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Lord Falconer’s Assisted Dying Bill: Is Slow Assisted Dying Legal?

Lord Falconer’s Assisted Dying Bill: Is Slow Assisted Dying Legal?

In 2005, the NZ Herald reported. “A man with motor neurone disease plans to starve himself to death rather than wait to die.

“Thirty-nine-year-old Andrew Morris of Hamilton has limited movement and can barely speak. He has gone public with his decision because he wants law changes to allow voluntary euthanasia.”

Such cases occur not infrequently, around the world. Last month, John Rehm took his life by dehydration. NBC News reported:

Diane Rehm and her husband John had been married for 54 years when he knew he didn’t want to live another day.

His Parkinson’s disease had become unbearable. “He just kept getting weaker,” the NPR host told NBC News. “We called in the doctor and John said to him: ‘I am ready today.’ He said ‘I can no longer use my legs, I can no longer use my arms, I can no longer feed myself.’ And knowing with Parkinson’s it is going to get worse rather than better, he said ‘I wanted to die.’” He asked the doctor for help.

The answer they got surprised and disappointed both of them. “The doctor said ‘I cannot do that legally, morally or ethically’,” Rehm said. “He said ‘I don’t disagree with your wish that you could die with the help of a physician but I cannot do it in the state of Maryland.’”

John Rehm had to deliberately die by dehydration. It took nine days.

“John said he felt betrayed,” Rehm said. He said, ‘I felt that when the time came, you would be able to help me.’”

In a recent, short commentary on the sad case of Tony Nicklinson, I argued that two basic moral rights effectively equate to a legal right to slow assisted dying. In one sense, Rhem’s doctor was wrong.

Firstly, everyone, including Mr Hamilton, has a basic right to control what goes into their bodies, including food and fluids. Everyone has a basic right to refuse to eat and drink, even if this results in their death.

Secondly, everyone has a basic right to health care, including the relief of pain and suffering. As someone is dying, they have a right to palliative care to achieve that end. This includes the administration of narcotics and sedatives, as necessary to relieve their suffering and as requested by the patient. This is so, regardless of whether their suffering is self-inflicted or not.

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Carbon caps and IVF

by Dominic Wilkinson @NeonatalEthics Over on the Journal of Medical Ethics blog are a couple of posts that might be of interest to Practical Ethics readers. Last week, the journal published online an article by Cristina Richie on carbon caps and IVF. She argues that the environmental costs of reproduction should lead to carbon caps… Read More »Carbon caps and IVF

Evolutionary psychology and multidisciplinary challenges

Evolutionary Psychology has recently gained some public attention in Finland, as the University of Turku has announced that it will establish the discipline as a permanent study module from the beginning of autumn 2014. University of Turku reports itself to be among the first universities in Europe to provide studies in this discipline[1].

Evolutionary psychology (EP) is a debated discipline, and its institutionalisation adds some weight to the debate. A thorough discussion of its “pros and cons” are beyond this entry – instead, I am interested on the manner in which this relatively young and multidisciplinary discipline is debated.

Most debaters seem to have a strong opinion about EP. It can be seen as the Grand Theory answering all the questions of humanity, or as pseudoscience without slightest scientific background. Obviously, none of the extremist positions is sensible.

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Geoengineering: Lessons from Human Bioengineering

[W]e have no non-radical solutions left to deal with climate change… either we face a radical climate catastrophe or we must radically shift our economy and modes of social organisation away from the current fossil fuel economy

That was the message given by David Spratt, author of Climate Code Red, and Ian Dunlop, who formerly chaired the Australian Coal Association but has since become a climate activist, at the Breakthrough 2014, National Climate Restoration Forum, last month in Melbourne, reported by Green Left Weekly.

One source of radical solutions is the growing geoengineering industry. Recently proposed methods for the sequestering of carbon dioxide include  ants, iron sulfate  and artificial trees .

Debate continues about when and how geoengineering might ever be deployed. Amongst environmentalists, support for geoengineering methods is low. Green Left Weekly explains:

as Clive Hamilton describes in his book Earthmasters, geoengineering technologies are supported by leading climate denial organisations and by the fossil fuel industry. This is because they seem to offer a way that fossil fuel use can continue unabated. The side effects of these technologies could be brutal: for example, severe drought in Africa and Asia. Moreover, if spraying was stopped, temperatures would rise rapidly, leading to even more devastating impacts.

Will regulation help? Green Left Weekly argues that governments have been unable to regulate fossil fuel industries effectively, and that they will be unlikely to succeed more here.

It is fruitful to look at comparisons with human genetic or biological modification, or human bioengineering.

Both are complex systems affecting life processes. There has been considerable debate and reflection on human bioengineering, human bioenhancement or genetic selection. Could the results of this reflection be of use in considering the ethics of geoengineering?

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The Indignity of Imprisonment

            Do we need to radically rethink the practice of imprisonment of criminals – not in the direction of novel forms of punishment, but rather in the form of vastly reducing punitive imprisonment altogether?  While prisons are integral to modern criminal justice system, a report from the British Academy earlier this month puts serious pressure on the institution.  Their overall argument is that we should move away from current levels of incarceration and focus on alternative responses to criminality like fines, rehabilitation programs and restorative justice.  Part of the report rehashes familiar empirical, consequentialist arguments for prison reform: prisons are expensive, they have deleterious effects on society, they have unclear deterrent effects, and so on.   Those arguments are relevant and important, but in this post I’d like to focus on the more theoretical, non-consequentialist arguments for prison reform.  The British Academy report argues that, in essence, current imprisonment practices are incompatible with the values of liberal democracy.  This is roughly in line with a growing body of philosophical literature militating against mass incarceration and other forms of punishment.  Here, I’ll go through some of the report’s arguments (and one of its weaknesses), as well as introduce an alternative account I’m developing that links up the imprisonment debate with the torture debate and emphasizes a respect for dignity and humanity. Read More »The Indignity of Imprisonment

A Wrong Turn, A Hundred Years Ago

Just over a hundred years ago, a car took a wrong turn. It happened to stop just in front of Gavrilo Princip, a would-be assassin. Princip took out his gun and shot Archduke Franz Ferdinand and his wife from point blank range. This triggered a chain of events that would soon lead to the Great War. Millions died in the trenches, and the map of Europe was redrawn. In those few breathless minutes, history had taken a different, more sinister turn.Read More »A Wrong Turn, A Hundred Years Ago

Principles for the Legalization of Trade in Rhino Horn

Last Wednesday night in Kenya, on a private ranch near Nanyuki, armed gangs killed four rhinoceroses for their horns. According to a representative from the Kenyan Wildlife Service, this could be the worst rhino-poaching incident the country has seen in 25 years. 22 rhinos have been poached in Kenya this year. There are only 1,037 now left in that country, and fewer than 25,000 left in the world. The Western Black Rhino was declared extinct in 2011.

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Economic arguments and assisted dying.

by Dominic Wilkinson (@NeonatalEthics)

Lord Falconer’s assisted dying bill is being debated today in the House of Lords. In the past week or two there has discussion in the media of many of the familiar arguments for and against such a proposal. As Roger Crisp noted in yesterday’s post, there have been relatively few new arguments. Supporters of the bill refer to compassion for the terminally ill, the difficulty of adequately relieving suffering, and patients’ right to make fundamental choices about the last stage of their lives. Opponents of the bill express their compassion for the terminally ill and those with disabilities, fear about coercion, and the omnipresent slippery slope.

One concern that has been raised about the assisted dying bill is the fear of abuse in the setting of an overstretched public health system. For example, Penny Pepper, writing in the Guardian notes that “Cuts to social care are monstrous…How would the enactment of the Falconer bill work if brought to our harassed NHS?”

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When Are Objections ‘Religious’ Objections?: Hobby Lobby, Wheaton College, and Contraceptive Coverage

On June 30th, the Supreme Court of the United States handed down its decision in Burwell vs. Hobby Lobby. The case required the court to consider whether closely held for-profit companies owned by individuals with sincere religious objections to abortion should receive a special exemption from providing healthcare coverage for contraceptives that may act after fertilisation but before implantation of an egg. Coverage of twenty types of contraceptives – including the four specific types that the owners consider to be abortifacients – is otherwise legally required as part of the employer-sponsored health insurance mandated by the Patient Protection and Affordable Care Act 2010 (ACA). For a more in depth overview of the facts of the Hobby Lobby case and the key questions before the court, see my previous post on this blog.Read More »When Are Objections ‘Religious’ Objections?: Hobby Lobby, Wheaton College, and Contraceptive Coverage