Phil 104 – Fall 09 First Writing Assignment

Anderson

Due Wednesday, Sept. 30

1. Re: The Elizabeth Bouvia Case. The physicians at Riverside Hospital refused to let her starve to death. At the legal hearing Judge Hews allowed the forced feeding of Ms. Bouvia. He argued that although Bouvia was rational, sincere, and competent, to permit her to starve herself to death would have a “profound effect on the medical staff, nurses, and administration of the hospital” as well as a “devastating effect on other …physically handicapped persons”. Also, since she was not terminally ill and could live for decades, “there was no other reasonable option” (3).

If you were Bouvia’s attorney, what could you say in her defense?

2. Many people believe that every human life is sacred or, as Kant puts it (12), every human life is of infinite worth; we can’t put a price on life. He argues it follows from this fact that suicide can never be justified. What is his argument for this? Suppose you agree with this way of valuing human life. Does it follow that physician assisted suicide could never be justified?

3. The SUPPORT study (16) found that many people who fill out advance directives regarding their preferred medical care should they become seriously ill or incompetent, often have a poor understanding of what they will later find to be an acceptable or unacceptable quality of life. Does it follow from this study (assume it reflects the general population) that people don’t really know their own best interests very well and therefore, physicians need not take advance directives very seriously?

4. Pence is disturbed by the fact that social conservatives have co-opted the label “family values” to characterize their own moral preferences as contrasted, presumably, with more liberal perspectives on controversial moral issues (26). Can a supporter of euthanasia for a person like Nancy Cruzan justifiably claim to be as supportive of family values as the conservatives who oppose euthanasia? Explain your answer.

5. Although the Cruzan case was a milestone in medical ethics, its “clear and convincing” standard has been harshly criticized by many persons, both within the medical profession and without, for the reason that they believe it imposes an overly demanding standard on people who would not want to be kept on life-support should they suffer the fate of being in a persistent vegetative state (PVS).

- Explain why that standard is thought to be too demanding.

- The late Justice Rehnquist, who wrote the majority opinion in the Cruzan case, defended the clear and convincing standard on the ground that it protects patients against guardians who might abuse their trust. Is that a convincing justification?

- Another argument Rehnquist gave for imposing the clear and convincing standard is that the state has an interest in preserving life. Granted the state does have such an interest, does it follow that the clear and convincing standard must be imposed on anyone in a PVS, even if they clearly made their wishes known previously that they did not want to be kept alive?

6. Many people - including a good many physicians - agree that if a patient does not want, say, to be put on a ventilator, their request should be respected even if it means they will soon die as a result. A competent patient has a right to refuse any medical treatment they emphatically do not want. But some physicians also think that if the patient is once on a respirator, they cannot under any circumstances remove it because then they would be guilty of killing the patient. Explain why this distinction between killing and letting die appears to be completely bogus.

7. Some people, physicians and non-physicians alike, respond to the debate over physician assisted suicide by saying “Doctors shouldn’t kill; end of issue”. Proponents of PAS can say in response: “That begs the question.” Why are they justified in making this response?

8. Although one hears it less and less frequently these days, some people argue that physician assisted suicide is extremely dangerous because euthanasia was the first step in the Nazi program that led eventually to the Holocaust. What are some reasons for thinking this is a very weak analogy?

9. Explain what is meant by a conceptual slippery slope.

- Why do some critics of physician-assisted dying think the legalization of it would put us on a conceptual slippery slope?

- What can be said in reply to these critics?