An important part of the debate over physician-assisted suicide concerns moral duties that are specific to physicians. It is sometimes argued that physicians, by virtue of special commitments rooted in the nature of their profession, may never intentionally kill a patient, and that therefore, whether or not assisted suicide may be justifiable, it can never be right for a physician to take part in such an act. I examine four types of argument that have been offered in support of this conclusion, and find that none succeeds. Each attempts to show why the duty to conserve life must be unconditional for physicians, yet a consideration of the ways in which contemporary medicine has evolved shows that such a duty is now no more fundamental to the profession than a duty to relieve suffering, which may in some cases override it.
The authors look closely at the often cited Rule of Double Effect and argue that, in some cases, a physician can legitimately claim to have acted within the Rule's parameters. In other cases, however, physicians can abuse the notion of unintended consequences. The test case they offer concerns palliative care that causes foreseeable death.
Opponents of euthanasia sometimes argue that it is incompatible with the purpose of medicine, since physicians have an unconditional duty never to intentionally cause death. But it is not clear how such a duty could ever actually be unconditional, if due consideration is given to the moral weight of countervailing duties equally fundamental to medicine. Whether physicians' moral duties are understood as correlative with patients' moral rights or construed noncorrelatively, a doctor's obligation to abstain from intentional killing cannot be more than a defeasible duty.
J. L. A. Garcia holds that my defense of voluntary euthanasia in an earlier paper amounts to an "assault on traditional common sense" about what medical ethics permits physicians to do, particularly insofar as I hold that a physician's duty to abstain from intentionally killing is only a defeasible duty, not an unconditional one. But I argue here that it is Garcia's views that are more at odds with common sense, and that voluntary euthanasia is in fact a humane alternative that respects patient autonomy and is consistent with the most fundamental moral duties of physicians. Among these is a duty to relieve suffering, which can sometimes outweigh the fundamental duty to conserve life.
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