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Understanding ‘Euthanasia’ Across Various Medical Practices

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Theories of the Self and Autonomy in Medical Ethics

Part of the book series: The International Library of Bioethics ((ILB,volume 83))

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Abstract

End-of-life decisions and assisted suicide are often equated with ‘euthanasia.’ In everyday parlance of social actors, the term euthanasia is understood rather broadly, even lumped together with other medical procedures. Still, the paper argues that ‘intended merciful death,’ whether we like the definition or not, ought not to be equated with other practices. Although all of these medical procedures result in the destruction of potential or actual life, the reasons behind such actions could be quite different from empathy or mercy, making the acceptance and advocacy of a problematic definition and understanding of euthanasia the subject of ethical and social debates and analyses. When considering the Universal Declaration on Bioethics and Human Rights, the debate stretches out to include also vulnerable groups in general, which in the contemporary context range from homeless persons and other marginalized groups to embryos created during IVF (in vitro fertilization). The paper presents two case studies, chosen from ten personal stories of former and current IVF procedure patients. In all ten narratives, interlocutors equate abortion with embryo reduction, and both of those with euthanasia. The paper analyzes their perspective to embryos that were not implanted, as well as similarities and differences in their views regarding the activities in the cases of implanted embryos (twin and triplet pregnancies).

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Notes

  1. 1.

    Tom Beauchamp and James Childress, in Principles of Biomedical Ethics, begin their analyses of autonomy “in terms of normal choosers who act (1) intentionally, (2) with understanding, and (3) without controlling influences that determine their action” (Beauchamp and Childress 2013, 104).

    This issue is analyzed partially in the context of their three other principles, i.e. nonmaleficence, beneficence, and justice. For Beauchamp and Childress, individual autonomy is preserved wherever it is rooted in some social, cultural or religious belief. However, such social influences are understood as internal characteristics of autonomy. Thus, Beauchamp and Childress essentially still presuppose an individualistic conception of autonomy (Cf. Beauchamp and Childress 2013, 106).

  2. 2.

    (Dowbiggin 2005).

  3. 3.

    (a) Human dignity, human rights and fundamental freedoms are to be fully respected. (b) The interests and welfare of the individual should have priority over the sole interest of science or society.

  4. 4.

    In applying and advancing scientific knowledge, medical practice and associated technologies, direct and indirect benefits to patients, research participants and other affected individuals should be maximized and any possible harm to such on individuals should be minimized.

  5. 5.

    The autonomy of persons to make decisions, while taking responsibility for those decisions and respecting the autonomy of others, is to be respected. For persons who are not capable of exercising autonomy, special measures are to be taken to protect their rights and interests.

  6. 6.

    In applying and advancing scientific knowledge, medical practice and associated technologies, human vulnerability should be taken into account. Individuals and groups of special vulnerability should be protected and the personal integrity of such individuals respected.

  7. 7.

    Mark S. Frankel. 2003. “Inheritable Genetic Modification and a New Brave World: Did Huxley have it wrong?” in The Hasting Center Report. 33 (2): 31.

  8. 8.

    For detailed insight into the questions used for this research, see appendix, in Mitrović 2016.

  9. 9.

    For example, a characteristic response of the partner was: “She lost patience, so it was her initiative, I had nothing against it, it was up to her. In May, we approached the clinic, the insemination was in July…” (P7).

  10. 10.

    For more about principle “ought implies can,” see in Kühler 2017.

  11. 11.

    The participant used the Serbian word kljakavo, an extremely derogatory version of lame or damaged. The patient is using the word ironically, because during the IVF procedure, at a private clinic in Serbia, one of the nurses used it to describe the embryos being implanted in her uterus, letting her know that the odds of a baby are slim.

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Correspondence to Veselin Mitrović .

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Mitrović, V. (2020). Understanding ‘Euthanasia’ Across Various Medical Practices. In: Kühler, M., Mitrović, V.L. (eds) Theories of the Self and Autonomy in Medical Ethics. The International Library of Bioethics, vol 83. Springer, Cham. https://doi.org/10.1007/978-3-030-56703-3_13

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