Tufts OpenCourseware
Author: Ross S. Feldberg

1. Assignment

As you read these articles and view the movie, you might want to keep some of the following points or questions in mind.

1.1. Physician Assisted Suicide (PAS)

Probably the clearest exposition of the arguments for and against Physician Assisted Suicide has been made by Margaret Pabst Battin in her book Notes from Ending Life: Ethics and the Way We Die (Oxford Univ. Press, 2005). Battin points out that often the opposing sides in this argument really never directly confront the arguments of the other side. She suggests that the debate can be reduced to a few cogent arguments.

  1. Principal Arguments for PAS

    1. The importance of individual autonomy (the right to decide one’s own fate)

    2. The individual right to relief of pain and suffering

  2. Principal arguments against PAS

    1. The intrinsic wrongness of killing

    2. PAS weakens the integrity of the medical profession

    3. Allowing PAS risks potential future abuse (slippery slope argument)

As you read through the two assigned papers think about the arguments. Do they fit one of the above categories? Do the authors argue for their side or against the other side or do both? What devices do they employ to try to convince you of the rightness of their view?

1.2. Mar Adentro directed by Alejandro Amenabar

This movie is based on the story of Ramon Sampedro, a Spanish sailor who lived as a quadriplegic for many years before deciding to commit suicide. It is a touching movie that raises several questions you might consider as you view it.

Why would Ramon Sampedro not qualify for PAS under the Oregon law as presently written? Can you make a coherent argument for or against extending this law to cover individuals like Ramon?

Although not emphasized in the movie, Julia (the attorney who visits him in the opening scene) suffers from “cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy” (CADASIL). This is a real but rare dominant mutation that presents itself in young adults initially as migraines, strokes and focal neurologic defects (note her problems walking). The disease is progressive and eventually can lead to dementia. Julia’s progressive disease will eventually leave her incapable of making a decision re PAS or of implementing one made earlier. What particular problems does this situation raise for PAS and how might it differ from Ramon’s?

(Mar adentro means “out to sea” or the “sea outside”. Why do you suppose the English title was changed to “The Sea Inside”? Also, if you are a film buff and have the time, I highly recommend viewing the documentary about making the move on the DVD.)