Abortion and Euthanasia Ethics, Respect, and Community

1. Abortion and EuthanasiaEthics, Respect, and Community • ITESM, Campus Ciudad de Mexico • 17 Oct. 2007 • Mark Waymack, PhD • Department of Philosophy • Loyola University Chicago

2. Ethically & Socially Divisive Issues • Both have been disputed for centuries • Both are the subject of intense, continued, sometimes violent, contemporary debate

4. Abortion in the Ancient World • Plato: appropriate in certain circumstances • Aristotle: permissible prior to the higher soul develops • The Hippocratic School: not to be performed by physicians (apparently because of harm to woman) • Aquinas: a minor sin before ensoulment, homicide after ensoulment

5. Abortion in the Modern World • Widely performed (half of abortion world-wide are illegal) • Most controversial is “elective abortion” (not necessary to save the woman’s life) • Legalized in some U.S. states in the 1960’s • Legalized by U.S. Supreme Court in 1973 • Legalized by Ciudad de Mexico in 2007

6. Abortion:The Main Argument Against • Premise 1: It is wrong to kill an innocent person • Premise 2: The fetus is an innocent person • Conclusion: It is wrong to kill a fetus • It is a question of moral respect for the basic human rights of the fetus

7. The Moral Status of the Fetus • The main argument thus presumes that the fetus is a person • If the fetus is not a person, then the main argument collapses

8. Fetus and Personhood • Is the fetus a person? • Aristotle & Aquinas: only once the soul has entered the fetus • Contemporary Pro-Life Argument: At the moment of conception the embryo is a person

9. Fetus & Personhood • On What Grounds Would the Fetus Count as Person? • DNA? • Perception? • Potentiality?

10. Ordinary Moral Intuitions • Many of our “ordinary” moral intuitions conflict with the idea that the fetus is a person from the moment of conception • Abortion is often allowed in cases of rape or incest • We do not legally name fetuses • We do not have funerals for fetuses that result in miscarriage/spontaneous abortion

11. AbortionMain Argument for Permissibility • 1. The fetus is not a person • 2. The fetus is a part of the woman’s body • 3. Adults are said to have a moral and legal right to self-determination, a right to privacy • Conclusion: 4. Therefore, it ought to be a woman’s moral right to choose

12. Problems With The PermissibilityArgument • When does the fetus become a person? • At birth? (Sounds arbitrary. What is the morally important difference between a 39-week fetus and a newly born baby?) • Viability? • Why consider viability? • When is viability? 30 weeks? 23 weeks?

13. Critique of Extreme Views • The main arguments typically used both for and against abortion are problematic • Conceptually weak • Are in conflict with ordinary moral intuitions

14. Euthanasia in the Ancient World • Euthanasia • Widely accepted in the Ancient World • Greeks • Romans • (Includes infanticide for congenital defects and mercy killing of debilitated elderly who want to die) • But Not Universally approved • Hippocratic School

15. Euthanasia in the Contemporary World • Involuntary euthanasia used as part of the Nazi social experiment • Other Countries • Medical euthanasia tolerated by the Netherlands beginning in the 1970s • Legalized in the Netherlands in 2003 • Now legal also in Belgium, Switzerland, Japan, and Columbia

16. Euthanasia in the U.S.A. • Physician-Assisted Suicide was made legal by vote in the state of Oregon (1994) • Remains illegal or not-legislated in all other states • The U.S. federal government (the Bush administration) has repeatedly tried to over-rule Oregon’s law, but always unsuccessfully

17. Arguments Against Euthanasia • Sanctity of Life • Harm to Self • Harm to Others

18. Euthanasia & Sanctity of Life • Your life does not belong to you like personal property • Your life belongs to God • Therefore, when you die should be up to God, not you

19. Sanctity of Life Argument: Criticisms • This is ultimately a religious argument. Should religion set public policy? • Furthermore, even within Christianity, there is disagreement here. What kind of God would require that certain persons must die a slow, painful, suffering dying process?

20. Argument of Harm to the Self • Anti-euthanasia argument sees death as an evil, a harm to the individual • But is death always bad for the individual? • When burdened by un-relievable suffering (such as through terminal illness) might there not come a time when burden of suffering outweighs the good of living?

21. Argument of Harm to Others • Anti-euthanasia movement includes those who think that allowing euthanasia/assisted suicide would harm other people in society. • This is especially argued by some groups of the Disabled, who believe that allowing euthanasia would open the door for society to question why we should bother to support the lives of the Disabled (since their lives are burdened by disability)

22. Harm to Others (con’t) • But is there any evidence to suggest that we would conflate (mix-up) dying individuals who themselves wish to escape their suffering and the Disabled who do not see themselves as overly-burdened? • The evidence is not there

23. Harm to the Poor • Anti-euthanasia forces also argue that the poor will be unfairly coerced into choosing euthanasia, out of fear of large medical expenses. Hence, this would place an unjust burden on the poor. • But there is no evidence to show that this is what would happen.

24. The Oregon Experience • Approximately 30 cases per year of physician assisted suicide • Represents 0.15% of deaths in Oregon • 80% cancer patients • Average age of 70 years • Tends to be individuals with higher education • Almost exclusively upper-middle class

25. Problems With Pro-Euthanasia • How far should respect for individual self-determination extend? • In the Netherlands, some patients have opted for euthanasia because of depression • In the Netherlands, some neonates with severe defects have been euthanized by parental choice • Our ordinary moral intuitions suggest that there should be some limits on euthanasia, even when it is voluntary

26. Valuing Life Does permitting euthanasia say something about how we, as a society, value life?

27. Problem of the Extremes • We have seen that both extreme views (about both abortion and euthanasia) have problems. • They have some philosophical assumptions that sound arbitrary • They do not agree with our ordinary moral intuitions

28. Why, Then, Do We HearThese Extreme Arguments So Much? • Each side characterizes itself as upholding moral respect for individuals, human rights, and the character of our community • Complex arguments and subtle distinctions tend not to arouse much passion and commitment

29. Politics • The incentive to “leaders” is not to argue for a complex, murky, middle ground. • Leaders energize their followers (and hence gain power) by using simple, dramatic slogans and images. • Followers are encouraged to protest in the streets, write letters to legislators, donate their own money. They are not encouraged to think critically !

30. Ethics Is Not Politics • Politics, especially “real politik,” is not about moral truth. It is about winning, about power. • Ethics, at least in some sense, is about moral truth. • But what is “moral truth”?

31. Dangers • Arrogance • Excessive Self-Confidence • Unwillingness to Acknowledge and Engage Other Points of View

33. A Wish • El Diccionario Incompleto de Bioética • “incompleto” suggests a project that is not entirely finished. Bioethics is not necessarily some set of timeless, abstract truths. It is a project that requires continuing thought, discussion, and often, compromise

34. Progress? • Can we “temper,” can we moderate the extreme views and extreme passions that drive politics with at least a portion of measured philosophical reflection and discussion? • Can we “hear” what each of the sides has to say? What their deepest concerns are?

35. Working Together • No One is “Pro” Abortion • No One is “Pro” Euthanasia • No One is “Anti” Life

36. Respect and Community • Abortion and Euthanasia both have to do with respect and community • What does it mean to show respect? • Who/what counts as a member of our community • We Should Look For Policies That: • Respect individual rights, including choice • Minimize harm

37. The Abortion Challenge • Decrease the Demand for Abortion Through Education and Availability of Birth Control • Decrease the Harm of Abortion by Making It Legal • Illegal abortion is a major health problem • Legal abortion can be done safely. • Discourage Late-Term Abortions

38. The Euthanasia Challenge • Why Do People Desire the Euthanasia Option? • Fear of unrelieved suffering (physical and emotional) while dying

39. Euthanasia Strategies • We Can Decrease the Demand for Euthanasia By Improving the Quality of End-of-Life Care • Better use of pain-relief medications • Better social-psychological supports for the dying • Admit That Despite Quality Care, Some Individuals May Still Suffer Terribly • Allow assisted death under certain circumstances • Safeguards: Use Policy to Minimize “Inappropriate” or “Unnecessary” Euthanasia

40. Conclusion • The Extreme Views Are Conceptually Flawed • But Each Extreme View Also Has Some Moral Appeal • A Compromise Public Policy Would Try To: • Show some respect to the concerns of each side • Build upon common ground • Seek to respect individuals, minimize harm, and promote benefit as far as practical