Thursday, September 15, 2016

Killing for one's "Best Interests"

The distinction between killing (act) and letting die (omission) is nuanced and controversial in ethics.  It divides theorists into many different camps given its potential application and implications in medical scenarios.  On the other hand, Trolley Problem cases appear purely theoretical.  More often than not, testing our moral intuitions by thinking about whether we'll pull a lever or push someone onto some railroad tracks appears useless...interesting sometimes, but not really helpful.

What if we combined the issues, however?  In a recent paper, published in the Journal of Medical Ethics (31 August 2016), Dr Zoe B. Fritz of Warwick University proposes a way to determine whether we should actively kill an "incapacitous patient", i.e., a patient that is in a permanent vegetative state, in order to harvest their organs.  Is it possible to evaluate what the "best interests" of that patient might be in order to make this decision?  Dr. Fritz suggests the use of trolley problem scenarios to help answer this question.


"In this paper, I explore under what circumstances it might be morally acceptable to transplant organs from a patient lacking capacity. I argue, with a developed hypothetical based around a mother and son, that (1) ‘Best interests’ should be interpreted broadly to include the interests that people have previously expressed in the well-being of others. It could, therefore, be in the ‘best interests’ of an unconscious patient to donate a non-vital organ to a family member. (2) Further expanding upon this case, and developing a variation on the ‘trolley problems’ I argue that where it is inevitable that an incapacitous patient is going to die—and specifically when it has been agreed through the courts that a patient in a permanent vegetative state is going to have clinically assisted nutrition and hydration withdrawn (with the inevitable consequence of death, and causing desiccation of the organs such that they are no longer able to be donated)—it could be in a patient's best interests to actively end their life with a drug that would stop the heart both to minimise potential suffering and in order to be able to have vital organs donated. I argue that in this case the strict adherence to the distinction between acts and omissions is not in the patient's best interests and should be reconsidered."

To read the full article, click HERE

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