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E-raamat: Euthanasia, Ethics and the Law: From Conflict to Compromise

(University of Bristol, UK)
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Euthanasia, Ethics and the Law argues that the law governing the ending of life in England and Wales is unclear, confused and often contradictory. The book shows that the rules are in competition because the ethical principles underlying the rules are also diverse and conflicting.

In mounting his case Richard Huxtable considers some familiar and topical debates, including assisted suicide and voluntary euthanasia, examining such situations as the Dianne Pretty litigation and Lord Joffe's Assisted Dying for the Terminally Ill Bill. The book also enters some important, but less well-charted areas, looking at the advent of 'death tourism' and the real status of involuntary and passive euthanasia in English law, in addition to clarifying the confusion that surrounds the use of powerful painkillers like morphine. Dealing with both legal and ethical issues, the text concludes that the time has come to more openly adopt a compromise position - one that more honestly recognises and accommodates the competing values, whilst also restoring a measure of coherence to the law.

Acknowledgements xi
List of abbreviations xii
Introduction xiii
1 Judging the end(ing) of life: conflict and confusion 1
1 Conceptual rights and conceptual wrongs: defining 'euthanasia'
3
1.1 Humpty Dumpty at the end of life
4
1.2 Towards a working definition of 'euthanasia'
8
2 Moral rights and moral wrongs
9
2.1 The intrinsic value of life
10
2.2 Choosing the value of life
13
2.3 The instrumental value of life
15
2.4 Executioners on slippery slopes
17
3 Assessing the rights and wrongs of ending life
21
3.1 The intrinsic value of life
21
3.2 Choosing the value of life
24
3.3 The instrumental value of life
26
3.4 Executioners on slippery slopes
27
4 Conclusion: conflict and confusion at the end of life
30
2 Not Pretty: 'mercy killing' in legal fact and legal fiction 32
1 The mercy killer as murderer
34
2 The mercy killer at 'breaking point'
37
2.1 Accommodating the mercy killer
37
2.2 Stretching a (breaking) point
39
2.3 Diminishing the mercy killer
40
3 The 'unique' mercy killer
42
3.1 Before the breaking point
43
3.2 After the breaking point
44
3.3 The 'unique 'mercy killer
45
4 Locating the mercy killer
46
4.1 When is a killing not a mercy killing?
47
4.2 When is a killing a mercy killing?
48
4.3 Pretty, not Pretty and the sentencing lottery
49
5 The mercy killer: presumed innocent?
50
6 Conclusion: collusion, compromise and confusion
52
3 Assisted suicide in 'the shadowy area of mercy killing' 55
1 What is assisted suicide?
57
1.1 Guilty for aiding the innocent
58
1.2 Publishers in peril
58
1.3 Assisting, assisting an attempt, and attempting to assist in an attempt
59
1.4 Pills, pillows and pistols
60
2 Looking for borders in 'shadowy areas'
62
2.1 Stretching the borders of assisted suicide
62
2.2 Assisted suicide beyond the borders: the curious case of 'death tourism'
63
2.3 The classic case of providing the pills
66
2.4 Left to die
68
2.4.1 Passive complicity in suicide
70
2.4.2 Innocent doctors and guilty relatives
72
2.4.3 Left to die or abandoned to die
73
3 The 'unique' mercy killer revisited
77
4 A right to assisted suicide
79
4.1 Dianne Pretty's failure: the right to die denied
79
4.2 Why Dianne Pretty failed
81
5 Conclusion: complicity, compromise and confusion
82
4 Get out of jail free? Double effect and doctors in the dock 84
1 Double effect in English law
87
2 Clarifying the clinical confusion
88
2.1 Clarifying the clinical concepts
89
2.2 When double effect matters
89
2.3 Double effect or covert euthanasia
91
3 No intention
92
3.1 The guilty...father and the innocent doctor
92
3.2 Double effect or covert euthanasia (revisited)
94
3.3 Double effect in the dock
96
3.4 Killing by accident
99
4 Not a cause of death
100
4.1 The guilty layperson and the innocent doctor (revisited)
100
4.2 Not a cause in fact
101
4.3 Not a cause in law
102
5 Justified murder
102
5.1 Overstretching the judicial reach
102
5.2 The guilty layperson and the innocent doctor (re-revisited)
104
5.3 Get out of jail free
105
6 Beyond the boundaries of double effect
106
6.1 Dodging the dock
107
6.2 Engaging the jury's sympathy
109
6.3 Directing the jury and directing the result
110
6.4 Get out of jail free (revisited)
112
7 Conclusion: compromise or confusion?
112
5 Beyond Bland: hedging bets on the value of life? 115
1 Quinlan's challenge: letting die and letting morality in
117
1.1 Quinlan's challenge
117
1.2 Letting die as a moral matter
119
1.3 Duties, doctors and intruders
120
2 Beyond Bland: the problem of fatal omissions
123
2.1 Bland's challenge: letting the incompetent patient die
123
2.2 Karapetian's challenge: duties, doctors and intruders (revisited)
126
2.3 Diverting doctors from the dock
128
2.4 Beyond Bland: letting die as a moral matter (revisited)
130
3 Doctrinal difficulties: what is the value of life?
131
3.1 The intrinsic value of life
131
3.2 From intrinsic value to instrumental value
133
3.3 From intrinsic value to self-determined value
136
4 Conclusion: hedging bets on the value of life
139
6 Euthanasia and the middle ground: from conflict to compromise 141
1 From conflict to creativity and consensus
143
1.1 Condoning conflict and confusion
144
1.2 Creativity at the end of life
145
1.3 Consensus and convergence at the end of life
146
2 The case for compromise
149
2.1 The conditions of compromise
149
2.2 Condoning compromise
151
3 The contours of compromise
155
3.1 Compromise by committee
155
3.2 Moral discomfort, justification and excuse
158
3.3 Clarifying the compromise on fatal omissions
160
3.4 Clarifying the double effect
162
3.5 Clarifying the 'shadowy area' of mercy killing
165
4 Conclusion: from conflict to compromise
172
Bibliography 175
Index 199


Richard Huxtable is a Senior Lecturer and the Deputy Director of the Centre for Ethics in Medicine at the University of Bristol, UK.
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