GESTIÓN EN SALUD PÚBLICA: BioEdge: Daniel Callahan backs ‘slippery slope’ on assisted suicide

domingo, 25 de marzo de 2018

BioEdge: Daniel Callahan backs ‘slippery slope’ on assisted suicide

BioEdge: Daniel Callahan backs ‘slippery slope’ on assisted suicide
Bioedge

Daniel Callahan backs ‘slippery slope’ on assisted suicide

by Michael Cook | 25 Mar 2018 |

The idea of a slippery slope for euthanasia is mocked by supporters. But in a recent opinion piece in the Bioethics Forum of The Hastings Center, one of America’s most respected bioethicists endorses it. In a brief opinion piece, Daniel Callahan, the co-founder of The Hastings Center, the world's first bioethics research institute, and the author or editor of 47 books, writes:

I have been opposed to physician-assisted death for well over 30 years. ....

I came into the debate with wariness and curiosity. On the one hand, my work on end-of-life care and the emergent hospice movement made clear that many deaths could be painful, psychologically traumatizing, and messy. I could well understand interest in that problem, but I wondered why the growing hospice program was not enough. What was to be made of the zealotry of proponents for euthanasia or physician aid in dying? I was especially curious about their long-term aspirations.

I also became interested in the pressures that medical progress was putting on care of the dying. Most notably, it has been increasing the possibility of medical efforts to incrementally find ever more ways to keep the sick and dying alive. The logic of medical progress has an unpleasant feature. It is the gradual movement from short lives and quick death to longer lives and extended dying. The quick deaths from heart attacks in my parents’ generation have given way to longer lives and Alzheimer’s disease. Is that progress?

Interest in assisted death comes, in part, from a culture of medical progress that does not know how to stop extending our lives. Medicine is particularly good in extending our dying—and much of that extension is in old age. I believe that the care of the elderly is rapidly coming to be a crisis for many countries, rich and poor. Inevitably, this crisis has also meant a growing attraction to assisted death. Some studies show that suicide rates are especially high in countries with low birthrates, rapidly aging populations, and significant health care and caretaker costs. The U.S. may not be spared.

My introduction to the Dutch scene in the late 1980s was to see a slippery slope in the making, first in the Netherlands and then in other countries. In Belgium, for example, euthanasia is now legal for terminally ill children, as well as for adults who have mental illness and dementia, and who are “tired of living.” The loosening of restrictions on who qualifies for euthanasia is evidence of the high value placed on individual autonomy in determining the time and means of death. It is a concept with no inherent limits.

The tragic death of a Florida woman struck by a driverless Uber has revived public interest in robot ethics. How do these cars make decisions in life and death situations? Are they transparent enough about the standards?

Such questions will be asked more and more as the age of autonomous vehicles approaches. Perhaps you could program it yourself. Highly Ethical Cars would take almost no risks and take two hours to get to work. Minimally Ethical Cars would run red lights and get there in five minutes. It’s going to be an interesting debate.