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Assisted Death: A Study in Ethics and Law [Hardcover]

L. W. Sumner

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Book Description

Aug. 7 2011
Ethical and legal issues concerning physician-assisted suicide and euthanasia are very much on the public agenda in many jurisdictions. In this timely book L.W. Sumner addresses these issues within the wider context of palliative care for patients in the dying process. His ethical conclusion is that a bright line between assisted death and other widely accepted end-of-life practices, including the withdrawal of life-sustaining treatment, pain control through high-dose opioids, and terminal sedation, cannot be justified. In the course of the ethical argument many familiar themes are given careful and thorough treatment: conceptions of death, the badness of death, the wrongness of killing, informed consent and refusal, the ethics of suicide, cause of death, the double effect, the sanctity of life, the 'active/passive' distinction, advance directives, and nonvoluntary euthanasia. The legal discussion opens with a survey of some prominent prohibitionist and regulatory regimes and then outlines a model regulatory policy for assisted death. Sumner concludes by defending this policy against a wide range of common objections, including those which appeal to slippery slopes or the possibility of abuse, and by asking how the transition to a regulatory regime might be managed in three common law prohibitionist jurisdictions.

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Review

the target audience extends beyond professional philosophers, and the aim is not merely to understand the situation but to change it. This is altogether laudable, and some pulling of punches might help. And what might well be hoped for this very good book careful, modest, wellstructured throughout is that its importance is not long-lasting and that it helps bring about its own demise. Christopher Belshaw, The Philosophical Quarterly Lucid and powerful... Sumner's book provides a superb example of the relevance of philosophy to public policy. Thomas Nagel, London Review of Books

About the Author

L.W. Sumner is University Professor Emeritus in the Department of Philosophy at the University of Toronto. He is the author of four books: Abortion and Moral Theory (1981); The Moral Foundation of Rights (1987); Welfare, Ethics, and Happiness (1996); and The Hateful and the Obscene: Studies in the Limits of Free Expression (2004). He is a Fellow of the Royal Society of Canada and recipient of the 2009 Molson Prize in Social Sciences and Humanities from the Canada Council for the Arts.

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Front Cover | Copyright | Table of Contents | Excerpt | Index
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Amazon.com: 4.3 out of 5 stars  3 reviews
1 of 1 people found the following review helpful
4.0 out of 5 stars Making Wise Medical Choices at the End of Life May 20 2013
By James L. Park - Published on Amazon.com
Format:Hardcover
L. W. Sumner

Assisted Death:
A Study in Ethics and Law

(New York: Oxford Unitersity Press, 2011) 236 pages
(ISBN: 978-0-19-960798-3; hardcover)
(Library of Congress call number: K5178.S86 2011)
(Medical call number: WB33.1S955a 2011)

A careful philosophical exploration of end-of-life medical choices,
which are intended or forseen to shorten the process of dying:
1. 'euthansia' and 'physician-assisted suicide';
2. using pain-killers with the knowledge that vital functions will probably be suppressed;
3. terminal sedation--keeping the patient continuously unconscious until death;
4. terminal dehydration--giving up all food and water, however provided.

Specific chapters discuss these important themes:
(2) patient consent and/or refusal of medical treatments.
(3) using pain-relieving drugs with the purpose of reducing suffering
and/or the intention of bringing death;
(4) evaluating and responding to patient requests for death;
(5) deciding death for others.

Part II deals with the attempts to control end-of-life choices
using various laws and regulations.

Almost all laws dealing with life-ending decisions
focus just on two high-profile methods of choosing death:
(1) 'euthanasia'--the doctor gives a lethal injection;
(2) 'physician-assisted suicide'--the doctor prescribes a gentle poison.
But even in jurisdictions where both of these life-ending options
have been available for many years,
less than 2% of all deaths are achieved by these methods.

Many more deaths are achieved by other methods,
which have the same result--death--but have not been controversial:
(1) ending all curative treatment and life-support systems;
(2) increasing pain-killing drugs to relief suffering
with the knowledge that the process of dying will also be shortened;
(3) choosing terminal sedation
--keeping the patient continuously unconscious until natural death; &
(4) giving up all food and water
--which will result in death by dehydration within a few days.

Because these four additional methods of choosing death
have not been thoroly discussed or studied,
we do not have precise data about how often they occur.
Also, these additional methods of dying are often combined.
In fact, it would be possible to use all four at once.

Even in locations where the controversial methods are banned,
doctors are already recommending these methods of choosing death
when the patient faces the last few days in the hospital.
When we ourselves are on our death-beds,
we already do have these possible methods of dying.

This book supports the right-to-die
and proposes some common-sense methods of preventing abuses and mistakes.
It should be read by careful students of choices at the end of life.

James Leonard Park, advocate of the right-to-die with careful safeguards
and author of How to Die: Safeguards for Life-Ending Decisions
1 of 1 people found the following review helpful
5.0 out of 5 stars Great end of life discussion!! Jan. 4 2013
By Richard R. Stenton - Published on Amazon.com
Format:Hardcover|Verified Purchase
This topic is one of great interest to me and should be a topic of conversation with everyone as our medical costs sky rocket. Also the quality of life at the end is not great and should allow for a peaceful ending. This book was one that addressed all the concerns that come up at the end of life and gives one a good picture of that part of our existence. It is good for the whole family to be involved with this decision process and what it entails--this book does a very good job!!!
1 of 3 people found the following review helpful
4.0 out of 5 stars The time to die Aug. 10 2011
By Hande Z - Published on Amazon.com
Format:Hardcover
Sumner is a 71-year old professor of philosophy in the University of Toronto who is contemplating his own death as he ages towards that direction. This book is the result of his long and serious study on the question as to whether we should be allowed by law to choose the hour and manner of our death, bearing in mind that assisted death is either suicide or euthanasia. Before he discusses the diverse approaches by legal institutions across the world, he takes us through the moral and ethical issues and how the debate takes shape. He presses forward with a clear discussion on the two concepts of death - biological (irreversible cessation of the integrated functioning of the organism) and personal (the irreversible cessation of whatever psychological states or capacities of a person). He also discusses the moral claims and justifications for the cessation of medical treatment, and importantly, what constitutes medical treatment. In many cases the action sought was the removal of feeding tubes which some regard as basic and essential requirement while others consider it a medical treatment.

Sumner makes it clear that he is in favour of autonomy and is a pro-choice proponent, but he writes clearly and objectively in presenting the best arguments from opposing sides without being judgmental. Religious people as well as non-religious people who oppose assisted suicide will not be offended by the book, and may indeed find his arguments helpful in their own positions.

Part of his discussion on the legal landscape as he calls it involved detailed studies of landmark cases such as the case of Karen Quinlen and Nancy Curzon. However, he seemed to have omitted the latest and most controversial case of Terri Schiavo. For that the reader might want to refer to Jon Eisenberg's "Right vs Right to Die", and if one wishes to read the partisan views, there is a book written by Schiavo's parents, the Schindlers, called "A Life That Matters", and one by her husband, Michael Schiavo, "Terri - The Truth". The one other drawback is the absence of an index to the book. These are two further reasons in wishing Sumner a long and healthy life so that a second edition of this marvellous book can be made even better.

As Sumner says, "Euthanasia is easiest to justify when it is voluntary, hardest when it is not." The fundamental issue is not so much about "rights" but what one's views are as to whether human life is sacred. That calls for a clear understanding as to what that word means and if there is such a thing as the sanctity of life that prohibits the taking of a life under any circumstances. Unless we clarify that, rights and wrongs about the taking of a life can be argued without conclusion. One small step to approaching death, whether we are pro-choice or pro-life, is to remember Seneca's words: "Where death is, I am not; where I am, death is not."

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