Ethical and Moral Issues

* Ethical, Moral & Religious Issues * When is it moral to kill? Self-defense? War? Capital punishment? Abortion? Physician assisted death? Suicide? * Religious ?Thou shall not kill? Thou shall not commit adultery Thou shall not give false testimony against your neighbor You shall not covet your neighbor?s house Common theme? = others First biblical story about killing? Cane and Abel ? Cane becomes a wanderer and gets protected by God. Biblical stories about suicide? The word suicide is not mentioned anywhere in the Bible. Judith * Religious Has suicide always been forbidden? Early Judeo-Christian tradition Suicide was not forbidden THEN Justified? Military defeat (Saul: I Samuel 31) Guy grabs guard?s sword after he refuses to kill him and kills himself Revenge (Samson: Judges 16) Samson destroys the temple he?s chained to and kills his enemies in the process. Shame (Judas: Matthew 26&27; Acts 1) Judas commits suicide by hanging * Religious So, when/why was suicide forbidden? Interpretation of ?thou shall not kill? By St. Augustine (412 C.E.) Because people started believing they could get to Heaven faster if they committed suicide. Christian Council of Braga (563 C.E.) Then it was put into code and became a doctrine. * Religious Does religious participation help prevent suicide and suicide attempts? It does! Why? Maybe based on one?s beliefs of sin and wanting to avoid those consequences Social aspect of being connected * Religious How do religious beliefs affect suicide rates in America? Why? Protestants Higher suicide rate than Catholics and Jews Catholics/Jews Maybe because suicide as a sin is more pronounced in the Catholic church * Ethical ?Psychiatrists now stigmatize suicide as much as priests did before them ? psychiatrists ally themselves with the police powers of the state.? Thomas Szasz * Ethical Are some suicides more rational than others? When does one have the right to die? Never, sometimes, always? Who decides? Right now it seems to be the law since it?s against the law to commit suicide. In all states but Washington and Oregon, physician assisted suicide is also illegal. How is it decided? Ambivalence throughout history * Philosophical Issues Kantian Perspective Rational and autonomous self Suicides compromise eithers ideal Degrades humanity in oneself Not concerned with values or others ?Dare to know.? Think autonomously ?.blah * Philosophical Issues Utilitarian Perspective Bodies belong to ourselves Examine consequences No obligation to carry on Emotional, legal, or financial hardship Moral worth of an action is determined by its consequences (not by some higher moral authority). A.k.a ? The ends justify the means * Antiquity Varied beliefs about suicide in Greece Stoics & Epicureans Right to choose means and time of death In Thebes and Athens Legal but denied funeral rights and severed hand of person who committed suicide Aristotle Thought it was an act of cowardice against the state * Antiquity Not a cry for help ? act of will Pythagoras (6th century BCE: body & soul) Believed there was a body and soul. Whatever you did to the body, you did to the soul. Preserve ones honor In military defeat Example: WWII Japanese military leaders In political defeat In the face of debt In sexual exploitation To avoid rape * Antiquity Romans Prohibited by law Prohibited passing on one?s estate if committed suicide Roman Gladiators Thrust spears down throat Forced heads into spokes of moving carts * Middle Ages Christian influence Counsel not condemnation Martyrdom ? to die for one?s faith St. Augustine?s writing Against a sect that believed in suicide * Middle Ages Church condemned suicide Hanging ? cannot repent at last minute, so really bad in the church?s eyes Excommunicated, denied funeral rights Excommunication Denied funeral rights * Middle Ages Jewish Customs Not so much condemned, but denied some of the rituals, etc * Middle Ages Secular authorities Capitalized on church?s position Seized property Desecration of corpses Buried at night at crossroads They had a lot of superstitions. Sometimes they?d put a steak through the heart of the dead person to keep the body in place. * Early Modern Times France Dragged through streets face down Hanged on a gallows Body thrown in sewer or city dump Germany Bodies put in barrels and floated down river * Early Modern Times Secular & Religious Leaders Reserved judgment Luther: Madness: not responsible Sane person: damnation Calvin: did not discuss suicide Wesley: public display of suicide corpses He?s Presbyterian Puritans: individual submission to Satan You can kind of see this with some old fashioned views of giving into alcohol and things?that they?re giving into temptation. * Trivia Earliest suicide of an English settler in Massachusetts? Dorothy Bradford Not certain, but she ?accidentally? walked off ship Passenger on Mayflower Wife of William Bradford who became governor of Plymouth Colony * 18th ? 19th Century Hume ? big believer in logical reasoning Thought people had the right to die Locke & Rousseau Against any kind of social or religious acceptance Didn?t think people had right to die * 18th ? 19th Century Shift away from condemning to understanding suicide Not heroic act Not sin Advent of mental illness But! People were still buried on north sides of churchyards along with non-Christians, unbaptized infants & executed felons * Contemporary More knowledge than ever before about: Human nature Disease Maybe like mental illness Suffering Suicide * Contemporary When is it acceptable to commit suicide? In war? To save many? To kill many? Suicide bombing One soldier taking out a machine gun, but pretty much ?suicide mission? Preserve ones honor? In military defeat In sexual exploitation To avoid rape Example: Sex slaves captured * Contemporary Yuit Eskimos of St. Lawrence Island They believe in suicide in order to save scarce resources Among elderly and sick (even teenagers maybe) Must request 3 times Ritual death clothing ?Destroying place? ? they choose where to go Die of hunger or freeze to death Using Durkheim?s model, what type of suicide does this represent? Altruistic ? to help others, for the greater good (of their tribe) Can a human species choose extinction? Example: Dying pygmy population chose to no longer have children. There was so much inbreeding that many of the babies were born with deformities and died. Planned extinction of their entire species. * Physician-Assisted Suicide in Netherlands It was legal there long before it was legal in Oregon. Details Act voluntarily ? not coerced Be mentally competent Hopeless disease, not necessarily a terminal disease Hopeless ? maybe something with no cure, but not necessarily a shortened life span. Persistent wish for death MD consult with at least one colleague MD written report Is this inconsistent with the Hippocratic Oath? I think no because sometimes death is an act of mercy and would be better than the suffering. Many people believe it IS against the HOath. * Types of Euthanasia in America Active / Passive Active ? When something is done to the person Passive ? When something is not done Example: Feeding tube not inserted Voluntary / Involuntary Voluntary ? When person can choose it Involuntary ? When others choose it for them because the person no longer can Direct / Indirect (i.e., intention) Direct ? Intention is for person to die Indirect ? Intention is NOT for person to die Example: Patient given high doses of morphine to combat pain, but doctor knows they might die too. * Christian Moral Perspective against Physician Assisted Suicide God?s purpose would be impeded Called to alleviate pain and suffering Treat pain and suffering decreases request for PAS Role of physician to heal, not to kill Use advanced directives to curb overuse of medical technologies Dangers of abuse Pressure to end life due to $ reasons Social isolation of sick may lead them to PAS * Christian Moral Perspective for Physician Assisted Suicide Respect for autonomy You can see this in the story of Adam and Eve. They have the choice to still eat from the tree. God?s purpose & sovereignty still honored Maybe appropriate moral response to pain and suffering To curb unrelenting power of medical technology Example: Terry Shaivo Okay to withdraw treatment When healing is now impossible Risks to society can be overcome Precautions against $ coercion