Daniel Callahan's Article 'When Self-Determination Runs Amok'

Olivia Scheyer 2-21-15
Bioethics

Slippery Slopes

The debate around euthanasia is a tricky topic from the perspective of both patients and doctors. Should it be allowed, and if so, when is it appropriate to practice? Should doctors be held to moral standards when practicing euthanasia, and if so, which ones? Is killing a patient any different than letting a patient die? Daniel Callahan has responded to philosophers such as James Rachels in his article, “When Self-Determination Runs Amok,” and insists that recognizing the moral distinction between killing and letting die is crucial in evaluating whether euthanasia is permissible. Callahan discusses how euthanasia should not be permitted under any circumstances based on three important turning
He presents an argument against the practice of euthanasia stemming from three turning points in western thought. The discussion begins with the “killing versus letting die” distinction. Contrary to some beliefs on the matter, Callahan says that there is a moral difference between killing and letting die, and to overlook this difference would conflate causality and culpability. Callahan writes, “to say that a doctor ‘kills’ a patient by allowing [death] to happen should only be understood as a moral judgment about the licitness of his omission…it is the underlying disease that brings death when treatment is omitted…” (383). This leads to two disturbing possibilities: health care practitioners are morally and physically responsible for the deaths of their patients and every time life-prolonging treatment proves ineffective, a quick and direct killing will be logical. Next, he turns to the role of self-determination, claiming that it does not follow from the fact that you have a right to self-determination that someone else can permissibly kill you. If everyone has a right to life, then others have a duty to protect this right. So then how can others assist in killing you if they have a contradictory duty to help preserve your life? One of Callahan’s replies is that if one is a slave, her will and moral responsibility are turned over to someone else, and this turning over of her rights
He inquires into how people should conduct their lives and arrives at an answer: “The idea that we can waive our right to life, and then give to another the power to take that life, requires a justification yet to be provided by anyone” (Callahan, 382). Callahan seems to miss a central purpose behind euthanasia, which is to relieve a person from unnecessary suffering. Say there is a sick person who is unable to function like a normal human. Their heart is beating, but they are not experiencing life at the conscious level. Their life is no longer of any benefit to them, and perhaps it has even become burdensome to others who have to watch someone they care about live as a vegetable. At the same time, this person does not have the physical capacity to end their own life even though it is the more peaceful option, so they may turn to a medical professional to assist them. They have chosen to authorize another to their right to life, which is opposed to having been alienated of this right, as Callahan says. This seems to be in conflict with Callahan’s claim in the logical slippery slope, which says that it is not permissible to kill an incompetent patient to relieve suffering. But, this is merely a moral high-ground that he assumes readers will (or should) agree with. The example of the comatose patient under consideration for euthanasia brings up an important discussion of when it