Paste your essay in here…Student ID: 201415472
Word Count: 1497
Question Number: 5b
How compelling is David Velleman's argument against a right to euthanasia?
In the following essay I will argue that Velleman’s argument against a right to euthanasia is ultimately unconvincing. I will begin by stating velleman’s argument that giving people the option of euthanasia can harm them. I will raise the objection that if such strong negative consequences existed if active euthanasia was to be legalised that we would expect to see serious negative consequences from the legality of passive euthanasia, and yet we do not. I will then raise the response that a possible disanalogy exists between the justification needed for one to argue for their continued existence in active euthanasia circumstances compared to the justification needed for one to argue for their continued existence in passive euthanasia circumstances. I will concede that the option of euthanasia can harm people, but I will argue that it does not follow from this that one has no legal right to it; overall, there may be more harm caused by not having a right to euthanasia. I will then raise the fact that Velleman’s own conclusion on euthanasia is weaker than his argument would suggest, before ending by showing that this conclusion is unsatisfactory as it leaves one’s ability to end their agony up to chance and their socioeconomic background.
Velleman’s argument against a right to euthanasia
Velleman argues that a right to euthanasia may harm the infirm by creating circumstances where they feel that they should exercise their ability to be killed even though they would rather live on, due to the stresses their condition puts on their family (Velleman, 1992). Giving people choices can mean that options which were once status quo (e.g. living) must now be justified, and this justification process can come with a cost. For example, a bedridden elderly person who will continue to live a low quality of life for some time might have to justify to his family members why this low quality of life outweighs the economic expense it is costing their family. These family members will then be able to hold the person responsible for their continued existence, and perhaps this choice will “threaten his standing as a rational person in the eyes of friends and family” thereby drastically reducing the very value that make his life worthwhile, by removing one’s ability to retain status as a person among others (Velleman, 1992). Such a bedridden person may well prefer that euthanasia was illegal, and that death was therefore not an option; they would not have to justify their continued existence and risk losing their status as a person amongst others, which would remove their life’s value.
Would the harms of active euthanasia be serious given the lack of harm that passive euthanasia causes?
Velleman’s argument suggests that legalising all forms of euthanasia would lead to harm being done to some members of society. In particular, he is concerned that the option of active euthanasia, whereby someone must take action to help another die, would cause harm. The harm he talks about, however, would seem to possibly exist for cases of passive euthanasia as well, where somebody is allowed to let die naturally. Passive euthanasia is currently allowed in almost all circumstances as a patient has the right to choose to refuse treatment, yet we do not see any notable harm from this being legal. If an elderly patient who was a financial burden on their family came down with an easily treatable illness, like a cold, they might be seen to have the same responsibility as the aforementioned bedridden person; they could refuse treatment and spare their family the continued burden of their existence, and by choosing to get treatment they are leaving themselves open to justificatory questions. Given that the right to passive euthanasia seems not to have caused such scenarios to be prevalent and not to have notably harmed members of society, it seems unclear why a similar such right to active euthanasia would cause harm to the extent of Velleman’s concern.
In Velleman’s defence, however, there does seem to be an important disanalogy between the justification needed for one to argue for their continued existence in active euthanasia circumstances compared to the justification needed for one to argue for their continued existence in passive euthanasia circumstances. In cases where passive euthanasia applies, where one is able to die quickly without assistance, it is either the case that their illness is severe and untreatable, likely causing them great pain, or their illness is treatable and their pain can be reduced. If the illness is untreatable and one’s pain significant then there is little concern that they are being pressured into the decision by the option of passive euthanasia. In treatable illness passive cases, however, there is an expectation from the outset that the patient will survive; justification for not choosing to die is hardly required therefore, as survival is assumed and it seems unjustifiable to expect someone to die slowly and potentially painfully when they could be saved. In active euthanasia cases, however, there is the potential to die quickly and without pain whilst also removing a burden from family and friends. The burden of justification of one’s continued existence is therefore higher for those with the option of active euthanasia compared to those with the option of passive euthanasia: active euthanasia being legal would potentially allow for more of the harm that Velleman is concerned about to exist compared to the harm caused by passive euthanasia currently being legal.
Accepting the fact that euthanasia can harm some people, does it follow that there should be no legal right to euthanasia?
Given Velleman’s argument is fundamentally a consequentialist one, the suggestion that active euthanasia should be illegal only follows from it if the harm its legality would cause outweigh the potential benefits of legality. This seems untrue. Firstly, the number of people who would be harmed by not having the option of active euthanasia would probably be higher than the number who are harmed if the option did exist; there are likely to be more people who want to be helped to die in order to avoid the pain of their existence than there are people who would choose to stop living due to insufficient justification. Velleman himself states that the assumption that people will continue to live is so deeply engrained in society, so it would seem that a right to euthanasia would be unlikely to make our choice to continue living become a conscious, explicit decision in need of justification (Velleman, 1992). Secondly, whether one is in immense pain or feels like a burden upon their family, on the level of an individual’s utility calculus, being helpless to do anything about it seems to be a worse circumstance than having one’s fate in their own hands.
Velleman’s weaker conclusion
Despite his arguments seeming to suggest that there should be no right to active euthanasia, Velleman ultimately make a much weaker conclusion. Velleman suggests that active euthanasia should at most be permitted in some (undefined) circumstances, but that health professionals should never be required to offer euthanasia or to grant euthanasia requests (Velleman, 1992). In doing so Velleman’s argument against a right to euthanasia has to be reinterpreted as an argument against a right to force a doctor to kill you, rather than against a right to be euthanized if someone is willing to carry out the procedure. Under such an interpretation, Velleman can respond to my previous objection by arguing that leaving euthanasia decisions up to doctors’ discretions would have better consequences than there being a universal right to euthanasia.
Without further stipulation, however, this seems an unsatisfactory stance as it leave one’s ability to end their agony up to chance and their socioeconomic background. A discretionary policy on euthanasia could leave it accessible only to those who live in the right place and or could afford to pay a doctor who was willing to come and carry out the procedure. There is a strong chance the likely high volume of paperwork the procedure would require, and its discretionary nature, would limit its availability and make it expensive. Yet, it would be very unfair to deny someone in extreme pain the possibility to have a legal and medically-regulated assisted suicide based solely on their wealth (Dworkin, n.d.). Unless it is stipulated that all people who uncontroversially desire to be euthanized have access to the procedure, it seems that having a right to a euthanasia procedure may be the approach a consequentialist must favour.
Conclusion
In conclusion, I have shown that even Velleman’s weakest claim is not truly compelling. It does seem objectionable to force any specific doctor to carry out a euthanasia procedure against their conscience. Not having a right to a euthanasia procedure, however, would mean that no medical facility would be required to offer such services. This could in turn lead to an undue amount of harm being caused to those in immense pain, particularly those of little wealth, who are helpless to end their suffering.
Bibliography:
• Dworkin, R., n.d. “The Philosopher”s Brief’: An Exchange [WWW Document]. N. Y. Rev. Books. URL http://www.nybooks.com/articles/1997/05/29/the-philosophers-brief-an-exchange/ (accessed 1.8.17).
• Velleman, J.D., 1992. Against the Right to Die. J. Med. Philos. 17, 665–681.
Velleman's argument against euthanasia
• Even someone capable of voluntary and rational choice might be made worse off by being given legal option of lethal injection
• Creates a social climate in which elderly and infirm feel that they should exercise legal recognised option of going quietly into death even though personally would rather hang on
o In oregon 1/3rd of people who did assisted suicide listed family
• Many of elderly and infirm have these preferences:
o Living if euthanasia is illegal
o Being killed if euthanasia is legal
o Living if euthanasia is legal
o Being killed if euthanasia is illegal
• Similar preferences about attending wedding you don’t want to go
o Rational choose
velleman right that giving someone an option can harm them
i. Even if they do not take it
ii. Where they do take it, even though taking the option is in their best interest?
– Options that were status quo (not going to party) can with choice now come with cost (once invited, rejecting is a cost)
But maybe euthanasia can’t harm?
– if people would be made worse off by the option of a right to die, than why don't we see any consequences of voluntary passive euthanasia? People already have the option to refuse life-sustaining treatment and there is no evidence of harmful effects or public desire to take away such right. How would establishing an institutional right to active euthanasia make any difference?
o Can already chose to die of a cold
– But expectation that you would survive, whilst life-extension with idea will eventually die
Euthanasia can harm, but does this mean should be no legal right?
• Even if velleman is right that many rational chooser would be made worse off, many who would be better off
• Perhaps interests of latter outweigh the former
• Source of comfort for those who might not but know can if need to
• Harm of not having option, feeling a burden and not being able to do anything about it (helpless) sounds even worse
• Particularly given doubt over how many cases might exist of those who are made worse off: If psychology of human mean see life as default why would euthanasia option change that fact?
• the assumption that continued existence is a "given" seems so deeply ingrained in our ordinary thoughts that Velleman's worries may well be moot. Even if our political institutions introduced a 'right to die', would that really make it such a live question that we would come to reconceptualize of living as an explicit 'choice' that needed to be justified? The default expectation may persist even as alternative options are provided for those who want them.
But Velleman’s tentative conclusion: state shouldn’t get involved… can get killed if you want to but can’t force doctor to do it
– leave relationship between doctor and patient the key thing
– Right to die vs right to be killed
o Can’t have the latter
problems with this conclusion
– (No morally significant difference between killing and letting die (Rachels)
o Hard for doctor to justify that he doesn’t want to kill people but is happy to let them die)
– Dworkin: unfair to deny to the poor an option now enjoyed—though in an unregulated and dangerous form—by the well-off
– What duty does a doctor have to act as his patient wishes? What right does government have to prevent a doctor from acting as his patient wishes? These are plainly different issues: it is one question whether a patient may compel his doctor to administer an experimental treatment, for example, and quite another whether government may prevent the doctor from doing so.
Restructure society: Long term care insurance, so doesn’t take away money