6th Anscombe Memorial Lecture

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6th Anscombe Memorial Lecture - Joseph Boyle

Friday, October 16, 2015

On 11 September, MPs in Westminster voted to reject the Assisted Dying (No.2) Bill by a majority of 330 votes to 118.

The legislation was criticised for failing to safeguard vulnerable people, who might feel pressured to end their life, and evidence was heard from states that have already allowed physician-assisted suicide or euthanasia.

It was therefore fitting and timely that Joseph Boyle chose the title Against 'Assisted Dying' when he gave the 6th Annual Anscombe Memorial Lecture, hosted by the Anscombe Bioethics Centre and co-sponsoredby Blackfriars, Oxford, last Tuesday, 13 October. Professor Boyle is a world expert on the philosophy of double effect, a central issue in all discussions of end-of-life medical care.

Professor Boyle began by pointing to the reasons advanced for changing the current UK law, i.e. to allow assisted suicide. In particular, proponents of assisted suicide point to the fact that suicide is not a criminal offence, and that we already recognise a right to refuse medical treatment. So there is a tension in end-of-life care, where medical decisions are often taken to reduce suffering with the concomitant effect of shortening life.

Proponents of the legal status quo, who oppose assisted suicide, point to the distinction between killing and letting die. But Professor Boyle argued this is insufficient, since the duty of care implies a consideration of consequences and effects, even double effects, on which basis one must choose to act or not to act. The real distinction needs to be made about intentions. One can intend to relieve suffering (a good intention), even if it involves drugs that may hasten death (an unintended albeit foreseeable consequence). Some philosophers do not accept that intentions are morally significant; they think that what we do matters, rather than why we do it.

Referring to the seminal work of Elizabeth Anscombe on intention, especially 'War and Murder' and the classic paper on 'Modern Moral Philosophy', Professor Boyle pointed out that we do take intentions into account when judging a person's culpability in a wicked act. By holding onto the value of intentions, we avoid the dangerous inference that as long as we do not directly kill a person we may take any actions regardless of whether they lead to death. On the contrary, we need to talk about intended consequences, not just foreseen consequences. Hence, we need to start our moral judgments from the basis that some actions are absolutely prohibited, e.g. killing the innocent, rather than assuming an 'open field' of moral action until 'all the facts are in' (in any case, we may be waiting a long time for all the facts to come in).

Responding to the objection that as a society we allow limited legal violence (the police and the military), so why not also assisted suicide, the speaker argued that legal violence can be justified on grounds of the common good, whereas assisted suicide cannot clearly be justified for the common good, since the discretion given to doctors would be too hard to regulate. In short, assisted suicide leads to an 'open-ended proposal', where we cannot guarantee the outcome will be for the common good.

The lecture was followed by a short Q&A session and a reception at Blackfriars. A recording of the lecture will appear on the Anscombe Bioethics Centre website in due course. You may be interested in the Centre's resources on the topic of assisted suicide:

A Guide to the Evidence

http://www.bioethics.org.uk/evidenceguide.html

Eight Reasons Not to Legalise Physician Assisted Suicide

http://bioethics.org.uk/EightReasonsNottoLegalizePAS.pdf