with familiar than novel (...) verbs, while the 2½-year olds pointed correctly for both. In study 2, we tested passives: 2½-year olds were significantly below chance for familiar verbs and at chance for novel verbs, supporting the hypothesis that the entrenchment of the familiar verbs in the active transitive voice was interfering with interpreting them in the passive voice construction. The 3½-year olds were also at chance for novel verbs but above chance with familiar verbs. We interpret this as reflecting a lessening of the verb-in-construction entrenchment as the child develops knowledge that particular verbs can occur in a range of constructions. The 4½-year olds were above chance for both familiar and novel verbs. We discuss our findings in terms of the relative entrenchment of lexical and syntactic information and to interference between them. (shrink)

Euthanasia or mercy killing is, now a day, a major problem widely discussed in medical field. Medical professionals are facing dilemma to take decision regarding their incompetent patient while tend to do euthanasia. The dilemma is by nature moral i.e. whether it is morally permissible or not. In some countries of Europe and in some provinces of USA euthanasia is legally permitted fulfilling some conditions. It is claimed by Rachels that in our practical medical practice we do (...) euthanasia by forbidding patients from taking drugs. He concludes that if that type of euthanasia can be practiced in our society without any hesitation then why assisting euthanasia will not be permitted1. There are so many arguments both pro and con of euthanasia. But it is not the function of the current paper to discuss all the arguments. Philippa Foot in her article „Euthanasia‟ and J Velleman in his article titled as „A Right to Self-termination‟ discussed about the permissibility of euthanasia. The objective of the paper is to justify their arguments and then come to a conclusion regarding the permissibility of euthanasia. The focus will be given mainly on non- voluntary active and non-voluntary passive euthanasia. The method of discussion will be that an example will be given from Bangladesh and then the arguments provided by Foot and Velleman in their above mentioned papers will be discussed to justify the act of euthanasia on concerned patient. In the last section of the paper the situation of Bangladesh will also be considered for the permissibility of euthanasia i.e. whether the act of euthanasia can be permitted in our country considering the existing socio-cultural-religious practice. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Active Euthanasia and Assisted SuicidePat Milmoe McCarrick (bio)Although the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research in its 1983 report, Deciding to Forego Life-Sustaining Treatment, described the words and terms "euthanasia," "right to die," and "death with dignity" as slogans or code words—"empty rhetoric," (I, p. 24), the literature reviewed for this Scope Note continues to use these (...) terms. Therefore, to discuss the termination of a patient's life by a physician at the patient's request, the phrase active euthanasia is used, and the supplying of a means by a physician whereby a patient can end his or her life is referred to as assisted suicide.Euthanasia, either as the "good death" from classical Greek or "mercy killing" to end unbearable suffering in the dying, has long been a topic of interest in western civilization (III, Brody 1989). In recent years, public awareness of this discussion about control over the time of one's death has been informed by a series of well-publicized events. They include the November 1991 rejection by a vote of 54 percent to 46 percent of the Washington state Initiative 119, which would have allowed the option of requesting one's physician to "aid-in-dying" for adult patients in a "medically terminal condition" (V, Gross 1991); two medical journal articles describing physician's actions in helping bring death to two patients (V, Anonymous 1988; V, Quill 1991); Dr. Jack Kevorkian's assistance in the suicide of three women (V, Belkin 1990; V, Wilkerson 1991); and the best seller status of a how-to book on committing suicide with opiates obtained from a physician (III, Humphry 1991).For the most part, material included in the annotated bibliography in Scope Note 18 has been chosen from works published in the four years since "It's Over, Debbie" (V, Anonymous 1988) appeared in early January 1988 in the Journal of the American Medical Association.Dr. Edmund D. Pellegrino (V, 1991, pp. 3118-19) presented opposing views about active voluntary euthanasia as follows:Those who favor voluntary euthanasia argue that it is a beneficent and compassionate act; it respects autonomy by preserving the patient's control of the manner, method, [End Page 79] and timing of death; it takes the matter outside the reach of "medical power" (accessed in this Scope Note's bibliography at V, Fletcher 1973; V, Nowell-Smith 1989) and scrupulosity; and it prevents the injustice that allows some patients to choose death by refusal of life-support measures, while denying others the right to do so by active euthanasia....The opponents of active euthanasia argue that it undermines the value of, and respect for, all human life (V, Kass 1989; V, Coyle 1990; V, Singer 1990). They fear that guidelines cannot avoid sliding down the "slippery slope" to involuntary euthanasia and selective devaluation of the lives of the most vulnerable among us.... If euthanasia is legal, it is predicted that patients will feel subtle pressure to conform so as to relieve the economic and emotional burdens they impose on family and friends.Euthanasia, its opponents further argue, is socially destructive: it undermines trust in physicians, desensitizes society to killing, and imperils the ground already gained in legitimating passive euthanasia(IV, Wolf 1989).Physicians were not particularly involved with a patient's death until after World War II when participation grew in proportion to the growth of technology. Since the complex, life-sustaining equipment that could forestall death was located in a hospital, death itself became almost completely medicalized (V, Dagi 1991). For terminally ill persons who would like to die a painless death, either by their own hand or with assistance, physicians have almost a monopoly on obtaining strong drugs for distribution to patients (V, Abrams 1990).Active euthanasia for human beings is not legalized anywhere in the world (V, VonDrehle 1991). It is classified as homicide or murder in all fifty states and in Great Britain, Canada, Australia, and the Phillippines (V, Nerland 1989). Twentysix states in the United States prohibit assisted suicide by statute (V, Rosenblum 1990).In 1969 in the Netherlands, a physician named Jan Hendrik van... (shrink)

I consider four recently suggested difference between killing and letting die as they apply to active and passive euthanasia : taking vs. taking no action; intending vs. not intending the death of the person; the certainty of the result vs. leaving the situation open to other possible alternative events; and dying from unnatural vs. natural causes. The first three fail to constitute clear differences between killing and letting die, and "ex posteriori" cannot constitute morally significant differences. The (...) last constitutes a difference but is not morally significant. (shrink)

In this paper, we critically reflect on the concept of Euthanasia as understood in the West and in Africa, and especially in sub-Saharan Africa. From the Western block, we rely on the contributions of Ronald Otremba and James Rachels. In our view, Otremba represents the Traditional Western view of euthanasia, which holds that life is sacrosanct and therefore ought not to be taken away for whatever reasons. Otremba’s defense of passive euthanasia over active euthanasia (...) stems from this understanding. Rachels, on the other hand, does not see any morally significant difference between active and passive euthanasia, for the simplereason that the result is the same - death. Next, as we examine the African view of euthanasia with special reference to Munyaradzi Mawere’s interpretation of the Shona position on it, we want to ascertain whether or not there is something that can be called African euthanasia, and if not, whether or not the understanding of euthanasia in Africa has Western roots. (shrink)

It appears that the attitudes of health professionals differ towards suicide and voluntary active euthanasia. An acceptance of, if not an agreement with, voluntary active eutha nasia exists, while there is a general consensus that suicide should be prevented. This paper searches for a working definition of suicide, to discover ethical reasons for the negative value that suicide assumes, and also to provide a term of reference when comparing suicide with euthanasia. On arriving at a working (...) definition of suicide, it is compared with voluntary active euthanasia. An analysis of utilitarian and deontological considerations is provided and proves to be inconclusive with respect to the ethical principles informing the attitudes of professionals. Therefore, a search for other influences is attempted; this indicates that psychological influences inform attitudes to a greater degree than ethical principles. (shrink)

This paper does not present an advocacy of a passive education as opposed to an active education nor does it propose that passive education is in any way ‘better’ or more important than active education. Through readings of Maurice Blanchot, Jacques Derrida and B.S. Johnson, and gentle critiques of Jacques Rancière and John Dewey, passive education is instead described and outlined as an education which occurs whether we attempt it or not. As such, the (...) object of critique for this essay are forms of educational thought which, through fate or design, exclude the passive dimension, either within or outside of formal educational settings. An underlying component of this argument is therefore also that education does occur outside of formal educational settings and that, contra Gert Biesta and his critique of ‘learnification’, we may gain rather than lose something by attending to it as education. (shrink)

The philosophical debate over the moral difference between killing and letting die has obvious relevance for the contemporary public debate over voluntary euthanasia. Winston Nesbitt claims to have shown that killing someone is, other things being equal, always worse than allowing someone to die. But this conclusion is illegitimate. While Nesbitt is correct when he suggests that killing is sometimes worse than letting die, this is not always the case. In this article, I argue that (...) there are occasions when it is better to kill than to let die. (shrink)

In this essay I defend the following two claims: first, given appropriate circumstances, neither voluntary active euthanasia, nor assisting someone to commit suicide, is in any way morally wrong; secondly, there should be no laws prohibiting such actions, in the relevant cases. -/- The discussion is organized as follows. In the first section, I set out some preliminary concepts and distinctions. Then, in sections two and three, I offer two arguments in support of the thesis that assisted suicide (...) and voluntary active euthanasia are not morally wrong. Finally, in section four, I ask whether there is any reason for thinking that, even if, as I have argued, voluntary active euthanasia and assisted suicide are not morally wrong, they should, nevertheless, not be legally permitted, and I argue that this is not the case. (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)

The distinction between “passive” and “active” euthanasia, though problematic and highly criticized, retains a certain intuitive appeal. When a patient is allowed to die, nature appears simply to be taking its course. Yet when a patient is killed by, say, a lethal injection, humans appear to be causing his or her death. Guilt seems to follow naturally from the latter act while not from the former. Yet this view only holds up if age‐old and vague ideasabout “nature” (...) and “artifice” go unscrutinized. Once examined more closely the functional relevance of particular machines to particular bodies becomes evident. And the innocence and guilt less clear. (shrink)

Previous research shows that people can use the co-occurrence of words and objects in ambiguous situations (i.e., containing multiple words and objects) to learn word meanings during a brief passive training period (Yu & Smith, 2007). However, learners in the world are not completely passive but can affect how their environment is structured by moving their heads, eyes, and even objects. These actions can indicate attention to a language teacher, who may then be more likely to name the (...) attended objects. Using a novel active learning paradigm in which learners choose which four objects they would like to see named on each successive trial, this study asks whether active learning is superior to passive learning in a cross-situational word learning context. Finding that learners perform better in active learning, we investigate the strategies and discover that most learners use immediate repetition to disambiguate pairings. Unexpectedly, we find that learners who repeat only one pair per trial—an easy way to infer this pair—perform worse than those who repeat multiple pairs per trial. Using a working memory extension to an associative model of word learning with uncertainty and familiarity biases, we investigate individual differences that correlate with these assorted strategies. (shrink)

When it is considered to be in their best interests, withholding and withdrawing life-supporting treatment from non-competent physically ill or injured patients – non-voluntary passive euthanasia, as it has been called – is generally accepted. A central reason in support of the procedures relates to the perceived manner of death they involve: in non-voluntary passive euthanasia death is seen to come about naturally. When a non-competent psychiatric patient attempts to kill herself, the mental health care providers (...) treating her are obligated to try to stop her. Yet it has been suggested that death by suicide can be a part of the natural course of a severe mental illness. Accordingly, if the perceived naturalness of the deaths occurring in connection with non-voluntary passive euthanasia speaks for their moral permissibility, it could be taken that a similar reason can support the moral acceptability of the suicidal deaths of non-competent psychiatric patients. In this article, I consider whether the suicidal death of a non-competent psychiatric patient would necessarily be less natural than those of physically ill or injured patients who die as a result of non-voluntary passive euthanasia. I argue that it would not. (shrink)

Mr. Paul Mills suffered from cancer of the esophagus. Three major surgeries were unsuccessful in correcting the problem, and other treatment methods likewise failed. His condition deteriorated to the point where there was no longer any hope of recovery. Dr. Morrison, who was Mr. Mills's intensive care physician at the Queen Elizabeth II Health Sciences Centre in Halifax, and Mr. Mills's family agreed that active life support should be discontinued. Dr. Morrison then removed Mr. Mills's ventilator. To everyone's surprise, (...) and dismay, Mr. Mills did not die. He continued to breathe spontaneously and started to show signs of distress. Dr. Morrison increased the dosage of morphine, to no effect. She increased it again to the point where death could reasonably be expected to occur; signs of distress continued. Dr. Morrison at this point administered a dose of potassium chloride and Mr. Mills died. (shrink)

A questionnaire survey was conducted at the annual meeting of the Japanese Society for Hospice and Home Care to study attitudes toward euthanasia. Respondents were asked how they agreed with the doctor's decision regarding several forms of euthanasia in hypothetical clinical situations dealing with terminal and non-terminal patients. Their acceptance of euthanasia was correlated with respect to patient's autonomy. Results showed 54% and 62% of respondents agreed with voluntary and non-voluntary passive euthanasia at the terminal (...) stage, respectively. Indirect euthanasia was accepted by 71%. In voluntary active euthanasia, 21% agreed with the doctor's act. In non-voluntary active euthanasia, 13% and 37% agreed with the use of potassium chloride and sedative, respectively. In dealing with a quadriplegic patient, 18% and 37% agreed with voluntary active euthanasia with a sedative and voluntary passive euthanasia. Voluntary passive euthanasia in the terminal stage and voluntary active and passive euthanasia and mercy killing were more likely to be favoured by the respondents who respected patient's autonomy than those who did not. (shrink)

This paper is part of a larger project. My overall aim is to argue that the evolution of familiar forms of termination of life sustaining treatment, constituting so called passive euthanasia,1 has severaly undercut the logic of every form of reasoning that has traditionally been used to oppose active euthanasia and assistance in suicide. Basically, there are two such forms of traditional opposition, each represented in a range of different versions. There is the inevitable argument concerning (...) social utilities — that permitting euthanasia and assisted suicide will have bad social consequences. But more fundamentally, the idea persists that killing is intrinsically worse than letting‐die in some sense that justifies the current practice of prohibiting the first while allowing the latter. In this paper, I first consider this latter claim. My ultimate strategy, as I have said, is to show that the nature of certain things we have all come to approve regarding termination of treatment makes it next to impossible to convincingly explain, in either of these ways, what is wrong with certain forms of assistance in suicide and euthanasia. In the second part of this paper I take another step in this direction by discussing, in a preliminary way, a special case of the argument from social risks. (shrink)

Photo by Hannah Busing on Unsplash INTRODUCTION Religion has long provided guidance that has led to standards reflected in some aspects of medical practices and traditions. The recent bioethical literature addresses numerous new problems posed by advancing medical technology and demonstrates an erosion of standards rooted in religion and long widely accepted as almost axiomatic. In the deep soul-searching that pervades the publications on bioethics, several disturbing and dangerous trends neglect some basic lessons of philosophy, logic, and history. The bioethics (...) discourse on medical aid in dying emphasizes similarity over previously recognized important distinguishing features. For example, it overplays a likeness between assistance in dying and the withdrawal of life-saving technology. In many bioethics’ topics, arguments based on a logical continuum are used to question the lines demarcating important moral differences. l. The Line Between Ethical and Not: Logic Based on Continuum Careful case selection, often either end of a continuum, allows the tearing down or ridiculing of many rules and codes across most professions and fields of interest. This situation holds true for traffic laws as well as medical ethics guidelines. It is relatively simple for those who desire to attack a particular viewpoint by selecting a case that makes that position seem untenable. In the ethics realm, good and bad medicine exist at opposite ends of an ethical continuum, with many practices lying in between. For example, much of medical ethics exists between the Nazi criminal physicians and the most sainted nurse or physician. A gradual progression occurred over less than two decades from a utilitarian position that supported limited euthanasia for those with certain mental illnesses to genocide. German society embraced a utilitarian ethic in which the value of human life no longer was intrinsic but instrumental.[1] Many morally significant points on a continuum were then ignored as the misguided utilitarian policy rampantly continued. A point in the continuum to distinguish between ethically justifiable and that which is not can be difficult to identify compared to the two extremes. This continuum is not unique to ethics but can be applied to almost any other aspect of human life and endeavor. Between a severely ill schizophrenic person and a superbly well-adjusted individual, there is a continuum of mental and psychological function. The existence of a continuum should not paralyze thinking and prevent us from drawing lines and identifying moral differences based on objective criteria as well as moral philosophy. Yet, by focusing on a continuum, many bioethicists use logic to disregard dividing lines between an "ethical" and an "unethical" act. Unfortunately, sometimes bioethicists draw revolutionary conclusions that would change the scope of medical practices which is accepted as ethical. There are many examples of similar shifts on the continuum. Many authors argue for the ethical permissibility of abortion by pointing out that the human fetus is no different in various characteristics, one arguing it is as like an ape or chick as it is like a person,[2] and does not achieve unique human and individual characteristics until well into the first year of life.[3] While human fetuses arguably do not have certain distinctive qualities of personhood, most people shy away from the logical next conclusion: permitting infanticide. For example, Joshua Lederberg condemns infanticide, in the face of biological illogic, because of our emotional commitment to infants, to me, a relatively weak explanation. Sir Francis Crick suggests we might consider birth at two days of life in order to decide whether an infant is a "suitable" member of society.[4] Giublini and Minerva suggest that infanticide should be permissible since late pregnancy abortions are permissible, arguing there is no significant difference between a fetus just before birth and an infant just after birth.[5] Clearly the continuum approach would allow for subjective arguments in favor of later infanticide at other points many days post-birth. Years ago, with a cynical tone, I mentioned infanticide as a further step on the continuum beyond abortion, and I was rightly shouted down as being deliberately provocative to assert the logic would ever stretch so far. While it is not an accepted mainstream position, the movement in academic settings from widespread condemnation to limited possible acceptance of infanticide has taken place in an incredibly short time. Public opinion and medical opinion in these areas have shifted dramatically in a short time. In another area, from a biological and chemical point of view, there is a continuum from man down to a single carbon atom. Yet, it would not seem logical to ignore the emotional differences, the meaning of personhood, or the moral distinction between killing an insect and killing a person. ll. A False Continuum: Medical Aid in Dying I assert that there has been an erosion of ethical guidelines in recent years attributable to using continuums to camouflage important distinctions. James Rachels’ work on active and passive euthanasia, which contends that the two are ethically identical, exemplifies that logic.[6] He illustrates this thesis, using a continuum to compare different scenarios with like consequences as morally equivalent, by comparing the deliberate drowning of a child with a deliberate failure to rescue a drowning child when easily able to do so. The author's comparison proposes that since much of the medical profession has already made peace with withholding treatment in order to hasten death, consistency inexorably demands that we permit active euthanasia as well.[7] When permission for active euthanasia was first introduced, it was limited exclusively to patients suffering severely from an intractable, incurable, and irreversible disease. These guidelines have been continuously eroded. There is now a substantial serious consideration for permitting active euthanasia of healthy elderly individuals who feel that they have completed their lives and are "tired of living."[8] There are many moral and factual differences along the ethical continuum. In human life, there is a difference between a live baby and a fetus, between a viable fetus and one that is not, between a fetus and a zygote, and between a zygote and a sperm cell. Similarly, there is a difference between pulling a trigger to kill someone and not interfering in preventing his death, which is reprehensible though both may be. There is a difference between not resuscitating an 80-year-old man with cancer when his heart stops and injecting him with a fatal dose of potassium chloride. I argue that an overt act of taking life repels civilized human beings is to be commended and encouraged as the reverence for human life or even for just a moment of human life is one of the great contributions of our civilization. CONCLUSION As an orthodox Jew, I feel that divinely inspired guidelines that have stood the test of centuries shape my beliefs, and such guidelines contradict medical aid in dying. I cannot speak to the viewpoint of those who do not access religion in defining their moral stance, nor do I implicate them in the current bioethics' trends, as I am not aware of the personal role of religion in the lives of most such authors. While many nonreligious people have a firm philosophical grounding and oppose medical aid in dying, I suggest that in the absence of any religious or other absolute standards, developing logically defensible ethical guidelines may be challenging. At the least, religion may play a role in defining the points on the continuums that are ethically meaningful and refuting the trending beliefs that if the endpoint is the same, allowing different methods of arriving at that end are somehow ethically equal. The continuum of ways death may result does not negate analysis of whether death is brought about in ways that recognize the importance of life. The German philosopher Hans Jonas said, "It is a question whether without restoring the category of the sacred, the category most thoroughly destroyed by the scientific enlightenment, we can have an ethics able to cope with the extreme powers that we possess today and constantly increase and are compelled to use."[9] While countries vary on the role of religion in policy, with many emphasizing freedoms of religion, a recent position paper released by a group of Jewish, Christian, and Moslem leaders suggested the need for agreement on the unique sanctity of human life.[10] I would recommend that such a document serve as an example of consensus on critical foundational bioethical guidelines for democratic secular societies. - [1] Alexander L Medical science under dictatorship. New England Journal of Medicine, 241, p39-47 DOI10.1056/NEJM194907142410201 [2] Lederberg J. A geneticist looks at contraception and abortion, Annals of Internal Medicine 67, sup 2, 25-27. https:/doi.org/10.7326/0003-4819-67-3-25 [3] Ibid. [4] Editorial, Sociology: Logic of biology. Nature 220, 429 https://www.nature.com/articles/220429b0 [5] Giublini A Minerva F After-birth abortion: why should the baby live. J Med Ethics 39, 261- [6] Rachels J Active and passive euthanasia. New England Journal of Medicine 292, 78-80 [7] Ibid. [8] Cohen-Almagor R Euthanizing people who are "tired of life". in Euthanasia and Assisted Suicide-Lessons from Belgium. Ch 11 of Euthanasia and Assisted Suicide, Cambridge University Press pp173-187. 2017 and DOI; https://doi.org/10.1017/9781108182799.012 [9] Hans Jonas, Technology and Responsibility: Reflections on the New Tasks of Ethics, 1972, found as Chapter IX, Philosophical Essays, 1980. https://inters.org/jonas-technology-responsability [10] A position paper of the Abrahamic Monotheistic religions on matters concerning the end-of-life. Vatican Press 28 October 2019 https://press.vatican.va/content/salastampa/en/bollettino/pubblico/2019/10/28/191028f.html. (shrink)

When it is considered to be in their best interests, withholding and withdrawing life-supporting treatment from non-competent physically ill or injured patients – non-voluntary passive euthanasia, as it has been called – is generally accepted. A central reason in support of the procedures relates to the perceived manner of death they involve: in non-voluntary passive euthanasia death is seen to come about naturally. When a non-competent psychiatric patient attempts to kill herself, the mental health care providers (...) treating her are obligated to try to stop her. Yet it has been suggested that death by suicide can be a part of the natural course of a severe mental illness. Accordingly, if the perceived naturalness of the deaths occurring in connection with non-voluntary passive euthanasia speaks for their moral permissibility, it could be taken that a similar reason can support the moral acceptability of the suicidal deaths of non-competent psychiatric patients. In this article, I consider whether the suicidal death of a non-competent psychiatric patient would necessarily be less natural than those of physically ill or injured patients who die as a result of non-voluntary passive euthanasia. I argue that it would not. (shrink)

The Groningen Protocol allows active euthanasia of severely ill newborns with unbearable suffering. Defenders of the protocol insist that the protocol refers to terminally ill infants and that quality of life should not be a factor in the decision to euthanize an infant. They also argue that there should be no ethical difference between active and passive euthanasia of these infants. However, nowhere in the protocol does it refer to terminally ill infants; on the contrary, (...) the developers of the protocol take into account the future quality of life of the infant. We also note how the Nazi Euthanasie Programm started with the premise that there is some life not worthy of living. Therefore, in our opinion, the protocol violates the traditional ethical codes of physicians and the moral values of the overwhelming majority of the citizens of the world. (shrink)

This study was conducted to gain opinions about euthanasia from nurses who work in intensive care units. The research was planned as a descriptive study and conducted with 186 nurses who worked in intensive care units in a university hospital, a public hospital, and a private not-for-profit hospital in Adana, Turkey, and who agreed to complete a questionnaire. Euthanasia is not legal in Turkey. One third (33.9%) of the nurses supported the legalization of euthanasia, whereas 39.8% did (...) not. In some specific circumstances, 44.1% of the nurses thought that euthanasia was being practiced in our country. The most significant finding was that these Turkish intensive care unit nurses did not overwhelmingly support the legalization of euthanasia. Those who did support it were inclined to agree with passive rather than active euthanasia (P = 0.011). (shrink)

One of the most recent controversies to arise in the field of bioethics concerns the ethics for the Groningen Protocol: the guidelines proposed by the Groningen Academic Hospital in The Netherlands, which would permit doctors to actively euthanise terminally ill infants who are suffering. The Groningen Protocol has been met with an intense amount of criticism, some even calling it a relapse into a Hitleresque style of eugenics, where people with disabilities are killed solely because of their handicaps. The purpose (...) of this paper is threefold. First, the paper will attempt to disabuse readers of this erroneous understanding of the Groningen Protocol by showing how such a policy does not aim at making quality-of-life judgements, given that it restricts euthanasia to suffering and terminally ill infants. Second, the paper illustrates that what the Groningen Protocol proposes to do is both ethical and also the most humane alternative for these suffering and dying infants. Lastly, responses are given to some of the worries expressed by ethicists on the practice of any type of non-voluntary active euthanasia. (shrink)

In terminally ill individuals who would otherwise end their own lives, active voluntary euthanasia (AVE) can be seen as life-extending rather than life-shortening. Accordingly, AVE supports key pro-euthanasia arguments (appeals to autonomy and beneficence) and meets certain sanctity of life objections. This paper examines the extent to which a terminally ill individual’s wish to donate organs after death contributes to those life-extension arguments. It finds that, in a terminally ill individual who wishes to avoid experiencing life (...) he considers to be not worth living, and who also wishes to donate organs after death, AVE maximizes the likelihood that such donations will occur. The paper finds that the wish to donate organs strengthens the appeals to autonomy and beneficence, and fortifies the meeting of certain sanctity of life objections, achieved by life-extension arguments, and also generates appeals to justice that form novel life-extension arguments in favour of AVE in this context. (shrink)

A number of influential reports on influenza pandemic preparedness include recommendations for extra-autonomous decisions to withdraw mechanical ventilation from some patients, who might still benefit from this technology, when demand for ventilators exceeds supply. An unintended implication of recommendations for nonvoluntary and involuntary termination of life support is that it make pandemic preparedness plans vulnerable to patients’ claims for assisted suicide and active euthanasia. Supporters of nonvoluntary passive euthanasia need to articulate why it is both morally (...) different and morally superior to voluntary active euthanasia if they do not wish to invite expansion of end-of-life options during health system catastrophe. (shrink)

The Standard View in research ethics maintains that, under certain conditions, investigators may deceive subjects and may enroll subjects without their consent. In contrast, it is always impermissible to coerce subjects to enroll, even when the same conditions are satisfied. This view raises a question that, as far as we are aware, has received no attention in the literature. Why is it always impermissible to undermine the validity of subjects’ consent through coercion, but it can be permissible to undermine the (...) validity of subjects’ consent through deception, and it can be permissible to enroll subjects without any consent at all? The present analysis suggests that the answer traces to the conditions on the appropriate treatment of subjects. This conclusion suggests that some requirements for human subjects research, and for valid consent more generally, trace not to the protection of subjects per se but to the proper behavior of agents. (shrink)

We argue that the dead donor rule, which states that multiple vital organs should only be taken from dead patients, is justified neither in principle nor in practice. We use a thought experiment and a guiding assumption in the literature about the justification of moral principles to undermine the theoretical justification for the rule. We then offer two real world analogues to this thought experiment, voluntary active euthanasia and capital punishment, and argue that the moral permissibility of terminating (...) any patient through the removal of vital organs cannot turn on whether or not the practice violates the dead donor rule.Next, we consider practical justifications for the dead donor rule. Specifically, we consider whether there are compelling reasons to promulgate the rule even though its corresponding moral principle is not theoretically justified. We argue that there are no such reasons. In fact, we argue that promulgating the rule may actually decrease public trust in organ procurement procedures and medical institutions generally – even in states that do not permit capital punishment or voluntary active euthanasia.Finally, we examine our case against the dead donor rule in the light of common arguments for it. We find that these arguments are often misplaced – they do not support the dead donor rule. Instead, they support the quite different rule that patients should not be killed for their vital organs. (shrink)

In his plea for consensual democracy in Africa, Kwasi Wiredu recommends unanimity about what is to be done, not what ought to be done, or unanimity on action rather than unanimity of values, beliefs and opinion. I caution the use of this procedural instrument by showing that some issues are so value-laden that a group decision cannot be value-neutral. It may sometimes be more productive to entertain value differences to keep them from going underground and becoming dangerous. However, the (...) ability to locate some common interest or ground seems to be crucial for such value confrontation. (shrink)

This is a defense of Pyrrhonian skepticism against the charge that the suspension of judgment based on equipollence is vitiated by the assent given to the equipollence in question. The apparent conflict has a conceptual side as well as a practical side, examined here as separate challenges with a section devoted to each. The conceptual challenge is that the skeptical transition from an equipollence of arguments to a suspension of judgment is undermined either by a logical contradiction or by an (...) epistemic inconsistency, perhaps by both, because the determination and affirmation of equipollence is itself a judgment of sorts, one that is not suspended. The practical challenge is that, independently of any conceptual confusion or contradiction, suspending judgment in reaction to equipollence evinces doxastic commitment to equipollence, if only because human beings are not capable of making assessments requiring rational determination without believing the corresponding premises and conclusions to be true. The two analytic sections addressing these challenges are preceded by two prefatory sections, one laying out the epistemic process, the other reviewing the evidentiary context. The response from the conceptual perspective is that the suspension of judgment based on equipollence is not a reasoned conclusion adopted as the truth of the matter but a natural reaction to an impression left by the apparently equal weight of opposing arguments. The response from the practical perspective is that the acknowledgment of equipollence is not just an affirmation of the equal weight of arguments but also an admission of inability to decide, suggesting that any assent, express or implied, is thrust upon the Pyrrhonist in a state of epistemic paralysis affecting the will and the intellect on the matter being investigated. This just leaves a deep disagreement, if any, regarding whether equipollence is an inference based on discursive activity or an impression coming from passive receptivity. But this, even if resolved in favor of the critic (which it need not and ought not be), is not the same as confusion or inconsistency on the part of the Pyrrhonist, the demonstration of which is the primary aim of this paper. (shrink)

Kwasi Wiredu has proposed a democracy by consensus as an alternative to the majoritarian model of democracy many African countries inherited from their colonial masters. As part of his proposal, Wiredu made a number of claims about traditional African consensus democracy that appear to be personal conjectures rather than information obtained from proper empirical investigation. These apparent conjectures have led to confusion and disagreements regarding what actually happened in these traditional societies. In this article, I outline the dangers of (...) such an approach to scholarship. I show that Bernard Matolino’s attempt to defend this methodological laxity is not successful. I argue that inaccurate claims can lead to inaccurate values, and to the designing of mistaken social and political systems. (shrink)

In his proposal for a democracy by consensus, Wiredu argued that deliberation is an activity that depends solely on the logical persuasiveness of ideas. Emmanuel Chukwudi Eze and I had objected to this view of deliberation. Bernard Matolino has responded separately to Eze and me by sticking to Wiredu’s position that deliberation is a purely rational activity. In this article, I support my earlier claim that persuasion (and hence deliberation) is not an entirely logical activity, and our concern as human (...) beings is to recognize the influence of non-rational factors, for the purpose of minimizing the role of these non-rational factors. My general aim here is to explore the implications of a counterfactual situation in which we assume that deliberation is a purely rational activity, and these implications are unpalatable even to proponents of deliberation as a purely rational activity. My conclusion is that it is only by recognizing the role of non-rational factors in deliberation that we are driven to institute mechanisms to ensure that logic dominates over non-rational factors as much as practicable in either persuading or in being persuaded. Assuming that deliberation is a purely rational activity, on the other hand, forestalls any measures and allows non-rational influences to fester undeterred. (shrink)

To the question,“what is sports”, or what is a good sports activity or event, I am sure Plato would know what to say, using references to his philosophical division of man into three parts, namely: the appetite soul; the emotional soul and the reasonable soul. Plato would have said that sports comes from the human person and being, and so, for any particular sports to be accorded the accolade of goodness it must have the correspondence of the three constituent parts (...) of man’s true nature. The concept of the soul in Plato is what exploring just as that of Professor Maduabuchi Dukor’s expositions concerning the African philosophical concepts of soul, mind, spirit and body as they affect philosophy of sports and the discipline of physical education. The article will therefore analyze the link between Plato concept of the good sports, Professor Dukor’s ontological ideas about the African core values as they affect the balance, harmony and health both the mind and body of the human being. The central point here is the analytical framework of enquiry which Plato sustained in his Dialogues when he queries people:“what is this?”. By this he wants people to appreciate the fact that when they are in search of truth, they usually have the impression that they have all when, actually, they have only half-baked understanding of issues. It is important therefore to understand the issues involved in the disciplines of physical education, philosophy of sports, ethics and the ontological frame of African philosophy as profiled under Professor Dukor theistic humanism of African philosophy. Centrally, the dialectical link between Plato and Dukor will expose the ethical dimension to sports development since every thing is not wining and money or drugs should not be the ultimate motivation for sports and physical exercises. The exercise of sports should lead to the dual development and balance of both mind and body; the highest being the competition of the soul with itself and not with others in which laurels, gold or money is won or lost. The man who wins is the one, like in the communal spirit of the African ontology, who has conquered over his selfishness and sacrifices for the good of the community. (shrink)

Prior research has demonstrated that accountants differ from the general population on many personality traits. Understanding accountants’ personality traits is important when these characteristics may impact professional behavior or ability to work with members of the business community. Our study investigates the relationship between Machiavellianism, ethical orientation, anti-intellectualism, and social desirability response bias in Canadian accountants. We find that Canadian accountants score much higher on the Machiavellianism scale than U.S. accountants. Additionally, our results show a significant relationship between Machiavellianism (...) and relativism, idealism, anti-intellectualism, and social desirability response bias. Our results indicate that professional Canadian accountants may not share the same personality characteristics as U.S. accountants. We extend previous research investigating Canadian accountants, by explicitly recognizing the impact of social desirability response bias, and by including anti-intellectualism. (shrink)

This research exposes the connection between economic inequality and racism. The central argument is that racism is predicated on the economic superiority of the racist. The corollary argument is that conceptions of skin colour are consequences rather than causes of racism: racism does not arise because of skin colour, but because different skin colours have become associated with certain economic conditions for a very long period of time in history. The argument is in fact extended to posit that the (...) topography of the racist relationship would be reversed if the economic tables were also reversed. The conclusion is that the relationship between racism and economic inequality is, therefore, more significant than the relationship between racism and skin colour. This conclusion has consequences regarding how races at the receiving end of racism should respond to racism. (shrink)

In decrying the evils of supernaturalism, African philosopher Kwasi Wiredu proposes humanism, by making concern for human well-being the basis for morality. However, the presentation of humanism as a simple replacement of supernaturalism is objectionable. Wiredu’s notion of supernaturalism is too narrow, since it is only a variant of supernaturalism. His reference to humanism is too broad, since humanism is an umbrella of very conflicting worldviews, such as that between secular and theistic humanism. Although Wiredu does not specify which variant (...) of humanism he means, and although he acknowledges that the Akan believe in a Supreme Being, his general ontology shows that he is closer to the secular than the theistic variant. This article explores the ideological extensions of the two and argues that theistic humanism provides the compatibility needed for being religious and at the same time basing morality on humanistic/naturalistic concerns. In doing so, it distinguishes supernaturalism per se from its ethical and cosmological variants. As a corrective to Wiredu, this article blames these two variants of supernaturalism, rather than supernaturalism per se, for the evils that Wiredu adduces. The conclusion is that in theistic humanism, humanism escapes the dangers of ethical and cosmological supernaturalism without necessarily adopting the antisupernaturalist connotations currently popular with modern secular humanism. (shrink)

Quantum computers are hypothetical quantum information processing (QIP) devices that allow one to store, manipulate, and extract information while harnessing quantum physics to solve various computational problems and do so putatively more efficiently than any known classical counterpart. Despite many ‘proofs of concept’ (Aharonov and Ben–Or 1996; Knill and Laflamme 1996; Knill et al. 1996; Knill et al. 1998) the key obstacle in realizing these powerful machines remains their scalability and susceptibility to noise: almost three decades after their conceptions, (...) experimentalists still struggle to maintain useful quantum coherence in QIP devices with more than a pair of qubits (e.g., Blatt and Wineland 2008). This slow progress has prompted debates on the feasibility of quantum computers, yet the quantum information community has dismissed the skepticism as “ideology” (Aaronson 2004), claiming that the obstacles are merely technological (Kaye et al. 2007, 240). In a recent paper (Hagar 2009) I’ve argued that such a skepticism with respect to the feasibility of quantum computers need not be deemed ideological at all, and that the aforementioned ‘proofs of concept’ are physically suspect. Using analogies from the foundations of classical statistical mechanics (SM), I’ve also argued that instead of active error correction, the appropriate framework for debating the feasibility of large–scale, fault–tolerant and computationally superior quantum computers should be the project of error avoidance: rather than trying to constantly ‘cool down’ the QIP device and prevent its thermalization, one should try to locate those regions in the device’s state space which are thermodynamically ‘abnormal’, i.e., those regions in the device’s state space which resist thermalization regardless of external noise. This paper is intended as a further contribution to the debate on the feasibility of large–scale, fault–tolerant and computationally superior quantum computers. Relying again on analogies from the foundations of classical SM, it suggests a skeptical conjecture and frames it in the ‘passive’, error avoidance, context.. (shrink)

Many philosophers maintain that there is a distinction between acts that the agent plays an active role in producing, and acts that issue from the agent in a more passive fashion. According to the standard account, we can make sense of this distinction by maintaining that reflective or deliberative acts are paradigmatic cases of an agent’s playing an active role in the production of action. This chapter argues that this standard account is mistaken. Reflective or deliberative actions (...) will seem to be active only if we conflate three claims: that choice causes action, that motives do not determine choice, and that reflection suspends the effects of motives. The chapter argues that while and are true, is false. Further, is needed to support the claim that reflective acts are active. Given the falsity of, the chapter shows that reflective acts are not necessarily more active than unreflective ones. The chapter closes by suggesting a new model of agential activity. (shrink)

In this paper, I discuss an example from Buchanan of active voluntary euthanasia (AVE). I first refute objections to the intuitive permissibility of the killing described in the example. After explaining why the killing is intentional, I evaluate Buchanan's solution to the ‘problem of intending death’. According to Buchanan, what justifies a physician in intentionally bringing about a patient's death by AVE is a principle that embodies the values of patient self-determination and well-being. I argue that these two (...) considerations are not sufficient for justifying AVE. The motive of the physician matters, but it is his desire rather than his intention that is relevant. An ethical physician may bring about intentionally the death of his patient if in forming his intention, he began with an appropriate desire to keep the patient alive as well as a legitimate desire to prevent prolonged suffering, with the latter outweighing the former. The ethical physician also desires to respect the choice of his patient wherever possible. On my account, the physician should be guided by the virtues and goals of his profession rather than by strict ‘all-or-nothing’ principles. I defend my account by describing the advantages of my account, and dismissing possible objections. (shrink)

Merleau-Ponty’s understanding of ‘passivity’ is a key to his account of perception. For Merleau-Ponty, perception is the way in which we are involved in the world, and it is on perception that the functions of understanding, reason, and reflection ultimately rest. While in his Phenomenology of Perception it is already clear that passive and active are intertwined, from a series of lectures he gave in 1954–5 we learn that inauguration or ‘institution’ arises out of a passivity that is (...) not merely an absence of activity. I show how the thoroughly temporal status of the subject as ‘instituting’ distinguishes it from a certain model of the ‘constituting’ subject. Next, I argue that, to grasp the sense in which Merleau-Ponty intends ‘passivity’, we must recognize its mediating or transitional status. Specifically, I examine terms that arise repeatedly in his analysis of the Freudian account of the unconscious — namely, ‘pivot’ and ‘enjambment’ — to show how they reveal the peculiar status of a passivity that operates through a dialectic focused on its transitional terms rather than on opposing poles. Finally, I suggest the exchange between passivity and institution that Merleau-Ponty has in mind can be illuminated through consideration of late Palaeolithic cave paintings, where the rock itself seems to begin an expression that the artist completes. (shrink)