Life and Death With Liberty and Justice by Germain G. Grisez, Joseph M. Boyle, Jr. (review)

BOOK REVIEWS Life and Death With Liberty and Justice. By GERMAIN G. GmsEz and JosEPH M. BOYLE, JR. Notre Dame, Ind.: University of Notre Dame Press, 1979. Pp. 519. $~0.00. Many state legislatures in the past dcade have either passed or are presently considering the passage of bills permitting " death with dignity " and voluntary or nonvoluntary euthanasia. In general, these bills would either permit a person to choose his own death when his quality of life had become unacceptable or would allow one to bring death upon another whose life was deemed to be unacceptable or of poor quality. Classical prohibitions of death with dignity, voluntary or involuntary euthanasia, and suicide have been based on the sanctity of life principle. This principle sees the life of the human being as sacred, and prohibits any direct lethal attack on the human life of the person. It no longer enjoys the wide acceptance it once had, and the void created by its collapse has caused acute problems in ethics and jurisprudence. Grisez and Boyle attempt to fill this void and argue that the widely accep'ted jurisprudential principles of justice and liberty prohibit the legalization of voluntary and nonvoluntary euthanasia. First and foremost, this is a work of jurisprudence, for its primary concern is with showing that laws prohibiting voluntary and nonvoluntary euthanasia do not violate justice and liberty. But this is also an ethical work, for the authors elaborate a theory of ethics and discuss the ethical aspects of many problems related to the euthanasia debate. It is a thorough, subtle, detailed and wide ranging discussion of legal aspects of death, suicide, mercy killing, euthanasia, abortion and of justified killing, ethical theory and the relation of law and morality. The chapter discussing the definition of death provides a clear and accurate definition of death and the moment at which death occurs. While the critique of some of the newer definitions of death are informative, the discussion as a whole appears to lack rigor and clear foundation. Death is defined as the "turning point" at which respiration, heartbeat, and the functions continuously present throughout life give way to decomposition . A fuller discussion of the nature of the human person and the relation of the human person to this " turning point " would have aided the contemporary debates. Operationally, death is defined as the complete and irreversible loss of function of the whole brain, a definition which appears to be gaining wider acceptance. Discussing the right of competent patients to refuse medical treatment, 450 BOOK REVIEWS 451 Grisez and Boyle hold that it is always lawful for competent patients to decline treatment. The lawfulness of this is protected by the jurisprudential principle of liberty, and not that of privacy. The authors argue that decisions to refuse treatment should not be based on quality of life arguments or on the premise that some lives are not worth living. Rather, they argue that treatments may be refused when a person is dying and when further treatments would be useless. This account is not fully adequate, for it does not pay sufficient attention to the treatments themselves . A more proper account would hold that competent patients would be able to refuse those treatments that cause grave burdens themselves for the patient, cause these burdens for those responsible for the patient, or which have grave burdens associated with the treatments themselves. This account would make it lawful for the competent nondying patient to refuse treatments that required heroic or conspicuously virtuous acts on the part of the patient, which the account offered by the authors would not necessarily permit. In the chapter dealing with suicide and liberty, the authors argue that attempts at suicide should not be subjected to criminal punishment. This should be the case for the reason that suicide, considered in and of itself, does not constitute an offense against liberty or justice. Attempts at suicide do not bring unwarranted harm to others, and such attempts do not impinge upon other persons' rightful claims to liberty. In the discussion of voluntary euthanasia, Grisez and Boyle object that the practice of assisting others in their suicide is a violation of liberty, and should not be made...