Maciej Piwowarski
Jagiellonian University in Kraków
Most countries hold very similar regulations as it comes to medicine in almost every respect, but differ vastly when it comes to procedures that can be performed to purposefully bring about or hasten the death of the patient. These differences seem to be more than only minor labeling inconsistencies. For example: in some countries both active euthanasia and assisted suicide are legal (Canada, the Netherlands). But there are those countries where assisted suicide is allowed, though active euthanasia is not (Switzerland, parts of the USA); yet in others active termination of life by a medical professional is legal, while assisting in a suicide is not (Belgium); and of course, there are those where neither is legally permitted (Poland). However, even in countries where such procedures are not officially legal, decisions resulting in patient deaths are routinely made, and more than 70% of deaths in intensive care units occur in the wake of a medical decision (Rodríguez-Arias et al. 2020).
In my talk, I want to shed some light on the root causes of the discrepancies in regulating aid-in-dying (AID). I claim that they can be attributed to different ways in which axiological, or more broadly philosophical, presuppositions are embedded in the normative regulations and decisions regarding AID. We can see in particular different approaches to understanding the difference between killing and letting die (or more broadly act and omission), the moral significance of intention, understanding causality, valuing “a natural” course of events, patient autonomy, as well as medical paternalism.
Moreover, I would like to propose a somewhat unorthodox conceptual framework for classification of various AID procedures. In my view, they include: active voluntary euthanasia, assisted suicide (which itself can be differentiated based on the dying person’s level of involvement, as seen in Shavelson et al. 2022), and – what is more controversial – palliative sedation, lethal analgesia, as well as even withholding or withdrawing life-saving or life-prolonging medical treatment. I claim that those procedures are a part of a single spectrum, and the differences between them are mostly practical, but hold no moral significance in themselves. What distinguishes the practices that are morally acceptable from those that are not is whether they are conducted according to the fully informed patient’s autonomous wishes.
Chair: M. Hadi Fazeli
Time: September 8th, 10:40-11:10
Location: SR 1.005
SOPhiA 2026 