Death and Dying Ch. 7

Suicide =df the intentional termination of one’s own life

• Passive suicide =df omitting what is necessary to preserve one’s own life with the intention of ending it

• Active suicide =df taking action to end one’s own life with the intention of ending it

To some degree, the question of what a suicide is depends on intention:

• We are both snake bit with just one dose of anti-venom. You giving the dose to me does not constitute your suicide

• this action fails the qualification “with the intention of ending it” in the definition of both active and passive suicide

• Nonetheless, we have, historically, called Kamikazes “suicide attackers”

• does this action fail the qualification “with the intention of ending it” in the definition of both active and passive suicide?

What difference between these cases accounts for the difference in usage?

One difference could be that we deem suicide as wrong, and judging Kamikazes to be wrong, simply applied the term as added condemnation.

A principled, alternative account would be that …• in the poisoning case, there is no option that avoids

death• in the Kamikaze case, the option of using standard

warfare is simply judged intolerable (because it means losing the battle or war)

In the Kamikaze case, such a value judgment presents us with what the book calls “proportionate reasons.”

Examples of choices that entail death based on proportionate reasons:

• Maintaining your profession of faith despite facing execution by arrows, hanging, lions, etc.

• Diving on a grenade to save buddies

• Removing your oxygen mask due to unbearable pain

Which of the above are suicides?This last example differs from the

first two how?

When someone chooses to end their life by a proportionate reason, the question of whether that act constitutes suicide will be

a real question• mainly in non-altruistic cases (previous slide)• also in cases where the reasoning looks bad (suffering doesn’t

appear that serious, person has other responsibilities, etc.)

or, a mere verbal question. It will be …• an arbitrary decision about use of the word, • not a judgment about whether suicide has occurred

Page 169 (p167 4th ed)

1. God owns your life creating something or working for it results in ownership

2. Human life is precious intrinsically, or as the basis of all other goods, human life is

too precious to terminate

3. Suicide harms the community it eliminates a contributor to society

4. Suicide harms others it interferes with carrying out duties to others around us

A. The book says this argument, Argument 1, works only for those who accept the premises.

The trouble with that is:• that’s true of every argument• the great majority (90%+) of people believe in “God or a

universal spirit”• nonetheless, it is best to find universally acknowledged

premises…

B. Even if God owns your life, theists typically hold that

dying for their faith is right (martyrs are not condemned traditionally)

dying for others is right (e.g., “No greater love … lay down his life for a friend”)

however, neither of these are suicides by the book’s earlier definition since the intention is not to end life, but to not prefer one’s own life to something more important

C. (Not in book) God can’t own our lives because we own them

we’re the ones who feed ourselves rest ourselves clothe ourselves educate ourselves it’s all work and working for something (labor) is the

standard basis of ownership

On the contrary: God gives us life in the sense of existence and continued existence; those form his basis for ownership

Reply: It is wrong to give people things that 1. they didn’t ask for, and (1 diamond)2. are hard for them to return (1 & 2 fish tank)and at the same time expect something in

return

That sort of giving implies no duty of gratitude, no duty to return what’s given, no duty to treat what was given according to the

wishes of the giver

Therefore, even if God exists and provides us with existence or continued existence, we would have no duty to God to preserve our own life based on that alone

A. Life does not always form the basis on which all other goods depend:

When ‘life’ refers to a person terminally ill who experiences such severe and constant pain that none of life’s ordinary goods can be experienced, life does not appear too precious to terminate

When ‘life’ refers to a person in a persistent vegetative state, again, life does not appear too precious to terminate

B. The intrinsic value of existence is not decisive against suicide

even if existence is intrinsically good, that doesn’t mean it is better than any other intrinsic goods

If life is not necessarily better than other intrinsic goods, then perhaps it is not better than

freedom from suffering, or the indignity of having one’s body artificially sustained

Suicide only may reduce contributors to society

If everyone over 75 died society would likely have a net gain

those over 75 are not terribly productive on average; that group is very expensive to care for medically

If freeloaders, bums, drug addicts, etc., committed suicide, the net result would likely be positive

costs of supporting addicts and freeloaders are high; costs of rehabilitation are high

While the obligation to dependents will often outweigh the right to end one’s own life, that may not always be the case:

Terminally ill patients in unceasing pain perhaps have the right to terminate their own lives even if they have dependents dependents are 17 years old, able to be cared for by others better

positioned, dependents are independent in

temperament, etc.

On p169 the book considers an empirical and logical version of a slippery slope argument against permitting any form of suicide.

Empirical argument: allowing exceptions to the prohibition against suicide will lead to the widespread increase in the number of suicides Reply: it probably won’t … suicides will never be popular

Logical argument: allowing exceptions makes us inconsistent in opposing suicide Reply: consistency is no virtue when misapplying rules

(fallacy of accident); this appears to be such a case

By and large, suicide is legal in the US

Assisting a suicide, however, is only presently legal in Oregon and Washington. (And now, Vermont)

Read about the history of Suicide here, in The Straight Dope ... Cecil Adam’s syndicated column.

Reasons society sometimes claims the right to prevent suicides:

Life is intrinsically valuable Most individuals contribute to society Some individuals contribute a lot Some individuals have duties to family which society will have to

assume if suicide is allowed Some groups, such as physicians, may need protection from the

effects of active suicide on their profession

The book notes a libertarian argument, p171, that rejects all limitation on suicide (of the competent). The argument admits some suicides involve reneging on responsibilities (to family and others), but that society ought not attempt to sanction or punish for such offenses. Those “moral wrongs” cannot be “properly punished.”

The book points out in response that laws can be crafted to prevent such suicides on the basis of protecting others from harm, laws that permit coercion in some form …

interventions? forced institutionalization? jail time until the urge to kill yourself passes?

Pages 174-182 (p172-178 4th ed) discuss a wide array of situations that involve the ethics of cooperating with a competent, terminal patient’s refusal of treatment

The principles relied on are: Omitting treatment (okay) Omitting care (never okay)

Extending life v. Prolonging dying (p174-5) (Discontinuing Treatment)

Reducing suffering: Feeding and hydration can become painful p175-6 Antibiotics can cure a condition but prolong dying

Page 178-9 discusses the ethics of cooperating with the refusal of treatment of non-terminal patients

Patient cites a proportionate reason for choosing to terminate care (respirator, feeding tube, etc.)

Health care providers have the right to disagree with patient’s judgment of a proportionate reason

cannot force treatment on an unwilling patient must continue care in this situation? Book says ‘no’

What, then, must a healthcare provider do?___________