Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-10T17:47:25.817Z Has data issue: false hasContentIssue false

A Moral Argument against Turning Off an Implantable Cardiac Device: Why Deactivation Is a Form of Killing, Not Simply Allowing a Patient to Die

Published online by Cambridge University Press:  22 May 2019

Abstract

Image of the first page of this content. For PDF version, please use the ‘Save PDF’ preceeding this image.'
Type
Departments and Columns
Copyright
Copyright © Cambridge University Press 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Notes

1. See, for instance, Rachels, J. The End of Life: Euthanasia and Morality New York: Oxford University Press; 1986, Ch. 7;Google Scholar Brock, D. Taking human life. Ethics 1985;95:851–65.CrossRefGoogle ScholarPubMed

2. Solomon, MZ, O’Donnell, L, Jennings, B, Guilfoy, V, Wolf, SM, Nolan, K et al. Decisions near the end of life: professional views on life sustaining treatments. American Journal of Public Health 1993;83:1423;CrossRefGoogle ScholarPubMed Caralis, PV, and Hammond, JS Attitudes of medical students, house staff, and faculty physicians toward euthanasia and termination of life-sustaining treatment. Critical Care Medicine 1992;20:683–90.CrossRefGoogle Scholar More recent, if less rigorous, evidence for physician opinion on physician assisted suicide are the results of an online poll of NEJM’s USA readers, of which 67% opposed physician assisted suicide: Colbert, JA, Schulte, J, Adler, JN. Physician-Assisted suicide—polling results. New England Journal of Medicine 2013;369:e15(1).CrossRefGoogle ScholarPubMed

3. Asch, DA, Faber-Langendoen, K, Shea, JA, Christakis, NA. The sequence of withdrawing life-sustaining treatment from patients. American Journal of Medicine 1999;107:153–56.CrossRefGoogle ScholarPubMed

4. Bone, RC, Rackow, EC and Weg, JG. Ethical and moral guidelines for the initiation, continuation, and withdrawal of intensive care. Chest 90;97:949–58.CrossRefGoogle Scholar American Thoracic Society. Withholding and withdrawing life-sustaining therapy. Annals of Internal Medicine 1990;115;478–85.Google Scholar Truog, RD, Campbell, ML, Curtis, JR, Haas, CE, Luce, JM, Rubenfeld, GD et al. Recommendations for end-of-life care in the intensive care unit: A consensus statement by the American Academy of Critical Care Medicine. Critical Care Medicine 2008;36:953–63.CrossRefGoogle ScholarPubMed

5. Sulmasy, DP. Within you/without you: biotechnology, ontology, and ethics. Journal of General Internal Medicine 2008 Jan;23 Supplement 1:6972.CrossRefGoogle Scholar

6. For a recent explication of this position, see Miller, FG, Truog, RD and Brock, DW. Moral Fictions and Medical Ethics. Bioethics 2010;24:453–60.CrossRefGoogle ScholarPubMed

7. Sulmasy, DP. Killing and allowing to die: another look. Journal of Law Medicine and Ethics 1998;26:5564.CrossRefGoogle ScholarPubMed

8. Mueller, PS, Hook, CC, and Hayes, DL. Ethical analysis of withdrawal of pacemaker or implantable cardioverter-defibrillator support at the end of life. Mayo Clinic Proceedings 2003;78:959–63.CrossRefGoogle ScholarPubMed

9. Kapa, S, Mueller, PS, Hayes, DL and Asirvatham, SK. Perspectives on withdrawing pacemaker and implantable cardioverter-defibrillator therapies at end of life: Results of a survey of medical and legal professionals and patients. Mayo Clinic Proceedings 2010;85:983.CrossRefGoogle Scholar

10. See note 7, Sulmasy 1998, at 57.

11. McMahan, J. “Killing, Letting Die, and Withdrawing Aid.” Ethics 103(1993):250–79 at 262.CrossRefGoogle ScholarPubMed

12. Cf. Cartwright, N. Hunting Causes and Using Them: Approaches in Philosophy and Economics. Cambridge: Cambridge University Press, 2007;CrossRefGoogle Scholar Driver, J. Attributions of causation and moral responsibility. Moral psychology 2(2008):423–40;Google Scholar Hitchcock, C. and Knobe, J. Cause and norm. Journal of Philosophy 11(2009):587612;CrossRefGoogle Scholar Alvarez, M.Letting happen, omissions and causation.” Grazer Philosophische Studien 61(2001):6381;CrossRefGoogle Scholar and Godfrey-Smith, P. Causal pluralism. Oxford Handbook of Causation 2009:326–37.Google Scholar

13. As is suggested by recent empirical work on how people draw these distinctions. See Cushman, F., Knobe, J., & Sinnott-Armstrong, W. Moral appraisals affect doing/allowing judgments. Cognition 2008;108:281–89.CrossRefGoogle ScholarPubMed

14. Compare with Cartwright, on causation as a family resemblance concept, note #15, Cartwright 2007; and Cartwright, N. “Comments on Longworth and Weber.” Analysis Reviews 2010;70:325330.CrossRefGoogle Scholar

15. For example, Woolard, F. The Doctrine of Doing and Allowing II: The Moral Relevance of the Doing/Allowing Distinction. Philosophy Compass 2012;7:465.Google Scholar FitzPatrick, W. Intention, Permissibility and Double Effect. Oxford Studies in Normative Ethics 2012;2:97127.CrossRefGoogle Scholar