C. G. Prado, choosing to die: elective death and multiculturalism

Journal ArticleThe central practical issue that this thorough, stimulating, and important book addresses is whether suicide can be rational in the context of terminal illness. Answers to this issue can be readily formulated in the familiar context of western political thought, with its liberal paradigm of autonomy: yes, suicide can be rational if elected in a clear-thinking, voluntary way, without pressure or undue influence, external or internal, and with full information, but without other impairment; or no, suicide is irrational, since it may be based on a narrow, pessimistic view of one's future, on short discounts and high emotionality, or because it fails to recognize the impossibility of discerning what (if anything) comes after death

Terminal sedation: pulling the sheet over our eyes

Journal ArticleTerminal sedation-also called "palliative sedation," "continuous deep sedation," or "primary deep continuous sedation"-has become a new favorite in end-of-life care, a seeming compromise in the debate over physician-assisted dying. Like all compromises, it offers something to each side of a dispute. But it is not a real down-the-middle compromise. It sells out on most of the things that may be important-to both sides. To corrupt an already awkward metaphor, terminal sedation pulls the sheet over our eyes. Terminal sedation may still be an important option in end-of-life care, but we should not present it as the only option in difficult deaths

Dreariness of aesthetics (continued), with a remedy

Journal ArticleIn 1951, J. A. Passmore shamelessly titled an essay "The Dreariness of Aesthetics." Drawing on John Wisdom's earlier complaints, he denounced aesthetics' dullness, its pretentiousness, and the fact that it was "peculiarly unilluminating." What Passmore had in mind were the vapid abstractions and metaphysical hyperbole involved in "saying nothing in the most pretentious possible way"; he thought aesthetics wasn't in touch enough with the real world of the specific, different arts. He was right. But while in the intervening years aesthetics has changed course and this complaint has largely been heeded, Passmore's uncompromising title can still provoke a ripple of embarrassment among aestheticians who suspect that the accusation might be true

On being blue, a philosophical inquiry by William Gass

Journal ArticleOn Being Blue is a remarkable piece of rumination: it toes, wades, pulls its skirt up and immerses itself in the word 'blue.' Blue noses, blue laws, blue devils, blueblood; Gass begins by producing wonder, and we say: / didn't know the word 'blue' could be used in so many different ways. Bluebird, blue coats, blue collar, bluing. . . . Gass' work is first, then, an homage to the word 'blue'-a celebration of it, in all its astonishing multiplicity. Much of the book consists of just this: in bathing in the word 'blue'

On the relationship between suicide-prevention and suicide-advocacy groups

Journal ArticleLargely in response to contemporary medicine's advancing technological capacities to extend the process of dying to extraordinary lengths, recent years have seen the emergence of numerous advocacy groups concerned with what is often called "death with dignity." For instance, the New York-based group, Concern for Dying, distributes the Living Will as a means for individuals to secure their right to refuse unwanted, life-prolonging medical treatment. Another New York group, the Society for the Right to Die, lobbies for passage of "natural death" legislation, and has seen passage of Natural Death Acts in California and ten other U.S. states, and legislative consideration of similar bills in another twenty-seven. The Los Angeles-area group, Hemlock, led by a British writer who helped his cancer-striken wife drink a lethal potion, argues for societal recognition of assisted suicide as an option in terminal illness. Britain's Voluntary Euthanasia Society, once renamed EXIT: The Society for the Right to Die with Dignity, has published and distributed to its members a booklet of suicide methods for use by terminally ill persons; a similar book has become commercially available in France. Nor are such groups a local phenomenon; they are emerging world-wide. Although their views range from quite conservative insistence on passive refusal of treatment to radical suicide-advocacy, there are new voluntary euthanasia societies in Australia, Norway, Sweden, Japan, Denmark, New Zealand, South Africa, Holland, Germany, France, Colombia, Zimbabwe, Canada, India, and Switzerland

Seven (more) caveats concerning the discussion of euthanasia in the Netherlands

Journal ArticleDiscussion in the U.S. about euthanasia in the Netherlands is characterized by profound disagreement, both about what the practice actually is and what risks it involves. Some time ago, I put together a little list1 of seven warnings for bioethicists embroiled in this discussion-things one ought to keep in mind in order to avoid the kinds of basic misunderstandings that have been so prevalent in the discussions about Holland, and that contribute so dramatically to polarization

Suicide and ethical theory

Journal ArticleExcept in the present century, suicide has been viewed throughout Western history as an act having ethical significance, one for which moral blame or praise was a proper response. Response, of course, varied with the times. During the Stoic era of Greece and Rome, suicide was praised as the morally responsible act of the wise man. During the medieval Christian era, it was blamed as the most reprehensible of sins. With the influence of Durkheim and Esquirol at the close of the 19th century, however, the old ethical view of suicide was replaced by a newer, scientific one. Suicide came to be seen as the result of sociological and psychological conditions for which the person could not be held responsible, and for which neither blame nor praise would therefore be appropriate

Seven caveats concerning the discussion of euthanasia in Holland

Journal ArticleAs the discussion of voluntary active euthanasia heats up in the United States (indeed, I believe it will be the major social issue of the next decade, replacing abortion in that role), increasing attention is being given to its practice in the Netherlands. Proponents of the view that the United States should legalize euthanasia (as legislation being proposed by the Hemlock Society in California, Oregon, and Washington would do) often cite the Netherlands as a model of practice; opponents, on the other hand, claim that Dutch practice already involves widespread abuse and will inevitably lead to more. For the most part, these generalizations invite misunderstanding, and they often reflect only the antecedent biases of those who make them. I would like to offer a few caveats for bioethicists about to become embroiled in t h e discussion of euthanasia?caveats offered in the hope of contributing to better mutual understanding during the next decade, rather than to greater polarization

Cases for kids: using puzzles to teach aesthetics to children

Journal ArticleNothing stupefies kids (I have in mind young people, though the same is true of many adults) as quickly as long-winded, jargon-filled, highly abstract theoretical discourse, especially when it seems to have no immediate utility. Kids like fun. They like play; they like games; they like challenges and puzzles; and they detest pompous academic abstractions. But if this is so, then it is easy to understand why aesthetics--this most abstract, theoretical, and sometimes pompous field of the art-related academic disciplines -- would seem completely unsuitable for teaching to children. After all, just picture yourself lecturing, say, on the aesthetics of Kant (skirting, of course, the full scholarly complexity of the Critique of Judgment), or on Santayana, or on Clive Bell, or any other major figure in the history of aesthetics--even if you try to buy relevance by jazzing it up with a couple of references to comic-book art or rap tunes--and you see a roomful of squirming, restless, utterly bored kids, eager for you to quit. Perhaps all you do is try to explain how some people think that art is the expression of feelings or that beauty is "really real" but you still may get the same apathetic response. "So what," the kids will say, "who cares?" But now picture a child faced with a genuine puzzle--a puzzle that does not depend on abstract terminology, scholarly tradition, or extensive background information, but a puzzle that presents a real problem, here and now. If you can get the child to see the puzzle so that it makes him or her think, you are in effect home free. With a bit of adroit guidance in the form of further, prodding questions, the child will do the rest--that is, try to figure the puzzle out

High-risk religion

Journal ArticleAmong some of the more colorful groups on the American religious spectrum, the religious faith of believers seems to involve a willingness to take substantial physical risks"risks to health, to physical functioning, even the risk of death. These groups include several in which the risks a believer takes are indirect (as in refusing blood transfusions or in refusing all medical treatment), and a few in which the risks are immediate and direct (for instance, in handling live poisonous snakes). We may think of these practices as extraordinary tests of religious commitment, or we may think of this willingness to risk death as a demonstration of the extraordinary value religious goals can have for believers. Indeed, willingness to risk death for religious reasons is often extolled as the highest test of faith. But I also think that the willingness o f the members of religious groups to risk death reveals a set of disturbing moral issues, issues concerning the ways in which religious groups "bring it about" that their adherents are willing to take such risks. In what follows, I want to take a careful look at the influence of religious groups on their adherents' choices, focusing on high-risk decision making which can result in death. To address these issues is not to suggest that a religious believer's willingness to risk death may not be sincere and devout, but rather to cast a morally skeptical eye on the way in which these sincere, devout beliefs are engendered by the religious institutions within which they arise