Classical American Pragmatism and Assisted Suicide

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Classical American Pragmatism and Assisted Suicide

ABSTRACT: Helping people to die may involve killing and/or alleviation of pain in a dying person. A dual commitment to the avoidance of killing and the alleviation of pain raises the question of whether these two ways of helping people are always compatible. This paper addresses the question through use of sources in classical American pragmatism and contemporary bioethics. First, I apply Charles Peirce’s notion of pragmatism to the concept of killing through consideration of the empirical consequences of alternative interpretations. James Rachels’ account of the distinction between active and passive euthanasia is critiqued in this analysis. Second, I examine what it means to relieve pain by relating Jane Addams’ concept of maternal nurturance to an ethic of care and opposition to killing. Utilizing these concepts, I apply William James’ notion of pragmatism as a method of mediating or straddling different theoretical approaches to resolve the apparent incompatibility between pain relief and the avoidance of killing. To address social concerns raised by the practice of helping people to die, I propose a corrective insight of Addams, along with John Dewey, about the role of the philosopher as social critic. Thus understood, pragmatism is a means of avoiding abuses that may occur in the process. I conclude that so long as permissive practices are restrained sufficiently to avoid injustices, it is morally both possible and desirable to resist killing while relieving pain.

Here is the doubt that triggers my inquiry: I have two beliefs that are apparently at odds. The first is that we should never kill; the second, that we should always attempt to alleviate pain. The apparent conflict between these beliefs arises from the fact that death may constitute the ultimate pain relief.

Certain caveats attach to both beliefs. For example, killing in self-defense or to save others’ lives is acceptable, (1) and inflicting pain through medical interventions in order to cure or restore function is also acceptable. (2) In general, however, both beliefs dispose me, as Peirce would put it, (3) to distinct plans or habits of action: avoidance of killing and provision of pain relief. In health care, the commitment never to kill implies that euthanasia is wrong, and the commitment to alleviate pain demands actions that may hasten the dying process.

The question that arises from these two commitments is whether both can be sustained simultaneously. Can I always and in every case avoid killing and alleviate pain?
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