Pearson Edexcel Level 3 Advanced GCE in Religious Studies – Anthology
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patients. For instance, a very handicapped baby (for example one who is
‘anac ephalic ’ or wit h a major part of t he brain missing) might be c onsidered so ill
that no amount of surgery would improve t heir c ondit ion signific ant ly. In this c ase a
doc tor might then presc ribe ‘nursing c are only’ (the baby should be kept warm and
fed) as proport ionat e t o t heir needs, knowing t hat t he baby will die short ly.
- The WSOL argues that where death is inevitable the doctor is bound by
compassion or love to treat the patient accordingly. T his at t it ude is summarised
by the muc h quoted phrase, from Arthur Clough’s poem: ‘Though shalt not kill:
but need’st not st rive Offic iously t o keep alive’. Singer (Rethinking Life and
Deat h, 1994, p.149) goes further. Rigid adherence to the doctrine never to kill
(vit alism) is an abrogat ion of t he doc t or’s responsibilit y t o his pat ient. The
question is not so muc h between ordinary and extraordinary means but
whether, in some cases, direc t t erminat ion of life is good medic ine. - In QOL the key fac tor is whether the use of extraordinary medic al means would
usefully promot e t he qualit y of life. T he not ion is essent ially ut ilit arian. For
instanc e, in Cases 4 and 6 above a number of fac t ors all need c onsiderat ion:
t he possible lengt h of useful life; st at e of mind of t he pat ient (a main
c onsideration in the Americ an QALYS or Quality Adjusted Life Year Schedules);
resources needed and available. All these factors contribute towards making
doctors’ choices. For instanc e a doc tor might have to weigh up whether very
painful surgery or powerful drugs whic h c ause permanent drowsiness would
result in a person who is a shadow of their former self. Can he or she base his
or her judgement on some minimum human life-standard? For instanc e John
Finnis’s ‘basic goods’ argument suggest s a possible list of ‘valuable’ life c rit eria
whic h inc lude: play, aest het ic experienc e, soc iabilit y; but inevit ably t here is no
agreement as to what these standards should be.
- Law and morality
So far the disc ussion has c entred on the doc tor-pat ient relat ionship wit hin t he
c onst raint s of law. There is no doubt that a shift in public opinion has inc reased the
pressure for reform espec ially for volunt ary eut hanasia, whilst the Bland case sets a
precedent for severely brain-damaged patients.
a) The liberal model
Mill’s essay On Liberty (1859) is oft en c it ed as an example of t he way in whic h law
should func t ion in a liberal soc iet y.
- T he princ iple is t hat law is not in it self a moral guideline. Law in a liberal
soc iety ac knowledges that eac h person has his or her own preferenc es whic h,
using t he ut ilit arian princ iple, if sat isfied lead t o t he great est happiness. The
law enables the greatest personal autonomy of the greatest numb e r. - The sec ond func tion of law is to protec t the individual. T his limit s t he majorit y
from exploit ing t he minorit y and also t he minorit y form exerc ising t oo muc h
sway over the majority. Law should have minima l interferenc e.