Incentivising Death

The recent revelation that the rolling out of the Liverpool Care Pathway as the NHS National End of Life Care strategy in 2008 had been financially incentivised and implemented with astonishing compliance emerged as a thought-provoking development. Many of us have been warning for years of the financial, political and research interests that there are in institutionalising sedation-and-dehydration regimes, and then, inevitably, medical homicide. Freedom of Information Act requests exposed the millions of pounds that have been paid for the implementation of this national end-of-life care strategy. Much more interestingly, they showed that some hospital trusts had been paid these funds for ensuring that up to two thirds of all deaths were Pathway deaths.

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Infanticide: A Reply to Giubilini and Minerva

In this article I reply to Alberto Giubilini and Francesco Minerva’s recent infanticide proposal which, I argue, is predicated on their personism and actualism. According to these related ideas, human beings achieve their moral status in virtue of the degree to which they are capable of laying value upon their lives or exhibiting certain qualities or being desirable to third-party family members. This article challenges these criteria, suggesting that these and related ideas are rely on arbitrary and discriminatory notions of human moral status. Our propensity to sleep, fall unconscious, pass out and so on, demonstrates that we often exhibit our status as ‘potential persons’ who are not in the condition of attributing any value to their own existence. Our abilities, age and desirability can and do fluctuate. The equal dignity principle, distinguished in turn from both the excesses of vitalism and consequentialism, is analysed and defended in the context of human rights logic and law. The normalisation of non- and involuntary euthanasia, via such emerging practices as the self-styled Groningen Protocol, is considered. Substituted consent to the euthanasia of babies and others is scrutinised and the implications of institutionalising non-voluntary euthanasia in the context of financial, research and political interests are considered. The impact on the medical and legal professions, carers, families and societies, as well as public attitudes more generally, is discussed. It is suggested that eroding the value of human life carries with it significant destructive long-term implications. To elevate some, often short-term, implications while ignoring others demonstrates the irrational nature of the effort to institutionalise euthanasia.

Jacqueline A Laing, “Infanticide: a reply to Giubilini and Minerva” J Med Ethics 2013;39:336-340 doi:10.1136/medethics-2012-100664

Managerialising Death

Of the fourth estate, Thomas Carlyle once vividly observed ‘Burke said there were three estates in parliament; but, in the reporters’ gallery yonder, there sat a fourth estate more important far than they all’. Now that clergy, nobles and commons are competing for celebrity status, all that remains of independent oversight of the publicity-seeking orders is the fourth. Yet as the Leveson report recommends compulsory state regulation of the press and greater concentration of power in the hands of politicians and their associates, we have recently been reminded, though it may have passed unnoticed, of the moral significance of press freedom.

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