Assisted suicide should be legal

The Debbie Purdy case in the United Kingdom shows a trend where assisted suicide is a notion that is becoming more common. Moreover, as modern medical technology advances, more people are given the opportunity to live longer than they wish, which results in unnecessary pain because they have no choice but to wait until natural death. 
Governments in liberal democracies which haven’t (such as Germany and Canada) should legalize assisted suicide in the form of active euthanasia. The conditions are as follows. 1. Patients who are diagnosed to have a terminally ill disease and suffer from unbearable pain may choose to do so. 2. The patient is informed of all the consequences of euthanasia. 3. The patient needs a diagnosis from an independent doctor to see whether the patient is able to make a rational decision. 4. The patient must show his/her will to die on his/her own to show that the choice is not forced. 5. The patient must be over the legal age. 6. The patient will die by lethal injection.

Assisted suicide should be legal

Yes because... No because...

Certain people have a right to death.

Governments must strive to maximize the happiness of individuals. In doing so, death should be allowed in certain circumstances.

Death is an option that people should have because death is similar to the options we already have. We are allowed to take risky choices for our own benefit, such as tobacco, or alcohol, as long as we know the consequences of the act. Similarly, choosing death is one form of choice that has benefits with minimal risk, and we do not see why death is an exception.

Moreover, the reason why death should be an option given only to terminally ill patients is because it is an option of hope for these people compared to those who do not suffer from terminally ill diseases. People who do not have an opportunity to recover should be given the option to receive hope if they wish, just like how people who do not have terminally ill diseases already have multiple options that they can choose from. It is better if we maximize options for those who have very limited choices.

Proposition’s first justification rests on the utilitarian principle that values like ‘happiness’ and mental states like ‘hope’ can be maximised when death is an option for terminally-ill patients. The risk, they claim, is “low”, citing counter-examples such as our use of alcohol or tobacco. From all this, a right to die is derived.

This argument has been injected with three lethal flaws.

First, mildly harmful substances like bits of nicotine or tar entering your lungs do not lead to immanent death – unlike a lethal injection, so the cases are relevantly dissimilar. This is further borne out by the fact that no government legalizes drugs that have been shown to have immediate, demonstrably terrible, effects on their users (heroine, cocaine, angel dust, etc). Death is not a ‘drug’ from which one can escape, it is simply a permanent sentence.

Second, questions about how we can maximise utility in our lives presuppose that we are alive! You can only wrestle with how to “maximise hope” if you are a living, breathing person. We can only hope the proposition team does not find it surprising to learn that non-existence makes any talk of maximising happiness, in the first place, irrelevant.

Third, even if these internal contradictions were cleared up (which has not been the case as presented), a “right to die” does not necessarily follow. No clear right, not even a putative one, is automatically entailed solely by virtue of a vague reference to utilitarian instincts – indeed if we show (as our positive matter does) that the utilitarian benefits are outweighed by overriding costs, the argument falls.

Proposition needs to do more substantive work to establish the right, and the benefits derived from it. Till then, opposition continues to regard their first justification as, at best, an interesting - relevant, even - assertion, but an assertion all the same.

Assisted suicide should be legal

Yes because... No because...

Death is a form of happiness for those who choose it

Euthanasia should be legalized for the benefit of terminally-ill patients. The current policy need to be reviewed for two reasons.

Firstly, in a practical sense, governments should help out terminally-ill patients so that they can escape from unbearable pain and die with dignity. Under the status quo, patients suffer from pain 24 hours a day and seven days a week. In the cases of terminal cancer, when cancer cells reach your bones, they continue to damage your bone tissues and cause throbbing pain. Painkillers sometimes work, yet they are not perfect. Not all cancer patients can have their pain alleviated. Thus, they chronically suffer from aching diseases with no prospect of recovery. Some may feel that their body exists only to vomit at night because of the illness. Or as the pain persists, they may start to think that they exist only to die in agony on the bed. In these situations, they have no way out. They have no other option but to choose death in order to become happy about their life. When their soul is locked in a torturing body, we need to legalize euthanasia to let them pursue their happiness. We say that happiness for them is not to live longer, but to die peacefully with the help of doctors. If they can end their life by painless injection, they don’t have to writhe in agony and spend sleepless nights. They don’t have to give in to pain and have speechless days. They don’t have to be dependent upon a life-support machine and lead inhumane life. They will achieve painless death and will be happy about the ending of their life.

The second reason is philosophical. The right to death should be regarded as important as other values. Generally speaking, people believe that our right to life is an absolute value, and to live as long as possible is an overriding good in every circumstance. Life is now treated as if it is a sanctuary and nobody should violate it and choose death until nature ends your life. However, life is not an ultimate value. The weight of life varies from one person to another. In other words, life is just a relative value and thus the right to death can be one of the options for the citizens. We believe that patients who are in a permanent torture of the disease prefer peaceful death to prolonged life. We are not saying that every single patient wants death when they get terminal cancer or any other painful diseases. What we are advocating is that some patients wish to shorten their life rather than continue to suffer from the illness. Therefore, when values differ among citizens, we should respect their choice.

Proposition’s second justification has two legs: a) an empirical one – a painful state of terminal illness is an unhappy, inhumane existence; and b) a philosophical one – choosing to die is a value judgement each person should make independently.

Both legs are wobbly.

First, the empirical claim rests on one melodramatic, hypothetical description of one possible state of terminal illness. It is not anchored in any evidence-based research. The truth is that many terminally ill patients do not live in a permanent state of hell, not least because modern medicine can significantly alleviate bodily pain to levels that make a functional, happy life possible . Medical science, especially in relation to terminal illnesses (because they are ‘terminal’ and thus constantly supplied) advance very rapidly. It is perfectly possible to believe that treatments get more effective, painkillers get better, and side effects are eliminated. Examples being chemotherapy, and HIV/AIDS treatments, ESPECIALLY in the developed world (where the debate is set). In many cases terminal illnesses can move from bad (approaching hell) to entirely bearable. For instance, the body can adjust to chemotherapy, or the amount of chemotherapy needed for a cancer patient can be vastly reduced (we assume this was what they meant by ‘vomitting’). In addition, the improvements in palliative care in many developed countries further enable terminally ill patients to alleviate the effects of their illness on their lives.

All of these realities militate against the singular, hypothetical case outlined by proposition of someone who *might* be an exception to these opportunities for living a fully functional, and even happy, life despite terminal illness.

Proposition is therefore being hasty in equating ‘terminal’ with ‘hell’. Many terminally-ill cancer patients, for example, not only live productive lives; many live inspirational lives that are qualitatively desirable – and often it is the very condition of their terminal illness that becomes a catalyst for full and flourishing existence. If we incentivised the route of an early death, many of these patients may not dig deep enough into the human will to live, inadvertently robbing themselves of the possibility of extracting inspiration from their medical despair.

Second, proposition is philosophically confused. ‘Death’ is not a value at all. Death is a state of non-existence. Values are attitudes and principles which we own, and which we demonstrate in the kinds of lives we live, and the choices we make. Crucially, however, we value life, not because we think it is an unquestionable intrinsic good (as proposition wrongly guesses we might say on the opposition side), but rather for the instrumental reason that a positive attitude towards being alive is necessary to live a worthwhile life at all! A dead person, to put it bluntly, cannot even wrestle with which lifestyle choices she wants to make. So if proposition is as happy – excuse the pun – as they seem to be about proselytising the world to care more about worthwhile lives, then they had better value existence itself. But doing so logically requires an acceptance that a policy promoting death – i.e. active euthanasia – conflicts with the spirit of proposition’s own utilitarian justifications.

Assisted suicide should be legal

Yes because... No because...

Tocacco and euthanasia are not similar cases (Response to Opposition)

The opposition claims the case of tobacco and euthanasia is not similar. The underlying principle that doing what is best for the individual (which the individual decides) is similar in both cases. We are not saying that imminent death or possibilities of death should be the line drawn between what governments should do and what governments shouldn’t do.
The reason why governments allow the use of cigarettes is because people are informed of the possible consequences of the use of it. Likewise, it is justified to allow the use of euthanasia as long as we inform the consequences to the patient.

Moreover, the response from the opposition is underlined by the assumption that death does not lead to happiness. However, there is no arbitrary line about what happiness is and happiness isn’t because the line is different from person to person. Therefore, we cannot say that the option of death will not lead to happiness.

Proposition's attempt to find a unifying rationale between tobacco being allowed in liberal democracies, and their case for active euthanasia's legalization, (still) fails.

If it is true, as proposition presupposes, that the *sole* justification for allowing tobacco to be sold and used is that all harmful activities are, and/or should be, permitted by the state so long as "people are informed of the possible consequences of the use of it", then why do so many countries - including liberal democracies - outlaw the use of drugs like heroine or prevent the promotion of [ "informed"] suicide?

Proposition has a choice: either a) they can shift their analyses to the wider contention that all activities - as long as they come with a 'health warning' of sorts - should be allowed by states, or b) they need to explain away the limitation states routinely place - as a matter of fact - on the use of some substances, and the engagement in some activities, i.e. those that are so dangerous that they likely will lead to immanent death or grave medical detriment. If they choose a), we challenge them for a justification, since none has been provided. If they choose b), they need to contend with an argument that we will presently develop as to why it is morally permissible to outlaw some substances/activities. At the same time, their entire analysis hinges on the as yet undefended claim that the sufferer is making a rational, informed choice when electing euthenasia. If this is not the case, as we have already contended, then again the analogy between smoking and euthenasia is broken.

Here goes:

There is a morally relevant distinction between outlawing actions and substances that can possibly lead to either immanent death and/or very serious, debilitating health and lifestyle negatives .... and permitting the use of substances, and the engagement in activities, that have some physiological harms, but none so great as to have gravely negative and, crucially, irreversable health effects. The use of tobacco and alcohol fit the latter categories, hence they are permitted in liberal democracies.

The reason for this moral distinction is that, yes, as proposition urges, the autonomy of individuals should be respected. So of course, as a GENERAL principle, we maximise the lifestyle choices available to individuals, and it is absurd for proposition to expect us to disagree, in GENERAL. Activities that have some harms are still permitted, because 1) many have simultaneous benefits (alcohol can be relaxing; smoking cultures around cafes are partly constitutive of some persons' conception of the 'ethically good life', etc.), and 2) done in moderation, these activities need not cause irreparable physical harm - small to moderate amounts of alcohol will not ruin a life.

On the other side of the coin, we recognise the need to protect the individual from substances or activities that constitute, even in small to moderate amounts, excessive harm that could, in fact, damage the very autonomy that liberal states otherwise wish to respect. Hence substances like heroin are not allowed because they are very dangerous; they can have an irreparable effect on the very capacities that constitute your 'rational faculties', even when only small amounts are taken.

The conclusion is clear - even liberal societies draw a distinction (and rightly so) between lesser and greater harms when ranking susbtances and activities, and deciding which ones should be legally allowed. Proposition is simply disingenuous in portraying liberalism as 'everything goes':

A] that description is factually false (many liberal societies outlaw activities EVEN WHEN we 'are informed of the possible consequences') ; and

B] it is normatively limp, since proposition never substantiated this 'everything goes' interpretation of the burden that falls on a liberal state, (a burden which even that classic exponent of the moral constraints on state power, J.S.Mill, would not recognise as desirable - but that's an aside ;))

What is the connection of this lenghty dialectic between us and proposition? Simple - proposition's overall case continues to falsely rely on a misanalogy between societies that allow the use of susbstances like tobacco and alcohol, on the one hand, and the cry out for the legalization of active euthanasia, on the other.

One shot of tequila never killed anyone. We can't say the same about one shot of lethal drug.

Assisted suicide should be legal

Yes because... No because...

Euthanasia will allow doctors to pursue their primary role in society

Firstly, every patient is under different circumstances, and having more options to think what's best for patients will allow doctors to pursue their role in society. The current situation undermines the primary role of doctors, which is to think what’s best for the patient, because alleviating pain by means of euthanasia is not an option to consider. Seeking for continued life isn’t an only way to treat patients. This principle should be transformed to the one in which active euthanasia is an option. The objectives of medical treatment are to eliminate or alleviate pain and discomfort caused by illnesses. Doctors give treatment to accomplish those aims. Similarly, when possible medical treatments are exhausted, they should prepare an option to let patients die in peace in order to achieve the goals of medical professionals.

Secondly, doctors are the ones who provide the best possible treatment for patients. In principle, doctors need to cure patients so that they can meet the needs of them because meaning of “best treatment” varies according to their personal values. That is why they need to take consent of the patients before they carry out surgeries. If patients refuse to sign a contract, doctors cannot treat patients because it will contravene their will or value. For instance, patients sometimes don’t want to waste their time by undergoing operation when they will miss out on the opportunities to have presentation and get their job done. In a situation such as this, medical professionals cannot and shouldn’t perpetrate their own value of health on patients. Likewise, they need to respect the choice of active euthanasia. That is the line which medical staff should take.

The opposition might say doctors don’t have to take consent of patients when they are dying such as the case of car accident. In those emergency cases, doctors can now treat them because they are assumed to be willing to live and they simply value life over the other values. However when we know patients do not want to live anymore, doctors cannot assume that patients value life. Thus they should respond to the needs of active euthanasia. That is how they can fulfill the role of medical professionals. For those reasons, we proudly propose the motion

We welcome analyses on the issue of euthanasia from the doctor's perspective (in addition to the patient's and the family's perspectives, already discussed). Unfortunately, the crux of proposition's new argument - i.e. that "the objectives of medical treatment are to eliminate or alleviate pain and discomfort caused by illnesses" and, ergo, that doctors should have the option of euthanasia available - is weak. It rests on a flawed understanding of the professional ethics that are at the heart of the role of doctor.

FIRST, we should, of course, note that this argument - at least as it is articulated here - represents a blunt shift in the letter and spirit of proposition's case. Earlier they were at pains (so to speak) to stress that they are advocating a policy that is, in practical and justificatory terms, about allowing patients and their families the option to choose euthanasia (subject to certain qualifying criteria).

Now, however, we are told that this is about doctors having options which they, doctors, might want to apply. But this is only a real benefit for doctors if they - doctors - have exclusive control over applying this "treatment" to "alleviate pain and discomfort" in the same way as they would, for example, give you an injection of mild sedatives without your consent on the presumption that you wish not to experience pain even though you are unable to state that to be the case.

BUT ... if we stick to the *intended* application of the policy - i.e. one that makes the decision to administer the lethal injection one that lies with patient and/or family, then clearly we are not ADDING to the range of treatments available to doctors. In that sense, then, it is a gross mischaracterisation for proposition to now try and claim that their policy is one that enhances, in a meaningful and substantive way, the range of treatment options that a doctor can apply. At best, proposition's policy allows doctors to accede to a patient's *request* for active euthanasia. But it is not a form of treatment that doctors would routinely be allowed to apply.

In fact, proposition does not even tell us whether doctors would be allowed to RAISE THE OPTION with the patient, or whether doctors can only enter the ethical equation once, and if, a patient or their family raises the issue. This lack of clarity further demonstrates proposition's failure to take account of the inherent practical problems with their case: it is not obvious, from an ethical viewpoint, that it is desirable for doctors to raise this option, and conversely it is not clear whether doctors would have a right to opt out of acceding to such a request on ground of conscience, should the request be made.

Far from enhancing the range of options doctors have available for alleviating pain, therefore, proposition's argument simply provides further occassion for us to highlight the practical ethical dillemmas that they did not anticipate, and consequently had not adequately dealt with. It gives us further reason to dismiss the proposal.

****

SECOND, the argument rests on a mistaken view of what it is that professional, ethical oaths, such as the Hippocratic Oath, require of doctors. Doctors are, fundamentally, committed to saving lives. That, very simply, is the general commitment from which more specific professional rules of conduct are then derived. A rule that is antithetical to that general commitment to save lives would be unrecognisable to most, if not all, medical professional bodies.

What is tricky, of course, is that 'existence' is not co-extensive with 'happy existence'. And that, sadly, is the crux of proposition's analytic mistake - they are wrongly assuming that a doctor's duty is guarantee lives of an ideal quality. That is not so; if that were the ethical burden, then indeed it would be the case that doctors should be expected to at least wish to prescribe euthanasia to someone who lives a profoundly miserable life due to extreme poverty, for example, and who is temporarily in hospital for depression. Should the prospect of their life improving look dim, or impossible, then the duty on a doctor would, by proposition's new logic, be to wish the State would give them the "remedy" to "alleviate pain" through lethal injection in these cases too.

This is not a cynical mistranslation of proposition's case. We are aware that it is initially couched in relation to terminal illness. The example illustrates, however, just how proposition has set doctors too high a burden in terms of their medico-social role. Doctors want patients to live. If they did not, then 65% would not have voted against euthanasia at the British Medical Council debate on the matter - for example. [ And we note proposition's silence on this fact.] Yes, of course, doctors may, in terms of general moral and ethical intuitions, also desire patients to recover quickly, experience less or no pain, etc. But that is a very different set of things to desire than to wish for your patient to be non-existent.

We therefore challenge proposition to do two things. First, they need to be brave enough to admit that they are urging a new ethical principle for doctors, rather than articulating an existing one. The new ethical principle is, roughly, "We, doctors in liberal countries, are not motivated by life, but more fundamentally by quality lives ". Second, one this shift is acknowledged, in a moment of honesty, we then challenge Team Japan to develop a normative justification for why 'quality life', and not just 'life per se' is what doctor's ethics should be centred on. Along the way they should feel free to give 'quality life' some definitional meat so we can know how much pain is necessary to make euthanasia-talk permissible...

Till then, proposition's argument is unconvincingly resting on a mistaken understanding of the role of doctors in society.

Assisted suicide should be legal

Yes because... No because...

Summary from Proposition

We feel that the proposition side presented more positive matter to the table than the opposition. Specifically, there were three main issues in this debate in which the proposition won.

The first issue is whether the right to death should be given as a choice to terminally ill patients.

We argued that the only hope for certain patients with unbearable pain is to choose death as an option. Of course, it must have been ludicrous for us to say "everything should be allowed for everyone" as the opposition argued throughout this debate. We have shown you that the right to death should be given to citizens, but it needs to be limited to patients who have terminal illness and incredible pain because the option is hope for these people.

The opposition tried in vain to deny our philosophy by presenting loads of general rebuttals as to why we should ban things like lethal drugs. However, what they did not do is argue why death shouldn’t be given as a choice, especially for citizens who are suffering from a terminally ill disease.

Moreover, another reason why we should allow the right is because the perception of death depends on person to person. If the benefit from death outweighs the benefit from living, then patients will choose euthanasia, and vise versa. The opposition’s assumption is that death is not a value for happiness, but we cannot determine what happiness is for each individual.

There is clear distinction between those who have painful diseases and who don't, and those who don't have a hope to live and who do or could have one.

The second issue is whether patients will be able to make the best choice for themselves.
The environment, doctors and families affect the decision making of patients who suffer from incurable pain and want to die peacefully. We analyzed in our point that

The first clash is whether or not the environment will allow the patient to make a rational choice. We argued that medical professionals have the capability and experience to decide whether the patient is rational. Moreover, if the patient feels that pain is a detrimental harm for him/herself, we think it is normal for that patient to choose death to alleviate it. If that is in the best interest of the patient after hearing what euthanasia is from the doctor, then we do not think it’s a problem. Just because you are alive doesn’t guarantee a good quality of life, which the opposition assumed throughout this round.

The second clash is whether or not doctors will hinder making the best choice for the patient. Doctors follow a certain code of conduct to become professionals, and they do have the morality to keep this conduct, just how we showed you in our example in our rebuttal. However, the opposition ended their response with claims and statistics without analysis of the reason why doctors act against their obligations.

The third clash is whether families have a positive or negative effect on the decision making of the patient. We argued that most families think about the patient first, and don’t have financial problems. The opposition conceded, and we believe families have a bigger possibility of having a good effect is higher.

Opposition claimed that modern technologies enable us to eliminate these situations. Having said that, if they wanted to completely deny our second point, they needed to show us why their cutting-edge medicine is the best choice that patients have in all circumstances.

The third issue is about whether this model will have an effect on society. First, we never saw a clear reason why this model is going to affect the decision making of rare 50-50 suicidal cases, which the opposition conceded. We do not think this is a strong reason why euthanasia should not be legalized. Netherlands never saw an increasing amount of deaths after legalization, which proves that this argument is unrealistic.

Assisted suicide should be legal

Yes because... No because...

The policy of allowing active euthanasia is fraught with fatal practical weaknesses

There are three fatal analytical failures in their first point.
Firstly, the opposition is wary about the abuse by doctors because of their moral objection. Yet, this is not the case. Doctors will not abuse their right based on their morality and thus will make fair judgment about patients’ rational status. The reason for it is that professional obligation as a doctor will be prioritized over their moral objection to euthanasia. For example, as the status quo shows that pro-euthanasia doctors do not carry out lethal injections even if patients might ask them to do so. This is simply because doctors keep the codes to maintain their professional status, and they never stick to their own morality because it would undermine their post as a doctor. Therefore, when we legalize euthanasia, doctors won’t make unfair judgment in diagnosing patients. Even if doctors abuse their right, which the opposition unnecessarily fears, those cases will be very rare because that kind of abuse is too high a price to pay for doctors who want to maintain their occupation.
The second question is about less abusive cases where doctors will (a) put pressure on or (b) give advice to patients to choose euthanasia.

We do not believe this problem would occur because doctors will persuade patients to choose death in vain. This is firstly because our case excludes the cases of “forced choices”. When patients say “I was forced to take euthanasia by a doctor,” those selfish doctors will not be able to carry out injection. The second reason is that they will not be persuaded by doctors to die when they really do not want to do so. Persuasion by medical staff will be unsuccessful because death is an important phase for human beings and patients will not choose death just for doctors who are not close to patients.
Giving advice to patients is not a bad act at all as long as patients make a decision by themselves in the end. If patients wish to live as long as they can, they will ask doctors to treat them and appropriate medical treatment will be given.

For the two reasons shown above, doctors will act responsibly and appropriately. Thus, our case is superior in a sense that we can rightly respect the choice of patients.

Thirdly, more patients will be able to make a rational decision than the opposition thinks. They will think seriously about choosing euthanasia, for example, from at the point when they are diagnosed as incurable illness. A case in point is Debby Purdy. She has started to consider euthanasia as an option before she gets a chronic pain by multiple sclerosis. In those cases, they are not rushing to die, and their choice will never be an irrational choice. Furthermore, having a chronic pain is exactly when patient’s value of life is overridden by the value of peaceful death. And patients are rational because they can make value judgment. The reason why we limit the cases of a state of coma or mental illness is that there is no knowing the real will of patients when we carry out lethal injection. Altouhg it might be possible to record their will to die before they get into those kinds of state, we cannot know their will at the point of euthanasia and the risks of being against the patient’s will remain. That is why we do not think our case overly limits the candidates of active euthanasia.

Even if what they said was true, we don't think its an important aspect in this debate because practical fatalities cannot justify why we <i>should not</i> legalize euthanasia.

Proposition’s policy will likely have many adverse effects when implemented, such that it is worth opposing it, regardless the normative flaws in their reasons for the policy. Here are the most serious problems:

1) It is unclear what counts as the capacity to make a ‘rational’ choice. So if the aim of the policy is to empower citizens (that is not clear), then allowing doctors to make decisions about the rational capacity of a patient, can be problematic, barring obvious cases such as a state of coma, mental illness and the like.

Two practical difficulties follow.

A) In difficult cases, a doctor who has moral objections, for example, can simply argue the patient is not rational. The policy has no safeguard against this abuse.

B) In addition, and less abusively, there can also be undue pressure on doctors to co-experience the anxieties of the patient: doctors suffer hugely when dealing with terminally ilI patients because of the nature of the disease. Thus some become incentivized to prescribe euthanasia as a treatment, because it limits their experience of the suffering. This is clearly not right – the ‘choice to die’ is being made by the doctor who does not have to suffer the consequences.

Conversely, doctors do not wish to experience this burden. It is unsurprising, for example, that some 65% of British doctors who are members of the British Medical Association have previously voted against assisted suicide. [ [ http://news.bbc.co.uk/2/hi/health/5123974.stm ] ]

2) Proposition clearly define the motion to only cases where there is terminal illness AND incredible, unbearable pain. Thus the policy will apply to only a few cases, because pain will invariably be cyclical rather than constant.

What is even more odd, then, is that the proposition limits the debate to people who are ‘rational’ and ‘fully informed of the consequences of euthanasia’. This is almost certainly going to limit the pool of candidates to near zero – people who are suffering unbearable pain at one moment in time will never be ‘aware’ of the consequences because death appears not as ‘death’ but as ‘no more pain’. Thus they lose sight of what they are really choosing, and the rational choice becomes moot.

Of course, we in opposition welcome this policy design flaw, since it unintentionally will save lives! But that was not by design: proposition evidently failed to appreciate that they are undercutting their own aim of making choices to die available to as many terminally ill patients with rational capacity as possible. But if so few people will even qualify by the lights of proposition's technical criteria, then surely we should ditch the policy entirely, given the overriding practical and ethical counter-considerations flowing througout our opposition analyses? The gains are simply not big enough.

3) Finally, the policy fails to take account of the enormous emotional and financial pressure that many patients will be under to choose death. If you know your family is suffering, for example, under the weight of your medical costs, you may choose to die, not because you want to, but because of a sense of guilt. Proposition fails to build in safe-guards against these unconscionable situations, which will reasonably arrive.

Assisted suicide should be legal

Yes because... No because...

Euthanasia legitmizes suicide - undesirably so

Just because there is an increasing number of suicides does not justify why we shouldn’t adopt euthanasia.
The reason why people commit suicide (which the opposition have not analyzed) is because people feel depressed due to social circumstances, such as “romantic rejection, problems with peers, or failing a big exam”. [http://www.handsonhealth-sc.org/page.php?id=964].
Therefore, suicide and euthanasia are irrelevant issues, and the opposition side is only using the word ‘suicide’ as a metaphor.

Moreover, it is extremely difficult for terminally ill patients to live a “happy, productive, worthwhile” human life if they do not see signs of cure.

Taking this model will not affect 50-50 suicide cases. People who are depressed can seek help from councilors if necessary. Moreover, for those who are well alive, death is not an easy option to make compared to terminally ill patients, who are facing death at that moment.

Government actions towards terminally ill patients will not affect ordinary citizens because ordinary citizens are not the targets of the proposal. Therefore, we don’t think this will change values in society. Even if it did, how many 50-50 suicide cases exist?

First, developed world countries have recently seen an increase in the number of suicides happening in their populations, specifically of young adults. This has been extensively documented and researched by organisations such as the International Association for Suicide Prevention working with the World Health Organisation
[ [ http://www.iasp.info/index.php ] ] Suicide is a bad thing; it steals human lives that could be happy, productive, worthwhile.

Second, the state, by legalizing euthanasia, sends a direct message about the value of human life to people who might be 50-50 suicide cases. The message is, principally, that a personal desire to avoid pain or sadness (note – this is exactly the Prop’s argument) trumps the importance of life. Regardless of any utilitarian argument for a right to life, this surely shows that imbuing in people a sense of the primacy of immediate personal desires can only be foolish. It is evident that Government actions can seriously change social opinions and beliefs, and can breed specifically dangerous cultures.

Third, we reject any policy that has seriously minimal benefits (as theirs evidently does, by being so restrictive), when it can cause so much harm to young people and their families.

Assisted suicide should be legal

Yes because... No because...

Euthanasia will have a severely negative impact on family dynamics

Euthanasia is not the cause of instability in family dynamics. Not allowing the option of euthanasia is the cause of instability.
First, families are not egoistic. Families can understand that death is the best option for the patient. Families get hurt not based on whether the patient is alive or dead, but whether the patient can live a good life or not. Therefore, euthanasia will not hurt families.

Not all families have financial issues. Families that do, however, will at least look as if they are caring for the patient, even if they are motivated by financial incentives. The important point is whether the patient can have a peaceful death.

Allowing euthanasia brings benefits for the family in emotional terms. Euthanasia gives opportunities to say goodbye to the patients, which will relieve the burden of families. Also, euthanasia allows time for families to prepare for death, which is better than unexpected death. [http://www.bmj.com/cgi/content/full/327/7408/189]
If we compare the situation under the status quo, families will not be able to prepare for death because they will not be able to predict when the patient will die.

Euthanasia is likely to hurt families hugely (because their loved ones are choosing to die, expressing a preference for death over living with their families). This builds unfair pressure on families to advise their loved ones about death. How can you responsibly give guidance to your brother or mother or daughter about euthanasia? The advice will always be perverted by (a) your love for them, (b) your desire to get your hands on their estate, etc. In turn, loved ones themselves will enter the calculus with the enormous emotional weight of guilt, for example, associated with seeing your family members under severe stress financially and emotionally.

These facts all conduce to familial dynamics that will likely be unduly emotionally taxing on each of the members involved in the situation. By categorically not allowing active euthanasia at all, the state would instead be signalling its profound psychological and social appreciation that it does not want to promote social policies that lead to these kind of morally perverted means-end reasoning within families.

Opposition therefore moves that active euthanasia should not be legalized in any country.

Assisted suicide should be legal

Yes because... No because...

Patients will rarely be able to make a good, rational decision (response to Proposition rebuttal)

Opposition's case hinges on the assumption that terminally ill patients suffering huge amounts of pain (as their policy specifies) will be able to make good, rational decisions about euthanasia.

While we concede that in a very small minority of cases patients will begin to consider euthanasia when they are first diagnosed with a terminal illness, it is clear that proposition's very policy predicts against this. Proposition is only willing to consider patients who are already feeling serious pain, so those who have just been diagnosed will rarely perceive any immediate reason to consider their long term options. The majority of patients will end up in hospital beds, during the worst parts of their illnesses, taking this decision. That, we argue, predicts for bad, and crucially, irreversable, decision making.

Moreover, proposition has failed to respond to the analytical substance of our argument. We showed that people will begin to view euthanasia not as death (which it is), but as an escape from pain in the present. This skewing of the patients' perceptions implies that the decision will be made on 'bad information', a hallmark of a bad decision. Thus proposition's simple 'aggregation of costs and benefits' does not hold, because the decision maker is unaware of the extent of the costs. Until this is rebutted, proposition's case must fall.

The extent of proposition's response to our argument of medical abuse is almost humorous. Effectively they are arguing that doctors will be frightened of losing their right to practise if they determine that a patient is 'not rational' and thus cannot be euthenised. First, we think it is ridiculous that proposition expects doctors to simply shelve their morals and values. In fact many doctors become doctors because they value life and are very intent on saving as many lives as possible. There are numerous cases of doctors acting outside of the law in an attempt to do what they feel is right - they shuffle patients around organ transplant registers, they prescribe drugs (or dosages thereof) that, legally, should not be prescribed, and they treat people for diseases that governments refuse to admit exist (in South Africa, for example, doctors campaigned against Thabo Mbeki's AIDS denialism). Second, the argument hinges on the assumption that the doctors might actually be held accountable for malpractice. This is highly unlikely because it is (a) expensive and time consuming, (b) this is a really insignificant type of malpractice because it puts no one at risk, and (c) it is near impossible to prove that someone is 'rational' or 'irrational', it is merely a doctor's opinion. Hospitals and health departments are unlikely to sack perfectly good doctors (who are a scarce resource) over non-hurtful malpractice. Third, proposition concedes that doctors will 'advise' patients. This is the type of 'force' we are speaking about, not doctors manhandling patients and 'making them choose euthanasia'. Doctors, who are in a natural position of authority and power, will almost certainly put a particular slant on the advice they give.

Clearly there are two conclusions to be drawn:

(a) Patients are unlikely to make a good, rational choice. Because that choice is irreversable, we must err on the side of caution and not legalize euthanasia.

(b) Doctors will likely abuse the situation in a variety of ways. Considering the gravity of the choice at hand, this abuse must be avoided at all costs, and euthanasia must not be allowed.

Assisted suicide should be legal

Yes because... No because...

The social consequences of legalizing euthanasia are irresponsibly dangerous (response to Proposition rebuttal)

Proposition does not fear a spike in the number of suicides in society as a result of legalizing euthanasia. They are confident that the 'issues' faced by (a) suicidal people and (b) euthanasia-preferring people are very different, and that this difference implies that the government's stance on euthanasia will have no effect on marginal suicide cases. Again the error here is that proposition has not examined our actual analysis and so the rebuttal outlined above does not stand. Our argument is that legalizing euthanasia breeds a culture of accepting that death is a legitimate alternative to sufficiently large personal challenges, regardless of what those challenges are. The same emotional mechanism is in place in both euthanasia and suicide - a belief that to die would be better than to continue living in adversity.

Until the proposition engages with the actual thrust of our argument, we can only assume that this dangerous social message continues, and that it implies that we should reject euthanasia.

Proposition's response to our second argument, that of family stress, hinges on two points: (a) a denial of selfishness in families, and (b) a small research study that suggests that having a chance to say 'goodbye' to your loved one helps the grieving process.

To the first point we would simply say that proposition is deluded. Most people are fairly selfish, and self worth is usually determined by what others (especially their families) think of them. To assume that people will not be affected by this is ridiculous. Moreover, when they are affected by these sorts of pressures, they will give bad, perverted advice, again skewing the supposedly rational decision. While we agree that not all families have financial 'issues', those that do may well find this a dangerously irresistable lure, and might support euthanasia for this reason.

To the second point we would first suggest that the research study is (a) based on a very small (and uneven) sample, leading us to question its objective validity, and (b) has a number of flaws relating to methodology and causality. No where in the paper is it shown that the 'better grieving process' is actually caused by euthanasia, merely that there is a corrolation. As the authors themselves note, this is quite likely down to am endogeneity problem - families who would select euthanasia are probably just be healthier families in general. What the study does not measure is the damage caused by facing the OPTION of euthanasia. In fact, it might be that the grief of those who did not choose euthanasia was in fact substantively worsened by the fact that they were made to choose life or death in a very immediate sense. Finally, we question the measurements made by the researchers. They measure grief at the point of death, rather than in the build up to it. This may bias towards euthanasia because people begin grieving earlier, and thus, when death occurs, they are part way through the grieving process. The result of this analytical consideration is that the grieving process is in no real way altered by euthanasia.

We see no reason why euthanasia would bring about positive social changes, and instead see a number of substantial dangers. We must vigorously reject its legalization.

Assisted suicide should be legal

Yes because... No because...

It is practically, philosophically, and sociologically untenable [ OPPOSITION SUMMARY]

The battle lines in this debate are clear. Opposition has clashed directly with proposition’s case by arguing that liberal democracies should not legalize active euthanasia under any circumstances. Proposition, in their turn, have tried, and failed, to build a case for (a very limited number of) specific situations in which euthanasia should be applied.

The debate hinges on three sets of concerns: practical, philosophical, and sociological.

As the debate unfolded, proposition inadvertently started to realise that, despite their highly prescriptive and limiting policy, they had not thought through the inherent practical difficulties of their case. And so, in a debating 101 move, they added for good measure that “practical difficulties cannot justify why we should not legalize euthanasia.” Nonsense!

For one thing, you cannot have your cake and it eat. The very policy outlined right at the start of their journey was at pains to put the practical nuts and bolts into place, while their core argumentative premise spoke directly to the practical conditions of terminally ill patients. This speaks to a case deliberately set-up as not solely normative, but indeed principally practical. So opposition reserves, as we will do shortly, the right to unpick the practical weaknesses that have stood right till the end.

Further, even if proposition wanted to define the debate as a solely normative one – which they did not do – we would have challenged that kind of unreasonable circumscription on an issue that is inherently an applied ethical dilemma for societies – the question of euthanasia is not (solely) an exercise in normative thought for bored philosophy types.

So, let’s get on with evaluating the first big question: which side was more convincing on matters practical?

Opposition, clearly. We pointed, consistently, to the fact that proposition’s case, at the end of the day, will have very few benefits but a range of overriding negative consequences that stem from unanswered practical concerns. For example, evaluating what counts as being rational is a tough, subjective process. Further, the very real likelihood of mental states like ‘guilt’ affecting a patient’s reasoning in the face of financial and emotional/familial pressures, may make them sign on to a choice to die under the appearance of rationality, while in fact their choice is due to these underlying mala fide influences. Even on the doctors’ front of this debate, doctors’ own desire to NOT be forced into the ethical equation, was simply ignored by proposition. Simply asserting these difficulties away is insufficient, and so we must conclude that they have not been dealt with cogently. Opposition’s concerns about the fatal practical design weaknesses in the policy, remains.

The second big issue is philosophical. Here the proposition’s case has become a tissue of philosophical problems. The crux of their case hinged on the misanalogy between societies currently allowing some harms, and the need to include euthanasia as yet another harmful activity we can, with full information, reasonably opt into. It is almost embarrassing to have had to spell out in detail just how dissimilar the lighting up of a cigarette is from taking a lethal injection. But we did so, and the point was never properly contested by proposition, so the misanalogy remains, undercutting proposition's best efforts. At bottom, proposition’s philosophical confusion stemmed from not realising that desiring non-existence is a desire not quite in the spirit of what we all take utilitarianism to mean. Existence is a precondition for freedom, and a precondition for happiness, and a precondition for rational choices about values to be made. To desire non-existence is not an exercise in utility maximisation; it defeats the spirit, and letter, as we consistently pointed out, of the very utilitarian reasoning that permeates proposition’s case.

Finally, although these internal problems suffice for proposition’s case to be dismissed, we turn to the question of sociological consequences. We remind e-judges, for good measure, that opposition’s two additional positive lines of argument still stand. Much like the other arguments in this debate, proposition attended to these with straw men and vast bouquets of asserted material. This is apparent, first, on the issue of suicide: We never contended, as their straw man might suggest, that marginal cases of suicide will directly become actual cases of suicide the day euthanasia is legalised. Our analysis of the social mechanisms at play is far more subtle – over time, as opting for death over personal strife becomes a socio-cultural norm, then indeed it WILL be the case that attitudes towards suicide could soften. The risk is that, in the end, we breed a society in which those 50-50 cases of suicide might just choose death over life. That is undesirable, again motivating a society in which euthanasia is not an option. Proposition's response to our second concern, that of family relations, was similar: We happily concede that not all families have financial and emotional problems. Proposition missed our point - the mere talk of death as a possibility for one’s loved ones will strain relationships and lead to unconscionable familial discussions. These, in turn, could irreparably damage family dynamics.

It is clear that these two social concerns are entirely undesirable, reaffirming our position in the negative.

Choosing death is an irreversable decision which clots the very lifeblood of liberty - choice; as a result it falls outside the ambit of Millian liberalism. Similarly, the practical and sociological concerns are vast and undeniable. All in all, the debate surely falls on side opposition.

Debates > Assisted suicide should be legal