Henry Imler April 26th, 2006

John Hardwig, in his paper, Is there a Duty to Die? suggests that sometimes people have an obligation to allow nature to take it’s course. I read the article a couple of years ago and made some rudementary notes from it:”The Unsound Argument(Is there a Duty to Die? by John Hardwig)”:http://unsoundargument.com/ethics/is-there-a-duty-to-die-john-hardwig. Here is his basic argument:

1. People’s needs and wants and goods are interconnected. (rejection of the indivualistic fantasy)
2. It is immoral to impose serious burdens on others to further one’s needs and wants
3. One is not relieved of their moral duties when they are sick and dying.
4. Sometimes continuing to live will place serious (and undue) burdens on loved ones.
5. ? Sometimes one has a duty to die

While it seems to fly in the face of all of our notions about old age and death, I think he has a point. We are all mortal creatures. We will all die at some point, why is the onus on everyone else to provide individuals constant healthcare? I am not arguing against universal healthcare, just artificially keeping people alive and draining the energy and resources of the community for something that is ultimately inevitable. The community can be one’s family, one’s town, one’s state, ect…

Since this topic is a very sensitive one, Hardwig goes out of his way to dance around specific instances of when a person has a duty to die. He does this to avoid stepping on anyone’s toes.

Is a good death better than a prolonged, miserable life? Can anyone make that determination for anyone? It is a good can of worms.

• Ethics , Euthanasia
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Henry Imler April 26th, 2006

A while back Dave made a pretty good chart showing the pro-life stance of three parties. I agree with most of his assessments of what stance is pro-life, excepting a couple therefrom. They were euthanasia, war, and poverty.

I want to use two of these areas to highlight what I consider pro-life.

What do I consider the guiding principle behind being pro-life? I can tell you what it is not. Pro-life is not simply being against death in any form or context. People die. It is a natural aspect of the human condition. I do not look upon old age as an evil, even though it brings one close to death.

Instead, it is the freedom to choose that makes our lives valuable. It is why slavery is evil. It is why totalitarism is evil. Freedom is why we shudder when we place ourselves in Kira Argounova’s or Winston Smith’s shoes. When I apply this concept of freedom giving life its value to the common pro-life issues I am forced two conclusions; 1) abortion is morally impermissible and 2) euthanasia is morally permissible. The killing of an infant takes away all possible choices that person could every have. Euthanasia on the other hand is the supreme enactment of choice. It is the choice whether to continue to make choices. Surely to rob a person of that is morally impermissible.

So while an anti-abortion and a pro-euthanasia stance might seem morally inconsistent to some, it is still possible.

• Ethics , Euthanasia , Personhood , Political Philosophy , abortion
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Henry Imler September 10th, 2005

When beginning any discussion in ethics, it is always beneficial to begin on common footing. For, without the same definitions, nothing can be agreed upon. I think Aristotle said that, but I am not sure.

Here are some definitions of some terms that will be popping up here in some posts about biomedical ethics.

Suicide: Self-killing.

• Typically there is not a distinction between levels of beneficence.

Euthanasia: “Good Death”(eu-good; thanasia-death) The killing of another at the request of the person killed.

• Distinguished from Suicide because another agent besides the self is the cause of death.
• the assisting the death of another for reasons of beneficence.
• Also known as “mercy killing or “mercy Letting die”
• There are several different “flavors” of euthanasia.

Assisted Suicide - Distinct from euthanasia in that it is the enabling of suicide by another party.

• Most commonly this takes the form of Physician Assisted Suicide, or PAS.

When considering the moral and ethical implications of these issues, be sure to distinguish between casual evaluations and moral evaluations. Casual refers to simply how something happened. i.e. The knife passing thru Matt’s head was the cause of death. Moral refers to the ethical evaluation of an act. i.e. It is morally impermissible to place a knife thru Matt’s head. A lack of this distinction is often the cause of muddled issues in biomedical ethics.

Casual Distinctions in Euthanasia:

1. Passive or Letting Die: The withdraw of treatment or sustenance that will lead to death.
   • Also known as “Pulling the plug”
   • Can take the form of removing food or water, discontinuing a vital treatment.
2. Active or Killing: actively bringing ab out the death of a person.
   • i.e. lethal injection

Types of Consent involved in Euthanasia:

1. Voluntary - Person requests euthanasia
2. Non-voluntary - Person cannot request nor deny euthanasia due to a lack of decision making ability. This is found in long term comas.
3. In-voluntary- The person does not wish to be killed.

While there can be an argument made whether or not voluntary and nonvoluntary forms of euthanasia are morally permissible; all would agree that nonvoluntary euthanasia is tantamount to murder.

Now that we have casual and consensual distinctions within the term Euthanasia, we can combine them to form the six types of Euthanasia:

1. Voluntary Passive Euthanasia (VPE) - Patient requests to be allowed to die for the easement of their suffering
2. Voluntary Active Euthanasia (VAE) - Patient requests to be killed for the easement of their suffering
3. Nonvoluntary Passive Euthanasia (NPE) - Patient is not able to request death or sustained life and is allowed to die for the easement of their suffering.
4. Nonvoluntary Active Euthanasia (NAE) - Patient is not able to request death or sustained life and is killed for the easement of their suffering
5. Involuntary Passive Euthanasia (IPE) - Patient requests to be left alive/continue treatment and is allowed to die for the easement of their suffering.
6. Involuntary Active Euthanasia (IAE) - Patient requests to be left alive/continue treatment and is killed for the easement of their suffering.

It is hoped that when one starts with this background when examining the euthanasia issue, one be able to sort through the topic clearly.

• Ethics , Euthanasia , Notes , Personhood
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Henry Imler April 13th, 2005

Article: Is there a Duty to Die?
Author: Hardwig, John

It is not absurd to think that sometimes we have a duty to die.

It is not absurd to think that sometimes our loved ones do not have a duty to continue to support the dying.

Basic Argument:

1. People’s needs and wants and goods are interconnected [rejection of the indivualistic fantasy]
2. It is immoral to impose serious burdens on others to further one’s needs and wants
3. One is not relieved of their moral duties when they are sick and dying.
4. Sometimes continuing to live will place serious burdens on loved ones.
5. ∴ Sometimes one has a duty to die

Hardwig gives the principles on when someone has a duty to die, but repeatedly abstains from giving anyone a duty to die.

Conditions that might lead to a duty to die:

• Fundamental reason: The duty to die [d2d] increases when continuing to live [c2l] will impose significant burdens on those that are interconnected with you [loved ones, family]
  • These burdens can include: emotional, extensive caregiving, destruction of life plans, finacial hardship
• Greater as one grows older
• Have lived a rich life
• Loved one’s life has been difficult or impovrished
• When loved ones have already made significant contributions to your life
• The extent to which you can adjust to your illness, the more one can, the less the duty - note on increased social medicine and hospice
• Less likely of a duty if one can still make contributions to the lives of others
• More likely if your personality dies by a dementing disease
• Greater Duty to die if you have played the part of the grasshopper instead of the ant.

Do the incompetent have a Duty to Die?
They do not if they have never been competent, for nonpersons do not have duties. Hardwig dances around the issue of whether or not the formerly competent can have such a duty.

Social Polices and the Duty to Die:
In light of #6 above, the increase in availibility of social services to the dying decreases the duty for them to die. This is due to postulate #4 in the argument for a duty to die: It is immoral to impose serious burdens on others to further one’s needs and wants.
Accordingly, if society [or anything else] has set up a means of support, and you do not impose a serious burden on loved ones, then you do not have a duty to die.

Conversely, if the loved ones are willing to accept the burden created by keeping you alive, then they may, but they are never forced to carry the burden created by keeping you live, on a prima facie basis.

Misc Points:
Irony that the advances in medicine have created conditions for people to live for a unnaturally long time
The duty to die affirms my moral agency, my personhood.

• To treat one as if they are releaved of their duties when they are sick and dying is to treat them as a child.
• It implies that they are morally incompetent.

Meaning in death requires an affirmation of connections

• Life without connection is meaningless
• These connections can be to other things, like land, nature, ect…

I really think he is worming his way out of the connections/meaning of life issue.

• Does not reflect the actions of Jesus or his followers
• Not clear that the belief that “all life is sacred and therefore we should postpode death as long as possible in all cases” is univerally true
• The bible sends a mixed message on the topic of suicide
  • [I have no idea about this, Saul and Judas were seen in a negative light, but I know of no absolute stipulation against it.]
• Physical Death is not the ultimate evil in the Bible

2. The duty to die is concompatible with human dignity
It actually affirms thier himan dignity to restore to them moral agency.

3. The dying are already shouldering most of the burdens and to give them an additional burden would be wrong.
Is this really true?
Example:

87 year old woman is dying, she wants to live and in the fulfillment of that, her 55 year old daughter takes care of her. The lady lives two years longer instead of the forcasted 6 months. In the span of that time, the duaghter has lost her life plan, her career, her savings, her house, all of which results in a greatly lowered quality of life for a period of 30 years.

Which is the greater burden?

To lose a 50% chance of 6 months of life at age 87.
–or–
To lose one’s life plan, her career, her savings, her house, all of which results in a greatly lowered quality of life for a period of 30 years?

Clearly, the second option is worse

4. The Duty to Die impacts the poor more than the rich.

• This objection is a red herring. That fact is more a critique of the social setup than the duty to die.

• Ethics , Euthanasia , Personhood
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