Euthanasia: Causing Death and Saving Lives

Presenter: Dr. Paul Kamill

March, 2016

“If yesterday I read a novel, am I to be prosecuted for not saving lives by working for Oxfam, or for not doing so by holding a road-safety class at the local school?

But, from the point that the law should not punish certain harmful omissions, it does not follow that they are morally acceptable [my emphasis]. If I see a child for whom I have no special responsibility drowning in a river and deliberately do nothing when I could save him, the law does not punish me, largely because of the difficulties of drawing clear-cut and sensible boundaries around any proposed offence. But few of us would feel entitled to conclude that my omission is immune from criticism…”

Acts, such as going to Africa and caring for as many babies as you are physically able to do requires time. Even working to fund Oxfam, requires time. However, omitting to do something, by contrast, does not require ‘time’. It is the easier option.

Then, we have the confidence or ‘trust’ issue. Some of you may know of Harold Shipman, a family doctor in north-west England. If not, here is his biography:

I turn to popular culture, and the film “Logan’s Run”, in which individuals reaching thirty years of age are ‘immolated’ in the ritual of “Carousel”. The ‘promise’ of a better life? Maybe? My question is, if there were such a law determining that I should die under certain circumstances, would I have confidence in my doctors if I was sent to hospital? It certainly undermines the current nature of the doctor-patient relationship.

Some of you may have come across the “doctrine of double effect”? This link has some examples, along with the conditions that must be fulfilled for it to be satisfied:

It dates from the time of Thomas Aquinas, and is often cited in medical situations. The problem arises not only in the administration of pain relieving drugs, but to some extent the withdrawal of life-saving technologies (Glover, 1977). It is also a problem for the practice of medicine. Who do I choose, mother or foetus (Shaw, 2002)1.

Perhaps I should add that the Hippocratic oath, allegedly administered to medical practitioners on qualification, is frequently considered too patronising for patient care. There is also the popular misconception that a poem, written in the nineteenth century by A. H. Clough, called the “Latest Decalogue” in which the lines appear, “thou shalt not kill, but need’st not strive, officiously to keep alive…” As something to do with medical practice. Currently, and probably for the last half-century or so Principlism has been the dominant ethical “code”, for medical practice. It came from W D Ross, a British philosopher at Oxford in the 1930s.

It has since been popularised by the University at Georgetown, and has come to be known as the “Georgetown mantra”.

It is mostly practical, although of course with philosophers there is always some dissent! It involves four principles. 1). Autonomy, 2). Beneficence, 3). Non-maleficence, 4).  And last Justice.

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