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    Wednesday, December 08, 2004

    Not a Slippery Slope: My thoughts on utilitarian bioethics and the Dutch at Tech Central Station.

    P.S. Some information that didn't make it into the column but that's worth mentioning for what it says about the uses of euthanasia to ease societal burdens rather than individual burdens is the data found in this survey of Dutch adult euthanasia practices from 1990 to 2001. About 39% of deaths are hastened in some manner, and shockingly, about 1000 of those each year are done without the patient's request.

    The very elderly (over age 80) account for an increasing proportion of the hastened group, from 41% in 1990 to 45% in 2001, while other age groups are decreasing. At the same time, the proportion of hastened deaths administered by nursing home physicians has increased from 17% to 24% while other specialities have decreased or stayed the same. The proportion of hastened deaths administered to cancer patients has remained about the same (from 30% to 29%), while heart disease is decreased (29% to 25%), but hastening death for "other or unknown" illnesses (which would include dementia) has increased from 40% of such deaths to 46%.

    No wonder more Dutch doctors said in 2001 that they feared healthcare economics was playing an increasing role in pressuring physicians into euthanasia decisions.

    P.P.S. And in the more things change, the more they stay the same, see this synopsis of a popular German film from 1941, Ich Klage an (I Accuse).

    NOTE: I the first P.S. has been edited to correct grammatical mistakes from the first edit and to read "hastened deaths" instead of euthanasia. Technically, euthanasia is active killing of a patient, but the categories in the study refer to all actions that make death come quicker, including treating pain with high doses of morphine.

    UPDATE: Healthcare policy blogger Matthew Holt thinks I've crossed the line of civility by equating the Dutch, Singerian ethics, the Sudanese, and Yugoslavians. I disagree. The Sudanese and Bosnian Serbs are no less human than the Dutch and Peter Singer, and therefore no more evil. Likewise, the Dutch and Singer are no more innately good.

    The only difference between them all are the groups of people they've chosen as too troublesome to tolerate. For the Dutch, it's severely handicapped infants. For Singer, just about any infant that no one wants. For the Sudanese, it's non-Arab Africans. For the Bosnians, it was Muslims. The attitude remains the same. Once a society accepts that it's OK to devalue one group because they are a burden, then no group is safe. Which group is chosen just depends on who holds the power.

    UPDATE: Hmmph. Just had a chance to read Matthew's full post at the office (for some reason, Internet Explorer on the Mac I use at home renders his posts too large to be viewed easily in their entirety. I have to keep scrolling horizontally which is difficult.) Somehow, I find the argument that opposing infant euthanasia is a closer cousin to opposing masturbation than embracing infant euthanasia is to genocide less than convincing.

    posted by Sydney on 12/08/2004 05:15:00 PM 0 comments


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