The Humanist Cafe
Wednesday, March 2, 7 – 8:30 pm
James Bay New Horizons 234 Menzies Street, James Bay


Topic: Causing Death and Saving Lives

Presenter: Dr. Paul Kamill
Moderator: John Pope

Most of you will already know that following the election of the Liberal government last year the Supreme Court of Canada granted an extension of six months for the government to make a decision concerning what I will call euthanasia. April this year sees the end of that six months.

Why do I not prevaricate and use some other term for “dying with dignity”. Well, simply because of brevity. However, the word “euthanasia” in spite of its Greek origins, carries with it considerable emotional baggage. I propose that you do your best to ignore both positive and negative implications attached to the word.

There are differences between actively killing, and letting die. We all of us die. There is no getting away from it, much as we might like to think differently. We seldom discuss death, considering it to be an almost taboo, or private, subject. However, killing someone, even ourselves, is not something that we generally do. There is, however, the principle of ‘acts and omissions’ which might incriminate you. How many people have you, today, killed by your omission? Did you do all that you could to save them?

Here is a thought experiment for you from one of Jonathan Glover’s books (Glover, 1990):

“If yesterday I read a novel, am I to be prosecuted for not saving lives by working for Oxfam, or for not doing so by holding a road-safety class at the local school?

But, from the point that the law should not punish certain harmful omissions, it does not follow that they are morally acceptable [my emphasis]. If I see a child for whom I have no special responsibility drowning in a river and deliberately do nothing when I could save him, the law does not punish me, largely because of the difficulties of drawing clear-cut and sensible boundaries around any proposed offence. But few of us would feel entitled to conclude that my omission is immune from criticism…”

Acts, such as going to Africa and caring for as many babies as you are physically able to do requires time. Even working to fund Oxfam, requires time. However, omitting to do something, by contrast, does not require ‘time’. It is the easier option.

Then, we have the confidence or ‘trust’ issue. Some of you may know of Harold Shipman, a family doctor in north-west England. If not, here is his biography:

I turn to popular culture, and the film “Logan’s Run”, in which individuals reaching thirty years of age are ‘immolated’ in the ritual of “Carousel”. The ‘promise’ of a better life? Maybe? My question is, if there were such a law determining that I should die under certain circumstances, would I have confidence in my doctors if I was sent to hospital? It certainly undermines the current nature of the doctor-patient relationship.

Some of you may have come across the “doctrine of double effect”? This link has some examples, along with the conditions that must be fulfilled for it to be satisfied:

It dates from the time of Thomas Aquinas, and is often cited in medical situations. The problem arises not only in the administration of pain relieving drugs, but to some extent the withdrawal of life-saving technologies (Glover, 1977). It is also a problem for the practice of medicine. Who do I choose, mother or foetus (Shaw, 2002)1.

Perhaps I should add that the Hippocratic oath, allegedly administered to medical practitioners on qualification, is frequently considered too patronising for patient care. There is also the popular misconception that a poem, written in the nineteenth century by A. H. Clough, called the “Latest Decalogue” in which the lines appear, “thou shalt not kill, but need’st not strive, officiously to keep alive…” As something to do with medical practice. Currently, and probably for the last half-century or so Principlism has been the dominant ethical “code”, for medical practice. It came from W D Ross, a British philosopher at Oxford in the 1930s.

It has since been popularised by the University at Georgetown, and has come to be known as the “Georgetown mantra”.

It is mostly practical, although of course with philosophers there is always some dissent! It involves four principles. 1). Autonomy, 2). Beneficence, 3). Non-maleficence, 4).  And last Justice.

Now, why have I given this and ethical slant? We already have the decision of the Supreme Court, and it is likely that whatever happens in April will simply be an affirmation of what has already been decided. We need, as Humanists, to consider what law has to do with justice, or in this case how law, which is usually immutable, can be applied to cases of such great difference as that of Sue Rodriguez, or, in the UK Tony Bland, or Terry Schiavo in the USA. We would all like to think that our death will be a good death. Perhaps we all wish to have some control over what happens to us.

So, here is your mission, should you accept it, what precisely do we all wish for from the “tablets of stone” that are likely to be enshrined in the new law?

A worthwhile read, at says, for me, a great deal is to be found on this website, outlining how two scientists, in Australia, decided for themselves.

1 This is the abstract of this paper: “The validity of the double effect doctrine is examined in euthanasia and abortion. In these two situations killing is a method of treatment [my emphasis]. It is argued that the doctrine cannot apply to the care of the dying. Firstly, doctors are obliged to harm patients in order to do good to them. Secondly, patients should make their own value judgments about being mutilated or killed. Thirdly, there is little intuitive moral difference between direct and indirect killing. Nor can the doctrine apply to abortion. Doctors kill fetuses as a means of treating the mother. They also kill them as an inevitable side effect of other treatment. Drawing a moral distinction between the direct and the indirect killing gives counter intuitive results. It is suggested that pragmatic rules, not ethics, govern practices around euthanasia and cause it to be more restricted than abortion.”

Oh, and by the way, there are so many other possible perspectives (perhaps you know of the slippery slope?) that I have not even begun to outline here…so argue the toss!

Let the games begin!

Reference List

Glover, J. (1977). Ends and Means: Double Effect. In Causing Death and Saving Lives. (pp. 86-91). London: Pelican.

Glover, J. (1990). Not Striving to Keep Alive. In Causing Death and Saving Lives: The Moral Problems of Abortion, Infanticide, Suicide, Euthanasia, Capital Punishment, War and Other Life-Or-Death Choices. (pp. 92-112). London: Penguin.

Shaw, A. B. (2002). Two challenges to the double effect doctrine: Euthanasia and abortion. Journal of Medical Ethics, 28, 102.
FYI – Victoria MP Murray Rankin was elected vice-chairman of the special parliamentary committee tasked with crafting recommendations for the federal government’s response to the Supreme Court’s landmark decision:

“Murray Rankin: Assisted-dying law will require careful balance”  – The Times Colonist Friday, Feb. 26:

See you there!  Bring a couple of friends.