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					 WEST COAST DEBATE
The 1998 September-October NFL Topic
    Sanctity of Life Versus Quality of Life




                    Edited by JP Lacy




                Written and Researched by
                      Matt Roskoski
                        Jeff Shaw
                      Matt Stannard
    WEST COAST DEBATE
 The 1998 September-October NFL Topic
             Sanctity of Life Versus Quality of Life

                              Edited by Jim Hanson, Matt Taylor and JP Lacy


                                         Written and Researched by
                                               Matt Roskoski
                                                 Jeff Shaw
                                               Matt Stannard

                                       ABOUT THIS HANDBOOK

  Thank you for purchasing the West Coast Lincoln-Douglas Topic Series. This handbook is divided into
 three sections. First, you will find a philosophical overview of the September-October 1998 NFL Lincoln
     Douglas debate topic. This overview should help debaters at all levels identify the major trends in
  philosophical thought regarding this topic. Second, you will find an affirmative case, extensions for the
case, and additional affirmative briefs that debaters can use to create their own case. Finally, you will find a
    negative case, extensions, and additional negative briefs that may be used to create other arguments.

  PLEASE DO NOT RELY ON OUR HANDBOOKS AS A SUBSTITUTE FOR RESEARCH ON THE
   TOPIC. Our handbook should be the beginning of your research process. Use the topic overview to
             brainstorm research areas and use the evidence as a bibliographic resource.

       4 WAYS TO ORDER WEST COAST HANDBOOKS1. Call toll free at 1-888-255-9133.
                                  2. E-mail us at wcdebate@aol.com
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          4. Write to West Coast Publishing; PO Box 8066; Fountain Valley CA 92728-8066

                      Copyright 1998. West Coast Publishing. All Rights Reserved.
Table of Contents

A MATTER OF LIFE, DEATH AND POLITICS: ....................................................................................4
   INTRODUCTION ...........................................................................................................................................4
   TRADITIONAL VIEWS ON THE QUALITY-SANCTITY DEBATE ....................................................................6
   THE RADICAL CRITIQUE .......................................................................................................................... 14
   BIBLIOGRAPHY ................................................................................................................................... 19
DEFINITIONS ............................................................................................................................................ 20
   INDIVIDUAL .......................................................................................................................................... 20
   OUGHT .................................................................................................................................................... 20
   VALUE ..................................................................................................................................................... 20
   SANCTITY OF LIFE .............................................................................................................................. 21
   ABOVE..................................................................................................................................................... 21
   QUALITY OF LIFE ................................................................................................................................ 21
   SANCTITY OF LIFE IS THE BEST VALUE ...................................................................................... 25
   MUST NOT USE PEOPLE AS MEANS ................................................................................................ 26
   SANCTITY OF LIFE PRESERVES HUMAN DIGNITY ................................................................... 27
   CHOOSING SANCTITY OF LIFE HELPS THE COMMON GOOD ............................................... 29
   SELFISHLY AUTONOMOUS DECISION-MAKING MUST BE LIMITED................................... 30
   EUTHANASIA CAUSES A DEADLY SLIPPERY SLOPE ................................................................ 31
   MUST ACT TO PRESERVE LIFE AT ALL COSTS .......................................................................... 32
   SOCIAL INEQUITIES CAUSE UNJUST DISCRIMINATION IN EUTHANASIA ........................ 33
   EUTHANASIA IS ALWAYS WRONG ................................................................................................. 34
   ANSWERS TO: "PEOPLE ARE SUFFERING IN PAIN".................................................................. 35
   DOCTORS MUST NOT PRACTICE EUTHANASIA ......................................................................... 37
NEGATIVE CASE ...................................................................................................................................... 38
   CRITERIA ............................................................................................................................................... 41
   EUTHANASIA IS JUSTIFIED .............................................................................................................. 42
   SANCTITY OF LIFE DOES NOT JUSTIFY ALWAYS OVERRIDING QUALITY OF LIFE ....... 43
   COMMON PRACTICE AND PUBLIC OPINION VALIDATE EUTHANASIA ............................. 44
   PHILOSOPHY, RELIGION AND LAW ALL SUPPORT PRIORITIZING QUALITY OF LIFE . 45
   BRAIN DEATH TERMINATES AN INDIVIDUAL’S INTERESTS AND MORAL STATUS ....... 46
   AUTONOMY CRITIQUE ...................................................................................................................... 47
   PERSONHOOD CRITIQUE .................................................................................................................. 49
   THE SLIPPERY SLOPE ARGUMENT IS FALSE.............................................................................. 50
   THE SLIPPERY SLOPE ARGUMENT IS UNPERSUASIVE ........................................................... 51
   THE HIPPOCRATIC OATH DOES NOT INVALIDATE THE RIGHT TO DIE ............................ 53
             A MATTER OF LIFE, DEATH AND POLITICS:
         A COLLECTION OF OPPOSING VIEWPOINTS ON THE
                  QUALITY-SANCTITY DEBATE
By Matt Stannard, California State University Long Beach

Resolved: That the individual ought to value the sanctity of life above the quality of life.

Introduction
"It boils down to two ideas, the quality of life versus the sanctity of every life. I believe this is a defining
issue in America's character and culture." -Representative Henry Hyde, R. Illinois(Quoted in FRESNO
BEE, April 26, 1997)

In what follows we will discuss the current Lincoln-Douglas resolution from the framework of
philosophical social criticism. The approach will draw from both traditional and radical philosophy, and
will be partly based in current topic literature. We will ask questions about who has the right to decide
when to take a life, or whether life is good in itself (or good only for other, possibly "higher" causes). These
are not subversive or irresponsible questions. Humans have always prioritized life only alongside a range of
other moral considerations. We have been willing to die in wars and support capital punishment. More
importantly, we have always been willing to let others die.

This essay examines both the responsibility not to let death occur and the corresponding, negative
responsibility of not killing or causing death. Because this is merely a topic overview, this essay takes no
specific position on the Sanctity-Quality debate. If I have a "position" at all, it is that we should think very
hard about the concept of life itself, and that this examination must begin with the various ways in which
various groups explain their positions about the concept. To that end, I will frequently return to leading
articles on the topic, including recent legal analysis and social commentary.

Debaters should take this essay as a starting point for a topic that requires a basic vocabulary grounded in
topic literature. "Quality" and "Sanctity" cannot be defined in a vacuum, and the phrases "Quality of life"
and "Sanctity of life" are solid ground points for literature searches.

The Sacred Nature of Life in Religious Traditions

Life is a gift. This is the theme in all religious traditions. The deities in question did not "need" to create
their subjects, but they did so, out of goodness and generosity. For most of history, life has been fleeting.
For centuries it was expected that a man would live to the ripe old age of thirty. To live to be fifty-that was
ancient, wise, and hardened.

Because of the fleeting nature of life, ethical codes were developed to preserve life: "You shall not kill."
There was no reason to modify this Mosaic law in the Christian tradition; indeed, if anything, Christianity
(in its most radical sense) disallows killing of nearly any kind. Even before the advent of Christianity and
other modern religions, there were codes forbidding doctors and others to use their powers to do anything
but SAVE and PRESERVE life. The Hippocratic oath states: "To please no-one will I prescribe a deadly
drug, nor give advice which may cause his death. Nor will I give a woman a pessary to procure abortion."
A slightly modified oath, the Declaration of Geneva, states: "I will maintain the utmost respect for human
life from the time of conception; even under threat, I will not use my medical knowledge contrary to the
laws of humanity."

These oaths seem to have lost their meaning in a world beset by medical breakthroughs, life-cheapening
political systems, and endless compromise. One of the themes we will trace in this overview is how life has
come to be defined as something less than sacred. On the one hand, this has proven to be a positive
development for those who believe that other considerations should matter just as much as the vitality of
individual life. On the other hand, those who still believe life is sacred complain that such developments
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                                 West Coast Sanctity of Life LD Supplement Page 53
have not simply made life "equal" to other considerations, but have subordinated the lives of the powerless
to the conveniences and desires of the powerful.

Life has been cheapened by modernism

"The Western world is undergoing a legal revolution. For centuries, the law in both common law and civil
law jurisdictions has stoutly upheld the principle of the 'sanctity of life.' Over the past thirty or so years,
however, courts and legislatures across the Western world have seriously compromised that principle.
Respect for life's inviolability has been eroded increasingly by efforts to promote largely unbridled
individual autonomy and the notion that only some human lives, those which pass a certain 'quality'
threshold, merit protection." (John Keown, JOURNAL OF COMTEMPORARY HEALTH LAW AND
POLICY, Spring, 1998, p. 253.)

Throughout this essay we will be drawing upon the arguments made by John Keown in defense of the
Sanctity of Life. We will also chronicle arguments made in favor of Quality-based ethics by other writers.
But Keown's perspective is interesting because it is disturbing. It suggests that society has devalued life at
the very time in which we have the technical and ethical capacity to preserve and promote life more than
ever before.

True, life has been more expendable in other periods. Kings could order citizens to their deaths; and during
the Crusades, children were drafted to fight and die in wars. But paradoxically, life was considered much
more sacred during these past times, when it seemed harder to hold onto. Could it be that in a world of so-
called overpopulation and near-universal availability of commodities to extend life, that life is no longer
seen as worth fighting for?

Pro-life advocates have long said this about abortion: Its availability and "convenience" seem to outweigh
any moral considerations involved in a practice which very clearly "kills" something, whether that
something is a human being, a potential human being, or an extension of another human being. Peace
activists point to the daunting technological means we have developed to kill millions of people in a single
instant. Clearly, not all those killed by weapons of mass destruction could be even remotely construed to be
"participants" in a war, and thus advanced weaponry already assumes an ethic which says killing innocent
people is acceptable.

On television, we see dozens of people murdered every day. The entertainment industry induces ritual
spectacle that might numb us to the reality of dying. The alienation of modernism and capitalism has
resulted in cities where the death of children by gunfire is a daily, headlined expectation. If we explore the
issue more deeply, we see that automobile manufacturers make decisions about safety features of their cars,
based on the "bottom line" of cost, fully aware, and prepared to absorb the costs, of the X amount of deaths
that will result from these unsafe vehicles. In a world where people are numbers, statistics, bystanders, life
is no longer an "absolute" value, even if more people are living than at any other time in history.

Preview of the essay
This essay uses quotations and readings from all perspectives of the Quality- Sanctity debate to raise issues
of how important "life" is. After examining the traditional viewpoints, including extensive examination of
the debate over whether abortion and euthanasia will descend into a "slippery slope" to genocide, the essay
then considers more radical interpretations of the debate. I argue that a social and economic system based
on zero-sum competition and the cold logic of capitalism distorts both the pro-Sanctity and the pro- Quality
arguments. This radical turn simultaneously challenges debaters to ask deeper questions, and gives them
the opportunity to make deeper arguments.

The essay concludes with case ideas for the affirmative and negative. It should be noted that the literature
on this topic is plentiful, and encompasses all of the following areas: Euthanasia, abortion, capital
punishment, suicide and the right-to-die movement, capitalism, and the philosophical definitions of "life."
We cannot hope to cover all this in an overview, or even an entire handbook. A bibliography at the end of
the essay will serve as a starting point for further research.
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                                  West Coast Sanctity of Life LD Supplement Page 53

Importance of the topic and debating it
This is a defining issue for the end of the century. Most of the relevant legal literature can be found within
the past year, and the controversy is certain to increase as various states in the U.S. take up the issues of
assisted suicide, euthanasia, abortion, and capital punishment. Debaters who research and debate this topic
will have a handle, a head start, on one of the most current, controversial, and prolific issues to face
lawyers, medical professionals, and human beings. In order to do justice to such a topical issue, it is
important to remember two things:

First, platitudes and cliches are no substitute for good argumentation. While it is easy (especially after
watching both sides of the abortion debate) to simplify issues for the sake of argument, we urge you not to
take that route. Phrases such as "life is sacred" or "we're all just dust in the wind" have deep meaning
beyond their intonation. That meaning lies in centuries of Eastern and Western philosophy and theology.
Those centuries have now been contextualized into the current legal and moral disputes at hand. As
debaters, we have a responsibility to find the meaning beyond the phrases, and this is done through using
good argumentation, by warranting your claims, by backing up your assertions with logic or evidence, and
especially by answering your opponents' arguments.

Second, it is important to remember that these issues cannot always be decided with any degree of certainty
in a debate round. This means that, after all the arguments have been laid out, all the evidence read, all the
answers answered, there is going to come a point when you must look at the judge or critic, look at the
audience and say: "These are complicated, controversial issues. We cannot decide the entire scope of the
history of philosophy in this single round. But we can decide what criteria to use, and in doing so, prioritize
the most important aspects of the debate." In other words, debaters will need to narrow the scope of their
inquiries in order to focus on the arguments necessary to win particular rounds. This may be frustrating:
One may wish to talk about Artistotle's potentiality argument, and why this makes abortion immoral. But in
doing so, one is forced to simplify their Aristotelian metaphysics, and keep the story as clear as possible.

These two points are seemingly contradictory: I have told you to go deep into the arguments, and I have
told you not to go too deep. Such is the paradox of Lincoln-Douglas debate...so much to say, so little time.
But between these poles lies a balance, and in finding it, you will already have learned more than you
thought you could.

                               Traditional Views on the Quality-Sanctity debate

This section examines three traditional views: Vitalism, which will be quickly dismissed and which is
sometimes confused with Sanctity. Sanctity itself, which argues that life should generally be prioritized
over other considerations. And, Quality, whose advocates call for life to be prioritized only as one
consideration among many.

Vitalism: All life is sacred

The "life debate" can be schematized as a spectrum. On one end of the spectrum is NOT the Sanctity
position; in fact, there is a life-affirming perspective even more radical than Sanctity. Vitalism holds that
one should never, in any circumstances, take a life. This means one cannot:
--fight in a war
--have an abortion
--support capital punishment

Well and good. Most of these are also held by the Sanctity position, as we shall see below. But vitalists go
on to say that one should not:
--assassinate a murderous tyrant who will kill millions
--mercifully end the life of a suffering, terminally ill patient
--kill to defend your family
These limitations begin to illustrate the problematic nature of "absolute" deontology. If "life" is taken as an
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utterly absolute value, it not only disallows what society would "reasonably" see as natural limits on the
extension of life-it also seems to disallow actions which are designed to save more lives, or to end a life
that serves no purpose and actually causes harm to its holder. As legal scholar John Keown, an advocate of
Sanctity, describes vitalism: "Regardless of the pain, suffering, or expense that life-prolonging treatment
entails, it must be administered because human life must be preserved at all costs. Vitalism is as ethically
untenable as its attempt to maintain life indefinitely is physically impossible. Its error lies in isolating the
genuine and basic good of human life, and the duty to respect and promote that good, from the network of
standards and responsibilities that make up our ethics and law as a whole..." (John Keown, JOURNAL OF
COMTEMPORARY HEALTH LAW AND POLICY, Spring, 1998, p. 253.)

In other words, respect for life, while important in the Sanctity context, cannot be separated from the
"network" of other responsibilities, laws and norms, which make life possible, and which contextualize our
choices. If vitalism does not even allow us to assassinate murderous tyrants, it becomes clear that a
philosophy which places the preservation of life above ALL other considerations is actually anti-life, both
in the consequent sense, and in the sense that this absolutism betrays a misunderstanding of the
prerequisites of life itself. Even pro-life advocates will admit that a more reasonable, if nevertheless strict,
standard is necessary.

Sanctity of Life

Life cannot be taken except in the most extreme circumstances. Keown and others lay out several
components of an ethic of Sanctity of Life. These are drawn from religious, moral, ethical, and
philosophical traditions in Western history. The first of these is that life is created "in the image" of a
creator. One need not subscribe to a specific religion to understand the philosophical meaning of this
assertion: It implies that there is an "ideal type" of humanity, and that humanity is special, possessing a
unique place in the universe. "With or without the theological underpinning," Keown writes, "the doctrine
that human life possesses an intrinsic dignity grounds the principle that one must never intentionally kill an
innocent human being." This differs from vitalism in two ways. First, the emphasis on "innocence" implies
that one can conceivably kill murderers and tyrants. Second, there may be some allowance for ending life-
saving treatment if it only prolongs suffering (but we will return to this issue later).

The second major tradition embraced by Sanctity is the concept of "rationality" serving as the basis for life.
Human beings are afforded a level of dignity not held by non-humans because of our capacity for rational
thought. Moreover, all humans should be assumed to possess that capacity even if they do not use it, or
even if the capacity is limited in some sense. This becomes very important when Sanctity advocates argue
against "eugenic" choices. They believe that the ultimate effect of Quality of Life advocacy would be to kill
the handicapped and mentally impaired, because this respect for rationality is assumed by Quality
advocates to only be allowable if actually possessed. But Sanctity advocates use rationality as a general,
ideal standard, meaning that even if one is presently incapable of that rationality, one is still granted the
dignity of the rationality of humans in general.

The third major point of the Sanctity argument is that humans are not to be treated instrumentally. This is
basically a rendition of Immanuel Kant's deontological ethics: Humans are to be treated as ends in
themselves, not means. The instrumental view of life is that life must, in order to be valuable, serve some
higher good. Sanctity advocates do not necessarily claim (like vitalists) that life is the "absolute highest
good," but they do claim that an individual's life is the highest good allowed to that individual, and that any
instrumental treatment of someone else's life is morally wrong.

Arguments against Sanctity

Most of the arguments against sanctity can be found when we explore the treatment of Quality of Life
advocates. However, one argument against sanctity which does not require (necessarily) an adherence to
Quality of Life is simply this: One cannot intrinsically justify all the values necessary to warrant the
assertion that life is more important than other values. We find those other values all the time: People say
freedom is more important than life itself, for example, or that the causes of one's nation, one's faith, one's
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                                 West Coast Sanctity of Life LD Supplement Page 53
political philosophy, are worth dying for, and even worth killing for.

The difficulty involved in enforcing a particular set of value assumptions regarding the sanctity of life has
been expressed by Joseph Fletcher, who believes that while "scientific" decisions are objective, value
decisions are inherently subjective, and thus impossible to universalize. This attitude favors quality-of-life
advocates since "quality" sounds more utilitarian, more scientifically-based, than "sanctity." Fletcher
writes: "It is harder to wrestle with value differences. There is no way to prove that one value (the worth we
assign to moral and non-moral goods) is "true" or "right" and another is "false" or "wrong." Indeed, value
assertions or ascriptions are not true-false statements; they are good-evil statements; they are justifiable or
unjustifiable, but they are neither verifiable nor falsifiable. In short, they are ethical and legal but not
scientific. We can disapprove of a given value, but we cannot disprove it. It can be judged, but that is all."
(Joseph Fletcher, NATIONAL FORUM, September 22, 1989, p. 43)

Fletcher illustrates the futility of convincing life-advocates of the destructive effects of their unswerving
dedication to sanctity. In fact, he seems to suggest that sanctity doctrines lead to the same effects as
vitalism: "A mountain of data showing that deleterious reproduction is inhumane might cause a change of
opinion in some advocates of the doctrines of the right-to- produce and the right-to-life, but if so it will not
come about by logical necessity. It would not "follow" as it would where the rule of reason runs by
induction. Advocates of control and their adversaries both can be logically coherent; they would differ not
in their reasoning powers, but in the different values at the basis of their ethics." (Joseph Fletcher,
NATIONAL FORUM, September 22, 1989, p. 43)

Fletcher finally concludes that one either picks the sanctity of life deontologically, or chooses to embrace a
quality-based pragmatism which is actually more responsible than deontology: "How we determine the
right course of action when we have to make morally significant decisions is of fundamental importance. It
is also the main source of ethical disagreements. At bottom, there are only two ways to go about it. We can
either follow a rule (or a ruler) of conscience, which is the a priori or prejudicial approach, or we can look
at the facts with an open mind and calculate the consequences, the human costs and benefits, pragmatically.
Rule ethics is in effect a policy of not deciding questions at all, if and when a rule applies; conscience is
handed over to the "moral law" or general rule. Thus, negatives are taboos and positives are decrees. By
contrast, relative moral judgments vary according to the variables in situations, and they balance values off
against values. They try to choose the constructive course, i.e., the one yielding a balance of benefit or
"proportionate good." This kind of case ethics truly calls for a moral agent; it needs choosers, not a blind
following of a prefabricated rule." (Joseph Fletcher, NATIONAL FORUM, September 22, 1989, p. 43)

Fletcher is arguing that utilitarianism, the ethical code which demands we try to achieve the greatest good
for the greatest number, is more responsible than Sanctity arguments, and that sometimes the two will come
into conflict. But this does not necessarily mean that Sanctity has lost the battle. There is still one more
reason to hold life "absolute," and that is because it is a prerequisite for all other values. In other words,
there can be no freedom without life, no political philosophies or religious faiths, no goods of any kind.
And once we begin devaluing individual lives, we run the risk of devaluing life AS A VALUE, and hence
(symbolically) risking extinction.

If this is true, then Quality of Life advocates must not only assert utilitarianism and science over the
deontology of the Sanctity advocates; they must also respond to the very utilitarian argument that life must
be a fundamental value because it is necessary for the realization of all other values.

Quality of Life: Life as instrumental

A summary version of the Quality of life argument goes something like: "You say we should live. I say,
live to do what? Live to be what sort of beings?" Instrumentality, utility, usefulness: these phrases define
the basic tenets of those who believe that life is not intrinsically good, but only good if certain conditions
are met. These conditions generally include the ability to enjoy a minimum level of independence,
intellectual ability, and freedom from overt suffering. They may also include the social responsibility to end
other people's suffering, or to accept punishment for suffering we have caused.
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                                 West Coast Sanctity of Life LD Supplement Page 53

Let us concentrate on the first of these: independence. Autonomy is generally regarded to be the
cornerstone of an individual's worthwhile existence in society. By choosing to value autonomy above mere
existence, Quality of Life advocates are merely echoing what was made clear by the Enlightenment's
revolution in thought: that freedom is more important than the security of a confined existence. This maxim
has important implications when one is forced to choose between Quality and Sanctity. The implication is
that life serves some other end rather than merely itself. In this sense, Quality of Life is a criterion: It
measures other actions and choices according to their impact on the worth of living.

In the most extreme examples, it seems clear that one should not choose to keep someone alive "at all
costs." Although we have previously drawn a distinction between "vitalism" and the Sanctity advocates,
proponents of Quality of Life say that this distinction breaks down when Sanctity advocates try to limit the
taking of life for reasons other than the intrinsic good of the patient. John Keown, for example, is careful to
make the distinction between Sanctity and vitalism, but then turns right around in his article and makes
vitalistic-type arguments in favor of Sanctity: that the life of the patient is more important than any
implications of that life.

In contrast to the semi-absoluteness (which becomes absolute absoluteness when backed into a corner) of
Sanctity, advocates of Quality of Life decisions shy away from saying that anything which threatens life is
"always" wrong. As Fletcher argues: "On the other side are those who would prefer to make quality choices
or to be selective. They cannot lay down a blanket norm such as "sterilization (or abortion) is always
wrong." For them, it would be reasonable and even obligatory to obviate some genetic tragedies by
sterilization before or by abortion after, conception. These things might be wrong (inhumane) in a
particular case, but not always. A quality-of-life ethic chooses the course which offers the most good, and
life is a value to be seen in relation to other values; at the most it is only primum inter pares ." (Joseph
Fletcher, NATIONAL FORUM, September 22, 1989, p. 43)

Quality of Life advocates criticize the absolutism of Sanctity advocates most strongly in the area of
medicine. Philosophers such as Peter Singer have suggested that we take an approach which does not hold
individual life to be sacred, since such a position suffers from the same problem as does individualism in
general: namely, that the good of the whole is ignored, and that the emphasis on autonomy is historically
obsolete. Fletcher seems to suggest that modern medicine has made the absoluteness of life obsolete
because we don't really know, anymore, what "life" is. It is possible to keep someone alive beyond their
natural inclination to be so. It is possible to define "life" merely as the absence of death, a gesture that
makes life utterly meaningless. This causes pro-Sanctity arguments to be fallacious and absurd. Fletcher
argues: "Perhaps the most searching conflict between absolute and relative ethics takes shape over the
sanctity (or sacrosanctity) of human life versus quality-of-life evaluations. This arises in genetic control and
abortion, but also in treating moribund patients. There are those who insist that all life is precious,
regardless of its quality or potential, and since they absolutize life just because it is life, they are logically
opposed to genetic control by abortion or sterilization. This kind of taboo, or undiscriminating prohibition,
is an example of what logicians call the material fallacy of faulty generalization." (Joseph Fletcher,
NATIONAL FORUM, September 22, 1989, p. 43)

Sheila McLean, a Professor of Law and Ethics at Glasgow University, believes that modern medicine has
radically altered the definition of "life." "Modern medicine can stave off death and prolong life with or
without quality, and has fundamentally altered our perspective on death and dying. In so doing, it has
provided immense benefits for many individuals, but it has also generated profound ethical dilemmas
which, in the general way of things, demand resolution by the law." (Sheila MaLean, THE HERALD,
March 27, 1997, p. 17)

Thus, Quality of Life advocates, while not arguing that people should be routinely allowed to die, do argue
that there are more important factors than life. Two of these, for our purposes (there are certainly more),
might be: 1. The possibility of happiness. The Hemlock Society, a pro-suicide rights group in the United
States, argues that if, as Sanctity advocates suggest, individual autonomy is so important, then people
should be allowed to kill themselves. While this strikes against our value systems rather deeply, there
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                                 West Coast Sanctity of Life LD Supplement Page 53
seems no logical reason why we should not extend individual rights in that direction, unless the value of
life somehow transcends all other values. If I can be reasonably sure (that is, enough to convince myself)
that I will not find happiness in life, then, it is argued, I should have the right to end my life. (I do not agree
with this view, and feel compelled to state rather strongly that those who feel so inclined should
immediately seek help. But for the sake of argument, we shall assume that the right to suicide is a logical
extension of the Quality of Life position). 2. Resource availability. Many health care experts predict that we
will need to "ration" our health services in the future, and this means letting certain people die. Again, this
strikes a hard blow to our values. But certain societies have been known to practice a selective "euthanasia"
of the old, the infirm, and even weak infants.

Quality of life judgments are arbitrary

What do we mean by "quality?" Keown and others are concerned that leaving that decision up to
individuals is no more consistent than leaving it up to some collective body. The individual who defines
quality in the case of euthanasia is usually the physician. However, a number of cases in recent years have
proven that the definition of a "quality" life is as diverse as the number of physicians making such
decisions. For Keown, this has a great deal to do with the fact that medicine, like all science, is not uniform
or universal in the beliefs of its practitioners: "The inherent arbitrariness of Quality of life judgments,
particularly when delegated to doctors, is underlined when it is recalled that medical opinion is often
divided and in flux. A patient may be treated by a doctor who thinks his life worthwhile, but that doctor's
ethical views may change, or the patient may come under the care of a doctor with different ethical views.
The upshot would appear to be that if a doctor responsible for a patient with advanced Alzheimer's disease
thinks the patient's life is of no benefit, and the doctor's opinion coincides with that of a 'responsible body'
of medical opinion, the doctor may, indeed must, cease treating the patient." (John Keown, JOURNAL OF
COMTEMPORARY HEALTH LAW AND POLICY, Spring, 1998, p. 275).

Thus, we are left believing the best thing would be to ask the patient whether she thinks her life is
worthwhile. But two problems occur at this point. First, the patient may be in an incapacitated state, unable
to answer such questions. Here, the temptation is strong to say that if the patient cannot contemplate her
own existence, she cannot possibly be in possession of a "quality" life, since sentience and consciousness
seem prerequisites to worthwhile living. But what if, unbeknownst to either the doctors or to the patient's
family, this incapacitated state is only temporary? Below we will read of an example of such phenomena,
and we will be frightened by its results.

The second problem is deeper: What right does the patient have to determine whether her life is
worthwhile? "Autonomy" is a catchword used to give people the right to determine their own values. But is
this valid? Sanctity advocates like Keown believe that individual autonomy and choice are only valuable if
they lead to socially desirable results. Valuing a patient's life is not the same as uncritically valuing any
decision the patient makes. As Keown puts it: "The value of individual choice lies in the fact that it is
through our choices that we are able to promote our own flourishing as human beings . . . such choices,
moreover, serve to reinforce dispositions to act in ways conducive to our flourishing." In other words, the
choice to die if one has any hope of living a decent life, to die when one could still contribute to others and
to society, is irresponsible. And as the next objection shows, the destructiveness of choosing death does not
end with the individual.

The Slippery Slope

The "slippery slope" position argues that once we begin allowing "Quality of Life" criteria to trump the
ethical necessity to preserve life, we will begin finding more and more reasons to do so. The ultimate
scenario: Genocide will become commonplace. People who seemingly serve no "productive" purpose, such
as the old, the disabled, the retarded, will be systematically killed.

The rhetorical force of this argumentation comes out clearly in a case outlined by Wesley Smith, in a 1995
article for the National Review. In the following passage, Smith recounts a situation where, because of
"Quality of Life" concerns, a human being with cognitive and mechanical ability intact was nearly killed by
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doctors. Robert, an alcoholic experiencing marital problems, is injured in an automobile accident. His wife
Rose, possibly because of their marital problems, exercises her authority to let Robert die even AFTER he
shows signs of improvement. It is a chilling and complicated story: "One week later, Rose's worst fears
came to pass. After a terrible auto accident, Robert was in a coma. Robert remained unconscious for 16
months. Then, last January, he unexpectedly began to wake up. According to court testimony by his nurses
and therapists, confirmed by the medical records, Robert has since learned to maneuver a motorized wheel
chair on command, avoid obstacles, and has even wheeled himself outside the hospital. He responds to
requests, such as "Hand me the ball," between 80 to 100 per cent of the time. He can retrieve and return
colored pegs from a tray, when asked to do so by a therapist, evidencing sophisticated neurological
function. He knows people when they come into the room. He can now support up to 100 pounds on one of
his legs, which means his muscle tone is returning. He shows emotional responses to his environment. For
example, he has reached out and kissed his mother's hand.”

"True, he cannot communicate well, and he remains profoundly disabled. But, according to the therapists,
he has been steadily, if slowly, improving since awakening. In early July, Rose approved an intensified
regimen of therapy for Robert. Two weeks later, his feeding tube came out of his abdomen. Unexpectedly,
Rose decided not to have the tube replaced. Robert would no longer receive food and fluids. In other words,
Robert was to be starved and dehydrated to death.”

"A temporary naso-gastric tube was placed in Robert for feeding, while Rose and the doctor in charge of
the case, lung specialist Dr. Ronald Allen Kass, brought the matter to the hospital ethics committee seeking
its imprimatur to let Robert die. The committee unanimously approved the withdrawal of food and fluids,
with the additional support of the San Joaquin County Ombudsman, who had been assigned as Robert's
patient advocate.”

 "However, a close look at the committee's approval reveals some disturbing facts. As far as is known, no
one argued on behalf of saving Robert's life. The nurses and therapists, the very people who spend the most
time with Robert, were never asked to appear before the committee. They could have told the committee, as
they later did a judge, that Robert is cooperating with his therapy, at least an implied statement that he
desires to live. Nor were family members, who were later to oppose the dehydration, allowed to appear.
Indeed, Robert's sisters and mother were not even told his killing was being contemplated. (Robert's brother
Mike, who supports Rose, was aware of her decision.) The ombudsman, whose job is to advocate on
Robert's behalf, wasn't even aware that Robert was able to manipulate a motorized wheel chair, when she
decided to support Rose's plan.”

"Had it not been for an anonymous phone call to one of Robert's sisters, he would be dead now. But the
phone call was made, and as a consequence, Robert's mother, Florence Wendland, and his sister, Rebekah
Vinson, obtained a restraining order preventing Robert's dehydration. Now, a divided family has squared
off in court…Judge Robert W. McNath will decide whether Rose will be empowered to continue to make
Robert's medical decisions and if so, whether she will be permitted to order Robert's food and fluids
withheld.”
“’This is stealth euthanasia,’ says Dr. William J. Burke, Professor of Neurology at St. Louis University.
‘The deaths of these patients are a dire warning about the increasingly perilous state of our medical
ethics.’” (Wesley J. Smith, NATIONAL REVIEW, December 11, 1995, p. 32).

Is the "slippery slope" argument merely a scare tactic? Joseph Fletcher thinks so. He believes that people
are simply too rational to allow such things to happen. He writes: "The most common "ploy" in rejecting
policies which have a solid pragmatic justification is to warn us that the remote consequences, if not the
immediate, will add up to a balance of evil over good--if we do what they already condemn on prejudicial
or "principled" grounds. "If you start down that road you will end up in even worse misery and horror than
the one you want to avoid." Or again, "Give up even a little of your right to reproduce and you'll lose it all."
This is called the slippery slope objection, or the entering-wedge objection." (Joseph Fletcher, NATIONAL
FORUM, September 22, 1989, p. 43)

Fletcher believes that such arguments only serve to remind us of potential possibilities. While we need to
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be careful to avoid the pitfalls of extremism, pointing to the impacts of such extremism does not constitute
a reasonable objection to simply prioritizing quality over sanctity. The prioritization itself does not
guarantee its abuse to illogical, horrible, or extreme ends: "This scare tactic has some merit; it reminds us to
be careful. Sometimes remote consequences can indeed cancel out immediate benefits. It fails, of course, to
appreciate the difference between the virtue of prudence and the paralysis of fearing to take reasonable risk
or accept reasonable limitations. Prudence requires us to forego foreseeable benefits if weightier and
undesirable side (or after-) effects are probable; the "wedge" requires us Cassandra-like to forego such
actions when the evil is only possible. And what can we ever do that is not in some measure either
ambivalent or ambiguous, or both? Sterilizations, for example, reduce the incidence of abortion
("prevention is the best cure"); yet each of them might well be unwelcome, taken alone." (Joseph Fletcher,
NATIONAL FORUM, September 22, 1989, p. 43)

But is this really a scare tactic? Consider, for a moment, the logic of euthanasia. 1. We ought to allow
patients whose quality of life has diminished to X the right to die. 2. Rights can be secured by proxy; when
a patient is not "competent" to exercise her rights, others can do so on their behalf. 3. Thus, others can
determine that a patient's quality of life has diminished to X. According to Wesley Smith, the "slippery
slope" resulting from such logic is not a "scare tactic," but an accurate assessment of what is happening
NOW, not twenty years down the road: "The patients about whom Dr. Burke speaks, like Robert
Wendland, are the cognitively disabled men, women and children whose nutrition and water, supplied by
feeding tube, is almost routinely being cut off in hospitals and nursing homes around the country. The
intentional killing of these patients, most of whom are quietly dehydrated behind closed doors because no
one objects, began with those diagnosed as permanently unconscious. In a classic application of the
slippery slope, it has now spread to the disabled who are without doubt conscious and interactive." (Wesley
J. Smith, NATIONAL REVIEW, December 11, 1995, p. 32).

At the end of this road, writes ethicist George Weigel: "…is Dr. Mengele (Joseph Mengele, the Nazi
scientist who began the technological process of genocide): the embodiment of the triumph of power over
principle, in the manipulation of life and death by the 'fit' at the expense of the 'unworthy.'" (Weigel, THE
WASHINGTON POST, March 26, 1995, p. X-1).

In the small subsections to follow, I outline the beliefs of Quality and Sanctity advocates regarding suicide,
capital punishment, euthanasia, and abortion.

Suicide

The concept of the right to die would not have been possible without initial deference to doctors concerning
patients' euthanasia. But once euthanasia was accepted in some circumstances, libertarians began to wonder
why, if doctors could decide to kill their patients, the patients themselves could not decide to die. Then, the
libertarian argument went a step further: If patients can decide to die, why can't everybody else? Sheila
MacLean traces such logic: "This is, perhaps, the most significant conclusion to come out of this debate.
Once we concede that we are prepared to make life and death decisions for others, we are morally obliged
to ask why it is that we will not permit people themselves to make such choices. In reality, of course, we do
permit this in limited circumstances. The competent, adult patient already has the absolute right to refuse
life-sustaining treatment. In effect, the patient whose condition will kill unless treated can choose death
over life." (Sheila MacLean, THE HERALD, March 27, 1997, p. 17)

In a nutshell: Quality of Life advocates may not believe that the right to suicide necessarily follows from
their opinions, but it does, because once we allow people to determine that there are more important
considerations than life, then we have, in effect, endorsed the personalization of such judgments, and what
follows is that every thinking citizen has the right to take his or her own life. On the other hand, Sanctity
advocates are understandably opposed to suicide, but have a difficult time explaining why such choices
should be limited, and what the impact of "more suicide" would be. The slippery slope argument is the ace
in the Sanctity hole; one must prove that the general devaluation of life that accompanies the right to die
will eventually be used to grant that right to unwilling recipients.
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Capital Punishment

Both Quality and Sanctity advocates are divided about the question of capital punishment. This is, indeed, a
"can of worms," because it is difficult to say whether capital punishment for murder affirms or cheapens
life. Pro-capital punishment forces say that a ritualized execution of a murderer is the ultimate pro-life
symbolic act, and that it deters murder. The former claim is subjective and difficult to judge, since it is a
matter of the way the public audience interprets the ritual. The latter claim seems impossible to prove.

But nevertheless, it seems reasonable to establish a Sanctity of Life case against capital punishment, and
only slightly less reasonable to establish (by proving some symbolic significance) a Sanctity of Life case
for capital punishment. The first of these cases seems strategically superior; it is somewhat more
convincing to say that a society which values life should never kill, period, than to say we should kill those
who kill, to demonstrate the wrong of killing.

Euthanasia

We have already mostly covered this, but I want to add a fragment of Dr. MacLean's well-written editorial
to demonstrate the problematic nature of resolving euthanasia through value judgments. She writes:
"Judging the quality of anyone else's life is, of course, highly problematic, and any decision is open to
challenge where the wishes of the individual patient cannot be, or have not been, identified. The debate
over quality versus quantity of life is an extremely hard one to resolve, and our conclusions will inevitably
vary depending on factors such as our religious, social or moral culture." (Sheila MacLean, THE
HERALD, March 27, 1997, p. 17)

Because of this, both sides of the debate need to make their criteria clear. What is really important?
Individual rights? Collective responsibility? The messages we send to society? And since the topic says the
INDIVIDUAL must choose between Quality and Sanctity, who is the individual in this case? The patient?
The doctor? Debaters must be prepared to answer these questions.

Abortion

Genetic screening advocate Joseph Fletcher constructed three questions to frame the quality of life issue as
it applies to childbirth: "Setting aside legal problems, looking at it only on ethical grounds, the problem
comes down to three controversial issues. (1) Is it right, i.e., are we morally free, to judge that the
predictable condition of a newborn could sometimes fall below a reasonable standard of quality? In short,
may we set a quality standard for our progeny? (2) Are we morally obliged to avoid having children with
serious genetic disorders, if and when we can avoid it? (3) Can we justify (ethically validate) interference
by society (through law) to uphold minimum standards and prevent predictable misbegottens?" (Joseph
Fletcher, NATIONAL FORUM, September 22, 1989, p. 43)

Quality of Life advocates clearly favor abortion rights, for two reasons: First, because the individual choice
of the woman is a prerequisite for quality. If the woman does not want the child, the argument goes, the
child will be miserable, and so will the woman, and so, on a net level, will society. Second, the right to
abortion is necessary to check various social maladies that could undermine the quality of life, such as
overpopulation, genetic defects, and the cycle of poverty.

Obviously, Sanctity advocates argue that these reasons only prove the moral bankruptcy of the Quality of
Life movement. Since when is the beginning of life a matter of convenience? Since when are we prepared
to kill the unborn in order to solve social problems that we should be solving in other ways? For the
Sanctity crowd, abortion is co-equal to euthanasia in constituting the defining issues of the "life" question.

The past several paragraphs have presented examples of the myriad of Quality and Sanctity issues involved
in public policy, health care, and personal lives. Newspaper articles are plentiful on individual cases of
each. Of particular interest, of course, are the health care issues, which pose rather frightening scenarios
involving often helpless human beings and others around them. Each of these issues has a philosophical
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component that should be the focus of debates on this topic. But at the same time, don't lose the human
component. Tell stories of these people's lives as you wade through the philosophy; attempt to strike a
balance between the values and their applications.

                                             The Radical Critique

Conventional philosophical analysis asks many of the questions we've been discussing in our essay:
whether utilitarianism is preferable, as a democratic choice, to deontology, which might have more
consistent values; or who has the right to decide whether another person lives or dies. Traditional
philosophy is "abstract," in that it asks value questions in value terms, rather than material, or political
terms. Traditional philosophy is also individualist, in that it asks about what particular moral agents should
do, about which agents have which rights, etc.

Radical analysis goes a significant step further. In particular, radical political philosophy tries to answer
questions about the "structure" of society, and whether traditional political terms can do justice to real
political change. The "Marxist" critique of society begins with the premise that the primary agent of
historical change is economic, and that a better society would result if control over the means of production
and distribution were made "democratic." The main reason Marxists want a democratic economy is that the
economy helps shape and determine society. It is a part of society that is more deeply influential than the
philosophical part or even the political part. The forms of production and distribution shape us as
individuals. The economic "base" of society contextualizes our choices, so that even though those choices
are made with "free will," we choose from the set of choices we inherit from society. I want to conclude the
philosophical section of this overview with an example of how radical analysis changes the scope of the
debate. A "feminist" critique of the Quality/Sanctity debate would question the male-oriented categories
implicit in the definitions of "life," "quality," and "sanctity." A libertarian critique would question whether
anyone has the right to define either quality or sanctity for someone else. But the critique of capitalism,
which originates in the work of Karl Marx, goes a step further.

Marxist analysis argues that the material realities of society are more important than the moral symbology
we use to express either "quality" or "sanctity." It is not so much that the imposition of these categories is
somehow "bad." Rather, the critique of capitalism argues that, in the current system of production and
distribution, it seems useless, futile, and potentially dangerous, to concentrate on either quality or sanctity.
Instead, we should examine how capitalism undermines both Quality and Sanctity advocacy. Like all moral
philosophizing, the Quality-Sanctity debate ignores the material conditions under which rights are realized.

Just as it is meaningless to suggest that I have "as much" freedom of speech as Ted Turner, even though he
has more MATERIAL access to speech than I do, it is equally absurd to debate about the "sanctity" of life
when the system de- privileges the lives of the poor and the working class; likewise, discussions about
"quality" are invariably framed capitalistically, suggesting that one need competitive economic success to
be "truly happy." A few other examples will illustrate the insidious nature of the capitalism critique.

Capitalism and Euthanasia

An anti-capitalist critique of euthanasia begins with the assumption that, since capitalist forms of
production commodify life itself, one's life and death decisions will become "driven by the market" if
society legalizes doctor-assisted suicide or other forms of self-termination. Picture this: Doctor-assisted
suicide is legalized. Jane, a poor woman, is diagnosed with cancer. She is told that the treatments will be
very expensive and will have, roughly, a fifty- percent chance of success. If Jane has no insurance, in such
a scenario she will surely contemplate, and perhaps be encouraged by health care professionals to
contemplate, simply ending her life. But the situation is no less confounding even if Jane DOES have
insurance, because HMOs and insurance companies already try to deny treatments and benefits to the poor.
In this hypothetical situation, they will almost certainly encourage Jane to end her life. They will couch it in
terms such as: "Jane, save your family from an economic disaster...Jane, the treatments probably won't
work anyway..."
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In other words, while euthanasia is touted as a libertarian victory, it is actually only an invitation to
institutionalize what already happens-the rich get the care they need, and the poor often die. If this is
allowed to become institutionalized, however, and is done so in the existing framework of haves and have-
nots, the LOGICAL extension of the capitalist ethic is that Jane, and others like her, will be economically
compelled to commit suicide. All of this will be quite legal and convenient. Perhaps Jane will be handed a
pamphlet: "Choosing Death," it might read. "Death is a viable option for those who are concerned with the
high medical costs associated with life..."

Once again, we see how a good idea in the abstract becomes a horrifying idea in the material reality of the
world. When explaining this objection, it is important to point to other examples that show how life has
become commodified. Think about how automobile manufacturers accept a certain number of deaths each
year, or how a society which rations its health care according to market forces (e.g. insurance companies)
seeks to exclude certain types of coverage because it is not profitable. The point is to demonstrate how
markets de-value principles such as life, principles we otherwise would hold value if economics were
removed from the picture.
Capitalism and Abortion

Societies with "enforced scarcity" are societies with forced choices. What does this mean? In the context of
the abortion debate, it means that individuals are discouraged BY THE SYSTEM from making life-
affirming choices. Women are forced to choose between carrying pregnancies to term, and surviving
economically.

An analogy might be useful: Within capitalist society, the public is offered another "choice:" have a clean
environment, or have strong economic growth. It is assumed to be a forgone conclusion that we could ever
have both, could ever save jobs and trees simultaneously. Such is also the case with the individual woman's
decision as to whether to maintain a pregnancy.
This is not to suggest that women have no individual choice. It is not to suggest that only poor women get
abortions. Nor is it to suggest that abortion is the best choice, or the only choice, for a poor woman. Any of
these conclusions would ignore the dialectical relationship between structural (economic) context and
individual choice. Karl Marx wrote that people "make their own history, but they do not make it any way
they choose." Rather, my choices, while "free" in the sense that I can cognitively choose them, only occur
within the realm of POSSIBLE choices. So the economic system, the options available to me, force me to
choose between various things that have already been laid out before me. In a capitalist system, these
choices inevitably trade off with one another.

The abortion question is a good example of how individuals cannot always choose the sanctity of life-since
the system under which they live is so far away from "life affirming." If abortion is an "evil" act, it also
seems to be an economic necessity for many people. At the very least, capitalism has given us a society
where life has been devalued in other ways, making abortion a more frequently occurring option.

Capitalism and Capital Punishment

This much is clear: In a society where legal representation is the key to legal defense, and where that legal
representation is available as a commodity, the rich are less likely to be executed for their crimes than the
poor. That is simply fact; it brooks few objections. This is another example of how a market-based culture
de-values life in reality while clinging to the value of life rhetorically.

For those arguing in favor of capital punishment, the capitalism objection is difficult to overcome. It will
require proof that the legal defense available to the poor is as adequate as the defense afforded the rich.
Conversely, one could, of course, argue that the poor deserve to die more often than the rich do, but this is
difficult to prove, and seems repugnant. Better to declare one's allegiance to capital punishment with the
caveat: "In a truly equal society." The counter- factual world of equality serves as a foil to the obvious
inequality that contextualizes current justice.

For those opposed to capital punishment, capitalism serves as a great example of what's wrong with the
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way things are. But we must be careful of confusing a moral attack on capital punishment with an attack on
the historical conditions in which capital punishment is practiced. Smart opponents will grant that the
present system represents a poor actualization of the death penalty's uniquely life-affirming praxis, but then
argue that the moral ground for capital punishment still stands, even if we would reject it in instances of
historical inequality. A deontological objection to capital punishment should be the starting point for death
penalty opponents, who should only then supplement their objection with the historical instances of
arbitrary and unequal application of death.
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                                                Ideas for Debate

Affirmative

Affirmatives will be arguing that individuals (read: not necessarily societies, or laws) should promote life
as sacred. To guard against the most extreme examples of the absoluteness of life, such as whether tyrants
should be slain or brain dead patients kept animated, affirmatives should make the distinction between
Vitalism and Sanctity as explained earlier. Vitalism fails as a philosophy because it admits of no possible
exceptions. The two philosophies are clearly distinguished by legal literature. This is an easy way out of
extremist counter-warrants by the negative, and suggests a reasonableness not found in some weaker pro-
Sanctity literature. Beyond this, affirmatives need only prove that an excess of emphasis on Quality over
Sanctity has been detrimental to us as individuals, and that each individual (or more strategically, some
individuals) should choose life over decisions to let oneself or others die in particular situations.

Each of these cases is a particular type of situation. Abortion is bad: It cheapens society's view of life; it is
murder; it empowers women only at the expense of the weakest and most marginalized human beings on
the planet. And it will lead to the "slippery slope." Euthanasia is bad: The reading above from NATIONAL
REVIEW serves to illustrate inherent problems in euthanasia ethics. People are already dying who may not
need to, and may not want to. Instead of allowing euthanasia, there are more reasonable tests for the vitality
of a patient's life. Get deep into the literature if you want to debate this issue. Television violence is bad:
The "sanctity" of life would be better served if death were not a staple of the entertainment industry.
Mountains of studies show that violence on television numbs us, and that especially in children, such
numbing, and the constant barrage of kill-kill-kill ideology can lead to violence in the real world. Capital
punishment is bad: Again, a can of worms. But the evidence is strong that capital punishment does not
deter murder, and there is also the possibility of a simple, deontological case against the death penalty.
There is no right to die: This applies to both "Final Exit" pro-suicide rights and to the right of families to
order their loved ones cut off life support. The case can simply be a refutation of all the key arguments
concerning the right to die. Criterially, collective responsibility seems to do the job. War is bad: An
interesting, but completely justified twist on the topic. Warfighting is incompatible with the Sanctity of
Life. Affirmatives might even want to distinguish between just and unjust wars, wars of defense versus
wars of aggression. "Peace" works well as a value here.

Negative

Negatives admittedly have a tougher call on the topic. Do you argue that life itself just isn’t that important?
I believe negatives will win by questioning the key concepts of sanctity, not necessarily by arguing the
"reverse" of the resolution. Negatives need only negate, and to negate the prioritization of one value over
another can be done in two ways: 1. Negatives can argue that Sanctity itself rests on faulty philosophical
assumptions, or 2. Negatives can argue that Sanctity and Quality must always be equally balanced.

Libertarianism: This is an example of the first type of objection. Instead of assuming that any individual
SHOULD choose life, libertarianism argues: All human beings should have complete control over their
bodies, period. Suicide does not directly hurt any other individuals. True, those individuals may be sad, but
negatives can argue that this attitude will change when people begin living their lives as if both life AND
death were the responsibility of the person living and dying. Likewise, libertarians would argue that doctors
should be allowed to make their own choices regarding the treatment of their patients. Jack Kevorkian
would be proud.

Capitalism is bad: This is a radical application of the first type of objection. It is a "critique" of the Sanctity
movement pointing out that as long as we live in a competitive, growth-oriented system which is inherently
destructive to human life, the whole "Quality and Sanctity" question is superfluous. Contemporary anti-
capitalist literature, such as that found in Monthly Review, New Left Review, and other journals, contains
many arguments which add up to the fact that capitalism is a culture of death.

Overpopulation: This is a utilitarian version of the second type of negative objection. We must constantly
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balance concern for each individual's life with the quality of life for those humans who are here now. The
argument is fairly self-explanatory. This may be something negatives would want to argue in front of
judges with backgrounds in policy debate. Basic Malthusian theory holds that since we are now past the
carrying capacity of our planetary population, saving one life now guarantees several deaths in the future.
This is a classic "case turn" against Sanctity arguments.

This short list of affirmative and negative arguments is not meant to be exhaustive. The Quality and
Sanctity debate is, as Rep. Hyde believes, a defining social issue. The job of criticism, and philosophy, is to
ruthlessly examine not only our stated meanings of these issues, but what we really mean when we think
we mean something else. Currently, Sanctity advocates are just beginning to seriously question the turns we
have taken in issues such as euthanasia and abortion. It may only be a matter of time before the debate is
extended to other forms of "legal death" such as capital punishment and war. Or, Quality of life experts
may reassert that, in a world thoroughly beset with technology and the means to live forever, it is time to
stop seeing living beings as sacred cows. A well-reasoned debate which cuts to the underlying assumptions
may be the best tool in the near future to promote a healthy discussion of an issue that is quite literally a
matter of life and death.
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                                      BIBLIOGRAPHY
Block, Eugene B. WHEN MEN PLAY GOD: THE FALLACY OF CAPITAL PUNISHMENT (San
Francisco, CA: Cragmont Publications, 1981).

Capron, Alexander Morgan. "For them rather than by them; ethical aspects of life support." THE
HASTINGS CENTER REPORT, November, 1993.

Cozic, Charles P., & Stacey L. Tipp, editors. ABORTION: OPPOSING VIEWPOINTS (San Diego, CA:
Greenhaven Press, 1991).

Dicks, Shirley, editor. CONGREGATION OF THE CONDEMNED: VOICES AGAINST THE DEATH
PENALTY (Buffalo, N.Y.: Prometheus Books, 1991).

Dworkin, R. M. LIFE'S DOMINION: AN ARGUMENT ABOUT ABORTION, EUTHANASIA, AND
INDIVIDUAL FREEDOM (New York: Knopf, 1993).
Glick, Henry Robert. THE RIGHT TO DIE: POLICY INNOVATION AND ITS CONSEQUENCES (New
York: Columbia University Press, 1992).

Hadley, Janet. ABORTION: BETWEEN FREEDOM AND NECESSITY (Philadelphia: Temple University
Press, 1996).
Humphry, Derek. LET ME DIE BEFORE I WAKE (Eugene, Or.: Hemlock Society, 1991).
Johnson, Gretchen L. VOLUNTARY EUTHANASIA: A COMPREHENSIVE BIBLIOGRAPHY (Los
Angeles, Calif., Hemlock Society, 1987).
Lee, Robert and Derek Morgan, editors. DEATH RITES: LAW AND ETHICS AT THE END OF LIFE
(New York: Routledge, 1994).
McMullin, Ernan, ed. DEATH AND DECISION (Boulder, Colo.: Westview, 1978).

Moreno, Jonathan D., editor. ARGUING EUTHANASIA: THE CONTROVERSY OVER MERCY
KILLING, ASSISTED SUICIDE, AND THE RIGHT TO DIE (New York: Simon & Schuster, 1995).
Poppema, Suzanne T. WHY I AM AN ABORTION DOCTOR (Amherst, N.Y.: Prometheus Books, 1996).

Petchesky, Rosalind P. ABORTION AND WOMAN'S CHOICE: THE STATE, SEXUALITY AND
REPRODUCTIVE FREEDOM (Boston: Northeastern University Press, 1990).
Scofield, Giles. "The calculus of consent; Nancy Cruzan's right to die case." THE HASTINGS CENTER
REPORT, January, 1990.

Sloan, Irving J., editor. THE RIGHT TO DIE: LEGAL AND ETHICAL PROBLEMS (New York: Oceana
Publications, 1988).
Whitney, Christina. "Refusal of food and water by a man with end stage Parkinson's disease; Ethics and the
Law." JOURNAL OF NEUROSCIENCE NURSING, August, 1996.
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                                            DEFINITIONS
INDIVIDUAL

AN INDIVIDUAL IS A PARTICULAR BEING
Walter Brugger, PHILOSOPHICAL DICTIONARY, 1972, p. 195.
The individual or the individual thing is the concrete bearer of an essence in its non-communicable
particularity, as this pine tree or this man Peter.

AN INDIVIDUAL CANNOT GIVE HER INDIVIDUALITY TO OTHERS Walter Brugger,
PHILOSOPHICAL DICTIONARY, 1972, p. 195.
The individual stands in contrast to the universal or the essence which abstracts from every definite bearer
and as such can be communicated to different subjects or carriers.

OUGHT
OUGHT MEANS OBLIGATION, DEBT OR RESPONSIBILITYMichael Inwood, A HEGEL
DICTIONARY, 1996, p. 208.
Ought: "debt," "guilt," "responsibility," but originally "obligation."

OUGHT MEANS RATIONALLY NECESSARY ACCORDING TO PRACTICAL REASON
Michael Inwood, A HEGEL DICTIONARY, 1996, p. 208.
Ought: It expresses the moral or rational necessity of an action, not from natural or physical causes, but
from a concept of practical reason.

OUGHT IMPLIES A LIMIT ON FREEDOM
Michael Inwood, A HEGEL DICTIONARY, 1996, p. 210.
Hegel associates the ought with the notions of limit, restriction, and finitude.

VALUE

TO VALUE SOMETHING IS TO HOLD IT DESIRABLE, GOOD, OR WORTHWHILE THE
ENCYCLOPEDIA OF PHILOSOPHY, 1967, p. 229.
Value: "Value" (in the singular) is sometimes used as an abstract noun in a narrower sense to cover only
that to which such terms as "good," "desirable," or "worthwhile" are properly applied.

TO VALUE SOMETHING IS TO SEE IT AS RIGHT, OBLIGATORY, VIRTUOUS, TRUTHFUL AND
HOLY
THE ENCYCLOPEDIA OF PHILOSOPHY, 1967, p. 229.Value: Rightness, obligation, virtue, beauty,
truth, and holiness.
VALUE CAN MEAN PRO- OR CON- IN REFERENCE TO THE THING VALUED
THE ENCYCLOPEDIA OF PHILOSOPHY, 1967, p. 229.
In its widest use "value" is the generic noun for all kinds of critical or pro and con predicates, as opposed to
descriptive ones, and is contrasted with existence or fact.

THE DEFINITION OF "VALUE" DEPENDS ON THE DEFINITION OF "GOOD"
THE ENCYCLOPEDIA OF PHILOSOPHY, 1967, p. 229.
Whether value judgments are susceptible to being justified or proved, and, if so, how, depends very
considerably on the position taken in answer to the questions regarding the meaning of "good."
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SANCTITY OF LIFE
SANCTITY IS ABSOLUTE
Thane Josef Messinger, J.D., University of Texas, DENVER UNIVERSITY LAW REVIEW, 1993, p. 175.
Sanctity itself is, by definition, absolute. This is an uncomfortable position for many, but an unavoidable
one when faced with the very real problems of miserable deaths.

SANCTITY OF LIFE HOLDS THAT ALL HUMANS ARE EQUAL
Matthew P. Previn, Georgetown University Law Center, GEORGETOWN LAW JOURNAL, February,
1996, p. 589.
The sanctity of life principle, as generally conceived, holds two basic tenets: the absolute inviolability of
human life and the equal value of all human life. This principle accordingly condemns the destruction of
any innocent human life, regardless of the quality of that life: all human lives are equally inviolable.

ABOVE
ABOVE MEANS HIGHER
WEBSTER'S THIRD NEW INTERNATIONAL DICTIONARY, 1986, p. 5.
Above: in or to a higher place than.

ABOVE MEANS SUPERIOR TO
WEBSTER'S THIRD NEW INTERNATIONAL DICTIONARY, 1986, p. 5.
Above: superior to or surpassing in any respect.

QUALITY OF LIFE
THE QUALITY OF LIFE IS ITS INTERPERSONAL RELATIONSHIPS
Kevin P. Quinn, Jurisprudence and Social Policy Program, University of California, Berkeley,
CALIFORNIA LAW REVIEW, July, 1988 p. 897.
Making quality of life decisions requires defining the essential characteristic of being human, which the
Author proposes is the capacity for interpersonal relationships. Absent this capacity, life offers a patient no
personal benefit.

QUALITY OF LIFE MEANS THE ABSENSE OF SUFFERING
Peter Budetti, Northwestern University, Director of the Institute for Health Services Research and Policy
Studies, CORNELL JOURNAL OF LAW AND PUBLIC POLICY, Winter, 1998 p. 267.
Quality of life, meaning the absence of suffering, has four domains: physical, psychological, social, and
spiritual.

QUALITY OF LIFE LACKS CLEAR DEFINITION AND IS INHERENTLY SUBJECTIVE;
John B. Oldershaw, M.D. DePaul University College of Law, Health Law Institute, DEPAUL JOURNAL
OF HEALTH CARE LAW, Spring, 1997 p. 505.
A good quality of life for one who has significant disabilities may be considered a poor quality of life by
another whose body image cannot tolerate lesser deficits. This disparity is exemplified by the cases of
Edward Hyde and Stephen Hawking, both of whom developed amyotrophic lateral sclerosis or Lou
Gehrig's disease. This condition causes a progressive loss in motor strength with eventual total dependence
on others. In the early stages of the disease, and while only mildly affected, Mr. Hyde was unable to
tolerate the inevitable and inexorable course of the illness. Therefore, he became one of the early assisted
suicides of Dr. Kevorkian. Professor Hawking on the other hand, although severely disabled, continues to
carry on his brilliant work in theoretical physics at the University of Cambridge, U.K.
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                                       AFFIRMATIVE CASE
            EUTHANASIA AND THE SANCTITY OF LIFE
This affirmative case focuses mostly, though not exclusively, on euthanasia as a violation of the sanctity of
life. The case argues that life is always precious, that ending life is almost always wrong, and that people
who advocate "ending suffering" actually end up using the suffering victim as a means to an end. Rather
than an empowered choice, the case argues, choosing to end a life wracked by suffering actually cedes
important freedoms. Instead of the individual choosing this path, the individual should choose to prolong
life and value the sanctity of life: a practice that defends the individuals’ rights and the community's well-
being.

VALUE: SANCTITY OF LIFE

1. SANCTITY OF LIFE IS A PREREQUISITE FOR THE QUALITY OF LIFE
Keith A. Fournier, practicing attorney and executive director of the American Center for Law and Justice,
and William D. Watkins, publications director for the ACLJ, IN DEFENSE OF LIFE: CONFRONTING
THE CULTURE OF DEATH, 1996, p. 83.
But even assuming such definitional disputes could be resolved, the stronger would still be making life-or-
death decisions over the weaker. Furthermore, you can bet they'd find a way to exempt themselves from
their own decision-making criteria. Even if they didn't, we would still argue that the quality of one's life is
dependent on the sanctity-of-life perspective. How can a person enjoy life if he lives under the constant
threat that someone stronger could rob him of it at any moment according to arbitrary quality-of-life
criteria?

2. ANY CONDUCT INTENDED TO SHORTEN LIFE BREACHES THE SANCTITY PRINCIPLE
John Keown, Lecturer in the Law and Ethics of Medicine on the Faculty of Law at the University of
Cambridge, Fellow and Tutor at Queens' College in Cambridge, JOURNAL OF CONTEMPORARY
HEALTH LAW & POLICY, Spring, 1998, p. 253.
In the medical context, there are no exceptions to sanctity's moral prohibition of intentional killing: the
doctor who intentionally shortens the life of a patient, whether a terminally ill adult or a child with Down's
syndrome, breaches the principle. It matters not, moreover, whether the shortening is brought about by an
act or an omission. Intentionally shortening a patient's life by withholding treatment, food, water, or
warmth, is no less wrong than injecting a lethal poison. Nor does a good motive, such as
the alleviation of the patient's - or the relatives' - suffering, redeem a bad intent. In short, any conduct that is
intended to shorten a patient's life, whether as an end or as a means to an end, and whatever the further
motive, breaches the principle.

CRITERIA: CATEGORICAL IMPERATIVE
MUST NEVER TREAT ANYONE AS A MEANS IN THE CONTEXT OF SANCTITY OF LIFE
Abraham Kaplan, Professor of Philosophy at the University of Michigan, LIFE OR DEATH: ETHICS
AND OPTIONS, 1968, p. 164-5.
In Kant's formulation, morality rests on the categorical imperative that we ought never to treat a human
being--whether the self or another--as a means only, and not also as and end in himself. The problems of
the sanctity of life are problems not simply for the physician, but also, and jointly, problems for the patient,
for the patient's family, and perhaps his friends; they are problems not only for the researcher or
experimenter, but also his editor (as has been pointed out in this symposium), his publisher and his
reviewers, his students and his professors, his administrators--in short, everyone caught up in that situation.
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CONTENTION ONE: SANCTITY OF LIFE IS THE MOST SOUND PHILOSOPHICAL
PRINCIPLE

A. ASSISTED SUICIDE WRONGLY CEDES FREEDOMS AND THE SELF
Mark E. Chopko, General Counsel for the United States Catholic Conference and National Conference of
Catholic Bishops, UNIVERSITY OF DETROIT MERCY LAW REVIEW, Spring 1998, p. 586.
John Stuart Mill, in his classic treatise On Liberty, argued broadly in favor of personal autonomous
individual liberty, except in one case: He reasoned that one did not have the liberty to end one's liberty. His
example was slavery, a classic example in his time. Mill wrote, "By selling himself for a slave, he abdicates
his liberty; he foregoes any future use of it, beyond the single act.... The principle of freedom cannot
require that he should be free not to be free. It is not freedom to be allowed to alienate his freedom." Had
Mill lived in this time, it is plain that he could also have written about assisted suicide and euthanasia. On
that topic, ethicist Daniel Callahan stated, "That is the most basic threat to, or violation of, the right of self-
determination that can be imagined.... If I am by right master of my fate, I cannot transfer my right of
mastery to another, nor can any person receive it from me."

B. CHOICE BETWEEN SANCTITY AND QUALITY IS CHOICE BETWEEN DEATH AND LIFE
Keith A. Fournier, practicing attorney and executive director of the American Center for Law and Justice,
and William D. Watkins, publications director for the ACLJ, IN DEFENSE OF LIFE: CONFRONTING
THE CULTURE OF DEATH, 1996, p. 86.
Some months before his death in July 1985, Dr. Alexander commented on an article that proposed
withholding food and fluids from a non-dying person with severe disabilities. Among his remarks, he
offered his final astute observations on contemporary America: "It is much like Germany in the Twenties
and Thirties. The barriers against killing are coming down." What will stop the barriers from falling
further? As we'll show in part 2, an essential part of the solution lies in Western society accepting the truth
that all human lives are worthy to be lived because all have inherent worth that no one thing or no thing or
no circumstance can remove. The choice between a quality of life approach and a sanctity of life approach
is literally the choice between death and life.

C. SANCTITY OF LIFE AVOIDS JUDGMENTAL CHARACTER OF QUALITY OF LIFE
John Keown, Lecturer in the Law and Ethics of Medicine on the Faculty of
Law at the University of Cambridge, Fellow and Tutor at Queens' College in Cambridge, JOURNAL OF
CONTEMPORARY HEALTH LAW & POLICY, Spring, 1998, p. 253.
"Quality of life" judgments purport to assess the worthwhileness of a patient's life. The sanctity doctrine
opposes such attempts and merely takes the patient's condition into account in determining the
worthwhileness of a proposed treatment. For, in order to decide whether a proposed treatment would be
worthwhile, one must first ascertain the patient's present condition and consider whether, and to what
extent, it would be improved by the proposed treatment.
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CONTENTION TWO: VIOLATIONS OF SANCTITY OF LIFE HURT SOCIETY

A. EUTHANASIA VIOLATES SANCTITY OF LIFE AND IS THE 1ST STEP TO BARBARISM
Thane Josef Messinger, Associate at the Law Firm of Oshima, Chun, Fong & Chung, Honolulu, Hawaii,
DENVER UNIVERSITY LAW REVIEW, 1993, p. 247.
In addition to violating the sanctity of life, euthanasia can be seen as the first step down a road of self-
destructive barbarism. Moreover, the medical community, and patients themselves, are
apprehensive about taking their own life before Death does. On the other side of the debate is essentially
one argument with two dimensions: we must allow euthanasia because we must
not allow needless suffering. Beyond that - even accepting the arguments of euthanasia opponents - to
continue as we do now is to ignore reality and insist on forcing euthanasia underground, where
no legal safeguards are available.

B. EUTHANASIA INFRINGES UPON THE SANCTITY OF LIFE
C. Everett Koop, Former Surgeon General, THE RIGHT TO LIVE; THE RIGHT TO DIE, 1976, p. 88.
As with abortion, any discussion of euthanasia by the individual leans heavily upon that individual's
understanding of the sanctity of human life, upon an understanding of man's understanding of God, and
upon whether or not in the synthesis of these things the individual believes that there is life not worthy to
be lived. My own perspective of the dilemmas presented by euthanasia represent an understanding
produced by the synthesis of where my belief in biblical revelation crosses my experience in medicine.

C. QUALITY OF LIFE ADVOCATES WOULD DOOM PATIENTS
John Keown, Lecturer in the Law and Ethics of Medicine on the Faculty of Law at the University of
Cambridge, Fellow and Tutor at Queens' College in Cambridge, JOURNAL OF CONTEMPORARY
HEALTH LAW & POLICY, Spring, 1998, p. 253.
To illustrate the differences between the two approaches, let us return to Angela. The sanctity approach
concluded that the blockage should be removed because - on a fair measure, that is, one
commonly used by people in relation to their own situation - the benefits promised by the treatment, the
improvement the operation would make to her condition (or "quality of life"), would significantly outweigh
any burdens. However, a Quality of life approach might well deny the operation on the ground that life
with Down's syndrome is simply not worth living. The focus is not on the worthwhileness of the treatment:
indeed, the problem is thought to arise by the Quality of life advocate precisely because the treatment
would be entirely successful.

D. WHEN IN DOUBT, WE MUST ALWAYS ERR ON THE SIDE OF LIFE
C. Everett Koop, Former Surgeon General, THE RIGHT TO LIVE; THE RIGHT TO DIE, 1976, p. 88.
Perhaps no more difficult question ever asked of me by an intern or a resident than to summarize in a few
sentences my feelings on this subject. when asked to do so, I put it somewhat like this: "As a basic
principle, keep as many men at as many guns for as long a time as possible; that's how you win the war. I
am in the life-saving business and that comes first, but I never take a deliberate action with the motive of
terminating a patient's life. It is possible that a patient's life might be shortened by some therapeutic
measure I employ with the intent of relieving suffering. In some circumstances where I believe that I have
sufficient experience and expertise with the life history of a disease process and my patient's response to
that disease as well as to his therapy, I might withhold treatment that could be considered extraordinary or
heroic in the given circumstance in reference to the quality of life that might be salvaged for a short period
of time." Even as I write these words I recognize full well the chance for errors in judgment. Because of
that I try to err only on the side of life.
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SANCTITY OF LIFE IS THE BEST VALUE

1. DAMAGING VALUE OF SANCTITY THREATENS A NEW AUSCHWITZ
C. Everett Koop, Former Surgeon General, THE RIGHT TO LIVE; THE RIGHT TO DIE, 1976, p. 88.
To assume the role of prophet, I can almost hear the arguments that will be given by the proponents of
euthanasia outlining the safeguards that the state can build into euthanasia laws to prevent euthanasia from
becoming perverted as it was in the days of the Nazis in Germany. It comes down to the question as it does
in reference to any matter of life: "Is there life not worthy to be lived?" The day may come when a death
selection committee may objectively consider my life not to be worth much. On the other hand the
subjective worth of my life in my eyes and those in my family who love me might be quite different. Many
cases will be open and shut, but the number of cases in the gray area will exceed those where physicians
have clarity of thought and relative unanimity of opinion. Certainly the rights of individuals will disappear;
depersonalization and dehumanization will reign. If our human-value concepts are to be preserved, no one
should take the life of another human being even passively without the deepest concern and consideration
of all the attendant implications. Once the human-value ethic becomes weakened or tarnished, it doesn't
take long for inhuman experimentation on human bodies to take place. Auchwitz could be in the offing.

2. SANCTITY OF LIFE IS A BASIC VALUE WITH DEEP HISTORICAL ROOTS
Mark E. Chopko, General Counsel for the United States Catholic Conference and National Conference of
Catholic Bishops, UNIVERSITY OF DETROIT MERCY LAW REVIEW, Spring 1998, p. 557.
A basic value in our society, at least as heretofore expressed, is the inviolability of each human life. We
have decided as persons in a human community that we will not take the life of another, even if asked. This
value itself implicates profound questions about the nature and role of law. In Washington v. Glucksberg
and Vacco v. Quill, the Supreme Court broadly endorsed the interest of a state in protecting life, even life
in a diminished capacity, even for those who are imminently dying. That ruling itself comes from Cruzan v.
Director, Mo. Dep't of Health, which strongly sustained the interest of the state in protecting life by
assuring that a state has sufficient means to assure that the consequences of an erroneous decision are all
resolved in favor of life, not death. The roots of that principle, that life is precious and must be protected, is
found in our Constitution and Bill of Rights, our Declaration of Independence, and in human society itself.

3. ONLY SANCTITY OF LIFE STOPS LIVES FROM ENDING
C. Everett Koop, Former Surgeon General, THE RIGHT TO LIVE; THE RIGHT TO DIE, 1976, p. 88.
In a sense the whole problem of the right to live and the right to die, centering around one's understanding
of abortion and euthanasia, has a significant analogy to the behavior of Lucifer. We do not know whether
his temptation came but we do know that he sought to be "like the most high." Our society, having lost its
understanding of the sanctity of human life, is pushing the medical profession into assuming one of God's
prerogatives, namely, deciding what life shall be born and when life should end.

4. SANCTITY OF LIFE PRESERVES FREEDOM: UNDERMINING IT DOESN'T
Mark E. Chopko, General Counsel for the United States Catholic Conference and National Conference of
Catholic Bishops, UNIVERSITY OF DETROIT MERCY LAW REVIEW, Spring 1998, p. 564.
In this society, law has always been both a guide and a regulator. Law, in our constitutional government, is
about "ordered liberty." Therefore, the law has acted to discourage, regulate, and
sometimes even prohibit personal choices that harm persons or the common good. Because we are a society
that "strongly affirms the sanctity of life," Americans have not supported demands that assist people in
making seemingly personal choices that diminish their own lives or the common good.
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MUST NOT USE PEOPLE AS MEANS

1. HUMAN LIFE IS AN INTRINSIC GOOD, NOT JUST AS A MEANS TO END
John Keown, Lecturer in the Law and Ethics of Medicine on the Faculty of Law at the University of
Cambridge, Fellow and Tutor at Queens' College in Cambridge, JOURNAL OF CONTEMPORARY
HEALTH LAW & POLICY, Spring, 1998, p. 253.
The right not to be intentionally killed is enjoyed regardless of inability or disability. Rejecting any such
distinctions as fundamentally arbitrary and inconsistent with a sound concept of justice, the principle
(whether in its religious or secular forms) asserts that human life is not only an instrumental good, a
necessary precondition of thinking or doing, but a basic good, a fundamental constituent of human
flourishing. It is, in other words, not merely good as a means to an end but is, like other integral aspects of
a flourishing human life, like friendship and knowledge, something worthwhile in itself. Of course some
people, like those who are pictures of health in the prime of life, participate in the good of life and health to
a greater extent than others, such as the terminally ill, but even the sick and the dying participate in the
good to the extent they are able.

2. QUALITY OF LIFE TREATS PEOPLE AS MEANS
John Keown, Lecturer in the Law and Ethics of Medicine on the Faculty of
Law at the University of Cambridge, Fellow and Tutor at Queens' College in Cambridge, JOURNAL OF
CONTEMPORARY HEALTH LAW & POLICY, Spring, 1998, p. 253.
From the standpoint of the sanctity doctrine, a central objection to the Quality of life philosophy is that it
denies the ineliminable value of each patient and engages in discriminatory judgments, posited on
fundamentally arbitrary criteria such as physical or mental disability, to determine whose lives are
"worthwhile" and whose are not. The arbitrariness is highlighted when it is asked which disabilities, and to
which degree, are supposed to make life not worth living? Such discrimination seems, moreover,
inconsistent with national and international declarations of human rights, which recognize the inherent
rights enjoyed by all human beings simply because of their common humanity, not because they pass some
Quality threshold.

3. REJECTING SANCTITY OF LIFE TREATS PEOPLE AS A MEANS
Keith A. Fournier, practicing attorney and executive director of the American Center for Law and Justice,
and William D. Watkins, publications director for the ACLJ, IN DEFENSE OF LIFE: CONFRONTING
THE CULTURE OF DEATH, 1996, p. 68.
We believe the re is hope, however. Recent trends can be stopped and even reversed. But the sliding will
turn into a freefall if our society continues to view people as a commodity to be bought, sold, and thrown
away as a means to an end. No matter how altruistic the desired result, we believe it is never right to violate
our intrinsic worth and dignity by using us for another's gain.

4. IN KANTIAN MORALITY, THE INDIVIDUAL BEARS RESPONSIBILITY FOR ALL CHOICES
Abraham Kaplan, Professor of Philosophy at the University of Michigan, LIFE OR DEATH: ETHICS
AND OPTIONS, 1968, p. 164.
A final feature of moral method was touched on by Dr. Bee, but it did not receive the attention that I think
it deserved. The moral judgment must accord with the principle of autonomy, as it has been known in
philosophy since Immanuel Kant. The moral will must be a lawgiver unto itself, for even if we act, as
moral agents, in obedience to laws laid down by others, we ourselves must accept the moral obligation the
laws impose. But in that case, we are committed to respecting the moral autonomy of other moral agents as
well.
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SANCTITY OF LIFE PRESERVES HUMAN DIGNITY

1. EUTHANASIA IS INHERENTLY WRONG BECAUSE IT VIOLATES DIGNITY
John Gay-Williams, Philosopher, EUTHANASIA: THE MORAL ISSUES, 1989, p. 101.
I hope that I have succeeded in showing benevolence that inclines to give approval to euthanasia is
misplaced. Euthanasia is inherently wrong because it violates the nature and dignity of human beings. But
even those who are not convinced by this must be persuaded that the potential personal and social dangers
inherent in euthanasia are sufficient to forbid our approving it either as a personal practice or as a public
policy.

2. SANCTITY OF LIFE SHOWS THAT HUMANS HAVE INTRINSIC DIGNITY
John Keown, Lecturer in the Law and Ethics of Medicine on the Faculty of
Law at the University of Cambridge, Fellow and Tutor at Queens' College in Cambridge, JOURNAL OF
CONTEMPORARY HEALTH LAW & POLICY, Spring, 1998, p. 253.
The principle of the sanctity of life is often advocated but much less often understood. In Western thought,
the development of the principle has owed much to the Judaeo-Christian tradition. That tradition's doctrine
of the sanctity of life holds that human life is created in the image of God and is, therefore, possessed of an
intrinsic dignity that entitles it to protection from unjust attack. With or without the theological
underpinning, the doctrine that human life possesses an intrinsic dignity grounds the principle that one must
never intentionally kill an innocent human being. The "right to life" is essentially a right not to be
intentionally killed.

3. ALL HUMAN BEINGS HAVE INTRINSIC DIGNITY, REGARDLESS OF DEVELOPMENT
John Keown, Lecturer in the Law and Ethics of Medicine on the Faculty of
Law at the University of Cambridge, Fellow and Tutor at Queens' College in Cambridge, JOURNAL OF
CONTEMPORARY HEALTH LAW & POLICY, Spring, 1998, p. 253.
The dignity of human beings inheres because of that radical capacity, inherent in human nature, which
normally results in the development of rational abilities such as understanding and choice. Some human
beings, such as infants, may not yet possess the ability to exercise this radical capacity. But a radical
capacity must not be confused with an exercisable ability: one may have, for example, the radical capacity
but not the ability to speak Swahili. All human beings should be presumed to possess the radical capacity
characteristic of their nature even though, because of infancy, disability, or senility, they may not yet, not
now, or no longer have the abilities that characteristically issue from possession of that capacity.

4. WE MUST EMBRACE THE NOTION THAT ALL HUMANS HAVE INTRINSIC DIGNITY
Keith A. Fournier, practicing attorney and executive director of the American Center for Law and Justice,
and William D. Watkins, publications director for the ACLJ, IN DEFENSE OF LIFE: CONFRONTING
THE CULTURE OF DEATH, 1996, p. 88.
We must re-embrace the truth that all human beings have intrinsic worth and dignity, that none should be
treated as objects, as property to be handled as the stronger see fit. Want does not make right. It didn't
during the days of slavery, it didn't during the Holocaust, and it doesn't now, no matter what the Supreme
Court or Congress decrees.
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QUALITY OF LIFE IS A BAD STANDARD

1. QUALITY OF LIFE LOGIC PUTS EVERYONE AT RISK
Keith A. Fournier, practicing attorney and executive director of the American Center for Law and Justice,
and William D. Watkins, publications director for the ACLJ, IN DEFENSE OF LIFE: CONFRONTING
THE CULTURE OF DEATH, 1996, p. 83.
We must abandon the notion that some lives are worthy to be lived while others are not. History teaches us
that it always leads to ever narrowing definitions of "worthy life" until virtually everyone but the most
powerful and politically correct are at risk.

2. QUALITY OF LIFE ARGUMENT DOESN'T JUSTIFY VIOLATING RIGHT TO LIFE
Ruth Gartner, Contributing Writer, BIBLE ADVOCATE, January 1997, p. 1.
Some people feel that anyone who doesn't have a good quality of life should be given the escape of death.
But there is immediate disagreement over what is good quality of life and what isn't. I listened to a
gentleman in his thirties talk about his condition during a news report on TV. He was a quadriplegic,
confined to a wheelchair. Every so often he had to go to the hospital to have liquid pumped out of his lungs.
This man said some people might think he had poor quality of life. But, he said, he loved life. He believed
he had a right to live and that this right should not be taken from him.

3. WE SHOULD CARE FOR THE DYING RATHER THAN "END THEIR SUFFERING"
Mark E. Chopko, General Counsel for the United States Catholic Conference and National Conference of
Catholic Bishops, UNIVERSITY OF DETROIT MERCY LAW REVIEW, Spring 1998, p. 590-1.
It is far better for this society to spend its time and resources caring for the dying, not killing them. Even
the proponents of assisted suicide admit that their solution is far from ideal. As a matter of public policy,
we should protect the dying, not make them more vulnerable to the caprice of disease, isolation, or pain.

4. QUALITY OF LIFE ARGUMENTS WERE USED TO JUSTIFY NAZI EUGENICS
Keith A. Fournier, practicing attorney and executive director of the American Center for Law and Justice,
and William D. Watkins, publications director for the ACLJ, IN DEFENSE OF LIFE: CONFRONTING
THE CULTURE OF DEATH, 1996, p. 84-5.
In pre-World War II Germany, Dr. Karl Binding, a law professor and one of Europe's foremost authorities
on criminal law, and Dr. Alfred Hoche, a distinguished psychiatrist and professor of medicine, laid out
what many believe became the philosophical framework for the German eugenics movement. The lawyer-
doctor team published two astonishing companion essays in 1920 under the umbrella title Permitting the
Destruction of Unworthy Life. There they called for the destruction of life they deemed unworthy of life.
Dr. Binding put the matter this way: "Are there human lives which have so completely lost all value both
for the bearer of that life and for society? Later in his essay, he answers his own question: "But I cannot
find the least reason--legally, socially, ethically or religiously--not to permit those requested to do so to kill
such hopeless cases who urgently demand death; indeed I consider this permission to be simply a duty of
legal mercy ..." He called these targets of mercy "the fearsome counter image of true humanity ... who
arouse horror in nearly everyone who meets them...!" Who were these useless, abhorrent creatures?
According to Binding and Hoche, they were those with brain damage, certain forms of psychiatric
disturbance, and retardation who has lost the capacity for human feeling. They were "empty shells of
human beings" who were "already dead". Insisting that physicians could be certain about the impossibility
of improvement for such individuals, Binding and Hoche highlighted the fact that caring for these lives
imposed a huge economic burden on society. This financial strain was particularly onerous when the
affected party was young, since such a person would require a lifetime of expensive, time-consuming
institutionalization.
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CHOOSING SANCTITY OF LIFE HELPS THE COMMON GOOD

1. WE MUST STRIVE FOR A BALANCE OF INTERESTS TO SERVE THE COMMON GOOD
Mark E. Chopko, General Counsel for the United States Catholic Conference and National Conference of
Catholic Bishops, UNIVERSITY OF DETROIT MERCY LAW REVIEW, Spring 1998, p. 557.
The Court is sensitive to what must be faced. The language that it uses to describe the difficulties
confronting those imminently dying is unique. Justice O'Connor wrote: "Death will be different for each of
us. For many, the last days will be spent in physical pain and perhaps the despair that accompanies physical
deterioration and a loss of control of basic bodily and mental functions. Some will seek medication to
alleviate that pain and other symptoms. Justice Stevens' point of departure for his concurring opinion is the
morality, legality, and practicality of physician-assisted suicide. Ultimately, the Justices recognize that
individual citizens will do the best they can to decide what best suits their own situations. The meeting of
these many perspectives in the legislatures and the electorate is what will define the civil law in this
society. It is often the particular lens chosen, like the mode of analysis, that most influences the outcome. If
the individual decisionmaker, judge, legislator, or voter only views the issue as a matter of an individual
dealing with a bureaucratized and institutionalized society, he or she will more readily reach a result
constitutionalizing that choice. However, making sound public policy is more complex and difficult,
because it must address a broad class of situations even if inevitably there may be gaps and hard cases.
What we strive for is the best possible balance of interests to serve the common good.

2. NOT CONDONING VIOLATIONS OF LIFE IS BEST FOR THE COMMUNITY
Mark E. Chopko, General Counsel for the United States Catholic Conference and National Conference of
Catholic Bishops, UNIVERSITY OF DETROIT MERCY LAW REVIEW, Spring 1998, p. 584-5.
Under the system now in place in most of the United States, the burden is on those who take life to justify
their actions, for example, self-defense against a deadly aggressor. The question raised in a public policy
debate should be: under what regime are we better off, a regime in which the dying should justify their
living, or one in which the living should justify bringing about dying? In the former regime, the message of
the law is do what you want. The law becomes an amalgam of pluralistic autonomous beings, each one
demanding and obtaining what he or she desires. It abandons each individual to his or her privacy and risks
isolating the helpless, leaving them subject to the pressures of those who are stronger. In the latter regime,
the message of the law is clear: "We will not condone your suicide, even if, at the same time, we
understand the temptation." In that circumstance, individuals are committed, for better or for worse, to the
building up of a community that best enhances the common good.

3. CHOICES MUST BE LIMITED BY IMPORTANT VALUES SUCH AS LIFE
John Keown, Lecturer in the Law and Ethics of Medicine on the Faculty of
Law at the University of Cambridge, Fellow and Tutor at Queens' College in Cambridge, JOURNAL OF
CONTEMPORARY HEALTH LAW & POLICY, Spring, 1998, p. 253.
This does not mean that just any choice by the patient merits respect, such as a choice to refuse treatment as
a means of committing suicide. The value of individual choice lies in the fact that it is through our choices
that we are able to promote our own flourishing as human beings (and that of those around us). Such
choices, moreover, serve to reinforce dispositions to act in ways conducive to our flourishing. For our
choices have internal as well as external effects: they shape our character. A's murder of B results not only
in B being murdered but in making A a murderer. As the ancient adage attests, an act tends to form a habit,
a habit tends to form a character, and a character tends to form a destiny.
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SELFISHLY AUTONOMOUS DECISION-MAKING MUST BE LIMITED

1. SOME AUTONOMY MUST BE SUBORDINATED FOR A FREE SOCIETY TO SURVIVE
Mark E. Chopko, General Counsel for the United States Catholic Conference and National Conference of
Catholic Bishops, UNIVERSITY OF DETROIT MERCY LAW REVIEW, Spring 1998, p. 563.
At the same time this body of law developed from the law of battery, the United States Supreme Court
began to construe constitutional law to protect a zone of personal privacy, or personal autonomy as it is
alternatively characterized, against arbitrary government action. In a line of cases at the turn of the
twentieth century, the Supreme Court sought to demarcate personal actions deserving constitutional
protection, on the one hand, and the interest of the government, the competing interest of other persons, and
the common good, on the other. Some personal interests had to be subordinated to societal values for a free
society to thrive, or even survive.

2. EVEN COMPLETE LIBERTY DOES NOT JUSTIFY TOTAL AUTONOMY
Mark E. Chopko, General Counsel for the United States Catholic Conference and National Conference of
Catholic Bishops, UNIVERSITY OF DETROIT MERCY LAW REVIEW, Spring 1998, p. 563.
In 1905, in Jacobson v. Massachusetts, the Supreme Court held that "liberty itself, the greatest of all rights,
is not an unrestricted license to act according to one's own will." In many instances, the Supreme Court has
protected personal choices not explicitly stated in the Constitution - choices involving the education of
children, the selection of a spouse, and similar interests, both personal and communal. Even in those
instances, the state retains regulatory authority to ensure that individual choices be evaluated in a balance
respectful of all persons affected and the legitimate interests of society.

3. EVEN ROE V. WADE SAYS AUTONOMY IS LIMITED BY OUR SHARED VALUES
Mark E. Chopko, General Counsel for the United States Catholic Conference and National Conference of
Catholic Bishops, UNIVERSITY OF DETROIT MERCY LAW REVIEW, Spring 1998, p. 583.
Even in a case recognized by many as a high water mark of personal autonomy, Roe v. Wade, the Court
refused to recognize an absolute right to do with one's body as one pleases, holding that such a right would
isolate a woman in her privacy against all other considerations. Although one can debate the meaning and
limits of the intervening jurisprudence between Roe and Casey, the Court at least gave lip service to the
idea that the common good has a place in constitutional decision making. Without consideration of the
common good, we may, as a society, duplicate the political error of regimes that have ended by suppressing
freedom. As Professor Shannon Jordan has written: "Privacy reduced to its extreme is isolation, one of the
conditions conducive to the success of totalitarian movements. It is the intention of free states to recognize
and protect an area of privacy for the citizen but not to reduce that privacy to isolation. Recognizing the
sociality of man as natural, states must recognize also that the affirmation of those rights the exercise of
which is essential to the fundamental integrity of the person can only be accomplished in community.
Alone the individual is naked and powerless, and the privacy he possesses becomes empty for lack of
content, for a person cannot give content and meaning to these protected rights except in the shared living
of affirmed values."

4. UNRESTRAINED AUTONOMY IS WRONG: IT DESTROYS LIFE
Mark E. Chopko, General Counsel for the United States Catholic Conference and National Conference of
Catholic Bishops, UNIVERSITY OF DETROIT MERCY LAW REVIEW, Spring 1998, p. 583.
Unrestricted autonomy is privacy reduced to its extreme. Each person becomes a law unto himself,
undermining the shared values necessary to the preservation of ordered liberty. Cruzan and assisted suicide,
Glucksberg and Vacco. The Court was, therefore, not only correct, but wise, in further declining to
constitutionalize medical decision making at the end of life. It is imperative that policy makers show
similar wisdom.
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EUTHANASIA CAUSES A DEADLY SLIPPERY SLOPE

1. EUTHANASIA PUTS US ON A DANGEROUS SLIPPERY-SLOPE
John Gay-Williams, Philosopher, EUTHANASIA: THE MORAL ISSUES, 1989, 101.
Finally, euthanasia as a policy is a slippery slope. A person apparently hopelessly ill may be allowed to
take his own life. Then he may be permitted to deputize others to do it for him if he should no longer be
able to act. The judgment of others then becomes the ruling factor. Already at this point euthanasia is not
personal and voluntary, for others are acting "on behalf" of the patient as they see fit. This may well
authorize them to act on behalf of other patients who have not authorized them to exercise their judgment.
It is only a short step, then, from voluntary euthanasia (self-inflicted or authorized) to directed euthanasia
administered to a patient who has given no authorization, to involuntary euthanasia conducted as part of a
social policy.

2. REALITY OF THE SLIPPERY SLOPE IS PROVEN BY EUTHANASIA ADVOCATES
D. Alan Shewmon, noted pediatric neurologist and author from U.C.L.A.'s School of Medicine,
EUTHANASIA: THE MORAL ISSUES, 1989, p. 131.
The reality of this slippery slope is evident within the euthanasia movement itself. Much of what follows
pertains to the Hemlock Society as a specific example, only because, of all the "right-to-die" societies, it is
the most forthright about its goal to promote active euthanasia. It began as an advocate of voluntary
euthanasia for the terminally ill. Hemlock's Manifesto declares that "[i]ncurable distress is a legally
insufficient basis for justification [of euthanasia] unless it is a product of terminal illness." Nevertheless,
with the passage of time, Hemlock began to refer to itself as "a society supporting the option of voluntary
euthanasia ... for the terminally ill, or the seriously incurably physically ill." Nowhere in any of their
literature is the concept "incurably physically ill" defined, but it is obviously intended to be distinct from
"terminally ill"

3. ONE INNOCENT STEP LEADS US DOWN A SLIPPERY SLOPE TO BARBARISM
Keith A. Fournier, practicing attorney and executive director of the American Center for Law and Justice,
and William D. Watkins, publications director for the ACLJ, IN DEFENSE OF LIFE: CONFRONTING
THE CULTURE OF DEATH, 1996, p. 85-6.
In this 1949 treatise, Dr. Alexander also pointed out that what happened in Nazi Germany could happen
again. To stop the slippery slope toward barbarism, he said, "basic attitudes must be examined
dispassionately" lest the first seemingly innocent step be taken that lead to the killing centers. He warned
that "corrosion begins in microscopic proportions".

4. ONCE LIFE IS NOT SACROSANCT, WE CAN'T TELL WHERE TO STOP
C. Everett Koop, Former Surgeon General, THE RIGHT TO LIVE; THE RIGHT TO DIE, 1976, p. 88.
Once any category of human life is considered fair game in the arena of right to life, where does it stop? If
the mongoloid [Down's syndrome] is chosen as the first category whose life is not worthy to be lived, what
about the blind and the deaf? If the hopeless cripple confined to a wheelchair and considered to be a burden
on society is the first category to be chosen, what about the frail, the retarded, and the senile? It does not
take much fanciful imagination to extend these categories to include certain categories of disease such as
cystic fibrosis, diabetes, and a variety of neurological disorders. the population-control people who are
concerned about food supply have been very effective in influencing society's thinking on abortion; it
seems very logical that eventually their targets could be the obese individual who not only has eaten too
much already but has to eat a lot in order to sustain his large body.
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MUST ACT TO PRESERVE LIFE AT ALL COSTS

1. PUBLIC POLICY SHOULD START FROM THE PREMISE THAT LIFE IS PRECIOUS
Mark E. Chopko, General Counsel for the United States Catholic Conference and National Conference of
Catholic Bishops, UNIVERSITY OF DETROIT MERCY LAW REVIEW, Spring 1998, p. 579-80.
The implications of the Court's refusal to find a constitutional right to help take a life are profound for
public policy. Under Glucksberg and Vacco, the debate in our society continues, and is actually advanced
by the Court's refusal to declare a constitutional right. Under the standard advanced in Cruzan by the
petitioners or in Glucksberg or Vacco by the respondents, individual interests in ending life would be
sufficient to trump a state's interest in protecting its citizens. Yet, the individual cannot "recover" from the
consequences of an erroneous determination in these circumstances. Death is irreversible. Thus, the Cruzan
Court, in sustaining a stringent evidentiary standard in end-of-life decisionmaking, gave states a strong tool
to protect life. So too, does the Court in Glucksberg and Vacco. Life itself is recognized as precious, even
at its end. Public policy should be built on that premise.

2. PRESERVATION OF LIFE OVERRIDES THE PRINCIPLE OF CONSENT
Mark E. Chopko, General Counsel for the United States Catholic Conference and National Conference of
Catholic Bishops, UNIVERSITY OF DETROIT MERCY LAW REVIEW, Spring 1998, p. 562-3.
That the principle of informed consent is grounded in the concern for the preservation of bodily health is
evident from its exceptions. When its application does not serve the goal of preserving life and health, the
principle of informed consent may give way to exceptions that will. This occurs, for example, (1) when, in
an emergency, immediate remedial treatment must be undertaken to preserve the patient's life or health, and
the patient's decision on the treatment cannot be obtained; or (2) when it is apparent that full disclosure
regarding the proposed treatment or procedure will only harm the
patient's health.

3. THE STATE HAS A COMPELLING INTEREST IN PRESERVING LIFE
Matthew P. Previn, J.D., Georgetown University Law Center, GEORGETOWN LAW JOURNAL,
February, 1996, p. 591.
Courts have articulated four interests militating against the legalization of physician-assisted suicide and
active euthanasia: (1) the preservation of life; (2) the prevention of suicide; (3) the protection of innocent
third parties; and (4) the integrity of the medical profession. Courts consider the state's interest in the
preservation of life to be the most significant of these interests. It is this interest upon which the courts have
focused to justify the criminalization of physician-assisted suicide and active euthanasia. The state's desire
to prevent suicide is a specific application of its general interest in preserving life. As one court opined, the
state's interest in preventing suicide "is motivated by, if not encompassed within, the state's more basic
interest in preserving life."

4. THE BEST PUBLIC POLICY WILL ALWAYS PROTECT LIFE
Mark E. Chopko, General Counsel for the United States Catholic Conference and National Conference of
Catholic Bishops, UNIVERSITY OF DETROIT MERCY LAW REVIEW, Spring 1998, p. 564.
In the vast majority of cases, a request for assisted suicide is rooted in specific and treatable mental and
physical conditions of the person. Sound policy begins by explaining carefully the vast majority of cases
and responding in kind. Such a consideration does not ignore the individual cases, but responds to them
with a public policy that embraces those cases by addressing their medical facts. Establishing a balance in
this area, therefore, means not opening the door to legalization of assisted suicide. The
best public policy protects life, rather than facilitates its end.
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SOCIAL INEQUITIES CAUSE UNJUST DISCRIMINATION IN EUTHANASIA

1. REGARDLESS OF QUALITY OF LIFE, ALL LIVES HAVE EQUAL VALUE
Matthew P. Previn, J.D., Georgetown University Law Center, 84 GEORGETOWN LAW JOURNAL,
February, 1996, p. 592-3.
The sanctity of life principle, as generally conceived, holds two basic tenets: the absolute inviolability of
human life and the equal value of all human life. This principle accordingly condemns
the destruction of any innocent human life, regardless of the quality of that life: all human lives are equally
inviolable. This principle explains why states long criminalized suicide and why states still assert an
interest in preventing suicide. Sanford Kadish asserts that the proscription of suicide reflects "the sanctity-
of-life principle in its strongest sense: the 'good and simple moral principle that human life is sacred,' either
because it is the gift of God or because of some more general religious commitment, and that it therefore
may never be taken by man."

2. SOCIAL INEQUITIES WILL CAUSE RACIST AND CLASSIST APPLICATION
Mark E. Chopko, General Counsel for the United States Catholic Conference and National Conference of
Catholic Bishops, UNIVERSITY OF DETROIT MERCY LAW REVIEW, Spring 1998, p. 588.
Assisted suicide and euthanasia will be practiced through the prism of social inequality and prejudice that
characterizes the delivery of services in all segments of society, including health care. Those who will be
most vulnerable to abuse, error, or indifference are the poor, minorities, and those who are least educated
and least empowered.... While our society aspires to eradicate discrimination and the most punishing
effects of poverty in employment practices, housing, education, and law enforcement, we consistently fall
short of our goals. The costs of this failure with assisted suicide and euthanasia would be extreme.

3. ASSISTED SUICIDE MAGNIFIES SOCIAL INEQUITIES
 Mark E. Chopko, General Counsel for the United States Catholic Conference and National Conference of
Catholic Bishops, UNIVERSITY OF DETROIT MERCY LAW REVIEW, Spring 1998, p. 589.
Critics question whether permitting assisted suicide will be an "excuse for not remedying profound
inadequacies in the way U.S. health-care system currently manages end-of-life issues." Moving to a regime
of assisted suicide can only magnify the inequities and increase the pressures on and risks to the poor,
minorities, and the vulnerable. To think otherwise would be, in the words of the Task Force, "naive and
unsupportable."

4. SANCTITY OF LIFE PRINCIPLE SHOWS ALL LIFE IS OF EQUAL VALUE
Matthew P. Previn, J.D., Georgetown University Law Center, 84 GEORGETOWN LAW JOURNAL,
February, 1996, p. 592.
The asserted state interest in the preservation of life derives from a belief in the sanctity of human life.
Some courts expressly recognize the derivation. In the famous Karen Ann Quinlan case, in which the father
of a permanently comatose patient sought the right to terminate life-support for his daughter, the New
Jersey Supreme Court indicated that the state's interest was "the preservation and sanctity of human life."
Other courts have referred to the state's interest as "preserving the sanctity of all life."
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EUTHANASIA IS ALWAYS WRONG

1. NO MORAL DISTINCTION EXISTS BETWEEN ACTIVE AND PASSIVE EUTHANASIA
Daniel Callahan, President of the Hastings Center, FIRST THINGS, April 1994, p. 13.
The technological seduction behind all this is that medicine has now become omnipotent, holding life and
death wholly in its hands. And we human beings, who wield this technology, have now become omni-
responsible. Whether we omit treatment or kill people directly is irrelevant. What matters is that, whatever
we do, death has now become our responsibility and can no longer be blamed on nature.

2. EUTHANASIA IS VIOLENCE AGAINST NATURAL GOALS LIKE SURVIVAL
John Gay-Williams, Philosopher, EUTHANASIA: THE MORAL ISSUES, 1989, p. 99.
Euthanasia does violence to this natural goal of survival. It is literally acting against nature because all of
the processes of nature are bent towards the end of bodily survival. Euthanasia defeats these subtle
mechanisms in a way that, in a particular case, disease and injury might not.

3. EUTHANASIA JUSTIFIES LIFE-THREATENING FRAUD
C. Everett Koop, Former Surgeon General, THE RIGHT TO LIVE; THE RIGHT TO DIE, 1976, p. 88.
Euthanasia opens up the opportunity at this early stage of the game for almost inconceivable fraud,
deception, and deceit. Think of the burdensome elderly people, economically burdensome, whose rapid
demise could be looked upon as an economic blessing for their family. think of the temptation to hasten a
legacy. Think of how easy, when there are ulterior motives, to emphasize the surcease from suffering and
anxiety that comes with painless death.

4. SLIPPERY SLOPE NOTWITHSTANDING, PEOPLE FEAR EUTHANASIA
Daniel Callahan, President of the Hastings Center, FIRST THINGS, April 1994, p. 13.
The only way there will be any chance at all of keeping the evil of euthanasia at bay will be to recognize
the moral and medical distortions that our obeisance to medical technology have insinuated into how we
commonly think about death and dying. Unless people can be convinced that the medical behemoth will not
extend their life beyond some reasonable point, they will not be much swayed by slippery-slope arguments.
For them the clear and present danger is a technologically induced bad death for themselves or their family
members, not the more remote hazard of involuntary euthanasia.

5. EUTHANASIA WILL BE UNDERTAKEN BY UNETHICAL PROFITEERS
C. Everett Koop, Former Surgeon General, THE RIGHT TO LIVE; THE RIGHT TO DIE, 1976, p.
88.Before the century is out, it is quite possible that the elderly will exceed in numbers those who bear the
burden of their support, whether as family or under some legal technicality such as the Social Security Act.
If the question of euthanasia presents a dilemma now, on moral and ethical grounds, think of what it will
present in days to come when, in addition to moral and ethical considerations, there is the overpowering
question of economics. Unless we get our ethics and our morals straightened out now, the death selection
committee that decides for you may be motivated more by money than by ecological concerns.
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ANSWERS TO: "PEOPLE ARE SUFFERING IN PAIN"

1. PAIN AND SUFFERING ARGUMENT IS DISPROVEN BY EMPIRICS
Mark E. Chopko, General Counsel for the United States Catholic Conference and National Conference of
Catholic Bishops, UNIVERSITY OF DETROIT MERCY LAW REVIEW, Spring 1998, p. 580-1.
Persons requesting assisted suicide are characterized by undiagnosed, but treatable depression, and
manageable, but unmanaged pain. Our current understanding of assisted suicide is informed by undisputed
evidence that virtually all who commit suicide (95% in almost every study) have "a major psychiatric
illness at the time of death." In fact, terminally ill patients expressing suicidal thoughts usually abandon the
wish to commit suicide after their depression has been treated, or they receive
other appropriate medical treatment.

2. VAST MAJORITY OF CASES DO NOT FALL UNDER PAIN AND SUFFERING
Mark E. Chopko, General Counsel for the United States Catholic Conference and National Conference of
Catholic Bishops, UNIVERSITY OF DETROIT MERCY LAW REVIEW, Spring 1998, p. 581.
Similarly, in the vast majority of cases, people who request suicide- terminally ill or not - do so for reasons
other than pain. In a 1990 Netherlands study, "pain" was the sole reason for requesting assisted suicide in
10 of 187 cases and a contributing factor in less than half of the cases. The Ethics Chairman of the
Academy of Hospice physicians emphatically wrote: "As a doctor who has been involved in hospice care
for more than 14 years, I can state without equivocation that the physical sources of suffering associated
with dying all can be controlled. Most often, such symptoms as pain, shortness of breath and nausea, yield
to routine evaluation and straightforward interventions. Even the pain of end-stage cancer commonly can
be managed with oral medications. In a small percentage of cases, pain or other bothersome symptoms do
require advanced interventions. Rarely, sedation is required to effectively alleviate pain, breathlessness or
terminal agitation."

3. SUFFERING HAS IMPORTANT VALUES FOR THE INDIVIDUAL
John Gay-Williams, Philosopher, EUTHANASIA: THE MORAL ISSUES, 1989, p. 101-2.
Suffering is surely a terrible thing, and we have a clear duty to comfort those in need when we can. But
suffering is also a natural part of life with values for the individual and for others that we should not
overlook. We may legitimately seek for others and for ourselves an easeful death, as Arthur Dyek has
pointed out. Euthanasia, however, is not just an easeful death. It is a wrongful death. Euthanasia is not just
dying. It is killing.

4. PAIN MANAGEMENT IS POSSIBLE FOR TERMINAL PATIENTS IN ALL CASES
Mark E. Chopko, General Counsel for the United States Catholic Conference and National Conference of
Catholic Bishops, UNIVERSITY OF DETROIT MERCY LAW REVIEW, Spring 1998, p. 581.
Symptom management is not always easy. Effective therapy may require the efforts of a physician with
special interest in palliative medicine and a team of hospice-trained nurses, consultant pharmacists and
others. Yet I want to state again clearly that in all cases the physical distress of the dying can be controlled.

5. ASSISTED SUICIDE WOULD ACTUALLY DECREASE PAIN RELIEF FOR OTHERS
Mark E. Chopko, General Counsel for the United States Catholic Conference and National Conference of
Catholic Bishops, UNIVERSITY OF DETROIT MERCY LAW REVIEW, Spring 1998, p. 581-2.
Pain medication is available even in the end stages of cancer. Experts agree that unmanaged pain is
generally due not to the unavailability of effective pain relief, but to the failure of health care providers to
learn and use available techniques. These techniques are being better disseminated. However, such
improvements could be dramatically undercut if assisted suicide were to become accepted practice for such
patients.
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IT IS IMPOSSIBLE TO DETERMINE WHO IS TERMINAL

1. PHYSICIANS ADMIT THEY AREN'T FIT TO JUDGE WHO IS TERMINAL
Mark E. Chopko, General Counsel for the United States Catholic Conference and National Conference of
Catholic Bishops, UNIVERSITY OF DETROIT MERCY LAW REVIEW, Spring 1998, p. 587-8.
Even if there were no regulatory authority, the AMA, in its amicus curiae brief in the assisted suicide cases,
argued at length that physician-assisted suicide would simply be incompatible with the nature and methods
of medicine as it is practiced in the United States. The AMA emphasized that it would be virtually
impossible to restrict assisted suicide to individuals in the last stages of a terminal illness, because there are
inherent difficulties in even identifying the eligible class. Evidence suggests that diagnoses themselves are
inherently unreliable. Studies indicate, for example, "that 15 percent of hospice patients survive longer than
six months and 8 percent survive longer than one
year." The evidence raises questions about the ability of physicians to distinguish among the terminally ill
and the chronically ill.

2. PREDICTION OF TERMINAL ILLNESS IS IMPOSSIBLE
C. Everett Koop, Former Surgeon General, THE RIGHT TO LIVE; THE RIGHT TO DIE, 1976, p. 88.
To show how difficult predictions might be, Medical World News on May 5, 1974, reported a case of a
woman with myasthenia gravis who lived "artificially" for 652 days in intensive care and then made a
remarkable recovery. Said a hospital representative at the Harbor General Hospital in Torrance, California,
"She made us recognize that there was no such thing as an inordinate effort. She had such a tenacity for life
we felt that everything we did, no matter how extraordinary, was appropriate to the situation."

3. PAIN OF TERMINAL ILLNESS CLOUDS THE PATIENT'S JUDGMENT
C. Everett Koop, Former Surgeon General, THE RIGHT TO LIVE; THE RIGHT TO DIE, 1976, p. 88.
It is most difficult to judge medical action from the standpoint of what is legal justice alone. If one gets into
the pure aspects of ethics, there could be concern that the use of a pain killer in a dying individual could so
cloud his conscious response that he might not in his dying moments be in a position to make decisions
which in theological terms might bear upon his eternal destiny. It is essentially impossible to control pain in
most instances, particularly in a debilitated or dying individual, without at the same time temporarily
impairing his ability to think. From a purely ethical point of view, because clouding of judgment
accompanies relief from pain produced by drugs, the situation seems to be insurmountable and therefore
has become acceptable.

4. DOCTORS DON'T HAVE ENOUGH KNOWLEDGE TO JUSTIFY EUTHANASIA
John Gay-Williams, Philosopher, EUTHANASIA: THE MORAL ISSUES, 1989, p. 100.
Contemporary medicine has high standards of excellence and a proven record of accomplishment, but is
does not possess perfect and complete knowledge. A mistaken diagnosis is possible, and so is a mistaken
prognosis. Consequently, we may believe we are dying of a disease when, as a matter of fact, we may not
be. We may think that we have no hope of recovery when, in fact, our chances are quite good. In such
circumstances, if euthanasia were permitted, we would die needlessly. Death is final and the chance of error
is too great to approve of the practice of euthanasia.
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DOCTORS MUST NOT PRACTICE EUTHANASIA

1. INTENTIONAL KILLING IS NEVER ETHICAL FOR A DOCTOR
Willard Gaylin MD, et. al., JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, April 8, 1988,
p. 2139.
Third, law and professional manner both aside, the resident violated one of the first and most hallowed
canons of the medical ethic: doctors must not kill. Generations of physicians and commentators on medical
ethics have underscored and held fast to the distinction between ceasing useless treatments (or allowing to
die) and active, willful taking of life; at least since the Oath of Hippocrates, Western medicine has regarded
the killing of patients, even on request, as a profound violation of the deepest meaning of the medical
vocation. As recently as 1986, the Judicial Council of the American Medical Association, in an opinion
regarding treatment of dying patients, affirmed the principle that a physician "should not intentionally
cause death." Neither legal tolerance nor the best bedside manner can ever make medical killing medically
ethical.

2. ALLOWING DOCTORS TO KILL AS WELL AS HEAL ELIMINATES MORALITY
Willard Gaylin MD, et. al., JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, April 8, 1988,
p. 2139.
The very soul of medicine is on trial. For this is not one of those peripheral issues about which pluralism
and relativism can be tolerated, about which a value-free stand on the substance can be hedged around with
procedural safeguards to ensure informed consent or "sound decision making." Nor is this an issue, like
advertising, fee-splitting, or cooperation with chiropractors, that touches medicine at its very moral center;
if this moral center collapses, if physicians become killers or are even merely licensed to kill, the profession
-- and, therewith, each physician -- will never again be worthy of trust and respect as healer and comforter
an protector of life in all its frailty. For if medicine's power over life may be used equally to heal or kill, the
doctor is no more a moral professional but rather a morally neutered technician.

3. DOCTORS DON'T HAVE ENOUGH KNOWLEDGE TO JUSTIFY EUTHANASIA
John Gay-Williams, Philosopher, EUTHANASIA: THE MORAL ISSUES, 1989, p. 100.
Contemporary medicine has high standards of excellence and a proven record of accomplishment, but is
does not possess perfect and complete knowledge. A mistaken diagnosis is possible, and so is a mistaken
prognosis. Consequently, we may believe we are dying of a disease when, as a matter of fact, we may not
be. We may think that we have no hope of recovery when, in fact, our chances are quite good. In such
circumstances, if euthanasia were permitted, we would die needlessly. Death is final and the chance of error
is too great to approve of the practice of euthanasia.

4. A DOCTOR'S OBLIGATION IS TO PROLONG LIFE AS LONG AS POSSIBLE
C. Everett Koop, Former Surgeon General, THE RIGHT TO LIVE; THE RIGHT TO DIE, 1976, p. 88.
I don't think a medical student is ever told what his mission in life is. Certainly no one told me when I was
a medical student what was expected of me as a lifetime goal in assuming the role of a physician. Yet it is
very clearly and indelibly imprinted upon the mind of the physician that the first obligation toward his
patient is to heal him and cure him and to postpone death for as long a time as possible. The second goal is
more difficult to practice: When cure is not possible the physician is to care for and comfort his dying
patient.
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                           NEGATIVE CASE
                  EUTHANASIA AND THE QUALITY OF LIFE
This case argues that death is one of the most personal and significant choices an individual can make.
Given the highly personal and agonizing nature of prolonged terminal illness, the debate should begin with
a heavy presumption in favor of a free option to select euthanasia. A wide variety of authorities concur -
ancient philosophers, the present American public and a wide variety of cultures around the world. Life
loses its sanctity when it becomes unbearable - in that situation, an individual is fully justified in opting for
death.

CONTENTION ONE: CRITERIA

A. SANCTITY OF LIFE IS NOT THE CRITERIA – AUTONOMY IS
John Harris, Professor of Bioethics and Applied Philosophy at the Centre for Social Ethics and Policy at the
University of Manchester, EUTHANASIA EXAMINED, 1995, p. 19.
“Making someone die in a way that others approve, but he believes a horrifying contradiction of his life, is
a devastating, odious form of tyranny.” I have tried to show that, if this is so, it is not because it involves
the frustration of a particular class of belief, namely one that involves “a contradiction of his life,” or of his
conception of its sanctity, but because it is simply a form of tyranny; an attempt to control the life of a
person who has her own autonomous views about how that life should go. The evil of tyranny does not
require explication in terms of the nature of the sanctity of life, but rather in terms of respect for persons
and of their autonomy.

B. THE DEBATE IS NOT ABOUT THE “RIGHT TO LIFE”
Thane Josef Messinger, practicing attorney, DENVER UNIVERSITY LAW REVIEW, 1993, p. 251.
Regardless of the course the courts or society takes, euthanasia will remain a controversial issue. We must
recognize this and accept the need for balancing the contradictory interests, and get on with our deaths. The
debate should not center around a "right to life"; does anyone question that? Rather, it involves a right to
non-life; a right, legitimately circumscribed, to abstain from that which is needlessly painful. As Hamlet's
soliloquy attests, the debate is intensely personal. Yet we cannot deny to those who are suffering beyond
our comprehension the alternative of a gentle and easy death.

C. ADVOCATES FOR OVERRIDING AUTONOMY MUST ARTICULATE GOOD REASONS
Paul Kurtz, bioethicist, ISSUES IN LAW & MEDICINE, December 22, 1992, p. 309.
Let me emphasize an earlier point that nothing that I have said is absolute. There are only general
guidelines, and it may be that in certain cases you would want to override autonomy. One can think of
moral dilemmas in which this may be the most meaningful option. I am prepared to admit that. But, if you
decide to limit autonomy, you have to give a good reason. In other words, it seems to me that we have a
prima facie obligation to recognize and respect the autonomy of those persons who, after a reflective
decision, have opted for voluntary active euthanasia. If you are going to deny them that right, then you have
to make a strong case.

D. AFFIRMATIVE ARGUMENTS MUST HAVE EMPIRICAL WEIGHT TO BE CONSIDERED
G. Steven Neeley, Assistant Professor at Saint Francis College, AKRON LAW REVIEW, Summer, 1994,
p. 74.
Furthermore, a certain equitable and logical burden of proof ought to be involved in any fair hearing on the
merits of a proposal. As previously addressed, there exists a very powerful and convincing moral argument
for the legalization of voluntary active euthanasia. If opponents of euthanasia are not, in turn, required to at
least match this argument with an equal measure of forensic weight, then the proposal will be effectively
dismissed on a priori grounds. No proposal for reform, however beneficent, can ever escape the allegations
of potential abuse.
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CONTENTION TWO: QUALITY OF LIFE SHOULD TAKE PRECEDENCE

A. CLASSICAL PHILOSOPHERS CONCUR THAT QUALITY OF LIFE TAKES PRECEDENCE
Craig Peyton Gaumer, Assistant U.S. Attorney at the Department of Justice, SOUTH DAKOTA LAW
REVIEW, 1997, p. 359.
To a large extent, the constitutional arguments for and against physician-assisted suicide are rooted in
politics, philosophy, religion, and medicine. Thus, any comprehensive analysis of the right to die must
examine how each of these disciplines have addressed the question, dating back to the ancient Greece and
Rome. The term "euthanasia" originated in Ancient Greece. Literally translated, the word "euthanasia"
means well (eu) death (thanatos). Magistrates in Ancient Athens, Ceos and Marseilles provided poison to
persons who received permission from the proper authorities to commit suicide. According to Plato,
Socrates considered the agony of painful disease and suffering as just reasons not to "cling to life." Socrates
"did not want to lengthen out good-for-nothing lives .... Those who are diseased in their bodies,
[physicians] will leave to die, and the corrupt and incurable souls they will put an end to themselves." True
to his beliefs, Socrates committed suicide by drinking hemlock. Plato also condoned suicide in cases where
a person suffered from an incurable and painful medical condition.

B. THE MAJORITY OF AMERICANS SUPPORT PRIORITIZING QUALITY OF LIFE
Sanford H. Kadish, Professor of Law, Emeritus, Boalt Hall School of Law, CALIFORNIA LAW
REVIEW, July, 1992, pp. 860-861.
The public has come largely to accept these practices, principally through the impact of such dramatic and
highly publicized cases as In re Quinlan. In 1976, the New Jersey Supreme Court held that a parent of
Karen Quinlan, a young woman in a permanent vegetative state, could authorize removal of a respirator
that was keeping Karen biologically alive. Since then, public opinion polls have revealed an impressive
shift of opinion in just one generation from a majority opposed to "pulling the plug" on permanently
comatose patients to a large majority -- sometimes nearing 90% -- in favor of such measures. Opinion as to
whether doctors should be permitted to actively kill incurable and comatose patients has also changed. In
1947, a majority disapproved. Since then, majorities of up to 64% have favored such proposals. There
appears to be even less dissent when the patient is not comatose and competently chooses to die. A recent
national survey showed that 79% of adults support laws allowing terminally ill patients to refuse life-
sustaining treatment or to order that it be stopped. A recent California poll indicates that about 70% of
Californians feel that the assisted suicide of seriously ill patients who wish to die should be legalized. In
Washington state, voters defeated a referendum proposing that doctors be permitted to kill terminally ill
patients at their request by a vote of 56% to 44%. But a month earlier a poll showed that, of those likely to
vote, 61% were in favor, 27% were opposed, and 12% were undecided. The defeat of the referendum might
have been a manifestation of the "cold feet" phenomenon that sometimes occurs when the voter enters the
voting booth. Despite this apparent setback, the marked increase in public acceptance of killing terminally
ill patients, both in Washington and nationally, has been striking.

C. CULTURES AROUND THE WORLD PRIORITIZE QUALITY OF LIFE
Thane Josef Messinger, practicing attorney, DENVER UNIVERSITY LAW REVIEW, 1993, p. 184-185.
Although less debated, in other areas of the world similar practices occurred. In some Eskimo tribes, an old
or sick member would request of his family to die. If the family was a good one, it would comply by
abandoning the Eskimo to nature or by killing him. When an elderly Aymara Indian's time came, relatives
and friends were summoned for a death vigil. If death was slow, the elder could ask for assistance,
whereupon his family would withhold food and drink until he slipped into unconsciousness and died.
Aboriginal Australians may have practiced their own form of euthanasia. The Khoikhoin of southern Africa
would prepare a lavish feast before ceremonial abandonment in the wilderness.
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D. DENYING EUTHANASIA TO THE TERMINALLY ILL IS IMMORAL AND INHUMANE
G. Steven Neeley, Assistant Professor at Saint Francis College, AKRON LAW REVIEW, Summer, 1994,
pp. 65-66.
The manifold arguments against suicide and euthanasia contrast with the simple humanitarian arguments
for their acceptance. When death becomes the only respite from torment, it is both humane and rational to
allow the individual to terminate his own existence. When the patient is unable to carry out his wishes, it is
morally acceptable to assist the individual to achieve a swift and easy passage. Conversely, it is inhumane
to keep a person alive against his will and best interests in order to satisfy abstract claims made by the state,
or in order to force grudging allegiance to an eschatology which the individual may not accept.

E. MEDICALLY PROLONGED LIFE IS DEHUMANIZING AND DESTROYS DIGNITY
Thane Josef Messinger, practicing attorney, DENVER UNIVERSITY LAW REVIEW, 1993, p. 226.
Some people object to the effect of intensive medical care on the process of dying. Although the goal may
be admirable, the effect is one of degradation of the patient to the status of a research specimen. The patient
sometimes becomes little more than an experimental mass, subjected to treatment after treatment in the
hopeless quest for a continued heartbeat.

F. THE CONSTITUTION STRONGLY IMPLIES A RIGHT TO DIE
Craig Peyton Gaumer, Assistant U.S. Attorney at the Department of Justice, SOUTH DAKOTA LAW
REVIEW, 1997, p. 366.
The U.S. Constitution does not expressly mention the right to die, nor does it mention the right to engage in
physician-assisted suicide. However, as discussed below, portions of the Fourteenth Amendment, as well as
language contained in the Ninth and Tenth Amendments, proclaim that American citizens do possess an
assortment of personal liberties other than those strictly set forth in the Constitution. These three
Amendments, all of which support a right of privacy seem to form the foundation to support a
constitutional right to control the manner of one's own death.
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CRITERIA

1. THE DEBATE SHOULD FOCUS ON LIVES THAT ARE NO LONGER WORTH LIVING
G. Steven Neeley, Assistant Professor at Saint Francis College, AKRON LAW REVIEW, Summer, 1994,
pp. 75-76.
Yet a thorough analysis of the purported interests reveals that the states' real concern should be with
preserving the lives of those persons for whom the loss of life would be infelicitous and with preventing
unnecessary harm to all relevant parties concerned. This statement of government interest takes into
consideration the observation that life is not always worth living and that the state must not ignore or
disvalue the overriding concern of the patient in effecting a balancing of interests. It reflects the
understanding that the "prevention of suicide" is not an independent interest worthy of consideration but
rather is subsumed within the more general interest in the "preservation of life," and further recognizes that
the integrity of the medical profession is not threatened by allowing the autonomy rights of individuals to
supersede institutional considerations.

2. AUTONOMY IS A RULING PRINCIPLE IN THIS CONTEXT
John Hodgson, Principal Lecturer at The Nottingham Law School, ANNUALS OF HEALTH LAW, 1996,
p. 170.
One of the ruling axioms of medical ethics is the autonomy principle. In the case of a competent patient,
self-determination is paramount and that patient may validly refuse consent to treatment. This may extend
to requiring the discontinuance of life support. Senior judges have repeatedly emphasized this. Lord
Scarman, in Sidaway v. Board of Governors of the Bethlem Royal Hospital and Maudsley Hospital, stated
that this right to accept or refuse treatment "may be seen as a basic human right protected by the common
law." Lord Templeman in the same case stated that the refusal may be for reasons that are rational or
irrational or for no reason. The absolute and unconditional nature of the right of the competent patient was
reiterated by Lord Mustill in Airedale NHS Trust v. Bland.

3. “PERSONS” HAVE A QUALITATIVELY DIFFERENT MORAL WEIGHT
John Harris, Professor of Bioethics and Applied Philosophy at the Centre for Social Ethics and Policy at the
University of Manchester, EUTHANASIA EXAMINED, 1995, p. 8.
I believe that there is a crucial distinction between the moral importance of the lives of persons and those of
any other sorts of beings and that this importance derives from what it is that makes an individual a person.
It is this difference (whatever explains and justifies it) that makes it permissible to sacrifice animals in the
interest of humans or at least to rescue humans before animals in case of threats to their lives.

4. THE KEY ISSUE IS THE INDIVIDUAL’S ABILITY TO LIVE A MEANINGFUL LIFE
Thane Josef Messinger, practicing attorney, DENVER UNIVERSITY LAW REVIEW, 1993, p. 182.
John Cooper points out, however, that our English understanding of the words "euthanasia" and "suicide"
are misleading in interpreting the opinions of Hellenic philosophers; suicide was more narrowly construed,
and euthanasia in its contemporary meaning was never discussed. The relevant issue was the person's
ability to live a full, active life in furtherance of socially useful activities that he was previously suited for,
not his medical conditions or suffering; their medical knowledge was insufficient to decide these matters
with certainty.
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EUTHANASIA IS JUSTIFIED

1. EUTHANASIA IS JUSTIFIED BY THE NEED TO ALLEVIATE PAIN
Thane Josef Messinger, practicing attorney, DENVER UNIVERSITY LAW REVIEW, 1993, p. 223.
The primary argument for euthanasia is not so much for euthanasia - no one enjoys the contemplation of
misery - as it is against the arguably absurd propositions that deny a remedy for that which exists -
insufferable and unending pain. Assuming that needless suffering is to be neither tolerated nor glorified, we
either act or do nothing, to relieve such pain.

2. THE MERCY ARGUMENT JUSTIFIES EUTHANASIA
G. Steven Neeley, Assistant Professor at Saint Francis College, AKRON LAW REVIEW, Summer, 1994,
p. 73.
Similarly, Rachel states: The single most powerful argument in support of euthanasia is the argument from
mercy. It is also an exceptionally simple argument, at least in its main idea, which makes one
uncomplicated point. Terminal patients sometimes suffer pain so horrible that it is beyond the
comprehension of those who have not actually experienced it...The argument from mercy says: Euthanasia
is justified because it provides an end to that.

3. CERTAIN CONDITIONS ARE SUFFICIENTLY UNBEARABLE AS TO WARRANT DEATH
Robert T. Hall, professor of sociology and philosophy at West Virginia State College, THE HUMANIST,
November, 1994, p. 10.
The type of case most directly associated with physician, assisted suicide in current discussion is one in
which a conscious and competent patient asks the physician to take some action that will bring about his or
her death or to provide the means for the patient or the patient's family to take the action. Cases that fall
into this category often involve the gradual disintegration of the powers and capacities which make us
human: severe instances of amyotropic lateral sclerosis, multiple sclerosis, Parkinson's disease, Lupus, end-
stage lung disease, and perhaps advanced brain cancer or gastric cancer, There are patients in some of these
conditions, although probably not very many, for whom hospice care does not work effectively. They
suffer not so much pain as the deterioration of their bodily functions and mental capacities, and the misery
of deterioration can be a long and costly process. The most compelling argument in favor of physician-
assisted suicide has always been the one based upon the fact that some conditions are so intolerable that the
only relief is death, and the patient wishes to end the suffering rather than to have it prolonged. Sensitive
and courageous human beings have often responded to these situations in the past by assisting the sufferer
to put an end to his or her misery. They are now doing this more openly and more often. The question is
whether this will be done with the assistance and regulation of the medical profession or whether it will
remain covert.

4. MEDICAL CARE OFTEN MERELY INCREASES AND EXACERBATES SUFFERING
Thane Josef Messinger, practicing attorney, DENVER UNIVERSITY LAW REVIEW, 1993, 177.
Against these contentions, proponents of euthanasia cite examples of human suffering that have become
increasingly frequent as medical technologies improve. Medicine can now save many who, arguably,
should not be saved; some, in essence, outlive their own deaths. The noble goal of medicine has proved a
double-edged sword: in the race to preserve life, suffering is sometimes prolonged instead.
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SANCTITY OF LIFE DOES NOT JUSTIFY ALWAYS OVERRIDING QUALITY OF LIFE

1. THE DOCTRINE OF DOUBLE EFFECT JUSTIFIES EUTHANASIA OR SUICIDE
Craig Peyton Gaumer, Assistant U.S. Attorney at the Department of Justice, SOUTH DAKOTA LAW
REVIEW, 1997, p. 397.
The concurring justices in Glucksberg and Quill indicated that a terminally-ill patient suffering from
unbearable pain may have a right to engage in physician-assisted suicide. This practice is common in the
medical profession. Doctors and ethicists consider it appropriate to engage in "terminal sedation" in
appropriate cases. "Terminal sedation" or "unconscious sedation" is used most often in cases of terminal
cancer: A drug coma is inducted to achieve complete control of unbearable suffering. Patients are given
either narcotics, usually in combination with barbiturates, or an anaesthetic .... The doctors expect these
patients to die. With the patients and families' consent, food and water may also be withheld .... Death is
caused either by the progression of the disease process or, for weak patients, by the withholding or artificial
nutrition or hydration, or from pneumonia that sets in because of lack of physical movement or breathing.
This practice is called the "double effect," because the effort to alleviate the patient's pain also leads to his
or her death. If, as the concurring justices suggest, a terminally ill person suffering from extreme pain has a
constitutional right to invoke this "double effect," physicians who assist in this process should not be
subject to criminal liability for doing so.

2. JUDGMENTS IN OTHER CONTEXTS PROVE ALL LIFE IS NOT UNIFORMLY SACRED
Thane Josef Messinger, practicing attorney, DENVER UNIVERSITY LAW REVIEW, 1993, pp. 225-226.
Opponents' assertions of sacrosanct life are seriously challenged by prima facie valuations of life made
continuously in the criminal law. For instance, persons convicted of murdering police officers face more
severe punishments. Whether those increased punishments are desirable is not at issue; that police officers
as a group are afforded stricter enforcement of differentiated laws is a value judgement that society has
made - determined not by the act, or even the actor, but rather by the person who dies. Conversely, the life
of someone who attempts to commit a felony but is killed by the victim as a matter of self-defense is per se
less "valuable" in the eyes of the law; no punishment is meted. Valuations are made regarding human life.
It is for civilization to justify those distinctions.

3. BENEFICENCE REQUIRES RESPECT FOR A DECISION TO END LIFE
Paul Kurtz, bioethicist, ISSUES IN LAW & MEDICINE, December 22, 1992, p. 309.
From the standpoint of the bystander, it seems to me that there is still another ethical principle that is
relevant, and that is the principle that Marvin Kohl has eloquently enunciated in his writings, the principle
of beneficence. This suggests that loving members of the family, relatives, friends, even doctors and
lawyers who know the person have some sense of compassion and mercy. I think this is a deep, Christian
principle of Christ's commandment to "love thy neighbour" and to be merciful to those who suffer.
Accordingly, if there is a plea from someone that you know to help him to die with dignity, then that entails
a kind of prima facie moral duty. That is a very powerful moral obligation in human society and should be
considered within the context of a moral dilemma that a person is facing.

4. NON-MEDICAL KILLINGS FAR OUTWEIGH EUTHANASIA IN SOCIETAL IMPACT
G. Steven Neeley, Assistant Professor at Saint Francis College, AKRON LAW REVIEW, Summer, 1994,
p. 65.
Finally, this twist of the "slippery slope" argument neglects to consider the importance of all of the other
forces at work in our culture. It is not the occasional euthanatic killing motivated by compassion that
negatively affects social relations and the quality of life in America, but the thousands of discompassionate
killings that occur every day perpetrated by individuals with little or no ties to the social and moral
community.
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COMMON PRACTICE AND PUBLIC OPINION VALIDATE EUTHANASIA

1. EUTHANASIA IS WIDELY ACCEPTED IN PRACTICE
Sanford H. Kadish, Professor of Law, Emeritus, Boalt Hall School of Law, CALIFORNIA LAW
REVIEW, July, 1992, pp. 859-860.
Departures from the official pieties usually occur first in our practices and only later in our professions. So
it has been with the issue of life-sustaining treatment. Doctors and hospitals have long engaged in or
tolerated practices that contravene the moral tradition I have just described. For decades doctors and
hospitals have accepted what is called negative euthanasia. "Every day . . . respirators are turned off, life-
perpetuating intravenous infusions stopped, proposed surgery canceled, and drugs countermanded. So-
called Code 90 stickers are put on many record-jackets, indicating 'Give no intensive care or resuscitation.'"
And though medical killing on request (active euthanasia) is apparently not common, neither is it unknown
in American hospitals.

2. CURRENT MEDICAL PRACTICE VALIDATES THE MERITS OF EUTHANASIA
William H.A. Carr, columnist, THE SATURDAY EVENING POST, September, 1995, p. 50.
As every physician, in moments of candor, is willing to concede, euthanasia is being practiced by doctors
all the time, right now, despite the risk of being charged with a felony and perhaps losing one's license to
practice. "Physician-assisted death is a common but private occurrence," American Demographics reported
four years ago. It quoted Dr. David Rogers of the New York Hospital-Cornell Medical Center as saying, "I
have let lots of people die. I've helped some of them die, although I'd deny that in court. And that's true of
most of my colleagues." Some doctors talk, in private, about how, when a terminally ill patient has pleaded
for something to end the agony, they will put a bottle of pills by the bedside and warn the patient, "Now
don't get confused during the night and take too many pills, because there are 50 in this bottle and 30 is the
lethal dose." Other physicians resort to the "morphine drip," with the dosage gradually increasing until it
becomes a fatal overdose. These are doctors who want desperately to serve the best interests of their
patients. They deserve to be honored.

3. ROUTINE MEDICAL PRACTICE VALIDATES EUTHANASIA
Derek Humphry, vice-president of Americans for Death With Dignity, founder of the Hemlock Society and
board member for the World Federation of Right to Die Societies, LAWFUL EXIT, 1993, p. 21.
If one listens at conferences of physicians and nurses, particularly those concerned with intensive care, it is
obvious that euthanasia in many forms is currently being practiced covertly in American hospitals. “It
happens every day in ICUs,” some health workers say. Nurses tell me that they have no qualms about
deliberately overdosing some patients who are close to death, with or without their permission, because the
suffering is so great and death does not come soon enough as a release. Two nurses in the presence of eight
other physicians and nurses who nodded agreement stated, “There’s not at ICU in the country which is not
practicing euthanasia but we don’t call it that. We prefer not to call it anything. We know in our hearts that
the person really died of the underlying sickness, not the bolus of morphine which we just injected.”
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PHILOSOPHY, RELIGION AND LAW ALL SUPPORT PRIORITIZING QUALITY OF LIFE

1. ANCIENT ROMAN LAW SUPPORTED PRIORITIZING QUALITY OF LIFE
Craig Peyton Gaumer, Assistant U.S. Attorney at the Department of Justice, SOUTH DAKOTA LAW
REVIEW, 1997, p. 360.
Like the Greeks, some ancient Romans viewed euthanasia as an acceptable, and in some cases noble,
practice. To live nobly also meant to die nobly and at the appropriate time. "This attitude was reinforced by
Roman law ... According to Justinian's Digest, suicide of a private citizen was not punishable if it was
caused 'by impatience of pain or sickness, or by another cause,' or by 'weariness of life ... lunacy, or fear of
dishonor.' Since this covered every rational cause, all that was left was the utterly irrational suicide...."

2. ANCIENT HISTORICAL PRACTICE VALIDATES EUTHANASIA
Thane Josef Messinger, practicing attorney, DENVER UNIVERSITY LAW REVIEW, 1993, pp. 182-183.
According to some historians, a custom existed on the island of Ceos whereby very old citizens who had
outlived their usefulness to society would gather annually, as if for a banquet, and drink together a lethal
potion. In one of Greece's oldest colonies, as well as in Athens and Ceos, it was the custom for public
magistrates to maintain a depository of poison available for anyone who could justify his desire for death
before the Senate. Libanius is quoted as stating the rules for requesting permission: Whoever no longer
wishes to live shall state his reasons to the Senate, and after having received permission shall abandon life.
If your existence is hateful to you, die; if you are overwhelmed by fate, drink the hemlock. If you are
bowed with grief, abandon life. Let the unhappy man recount his misfortune, let the magistrate supply him
with the remedy, and his wretchedness will come to an end. n68

3. SAINT THOMAS MOORE’S THEOLOGY PERMITS SUICIDE AND EUTHANASIA
Craig Peyton Gaumer, Assistant U.S. Attorney at the Department of Justice, SOUTH DAKOTA LAW
REVIEW, 1997, p. 360.
Not all theologians throughout history have opposed euthanasia. Sir Thomas Moore who was canonized by
the Roman Catholic Church, argued that the terminally ill should have a right to end their lives--and he also
endorsed the idea of assisting those who wished to do so.

4. RELIGIOUS VIEWS ARE SLOWLY AND PROGRESSIVELY CHANGING
William H.A. Carr, columnist, THE SATURDAY EVENING POST, September, 1995, p. 50.
Although the hierarchy of the Roman Catholic Church has been emphatic in its opposition to euthanasia,
spending millions to defeat such propositions at the polls, there are respected voices raised within that
church in support of physician-assisted death. Dick Westley, philosopher and ethicist at Loyola University
of Chicago, has published a book in which he says there is historical justification for church support of
euthanasia, going back to the Middle Ages. " Euthanasia," he wrote, "is now seen as a tragic necessity
required to protect human dignity." The Unitarian-Universalist Church has supported the concept of
euthanasia for some time. The United Church of Christ has recently come around to a favorable view of the
issue. Many other denominations are reexamining their beliefs. There is reason to believe that many
religious groups will end up endorsing death with dignity, because religions have a habit of changing.
George Fox would be hard-put to recognize in today's Quakers the Religious Society of Friends that he
founded. Calvin would probably be bewildered by the Presbyterian Church of today. Even the Roman
Catholic Church would be astonishing to a medieval pope. This is not a criticism of these religious groups,
but a tribute. The church was made for the living, not for the dead past; as times and social conditions
change, revelation brings about appropriate changes. That's why the church endures.
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BRAIN DEATH TERMINATES AN INDIVIDUAL’S INTERESTS AND MORAL STATUS

1. THE IRREVERSIBLY COMATOSE HAVE NO INTERESTS WHATSOEVER
John A. Robertson, Professor of Law at the University of Texas at Austin, GEORGIA LAW REVIEW,
Summer, 1991, pp. 1246-1247.
The second preliminary point concerns my analysis of the permanently unconscious or irreversibly
comatose patient. As my analysis of Cruzan makes clear, I make a normative judgment that irreversibly
comatose patients lack interests altogether, and thus are exempt from constitutional constraints on vitalist
and nonvitalist policies. This judgment depends on a philosophical view about the minimum neurological
capacity that an entity must have to possess interests and thus be the subject of moral duties in its own
right. While some persons would obviously disagree (perhaps including Professor Kamisar), I argue that an
irreversibly comatose person lacks interests of any sort.

2. BRAIN DEATH MAKES THE INDIVIDUAL NO LONGER A PERSON FOR ETHICAL PURPOSES
John Harris, Professor of Bioethics and Applied Philosophy at the Centre for Social Ethics and Policy at the
University of Manchester, EUTHANASIA EXAMINED, 1995, p. 41.
Finnis claims that every “living human being has this radical capacity for participating in the manner of a
person - intelligently and freely - in human goods.” As stated, this is simply false. It was false of Tony
Bland after he came to be in a persistent vegetative state. Bland had then permanently lost that radical
capacity. On my account he had, at that point, ceased to be a person because he had ceased permanently to
possess the radical capacity which Finnis and I agree is required for personhood.

3. THE IRREVERSIBLY COMATOSE OWE AND ARE OWED NO MORAL DUTIES WHATSOEVER
John A. Robertson, Professor of Law at the University of Texas at Austin, GEORGIA LAW REVIEW,
Summer, 1991, p. 1247.
Irreversibly comatose patients are, in any important sense of the term, other than the biological, "dead."
They may therefore be treated or not treated, used for experiments or as a source of organs or not, as other
social policies and symbolic concerns about how we treat the dead dictate. Society's stance toward the
irreversibly comatose, thus, is not a function of any moral duty owed to them in their own right, for they
have ceased forever to have the interests that make them a subject of duty. Rather, constraints on treatment
of the permanently comatose depend on social and symbolic interests in how we treat the dead. From that
perspective, symbolic and other concerns may indeed be sufficient to limit actions done to irreversibly
comatose patients, but these are considerations of policy not based on moral duties owed to them.

4. A PERSISTENT VEGITATIVE STATE ENTAILS A TOTAL DEARTH OF AWARENESS
Thane Josef Messinger, practicing attorney, DENVER UNIVERSITY LAW REVIEW, 1993, p. 210.
Persons in a persistent vegetative state "may react reflexively to sounds, movements, and normally painful
stimuli, but they do not feel any pain or sense anybody or anything. Vegetative state patients may appear
awake but are completely unaware."

5. BRAIN DEATH ENDS ANY OBLIGATION (LEGAL OR MORAL) TO RESPECT PHYSICAL LIFE
John A. Robertson, Professor of Law at the University of Texas at Austin, GEORGIA LAW REVIEW,
Summer, 1991, p. 1246.
While some persons might say that the "biological" is the only important sense of the term "dead" that
matters, totally brain dead patients, now recognized and defined as dead in nearly every state, also have
ongoing biological functions, including cardiac, respiratory and metabolic functions. The point here is
simply that total cortical or cognitive brain death, even though brain stem function still remains, constitutes
the death of the person, and ends any moral (and, I would argue, legal) obligation to treat them with the
respect accorded living persons.
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AUTONOMY CRITIQUE

Thesis: This argument is that the resolution itself is an affront to personal autonomy. The only moral agent
capable of prioritizing quality of life and sanctity of life is the individual whose life is in question. For
outsiders - i.e. the debaters and the judge - to attempt to preempt that decision is an affront to the autonomy
of the individual.

1. ONLY THE INDIVIDUAL KNOWS WHAT THEY VALUE – WE MAY NOT PRESCRIBE VALUES
Frederick R. Abrams, Professor at the Center for Health Ethics and Politics at the University of Colorado,
EUTHANASIA: THE GOOD OF THE PATIENT, THE GOOD OF SOCIETY, (Edited by Robert I.
Misbin), 1992, p. 46.
A patient may make an unwise decision in terms of optimal medical treatment, but once all measures have
been taken to ensure that the patient has the capacity to choose, a physician may not impose his or her ideas
of what will best benefit that patient. The patient may hold some values above health and life. Decisions
may be made that seem eccentric or tragic, but if they are those of a competent patient, they should be
honored.

2. THE POINT OF AUTONOMY IS NOT TO QUESTION ANOTHER’S LIFE OR DEATH DECISION
Derek Humphry, vice-president of Americans for Death With Dignity, founder of the Hemlock Society and
board member for the World Federation of Right to Die Societies, LAWFUL EXIT, 1993, p. 19.
This is the ultimate civil liberty, the freedom to select one’s own manner of dying without interference
from others, but with help if we choose. If we cannot die by our choice, then we are not free people. Those
who want this choice do not seek to impose our views on others who have different ethical perspectives.
Freedom of choice means just that: to each his own.

3. THE DECISION TO END ONE’S LIFE IS ESSENTIAL TO FREE PERSONHOOD
John Harris, Professor of Bioethics and Applied Philosophy at the Centre for Social Ethics and Policy at the
University of Manchester, EUTHANASIA EXAMINED, 1995, pp. 19-20.
Euthanasia should be permitted, not because everyone should accept that it is right, nor because to fail to do
so violates a defensible conception of the sanctity of life, but simply because to deny a person control of
what, on any analysis, must be one of the most important decisions of life, is a form of tyranny, which like
all acts of tyranny is an ultimate denial of respect for persons.

4. THE AUTONOMY OF THE INDIVIDUAL JUSTIFIES ANY DECISION TO END ONE’S LIFE
Craig Peyton Gaumer, Assistant U.S. Attorney at the Department of Justice, SOUTH DAKOTA LAW
REVIEW, 1997, p. 378.
The question of whether the Constitution affords individuals with a right to control the manner of their
deaths is more than a question of Fourteenth Amendment "liberty." It is, in truth, a question of sovereignty.
The Ninth and Tenth Amendments clearly establish that certain powers of sovereignty were never intended
to be delegated to either the state and federal governments. As a matter of common sense, it seems unlikely
that the founding fathers, who were distrustful of powerful governments, would have intended the system
they created to exercise the power to prevent a terminally-ill person from meeting their maker, in the
manner they see fit. Thus the foregoing cases have asked the wrong set of questions. In a constitutional
system founded on the theory that government derives its power from the consent of the governed, it seems
more appropriate to ask the right-to-die question in another form: "What source of authority commissions
the government to prolong the pain and suffering of a mental-competent, but terminally-ill persons?" By
reformulating the question in this manner, the focus is shifted from a consideration of individual rights into
an exploration of the legitimate breadth and depth of the state police power. This significant question
deserves more attention than has been devoted to it by courts been called upon to assess the
constitutionality of state prohibitions on physician-assisted suicide.
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THE VALUE OF AUTONOMY WARRANTS EUTHANASIA OR SUICIDE

1. PERSONAL AUTONOMY COMPELS A RIGHT TO SUICIDE
G. Steven Neeley, Assistant Professor at Saint Francis College, AKRON LAW REVIEW, Summer, 1994,
p. 66.
The recognition that life is not always worth living gives rise to an independent moral argument for the
legalization of suicide and euthanasia. The proposed right to suicide advances this claim and stems from the
Constitution's commitment to personal autonomy -- the view that the individual should have unfettered
liberty over his own life and person insofar as the exercise of such liberty does not harm others. As such,
the right to suicide is born of respect for individual choice and could never be used to sanction involuntary
euthanasia.

2. REGARDLESS OF ONE’S OPPOSITION, THE INDIVIDUAL CHOICE TO DIE MUST BE
RESPECTED
Paul Kurtz, bioethicist, ISSUES IN LAW & MEDICINE, December 22, 1992, p. 309.
There may be cases in which an individual opts for euthanasia, while his relatives or his community oppose
his decision as unreasonable. In such a case you have an obligation to try to persuade that individual to act
otherwise. If you have a person who insists that he does not want to be kept alive and you think that he is
mistaken and that he hasn't examined all of his options, or that he is reacting emotionally, then you have a
duty to try to persuade him that there is still some quality to life and that he ought not to exit so rapidly.
And you ought to try to prevail. But if, in the last analysis, the active person who is suffering does not agree
and insists that he still wants to die, then I submit that we ought to respect that demand for dignity. We
need not ourselves wish to help that person to die, and if in our inner conscience we cannot, we should at
least not prohibit or prevent him from dying, thus imposing our will upon him. In a clash of wills, it is the
person himself who must voluntarily decide whether his life is still meaningful, or whether he wants to die
gracefully and with as much dignity as he can muster.

3. THE AUTONOMY PRINCIPLE JUSTIFIES PRIORITIZING QUALITY OF LIFE OVER SANCTITY
Sanford H. Kadish, Professor of Law, Emeritus, Boalt Hall School of Law, CALIFORNIA LAW
REVIEW, July, 1992, p. 862.
The fulcrum on which the courts moved the law away from its traditional hostility to forgoing treatment
was the concept of consent. The requirement of consent goes back to the common law, which made it a
battery to subject a person to any force to which he had not consented, including such force as might be
involved in providing medical treatment. n28 In dealing with such issues as the constitutionality of laws
prohibiting contraception and abortion, the United States Supreme Court gave new and powerful support to
the common law concept of consent. The Court developed a jurisprudence of autonomy (sometimes under
the misleading label of privacy), finding in the Constitution a fundamental right of individuals to make
choices with regard to their own bodies. The lesson of the new autonomy jurisprudence for refusals of
medical treatment was plain, and the Quinlan case was one of the first to draw it explicitly. In that case the
New Jersey court found that just as the constitutional right of autonomy over one's body encompasses a
woman's decision to have an abortion, so does it "encompass a patient's decision to decline medical
treatment," at least under some circumstances.

4. INDIVIDUALS HAVE A LIBERTY INTEREST IN CHOOSING THE TIME OF THEIR OWN
DEATH
Craig Peyton Gaumer, Assistant U.S. Attorney at the Department of Justice, SOUTH DAKOTA LAW
REVIEW, 1997, p. 376.
Requiring a competent adult to endure such procedures against her will burden's the patient's liberty,
dignity, and freedom to determine the course of her own treatment. Accordingly, the liberty guaranteed by
the Due Process Clause must protect, if it protects anything, an individual's deeply personal decision to
reject medical treatment, including the artificial delivery of food and water.
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PERSONHOOD CRITIQUE

Thesis: This argument postulates that the resolution asks the wrong question. “Sanctity of life” is a
misnomer or a vacuous concept. The correct value is “personhood,” because life without personhood is
merely animate tissue. The typical life-ending decision does not place quality of life and personhood in
conflict - most diminutions of quality of life are also diminutions of personhood.

1. THEY ASSUME THE WRONG VALUE - THE KEY IS NOT LIFE BUT RATHER PERSONHOOD
John Harris, Professor of Bioethics and Applied Philosophy at the Centre for Social Ethics and Policy at the
University of Manchester, EUTHANASIA EXAMINED, 1995, p. 10.
Discussions of euthanasia and for that matter of other life and death issues such as abortion and
experimentation on embryos, are often cast in terms of the value of life or of how the sanctity of life, its
sacredness or its intrinsic importance are to be understood. However, these accounts all assume a special
importance attaching to human life or the life of some humans without trying to account for this special
importance. In attempting to account for it, as I have done, in terms of an answer to the question “What is
so special about the lives of persons?” a different perspective emerges. It is not so much life that is special,
rather it is the individuals whose lives are in question that are special and special precisely because they are
individuals of a certain kind. From this perspective, it is not respect for life but respect for persons that is
the moral imperative that has to be understood.

2. PEOPLE HAVE NO INTEREST IN LIFE, PER SE, JUST IN THEIR PERSONAS
Frederick R. Abrams, Professor at the Center for Health Ethics and Politics at the University of Colorado,
EUTHANASIA: THE GOOD OF THE PATIENT, THE GOOD OF SOCIETY, (Edited by Robert I.
Misbin), 1992, p. 45.
It is argued that doctors must be devoted to life and health. This is a useful but abstract notion. It must be
specifically applied by a doctor to the life and health of each patient. That patient has no interest in life and
health as abstractions. Rather, he or she is devoted to very concrete desires regarding life and health, and
correctly expects the physician to apply medical skills to achieve these goals. That patient has no interest in
the survival of random tissues or organs, but has a great interest in the integrated function of the unified
mind and body that is his or her persona. If there are limitations of mind or body (or both), only that patient
may determine whether that very specific (not speculative) quality of life is sufficient to serve his or her
ends.

3. A PERSONHOOD FOCUS ENTAILS RESPECT FOR INDIVIDUAL DEATH DECISIONS
John Harris, Professor of Bioethics and Applied Philosophy at the Centre for Social Ethics and Policy at the
University of Manchester, EUTHANASIA EXAMINED, 1995, p. 16.
If we take as our root idea the notion of respect for persons rather than that of the sanctity of life, and by
root notion here I mean the same as Dworkin – an idea about what is of intrinsic, cosmic importance; we
get the same answer (at the level of policy and legislation) to these issues as Dworkin does for a different, if
related, reason. That reason is of course that whether what people take to be of cosmic importance they
characterise as “opinions about what it means for his own human life to go well” or as “wishes to control
their own destiny,” what is at stake is a desire about a hugely important event in a person’s history. I
deliberately do not say “self-defining preference” because I wish to allow for the distinct possibility that
while someone might have strong, and for them important, preferences about the manner and timing of
their own death., these should be respected because they are just that, strong and important preference; and
not, if and only if, the individual also sees the manner and timing of their death as in some way self-
defining.
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THE SLIPPERY SLOPE ARGUMENT IS FALSE

1. THE SLIPPERY SLOPE ARGUMENT IS LOGICALLY FALLACIOUS
G. Steven Neeley, Assistant Professor at St. Francis College, AKRON LAW REVIEW, Summer, 1994, p.
55-56.
But many courts and scholars appear to be motivated by yet another and more implicit concern with the
so-called "quality of life" argument. This argument suggests that once the legislature or judiciary begins to
consider the quality of a persons' life, then a dangerous precedent exists for the state-imposed
"extermination" of all persons whose "quality of life" does not measure up to sufficient standards. This
ofttimes subtle design ultimately proves to be nothing more than a variation of the "slippery-slope"
argument. This paper will contend that such arguments are logically fallacious and, at best, sway only by
emotional appeal. As such, this style of argument should be afforded little forensic weight as it serves only
to further confuse the debate over the constitutionality of self-directed death.

2. PATIENT CONSENT CHECKS THE SLIPPERY SLOPE
Robert T. Hall, professor of sociology and philosophy at West Virginia State College, THE HUMANIST,
November, 1994, p. 10.
The other popular criticism is the reverse: if physicians alone decide when there is no hope left for a
meaningful life, we will be on the slippery slope toward the killing of people with any and every sort of
disability. The answer here is that current laws already require informed consent for any medical treatment:
physician-assisted suicide would have to remain strictly at the patient's informed request. People should, of
course, be allowed to express their wishes through living wills and surrogate decision-makers as long as
these means are used to enact the patient's wishes.

3. A LINE BASED ON VOLUNTARINESS SUFFICES TO CHECK THE RISK OF GENOCIDE
G. Steven Neeley, Assistant Professor at St. Francis College, AKRON LAW REVIEW, Summer, 1994, p.
59-60.
The reductio form of the argument is tantamount to the assertion that "once you allow euthanasia for the
patient in terrible agony, you are logically committed to approving of euthanasia in other cases as well."
Indeed, Sullivan claims that "[o]nce a man is permitted on his own authority to kill an innocent person
directly, there is no way of stopping the advancement of that wedge. There exists no longer any rational
grounds for saying that the wedge can advance so far and no further." But this is patently false. There are
rational and morally relevant grounds for distinguishing between the patient in agony who voluntarily seeks
death and other cases, such as Sullivan's catalogue of "charity patients," "wounded soldiers," and
"deformed children," who presumably do not wish to die. The line of demarcation can readily be drawn by
the voluntariness of the act. In the first instance, the individual requests death, while in the second, the
persons involved do not. The gulf between humanely assisting a competent and willing patient to effect his
own death and murdering nonconsenting persons under the slogan of "euthanasia" is too wide to glaze over.
Society is not logically committed to sanctioning involuntary euthanasia once it permits voluntary active
euthanasia. Nor does it follow that society must lose respect for human life once it begins to respect the
sanctity of individual choice. The legalization of voluntary active euthanasia simply does not entail the
horrors its opponents envision. As such, the logical variant of the "slippery-slope" fails, and cannot be used
to justify universal proscriptions of self-willed death.

5. AFFIRMATIVE EVIDENCE FROM THE NETHERLANDS IS FATALLY DEFECTIVE
G. Steven Neeley, Assistant Professor at Saint Francis College, AKRON LAW REVIEW, Summer, 1994,
p. 71.
In response to Gomez and Keown, Margaret Pabst Battin has critically warned that the various allegations
of abuse may well be fatally defective. Accordingly, "[s]uch works tend to conflate two issues: whether
abuse is actually occurring, and whether there are adequate protections against abuse; within the former
category they also fail to distinguish between procedural abuse (e.g., not following the guidelines) and
substantive abuse (killing patients against their will)." In the autumn of 1991, the results of two empirical
studies on euthanasia in the Netherlands were released.
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THE SLIPPERY SLOPE ARGUMENT IS UNPERSUASIVE

1. IT IS IMPOSSIBLE TO INVALIDATE EUTHANASIA BASED ON THE DUTCH EXPERIENCE
G. Steven Neeley, Assistant Professor at Saint Francis College, AKRON LAW REVIEW, Summer, 1994,
p. 74.
In sum, it is presently impossible to extrapolate any standard from the Dutch experience that could
realistically serve to bar the recognition of the constitutional right to suicide within the United States. Many
factors differentiate the two political climes. While there are scant allegations of abuse within the Dutch
system, there is certainly no incontrovertible evidence of substantive abuse. Whatever abuse, if any, that
exists in the Netherlands might well be halted altogether if there were clearer guidelines for health care
workers to follow. As it is, euthanasia remains illegal in Holland, yet it is not always punished, while
specific guidelines for the practice are effectively contingent upon further case law development. It would
stand to reason that even the most earnest practitioner under such a system would be hesitant to invite
public and legal scrutiny. One cannot unerringly follow guidelines when the guidelines are nonexistent or
unclear.

2. RELYING ON THE SLIPPERY SLOPE ARGUMENT ACTUALLY INCREASES THE RISKS
William H.A. Carr, columnist, THE SATURDAY EVENING POST, September, 1995, p. 50.
Said The Economist: "The slippery-slope argument deserves to be taken seriously. But some of those who
advance it teeter precariously on a much more slippery slope of their own. The rights of the individual, they
say, must be balanced against the interests of society: the taking of a life, at the patient's request, may seem
acceptable in particular circumstances, but must be forbidden because it attacks values that bind society
together. This way of thinking seems likable on the surface, but it sets the rights of the individual at naught:
in that respect, it is philosophically related to the view that society should exterminate those who are a
burden upon it. People who put society above the individual are indeed well-advised to be wary of assisted
suicide."

3. DENYING AUTONOMY PROGRESSIVELY EXPANDS DEVALUATION OF LIFE
G. Steven Neeley, Assistant Professor at St. Francis College, AKRON LAW REVIEW, Summer, 1994, p.
66-67.
Proponents of the "wedge" objection cannot successfully demonstrate that undesirable effects will follow
the right's adoption. It is particularly unobvious that the legalization of suicide and euthanasia will lead to a
disvaluation of human life. Indeed, it is equally tenable to postulate that a refusal to recognize the right to
suicide will actually pose a greater threat to the sanctity of human life because such a stance would promote
disregard for the quality and meaning of life. Universal proscriptions of self-willed death run afoul of
respect for individual choice and accommodate callous indifference towards the suffering of others.
Forcing an individual to remain alive against his own considered rational decree out of blind allegiance to
archaic legal and social taboos is antithetical to human dignity, as it effectively treats the person as a means
to advance society's ends. In this respect, it is simple enough to subvert the "wedge" objection by
constructing an "antiwedge" argument along similar lines -- for once society fails to recognize the
importance of self-sovereignty, and begins to ignore those critical aspects of existence which give life its
meaning, then there is little to prevent an erosion of personal rights which would ultimately culminate in
the loss of all freedom.

4. TURN: DENYING THE RIGHT TO EUTHANASIA ACTIVATES THE SLIPPERY SLOPE
Frederick R. Abrams, Professor at the Center for Health Ethics and Politics at the University of Colorado,
EUTHANASIA: THE GOOD OF THE PATIENT, THE GOOD OF SOCIETY, (Edited by Robert I.
Misbin), 1992, p. 46.
There are those who feel that the politics of selfishness and the pressure of economics will lead to a societal
retreat from the defense of the great value of life. The Massachusetts court in the Saikewicz case responded
to that concern specifically, saying: The constitutional right to privacy . . . is an expression of the sanctity
of individual free choices and self determination as fundamental constituents of life. The value of life as so
perceived is lessened not by a decision to refuse treatment but by the failure to allow competent human
beings the right to choice.
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THERE IS NO RISK OF A SLIPPERY SLOPE

1. SUICIDES ARE NOT FRIGHTENED BY SANCTION
G. Steven Neeley, Assistant Professor at St. Francis College, AKRON LAW REVIEW, Summer, 1994, p.
74-75.
The scope of the constitutional right to suicide is to protect the right of the competent adult to terminate his
own existence. The impact of the right will fall upon seriously ill patients who seek death but lack the
wherewithal to effect their own destruction. Judicial recognition of this right will not open social floodgates
to a wave of unwarranted suicides. Individuals who want to die and are capable of carrying out their wishes
are not likely to be deterred by the threat of criminal sanctions. Thus, incompetent or distraught persons
who would destroy themselves without sufficient cause or consideration will not be affected by a change in
the legal status of suicide. As a practical matter, therefore, broad proscriptions of suicide and (in particular)
assisted suicide seem to deny access to self- imposed death to that specific class of persons who might
actually benefit from existing life -- terminal and seriously ill patients.

2. DEMOCRATIC POLITICS WILL PREVENT THE DESCENT DOWN THE SLOPE
Derek Humphry, vice-president of Americans for Death With Dignity, founder of the Hemlock Society and
board member for the World Federation of Right to Die Societies, LAWFUL EXIT, 1993, p. 35.
The “slippery slope” would be an evil possibility if a government ruthlessly modified a successful Death
With Dignity Act, passed by popular vote, into a mechanism for killing the poor, the disabled, the elderly, or
anybody else it considered “undesirable.” But that is not how democracies work. People would not let it
happen.

3. LEGAL CHECKS PREVENT IMPROVIDENT EUTHANASIA DECISIONS
Robert T. Hall, professor of sociology and philosophy at West Virginia State College, THE HUMANIST,
November, 1994, p. 10.
The problem of physician-assisted suicide poses a double question and requires a double answer. Critics
often charge that, if physician-assisted suicide were legalized, patients who are mentally unstable or simply
depressed would too quickly choose suicide. But current laws stipulate clearly that no physician should
ever offer or agree to any medical procedure unless he or she is convinced that it is in the best interests of
the patient. With regard to physician-assisted suicide, the physician would have to be convinced that
nothing else could be done and that the situation was so intolerable to the patient that an easier death was in
his or her best interests.

4. EVIDENCE PROVES ABRIDGMENTS OF LIFE’S SANCTITY DO NOT DESTROY SOCIETY
G. Steven Neeley, Assistant Professor at St. Francis College, AKRON LAW REVIEW, Summer, 1994, p.
60-61.
There is a good amount of historical and anthropological evidence to support the claim that the approval of
killing in one context does not necessarily lead to killing in different contexts of a culture. The infanticide
of deformed offspring was widely accepted in ancient Athens and required by law in Sparta. Yet the
practice of infanticide "is not a sign that [the Greeks] placed little value on human life. They were not a
murderous people, and they took a stern view of some other types of killing." The early Christians accepted
homicide in times of war, capital punishment, or out of obedience to God, and yet rejected it under other
circumstances. In China, Confucian ethics permitted voluntary death in the case of hopeless disease, and
the great Eastern religions, including Shintoism and Buddhism, followed a similar path - in each instance,
without apparent disruption to the moral fabric of society. Among Eskimo societies, the killing of infants
and the aged was widely practiced as a measure to avoid depletion of the food supply, and yet murder was
virtually unheard of. Within contemporary Western society, killing is permitted in numerous
circumstances: war, capital punishment, heroic self- sacrifice, and self-defense. Yet there is no evidence
that such exceptions to the repulsion for killing have presented dangerous inroads leading to a general
devaluation of human life.
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                                 West Coast Sanctity of Life LD Supplement Page 53
THE HIPPOCRATIC OATH DOES NOT INVALIDATE THE RIGHT TO DIE

1. INVOCATION OF THE HIPPOCRATIC OATH IS INVARIABLY INCONSISTENT
Frederick R. Abrams, Professor at the Center for Health Ethics and Politics at the University of Colorado,
EUTHANASIA: THE GOOD OF THE PATIENT, THE GOOD OF SOCIETY, (Edited by Robert I.
Misbin), 1992, p. 47.
How does this square with the ancient oath of Hippocrates? Few of those persons who believe that quoting
the oath settles arguments about euthanasia would countenance physicians who have sworn to all of the
pagan gods and goddesses of ancient Greece. Nor would they expect physicians to maintain and support
their teachers and the children of their teachers.

2. THE HIPPOCRATIC OATH IS NOT A BARRIER TO PHYSICIAN ASSISTED SUICIDE
William H.A. Carr, columnist, THE SATURDAY EVENING POST, September, 1995, p. 50.
Some people who are opposed to the idea of physician-assisted death cite the Hippocratic oath as a barrier.
In fact, many medical schools no longer administer the oath, which was drawn up more than 2,400 years
ago. Obviously, current medical practice is quite different from that of early Greece. Moreover, those who
invoke the Hippocratic oath inevitably find themselves defending a document that, for many years, has
been more honored in the breach than in the observance.

3. THE OATH IS A HISTORICAL FABRICATION
Frederick R. Abrams, Professor at the Center for Health Ethics and Politics at the University of Colorado,
EUTHANASIA: THE GOOD OF THE PATIENT, THE GOOD OF SOCIETY, (Edited by Robert I.
Misbin), 1992, p. 47.
The evidence is convincing that these admonitions against surgery, abortion and euthanasia were the
precepts of the Pythagorean cult. Historical notice of the oath was first made centuries after the death of
Hippocrates. Christian teachings found this compatible with their theology and made authoritative use of it
by appending Hippocrates’ name – although it was far from Greek and Roman contemporaneous practice.
In fact, the ancient physician’s direct participation in euthanasia (literally, “a good death”) by poisoning or
phlebotomy was undertaken (along with the interdicted surgery and abortion) at the discretion of the
physician upon the request of the patient.

4. THE HIPPOCRATIC OATH DOES NOT ASSUME MODERN MEDICAL CONDITIONS
Craig Peyton Gaumer, Assistant U.S. Attorney at the Department of Justice, SOUTH DAKOTA LAW
REVIEW, 1997, p. 362.
The Hippocratic Oath, which has been traditionally administered at medical school graduations for
generations, seems to denounce the practice. Those who take the oath swear to "prescribe regimen for the
good of my patients according to my ability and my judgment and never do harm to anyone. To please no
one will I prescribe a deadly drug, nor give advice which may cause his death. However, trying to apply the
values enshrined in this oath to contemporary ethical issues is a questionable exercise insofar as
Hippocrates could not have foreseen many of the dilemmas created by the advanced medical technology
employed in the 20th century. The profession obviously has a need for a canon of ethics that reflects more
modern values.

				
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