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Euthanasia, efficiency, and the historical distinction between killing a patient and allowing a patient to die
  1. J P Bishop
  1. Correspondence to:
 J P Bishop
 Peninsula Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro TR1 3HD; jeffrey.bishop{at}

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Voluntary active euthanasia and physician assisted suicide should not be legalised because too much that is important about living and dying will be lost

In the first of this two part series, I unpack the historical philosophical distinction between killing and allowing a patient to die in order to clear up the confusion that exists. Historically speaking the two kinds of actions are morally distinct because of older notions of causality and human agency. We no longer understand that distinction primarily because we have shifted our notions of causality from a traditional formulation to a modern formulation of causality and thus of moral assessment that focuses on the effects of an action. In this essay, I prepare the ground for a companion essay by showing that the traditional formulation allows us to maintain notions of meaning and purpose to human living and dying that are precluded in the efficiency paradigm of modernity. Taken together with the companion essay, I am claiming that voluntary active euthanasia (VAE) and physician assisted suicide (PAS) should not be legalised because too much that is important about dying and living will be lost.


It would be naïve to think that euthanasia, in either the VAE sense, or in the more passive sense of PAS, does not happen. It would even be naïve to think that it does not occur in a non-voluntary form. It would be equally naïve, however, to think it could be controlled through governmental regulation. The real question with regard to PAS/VAE, put so eloquently by Martha Minow, is which lie do you countenance: the lie that euthanasia does not already happen, or the lie that it can be controlled without having repercussions well beyond the limits of procedural mastery?1 With this two part paper series, I will argue that the …

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