Table Of ContentInternational Library of Ethics, Law, and the New Medicine 64
Michael Cholbi
Jukka Varelius Editors
New Directions
in the Ethics
of Assisted
Suicide and
Euthanasia
International Library of Ethics, Law,
and the New Medicine
Volume 64
Series editor
David N. Weisstub
University of Montreal Fac. Medicine, Montreal, Québec, Canada
The book series International Library of Ethics, Law and the New Medicine
comprises volumes with an international and interdisciplinary focus. The aim of the
Series is to publish books on foundational issues in (bio) ethics, law, international
health care and medicine. The 28 volumes that have already appeared in this series
address aspects of aging, mental health, AIDS, preventive medicine, bioethics and
many other current topics. This Series was conceived against the background of
increasing globalization and interdependency of the world’s cultures and govern-
ments, with mutual influencing occurring throughout the world in all fields, most
surely in health care and its delivery. By means of this Series we aim to contribute
and cooperate to meet the challenge of our time: how to aim human technology to
good human ends, how to deal with changed values in the areas of religion, society,
culture and the self-definition of human persons, and how to formulate a new way of
thinking, a new ethic. We welcome book proposals representing the broad interest
of the interdisciplinary and international focus of the series. We especially welcome
proposals that address aspects of ‘new medicine’, meaning advances in research
and clinical health care, with an emphasis on those interventions and alterations that
force us to re-examine foundational issues.
More information about this series at http://www.springer.com/series/6224
Michael Cholbi · Jukka Varelius
Editors
New Directions in the
Ethics of Assisted Suicide
and Euthanasia
1 3
Editors
Michael Cholbi Jukka Varelius
Department of Philosophy Department of Behavioural Sciences
California State Polytechnic University and Philosophy
Pomona, CA University of Turku
USA Turku
Finland
ISSN 1567-8008 ISSN 2351-955X (electronic)
International Library of Ethics, Law, and the New Medicine
ISBN 978-3-319-22049-9 ISBN 978-3-319-22050-5 (eBook)
DOI 10.1007/978-3-319-22050-5
Library of Congress Control Number: 2015945601
Springer Cham Heidelberg New York Dordrecht London
© Springer International Publishing Switzerland 2015
This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part
of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations,
recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission
or information storage and retrieval, electronic adaptation, computer software, or by similar or
dissimilar methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this
publication does not imply, even in the absence of a specific statement, that such names are exempt
from the relevant protective laws and regulations and therefore free for general use.
The publisher, the authors and the editors are safe to assume that the advice and information in this
book are believed to be true and accurate at the date of publication. Neither the publisher nor the
authors or the editors give a warranty, express or implied, with respect to the material contained
herein or for any errors or omissions that may have been made.
Printed on acid-free paper
Springer International Publishing AG Switzerland is part of Springer Science+Business Media
(www.springer.com)
Contents
1 Introduction ............................................... 1
Michael Cholbi and Jukka Varelius
2 Assisted Dying and the Proper Role of Patient Autonomy ......... 11
Emma C. Bullock
3 Preventing Assistance to Die: Assessing Indirect Paternalism
Regarding Voluntary Active Euthanasia and Assisted Suicide ...... 27
Thomas Schramme
4 Autonomy, Interests, Justice and Active Medical Euthanasia ...... 41
Julian Savulescu
5 Mental Illness, Lack of Autonomy, and Physician-Assisted Death ... 59
Jukka Varelius
6 Euthanasia for Mental Suffering .............................. 79
Kasper Raus and Sigrid Sterckx
7 Assisted Dying for Individuals with Dementia:
Challenges for Translating Ethical Positions into Law ............ 97
Jocelyn Downie and Georgia Lloyd-Smith
8 Clinical Ethics Consultation and Physician Assisted Suicide ....... 125
David M. Adams
9 License to Kill: A New Model for Excusing
Medically Assisted Dying? ................................... 149
Richard Huxtable and Jonathan Ives
v
vi Contents
10 Medically Enabled Suicides .................................. 169
Michael Cholbi
11 Saving Lives with Assisted Suicide and Euthanasia:
Organ Donation After Assisted Dying .......................... 185
David M. Shaw
12 Implanted Medical Devices and End-of-Life Decisions ............ 193
Michael B. Gill
13 Everyday Attitudes About Euthanasia and the Slippery
Slope Argument ............................................ 217
Adam Feltz
14 “You Got Me Into This…”: Procreative Responsibility
and Its Implications for Suicide and Euthanasia ................. 239
Rivka Weinberg
Editors and Contributors
About the Editors
Michael Cholbi is professor of philosophy at California State Polytechnic Uni-
versity, Pomona. He has published widely on the ethics of suicide, as well as on
paternalism, Kantian ethics, and death and dying. He is a founding member of the
International Association for the Philosophy of Death and Dying (IAPDD).
Jukka Varelius is a Research Fellow at the Department of Behavioural Sciences
and Philosophy at the University of Turku, Finland. His work focuses on questions
of applied ethics.
Contributors
David M. Adams is professor of philosophy at California State Polytechnic Uni-
versity, Pomona, and Clinical Ethicist at Pomona Valley Hospital Medical Center.
His recent research has focused on problems in clinical medical ethics.
Emma C. Bullock is an assistant professor of philosophy and a research fellow of
the Centre for Ethics and Law in Biomedicine (CELAB) at the Central European
University, Budapest. Her central research interests are philosophy of medicine and
medical paternalism.
Jocelyn Downie is a fellow of the Royal Society of Canada and the Canadian
Academy of Health Sciences. She was the director of the Health Law Institute at
Dalhousie for ten years. She is now a full professor in the Faculties of Law and
Medicine at Dalhousie University and a faculty associate of the Dalhousie Health
Law Institute. Her work on end-of-life law and policy goes back many years and
includes special advisor to the Canadian Senate Committee on Euthanasia and As-
sisted Suicide; author of Dying Justice: A Case for the Decriminalizing Euthanasia
vii
viii Editors and Contributors
and Assisted Suicide in Canada (winner of the AbbyAnn D. Lynch Medal in Bio-
ethics from the Royal Society of Canada); member of the Royal Society of Canada
Expert Panel on End-of-Life Decision-Making; and, most recently, member of the
pro bono legal team in the case of Carter versus Canada (Attorney General).
Adam Feltz is an assistant professor of psychology and applied ethics at Michigan
Technological University where he directs the Ethical Decision-making and Ethical
Naturalism Laboratory.
Michael B. Gill is professor of philosophy at the University of Arizona. He has
written extensively about the ethics of end-of-life decisions and is the author of two
books on moral theory: Humean Moral Pluralism (Oxford, 2014) and The British
Moralists and the Birth of Secular Ethics (Cambridge, 2006).
Richard Huxtable is professor of medical ethics and law and deputy director of
the Centre for Ethics in Medicine at the University of Bristol. His research primar-
ily concerns legal and ethical issues in end-of-life decision-making, surgery, and
paediatrics. He is the author of Law, Ethics and Compromise at the Limits of Life:
To Treat or Not to Treat? (Routledge-Cavendish, 2012), Euthanasia, Ethics and the
Law: From Conflict to Compromise (Routledge-Cavendish, 2007), and (with Dick-
enson & Parker) The Cambridge Medical Ethics Workbook (CUP, 2nd edn, 2010),
plus numerous articles and chapters.
Jonathan Ives is a senior lecturer in bioethics at the University of Birmingham. He
is co-convener and chair of an academic network on Interdisciplinary and Empiri-
cal Ethics running jointly with King’s College, London. He is an associate editor
and section editor (methodology in bioethics) for BMC Medical Ethics and sits on
the editorial board of Healthcare Analysis. Ives is a co-opted member of the Royal
College of General Practitioners Medical Ethics Committee and sits on the Heart of
England NHS Foundation Trust Clinical Ethics Committee. He publishes predomi-
nantly in the field of biomedical ethics, focusing on fatherhood and families, and
methods in empirical bioethics and research ethics. He is also interested in public
health ethics and ethics in medical education.
Georgia Lloyd-Smith B.Sc., J.D. recently graduated from the Schulich School
of Law at Dalhousie University. She is currently an articled student at the Univer-
sity of Victoria Environmental Law Centre and will continue articling in the areas
of Indigenous and land-based laws in British Columbia, Canada. Georgia received
honours degree in bachelor of science in biology and international development
from Queen’s University. She enjoys spending her thinking time in spaces where
cultures, values, and ideas converge, in particular in the fields of environmental,
Indigenous, health, and human rights law.
Kasper Raus holds a Ph.D. in philosophy from Ghent University, where he
currently works as a postdoctoral researcher. His main research topics are ethical
aspects of euthanasia and continuous sedation at the end of life, ethical aspects of
palliative care, and clinical research ethics. He has published various articles on
these topics in international journals. He lectures a course in Methods in Ethics.
Editors and Contributors ix
Julian Savulescu is Uehiro Professor of practical ethics at the University of
Oxford, fellow of St Cross College, Oxford; director of the Oxford Uehiro Centre
for Practical Ethics; Sir Louis Matheson Distinguished Visiting Professor at Monash
University; and head of the Melbourne–Oxford Stem Cell Collaboration. He is the
editor of the Journal of Medical Ethics. In addition to his background in applied
ethics and philosophy, he also has a background in medicine. His areas of research
include the ethics of genetics, especially predictive genetic testing, preimplanta-
tion genetic diagnosis, prenatal testing, behavioural genetics, genetic enhancement,
and gene therapy; research ethics, especially ethics of embryo research, includ ing
embryonic stem cell research; new forms of reproduction, including cloning and
assisted reproduction; medical ethics, including end-of-life decision-making, re-
source allocation, consent, confidentiality, decision-making involving incompetent
people, and other areas; sports ethics; and the analytic philosophical basis of practi-
cal ethics.
Thomas Schramme is professor of philosophy at the University of Hamburg. His
main research interests are in political philosophy, ethics, and the philosophy of
medicine. He has published in journals such as Bioethics, Ethical Theory and Mor-
al Practice, Journal of Medical Ethics, and Theoretical Medicine and Bioethics.
Recent publications include the edited collection Being Amoral: Psychopathy and
Moral Incapacity (MIT Press, 2014).
David M. Shaw is senior research fellow at the Institute for Biomedical Ethics
at the University of Basel. He was previously lecturer in ethics in the School of
Medicine at the University of Glasgow and research fellow in the Department of
Philosophy at the University of St Andrews. He is interested in all areas of bioethics,
but particularly in research ethics and organ transplantation.
Sigrid Sterckx is professor of ethics and political philosophy at the Department
of Philosophy and Moral Sciences of Ghent University, Belgium. She lectures
courses in theoretical and applied ethics as well as social and political philosophy.
Her current research projects focus on end-of-life decisions, organ transplantation,
biobanking, neurosciences and criminal law, global justice, and intellectual prop-
erty rights. She has published more than 100 books, book chapters and articles in
international academic journals on these issues, including the co-edited book Con-
tinuous Sedation at the End of Life: Ethical, Clinical and Legal perspectives (Cam-
bridge University Press, 2013). Sigrid also serves on various advisory committees,
including the Belgian Advisory Committee on Bioethics and the Ethics Committee
of Ghent University Hospital.
Rivka Weinberg an associate professor of philosophy at Scripps College, Clare-
mont CA. She specializes in ethical and metaphysical issues with regard to procrea-
tion and future people. She received her Ph.D. in philosophy from the University of
Michigan in 2001. Her book, The Risk of A Lifetime: How, When, and Why Procrea-
tion May Be Permissible, is forthcoming from Oxford University Press.
