Euthanasia and Clinical Practice: Trends, Principles and Alternatives (review)

BOOK REVIEWS 487 mits that most moral heroes or saints say (perhaps mistakenly) that they were only doing their duty when they performed their heroic or saintly actions. One wonders whether a virtue-based morality or a version of Kantian.ism which distinguishes between perfect and imperfect duties might be better able to account for supererogation than Heyd admits. Creighton University Omaha, Nebraska DANIEL A. DOYBROWSKI Euthanasia and Clinical Practice: Trends, Principles and Alternatives. Report of THE WORKING PARTY OF THE LINACRE CENTER. London: 1982. Pp. 73 with Glossary and Note by A. J. L. GOID.ULLY. £2.75. On June 28, 1980, John Pearson was born in Derby City hospital in England. Four hours after his birth. Dr. Leonard Arthur learned that his parents did not wish him to survive on account of the fact that he suffered from Down's Syndrome. Dr. Arthur ordered "nursing care only " which meant that the child was to be placed in a corner of the nursery, given only water, and sedated so that he would not cry out for food. After the baby died from starvation because the duodenal atresia from which he suffered prohibited his taking food and because an operation for this condition was not permitted by the family, Dr. Arthur was charged with attempted murder. However, on November 5, 1981, Dr. .Arlhur was acquitted. Euthanasia and Clinical Practice: Trends, Principles and Alternatives is a book written by a number of noted physicians , moralists, jurists, theologians and health care professionals in response to this ease, and it challenges this decision and the arguments proposed by euthanasiasts and courts to justify this and similar decisions. This work is of topical interest on account of the recent decision of the Indiana Supreme Court which forbade ordinary life-saving surgery on a Down's Syndrome baby in order to uphold the supposed right of parents to allow their handicapped child to die. As an attempt to reverse the trend to give legal protection to infanticide, this work is a good and noteworthy contribution. For the current practices of euthanasia are reviewed in this book, along with criticisms of the arguments supporting this practice. The ethical rurguments presented by the .working party are generally in agreement with the principles enunciated by the magisterium. But, as I will try to show here, the understanding of the authors of this work of 488 BOOK REVIEWS these principles is not as complete and adequate as one would expect from a group such as this. The principle of double effect is regularly invoked by the authors to deal with difficult cases, but their understanding of this principle is not fully clear, ·and this unclarity may confuse some readers. This principle is explained as permitting an act that does not intend the death of another even if the act does cause the other person's death. Legitimate purposes and necessities can permit this kind of act in which death is a side effect. A fuller explanation is needed if this principle is to be properly used by clinicians and health care professionals . One may not only not intend the death of the other person as an end in itself, but also as a means to another end, and the death of the person cannot be entailed by the act of the agent as being caused necessarily, universally and principally. The means chosen by the agent must be such that the good effect which is brought about by the cause is not subordinated to the bad effect in the intention of the agent and in what the act itself does. For, if there is a subordination of the good effect to the evil effect, then the good effect will be brought about by means of the evil effect. The authors of this book appear to base their rejection of the morality of euthanasia on the principle that euthanasia violates the rights of persons , and hence is a violation of the virtue of justice. There is nothing inherently wrong with this view, but it does not go to the real heart of the Roman Catholic criticism of euthanasia. The principles of the rights of persons and of justice can be invoked...