Overview: PAS, VPE, VAE

PAS, VPE, VAE, and Rachels

A case to ponder

Mary is 93 years old

She will need to have a feeding tube inserted in order to survive

She is in constant pain

She has a terminal illness (she has about six months, at best, to live, even with medical intervention)

She is severely depressed

Currently, she has the right to refuse treatment and let her illness run its course

Does that sound reasonable?

Looking for a consistent, principled position

No moral difference

Consistent?

1. If the intentions/motivations are the same, and the end is the same, then there is no moral difference between killing and letting die.

2. With VAE, the intentions/motivations and the end are the same as with VPE.

3. So, there is no moral difference between VAE and VPE

Support for (1): The Smith/Jones case (killing vs letting die for personal gain)

Some distictions:

Euthanasia and Physician-assisted suicide

Active vs. Passive

Voluntary vs. involuntary vs. non-voluntary

Euthanasia: literally "good death"

Active: killing (something is done to the patient that results in death)

Passive: letting die (something is not done/life-sustaining treatment is removed, which results in death)

Physician-assisted suicide: doctor assists in providing means for patient to take own life, but does NOT administer the the lethal drug

Voluntary: a competent person makes the decision for him- or herself

Non-voluntary: the decision is made for a person who is not competent (and whose wishes are unknown)

Involuntary: the decision is made against the person's wishes

Rachels' view

Does this make sense?

The considerations that prompt us to allow VPE should prompt us EVEN MORE STRONGLY to allow VAE (and PAS)

If we allow VPE because we are trying to (a) fulfill patients' wishes, and (b) minimize suffering, then allowing VPE while barring VAE makes no sense

It is permissible for someone to refuse treatment and pass away (from dehydration/starvation) if that is what they want

It is NOT permissible to allow that patient to "speed up" their passing through VAE or PAS

To put it crudely: you have to suffer; we're not going to help you take "the easy way out"

Convinced?

VAE is more humane

Support: current practices w/r/t some patients (cases of infants with issues at birth, who would require extensive interventions to treat, and who might have tough lives).

Why not allow VAE, instead of essentially letting some infants starve/dehydrate to death???

Why not allow competent adults the same choice when it is more humane?

By extension, why not allow PAS?