Strengthening the ethical distinction between euthanasia, palliative opioid use and palliative sedation

• Published in: Journal of medical ethics 2020-01, Vol.46 (1), p.57-58
• Main Author: Symons, Xavier
• Format: Article
• Language: English
• Subjects: Anesthesia; Assisted suicide; Bioethics; Ethics; Euthanasia; Medical ethics; Morality; Narcotics; Pain; Pain management; Palliative care; Philosophy; Suicides & suicide attempts
• ISSN: 0306-6800; 1473-4257
• DOI: 10.1136/medethics-2019-105519

Correspondence to Mr Xavier Symons, Institute for Ethics and Society, University of Notre Dame Australia, Sydney, New South Wales 2007, Australia; [e-mail] Introduction Thomas Riisfeldt’s essay1 is a valuable contribution to the literature on palliative sedation, appropriately titrated administration of opioids (ATAOs) and euthanasia. The author claims that ‘the intrinsic criterion is derived from deontology, the predominant form of which is championed by Kant’, and that ‘the proportionality criterion is derived from consequentialism, the predominant form of which is the "classical utilitarianism" championed by Mill’ (p.128).1 These statements are anachronistic. On a Kantian framework, the right making feature of an action is whether it is in accord with moral ordinances issuing from practical reason.2 The good outcomes of an action are irrelevant. [...]it is incoherent to talk of the rightness or wrongness of an action being contingent on outcomes. The circumstances of an act include factors such as who performed the act, where and when the act was performed, the means used to perform the act, the manner in which the act was performed and with what outcome.5 On a Thomistic framework, a morally neutral or morally good act may be made impermissible depending on the outcomes of an act. [...]the act of going for a hike in the mountains is morally neutral.