The religious character of secular arguments supporting euthanasia and what it implies for conscientious practice in medicine.

Publisher: Kluwer Academic Pubishers Country of Publication: Netherlands NLM ID: 9805378 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-0980 (Electronic) Linking ISSN: 13867415 NLM ISO Abbreviation: Theor Med Bioeth Subsets: MEDLINE

Original Publication: Dordrecht ; Boston : Kluwer Academic Pubishers, c1998-

Secularism* ; Euthanasia*; Humans ; Religion ; Morals ; Dissent and Disputes

Contemporary bioethics generally stipulates that public moral deliberation must avoid allowing religious beliefs to influence or justify health policy and law. Secular premises and arguments are assumed to maintain the neutral, common ground required for moral deliberation in the public square of a pluralistic society. However, a careful examination of non-theistic arguments used to justify euthanasia (regarding contested notions of human dignity, individual autonomy, and death as annihilation) reveals a dependence on metaethical and metaphysical beliefs that are not universally accepted in a pluralistic society. Such beliefs function in non-theistic arguments in the same way that foundational beliefs justify moral convictions in religious frameworks of belief. This parallel is apparent when religious belief is defined broadly (a la John Reeder) as 'the search for the good in light of the limits and possibilities of the real.' Seen through this interpretive lens, frameworks comprising Secular foundational commitments function, in ethically relevant respects, like the guiding beliefs found in the comprehensive frameworks of traditional religions. When conscientious practice in healthcare is reconsidered in light of this foundational similarity between the religious and the secular, it is clear that those who object to the foundational beliefs underpinning Secular arguments for euthanasia should not be required to provide, participate in, or refer patients for euthanasia (or other ethically controversial practices similarly dependent on contested frameworks of belief) in pluralistic societies that prize moral freedom as a primary human good.
(© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Herrick, James A. 2003. The making of the new spirituality: the eclipse of the Western religious tradition. Downers Grove, Ill. : InterVarsity Press.
Taylor, Charles. 2007. A secular age. Cambridge, Massachusetts: The Belknap Press of Harvard University Press. (PMID: 10.2307/j.ctvxrpz54)
Smith, James K. A. 2014. How (not) to be secular: reading Charles Taylor. Grand Rapids, Mich.: William B. Eerdmans Publishing Company.
Koppelman, Andrew. 2014. Ronald Dworkin, religion, and neutrality, Boston University law review 94 (4). Boston: Boston University: 1241.
Schuklenk, Udo. 2018. On the role of religion in articles this journal seeks to publish. Developing World Bioethics 18 (3): 207. (PMID: 10.1111/dewb.12210)
Sumner, L.W. 2011. Assisted death: a study in ethics and law. Oxford: Oxford University Press. (PMID: 10.1093/acprof:oso/9780199607983.001.0001)
Taylor, Charles. 2011. Dilemmas and connections : selected essays. Cambridge, Mass.: Belknap Press of Harvard University Press.
Schuklenk, U., J.J. van Delden, J. Downie, S.A. McLean, R. Upshur, and D. Weinstock. 2011. End-of-life decision-making in Canada: the report by the Royal Society of Canada expert panel on end-of-life decision-making. Bioethics 25 (Suppl 1): 1–73. (PMID: 10.1111/j.1467-8519.2011.01939.x)
Smith, Richard, and Jane Blazeby. 2018. Why religious belief should be declared as a competing interest. BMJ 361: k1456. (PMID: 10.1136/bmj.k1456)
Dworkin, Ronald. 2013. Religion without God. Cambridge, Mass: Harvard University Press.
Reeder, John P. 1997. What is a religious ethic? The Journal of Religious Ethics 25 (3): 157.
Kaldjian, Lauris Christopher. 2019. Understanding conscience as integrity: why some physicians will not refer patients for ethically controversial practices. Perspectives in Biology and Medicine 62 (3): 383–400. (PMID: 10.1353/pbm.2019.0022)
Rawls, John. 2005. Political liberalism. Expanded. New York: Columbia University Press.
Rawls, John. 1997. The idea of public reason revisited. The University of Chicago Law Review 64 (3): 765–807. (PMID: 10.2307/1600311)
Voice, Paul. 2014. Comprehensive doctrine. The Cambridge Rawls Lexicon 126–129. Cambridge: University Press.
Audi, Robert, and Nicholas Wolterstorff. 1997. Religion in the public square: The place of religious convictions in political debate. Lanham, Md: Rowman & Littlefield.
Singer, Peter. 1995. Rethinking life and death, 2nd ed. Oxford: Oxford University Press.
Battin, Margaret Pabst. 2005. Ending life: ethics and the way we die. New York: Oxford University Press. (PMID: 10.1093/acprof:oso/9780195140279.001.0001)
Harris, John. 1995. Euthanasia and the value of life. Euthanasia examined, 6–22. Cambridge: University Press.
Dying with dignity Canada. Available from https://www.dyingwithdignity.ca (accessed Nov 11, 2022).
Genuis, Quentin I. T. 2021. A genealogy of autonomy: Freedom, paternalism, and the future of the Doctor-Patient relationship. The Journal of Medicine and Philosophy 46 (3): 330–49. (PMID: 10.1093/jmp/jhab004)
Gillon, R. 2003. Ethics needs principles—four can encompass the rest—and respect for autonomy should be first among equals. Journal of Medical Ethics 29 (5): 307–12. (PMID: 10.1136/jme.29.5.307)
Taylor, Charles. 2018. The ethics of authenticity. Cambridge, Massachusetts: Harvard University Press. (PMID: 10.2307/j.ctvv41887)
Campbell, L. 2017. Kant, autonomy and bioethics. Ethics, Medicine, and Public Health 3 (3): 381–92. (PMID: 10.1016/j.jemep.2017.05.008)
Cherry, Mark J. 2018. Bioethics after the death of god. The Journal of Medicine and Philosophy 43 (6): 615–30. (PMID: 10.1093/jmp/jhy024)
Saad, Toni. 2018. The history of autonomy in medicine from antiquity to principlism. Medicine, Health Care and Philosophy 21 (1): 125–37. (PMID: 10.1007/s11019-017-9781-2)
Leff, Arthur Allen. 1979. Unspeakable ethics, unnatural law. Duke Law Journal 1979 (6): 1229–49. (PMID: 10.2307/1372118)
Cassell, Eric J. 2000. The principles of the belmont report revisited: how have respect for persons, beneficence, and justice been applied to clinical medicine? The Hastings Center Report 30 (4): 12–21. (PMID: 10.2307/3527640)
Callahan, Daniel. 1990. What kind of life: the limits of medical progress. New York: Simon and Schuster.
Meilaender, Gilbert. 2005. Living life’s end. First Things 153 (May): 17–21.
Goligher, Ewan, E. Ely, Daniel Sulmasy, Jan Bakker, John Raphael, Angelo Volandes, Bhavesh Patel, et al. 2017. Physician-assisted suicide and euthanasia in the ICU: a dialogue on core ethical issues. Critical Care Medicine 45 (2): 149–55. (PMID: 10.1097/CCM.0000000000001818)
Strauss, Clara, Billie Lever Taylor, Gu. Jenny, Willem Kuyken, Ruth Baer, Fergal Jones, and Kate Cavanagh. 2016. What is compassion and how can we measure it? A review of definitions and measures. Clinical Psychology Review 47: 15–27. (PMID: 10.1016/j.cpr.2016.05.004)
Downar, James. 2014. Care, compassion, respect. Canadian Medical Association Journal (CMAJ) 186 (17): 1336.
Dembo, Justine, Udo Schuklenk, and Jonathan Reggler. 2018. For their own good: a response to popular arguments against permitting medical assistance in dying (MAID) where mental illness is the sole underlying condition. Canadian Journal of Psychiatry 63 (7): 451–6. (PMID: 10.1177/0706743718766055)
Riddle, Christopher A. 2017. Assisted dying & disability. Bioethics 31 (6): 484–9. (PMID: 10.1111/bioe.12353)
Sumner, L.W. 1999. Welfare, happiness, and ethics. Oxford: Oxford University Press. (PMID: 10.1093/acprof:oso/9780198238782.001.0001)
Pew Research Centre. 2021. Few Americans blame God or say faith has been shaken amid pandemic, other tragedies. https://www.pewforum.org/2021/11/23/views-on-the-afterlife/ .
Curlin, Farr, John Lantos, Chad Roach, Sarah Sellergren, and Marshall Chin. 2005. Religious characteristics of U.S. physicians. Journal of General Internal Medicine: JGIM 20 (7): 629–34. (PMID: 10.1111/j.1525-1497.2005.0119.x)
Prado, C.G. 2008. Choosing to die. Cambridge: Cambridge University Press. (PMID: 10.1017/CBO9781139167406)
Pieper, Josef. 1969. Death and immortality. New York: Herder and Herder.
Gamble, Nathan. 2018. Can euthanasia be classified as a medically beneficial treatment? Ethics & Medicine 34 (2): 103–67.
Schuklenk, Udo, and Ricardo Smalling. 2017. Why medical professionals have no moral claim to conscientious objection accommodation in liberal democracies. Journal of Medical Ethics 43 (4): 234–40. (PMID: 10.1136/medethics-2016-103560)
Savulescu, Julian, and Udo Schuklenk. 2017. Doctors have no right to refuse medical assistance in dying, abortion or contraception. Bioethics 31 (3): 162–170. (PMID: 10.1111/bioe.12288)
Kaldjian, L. Christopher. 2017. Concepts of health, ethics, and communication in shared decision making. Communication & Medicine 14 (1): 83–95. (PMID: 10.1558/cam.32845)

Keywords: Bioethics; Conscience; Euthanasia; Religion; Secularism

Date Created: 20221130 Date Completed: 20230224 Latest Revision: 20230313

20240513

10.1007/s11017-022-09602-2

36449202