(Book Review) What it means to be human: The case for the body in Public Bioethics

The deficiencies and dangers of ‘radical individualism’

Margaret Somerville

What it Means to be Human (book)

O. Carter Snead. What it means to be human: The case for the body in Public Bioethics. Cambridge, Mass: Harvard University Press, 2020, pp 321. ISBN-10: 0674987721.

Anyone concerned about the current values conflicts in our societies should read this book. Although it focuses on conflicts in public bioethics, the insights of the author, O. Carter Snead, have application to a much broader range of values conflicts in what are sometimes called the “culture wars”.

Snead starts with a history of American Public Bioethics. He then asks, “What does it means to be human” and addresses two competing responses – “expressive individualism” and “embodiment” – and articulates the anthropology (the study of human beings and societies) that informs each of these views. He argues the former is inadequate on at least two fronts. First, it “forgets the body” and sees the person as only a mind, a self-actualizing will. Second, it does not contemplate or accommodate human relationships and the reality that we are social beings.

Snead then takes an innovative approach to legal scholarship. He proceeds to an in-depth analysis of six judgments handed down by the Supreme Court of the United States in relation to abortion. He undertakes this analysis in order to determine the law’s view, as manifested in these cases, of what it means to be human, that is, the anthropology that undergirds and informs the judgments he considers. . . continue reading

Physician-assisted suicide and euthanasia: Emerging issues from a global perspective

Charles L Sprung, Margaret A Somerville, Lukas Radbruch, Nathalie Steiner Collet, Gunnar Duttge, Jefferson P Piva, Massimo Antonelli, Daniel P Sulmasy, Willem Lemmens, E Wesley Ely

Journal of Palliative Care
Journal of Palliative Care

Medical professional societies have traditionally opposed physician-assisted suicide and euthanasia (PAS-E), but this opposition may be shifting. We present 5 reasons why physicians shouldn’t be involved in PAS-E.

1. Slippery slopes: There is evidence that safeguards in the Netherlands and Belgium are ineffective and violated, including administering lethal drugs without patient consent, absence of terminal illness, untreated psychiatric diagnoses, and nonreporting;

2. Lack of self-determination: Psychological and social motives characterize requests for PAS-E more than physical symptoms or rational choices; many requests disappear with improved symptom control and psychological support;

3. Inadequate palliative care: Better palliative care makes most patients physically comfortable. Many individuals requesting PAS-E don’t want to die but to escape their suffering. Adequate treatment for depression and pain decreases the desire for death;

4. Medical professionalism: PAS-E transgresses the inviolable rule that physicians heal and palliate suffering but never intentionally inflict death;

5. Differences between means and ends: Proeuthanasia advocates look to the ends (the patient’s death) and say the ends justify the means; opponents disagree and believe that killing patients to relieve suffering is different from allowing natural death and is not acceptable.

Conclusions: Physicians have a duty to eliminate pain and suffering, not the person with the pain and suffering. Solutions for suffering lie in improving palliative care and social conditions and addressing the reasons for PAS-E requests. They should not include changing medical practice to allow PAS-E.

Sprung CL, Somerville MA, Radbruch L, Collet NS, Duttge G, Piva JP et al. Physician-assisted suicide and euthanasia: Emerging issues from a global perspective. J Palliat Care. 2018;33(4):197-203.

Euthanasia is not medical treatment

J Donald Boudreau, Margaret A. Somerville

British Medical Bulletin
British Medical Bulletin

Introduction or background

The public assumes that if euthanasia and assisted suicide were to be legalized they would be carried out by physicians.
Sources of data
In furthering critical analysis, we supplement the discourse in the ethics and palliative care literature with that from medical education and evolving jurisprudence.
Areas of agreement
Both proponents and opponents agree that the values of respect for human life and for individuals’ autonomy are relevant to the debate.
Areas of controversy
Advocates of euthanasia and assisted suicide give priority to the right to personal autonomy and avoid discussions of harmful impacts of these practices on medicine, law and society. Opponents give priority to respect for life and identify such harmful effects. These both require euthanasia to remain legally prohibited.
Growing points
Proposals are emerging that if society legalizes euthanasia it should not be mandated to physicians.
Areas timely for developing research
The impact of characterizing euthanasia as ‘medical treatment’ on physicians’ professional identity and on the institutions of medicine and law should be examined in jurisdictions where assisted suicide and euthanasia have been de-criminalized.

Boudreau JD, Somerville MA. Euthanasia is not medical treatment. Br Med Bull. 2013;106(1):45-66.