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Me and My Body: The Relevance of the Distinction for the Difference between Withdrawing Life Support and Euthanasia

Published online by Cambridge University Press:  01 January 2021

Extract

In a paper that has recently attracted discussion, David Shaw has attempted to criticize the distinction the law has drawn between withdrawing and withholding life-sustaining measures on the one hand, and euthanasia on the other, by claiming that the body of a terminally ill patient should be seen as akin to life support. Shaw compares two cases that we might, at least at first, regard as distinct, and argues that they are not. In the first case, Adam, who is dying of lung cancer, is connected to a ventilator and requests to be disconnected. In the second case, Brian, also dying of cancer, is not connected to anything, and so he requests his doctor to provide him with a lethal injection. In the first case, Shaw contends, Adam is being kept alive by a ventilator. In the second case, Brian is being kept alive by his body.

Type
Independent
Copyright
Copyright © American Society of Law, Medicine and Ethics 2011

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References

Shaw, D., “The Body as Unwarranted Life Support: A New Perspective on Euthanasia,” Journal of Medical Ethics 33, no. 9 (2007): 519521.CrossRefGoogle Scholar
Busch, J. Rodogno, R., “Life Support and Euthanasia: A Perspective on Shaw's New Perspective,” Journal of Medical Ethics 37, no. 2 (2011): 8183; McLachlan, H., “Assisted Suicide and the Killing of People? Maybe. Physician-Assisted Suicide and the Killing of Patients? No: The Rejection of Shaw's New Perspective on Euthanasia,” Journal of Medical Ethics 36, no. 5 (2010): 636–368.CrossRefGoogle Scholar
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Id., at 519.Google Scholar
Id. (emphasis added).Google Scholar
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Shaw, D., “A Defence of a New Perspective on Euthanasia,” Journal of Medical Ethics 37, no. 2 (2011): 123125.CrossRefGoogle Scholar
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For further discussion, see McGee, A., “Finding a Way through the Ethical and Legal Maze: Withdrawal of Medical Treatment and Euthanasia,” Medical Law Review 13, no. 3 (2005): 357385, and McGee, A. “Ending the Life of the Act/Omission Dispute: Causation in Withholding and Withdrawing Life-Sustaining Measures,” Legal Studies: Journal of the Society of Legal Scholars 31, no. 3 (2011): 467–491, at 489–90.CrossRefGoogle Scholar
One might protest that the shortening/prolonging distinction on which this passage relies is suspect, on the basis that it is not easy to draw the line between someone remaining alive without the aid of technology and someone's life being prolonged with the aid of technology. But it is important to distinguish the claim that it is not easy to draw the line from the claim that the distinction is suspect. Any claim that all forms of treatment are “life-prolonging” confuses these two claims. For example, it might be claimed that even the provision of antibiotics to otherwise healthy patients could, in certain circumstances, be seen to be “life prolonging” and would correlatively require a description of the patient as technically “terminally ill.” But of course, by “terminally ill” we normally mean someone who is in the advanced stages of an illness or condition from which they are going to die. It no more follows from the fact that “in a sense” all treatments can be seen as life-prolonging that we cannot distinguish those that prolong the life of a terminally ill patient from those that do not, than it follows from the fact that we are all descended from one ancestor that everyone is my relative.Google Scholar
See Shaw, , supra note 1, at 519.Google Scholar
Though, as we shall see, not necessarily a strong form under which I can survive the death of my body.Google Scholar
See Shaw, , supra note 7, at 124.Google Scholar
See Shaw, , supra note 1, at 519.Google Scholar
Shaw's use of “him” and “her” here perhaps itself points to a difficulty in the position he is advocating, for the use of pronouns is normally reserved for persons, and this difficulty is not overcome by using the words him and her in inverted commas. This is important, because it suggests that our extension of the concept “person” does not track the philosophical uses of this word.Google Scholar
See Shaw, , supra note 1, at 519.Google Scholar
The distinction has been drawn, of course, because it is possible to maintain circulatory functions while a patient is brain dead, and, unless the distinction is drawn, it would be unclear in such a case whether the patient is alive or dead.Google Scholar
What we call a person in ordinary language – the criteria that apply – differs from the stipulative definitions often proffered by philosophers, who traditionally have held that a being must have consciousness, or even self-consciousness, in order to qualify as a person, thereby recommending a more restricted use of the term in accordance with their own substantive convictions.Google Scholar
These matters are discussed at length by Hacker, P. M. S. in his Human Nature: The Categorial Framework (Oxford: Blackwell Publishing, 2007): At Chapters 8 and 9, and my discussion throughout this paper is indebted to his analysis. See also Kenny, A., The Self: The Aquinas Lecture (Milwaukee: Marquette University Press, 1988).CrossRefGoogle Scholar
Id. (Kenny, ), at 25.Google Scholar
See Hacker, , supra note 21, at 251.Google Scholar
Strawson, P., “Self, Mind and Body,” in Freedom and Resentment, and Other Essays (London: Methuen, 1974): At 169–77.Google Scholar
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The brain, or processes in the brain, may be the enabling conditions for the exercise of those powers, but it is not identical to those powers. It is simply what makes it possible for a human being to exercise the powers. For more detailed discussion on this point, see Bennett, M. R. Hacker, P. M. S., Philosophical Foundations of Neuroscience (Blackwell: Oxford, 2007): At Chapter 3.Google Scholar
See Hacker, , supra note 21, at 280.Google Scholar
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Indeed, he claims that “people…are their brain activity, or their minds” (see Shaw, , supra note 7, at 125). For reasons we cannot address here, “brain activity” and “mind” are not the same at all. At most, brain activity is an enabling condition for consciousness.Google Scholar
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