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Society agrees upon nonmaleficence, the avoidance of causation of harm, as a fundamental principle of biomedical ethics (Beauchamp and Childress 13). For example, the idea of “do not kill” guides many in everyday actions. However, society has specified the aforementioned principle to include exceptions, such as “in the case of self defense”. Case 6.3 with Robert Latimer and his daughter Tracy exemplify another specification on the idea of “do not kill”, for Robert argues not to kill an individual unless in the best interest of the individual. For example, “Robert’s defence was that his act was “mercy killing” and that he had acted only to relieve his daughter’s continued and inevitable suffering,” (Thomas, Waluchow, and Gedge 222-223). Thus, he killed Tracy to protect her from a future life of pain. As a result, the judicial system classified this case as a “compassionate homicide”. The term “compassionate homicide” seems oxymoronical, for the principle of maleficence typically does not align with beneficence. For instance, beneficence would not justify an act of killing. However, the idea of “compassionate homicide” argues that beneficence, a connotation for acts of kindness and mercy (Thomas, Waluchow, and Gedge 202), promotes nonmaleficence. Thus, perhaps one principle of biomedical ethics can outweigh another principle.
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Nonetheless, this case highlights many other ethical issues as well. For example, as an individual with cerebral palsy, the murder of Tracy challenges the rights of the disabled. The text articulates the slippery slope with regard to parallel scenarios, such as the withdrawal of life-support and physician-assisted suicide. However, the permissible violation of the fundamental right to life for people with disabilities can lead to the slippery slope of others further specifying “do not kill” to include other groups, such as the terminally ill. Thus, the judicial system opened up a frightening path for discrimination. In addition, this case questions the role of a medical proxy for an individual who cannot competently make a decision for himself or herself, because Robert made the medical decisions for Tracy. In Robert’s decision to end Tracy’s life, he acted on an extension of his duty to decide the treatment in the best interest of Tracy. As previously mentioned, Robert claimed that he killed Tracy to free her from future pain and suffering. However, his justification relies on an assumption that Tracy did not want to experience pain and preferred to die. The judicial system, for the context of this case, cannot assume that Tracy would have expressed the aforementioned desires. Unfortunately, however, the media influences individuals’ beliefs. For instance, news stations broadcasted the story of Brittany Maynard, a woman diagnosed with a brain tumor and only six months to live (Maynard). As a result of her poor projected quality of life, Maynard chose to undergo “death with dignity” and end her life instead of living in pain (Maynard). Thus, one can understand Robert’s justification for the “compassionate homicide” due to the influence, but Tracy could not express the sentiment of preferring a high quality of life rather than life at all like Maynard. Therefore, society and the judicial system should not justify the violation of “do no harm” and nonmaleficence on an influenced assumption of beneficence.
Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. 7th ed. New York: Oxford U, 2013. Print.
Maynard, Brittany. “My Right to Death with Dignity at 29.” CNN. Cable News Network, 02 Nov. 2014. Web. 26 Feb. 2015. <http://www.cnn.com/2014/10/07/opinion/maynard-assisted-suicide-cancer-dignity/>.
Thomas, John E., Wilfrid J. Waluchow, and Elisabeth Gedge. Well and Good: A Case Study Approach to Health Care Ethics. 4th ed. New York: Broadview, 2014. Print.
I agree with your point that “do not kill” is a fundamental rule that most of the world lives by, and therefore is difficult to see how taking another person’s life can be seen as acceptable by society’s standards. All parents who give birth to a child with a mental disability is faced with a similar decision. Inevitably, raising the child will be more difficult than if there was no disability, so the decision revolves around the outlook/approach with which the parents are going to take on the added challenge. I think it is much easier to consider both sides of this dilemma if it is not your child, but there should be no question if it is. In other words, Latimer can argue that his actions were driven by beneficence, but parents have an inherent responsibility to protect the lives of their children, regardless of their condition. So calling this a “compassionate homicide”–classifying any homicide as compassionate is counterintuitive–is a misguided interpretation of the man’s actions. A compassionate homicide would be killing a 95 year old homeless man you find in the middle of the forest, bleeding out, without arms or legs…and who expresses he wants to die. This is somewhat of a joke, but the underlying point is that the father should, as long as she isn’t expressing any explicit desires herself, want to do anything he can to provide his child with the best life possible. So no, I think it is not justifiable what Latimer did to his daughter.
I would argue that, in this case, the father is violating nonmaleficence regardless of the choice he makes. By killing his daughter, he is obviously causing her harm. However, he is also causing her harm by prolonging her suffering. While you are right that she has not expressed her wishes to die since she is not capable of orally communicating her thoughts, she is still clearly suffering from these symptoms and requires yet another procedure that may not successfully relieve her of those symptoms. I would suggest that in this scenario, it is a matter of which choice violates nonmaleficence more. I believe it is morally justifiable to do what he did, and violation of nonmaleficence by prolonging her suffering outweighs the violation of nonmaleficence by causing her death. In addition, since I believe the decision was morally justifiable, it is also important to mention that he did not have any other options since euthanasia was not a legal option in Canada.
Dmitriy, I agree with your points. I think the father’s actions can be morally justified. When dealing with challenging ethical discussions we must consider the balance between the four principles of biomedical ethics that Beauchamp and Childress present: autonomy, non-maleficence, justice, and beneficence. The average weight for a 12 year old girl is 91.5 lbs (http://www.disabled-world.com/artman/publish/height-weight-teens.shtml). In this case a 12 year old girl, Tracy, had severe cerebral palsy and weighed only 38 lbs at her death. She had endured numerous surges, “cut[ting] the muscles and tendons in her hips….[leaving her] with a flail limb she could no longer control” (p. 225). By taking her life in a peaceful manner, I think the actions of the father are justified. There was no current treatment to improve her condition. I sympathize with the suffering both Tracy and her family were enduring. Tracy does not have autonomy since she is not competent and thus surrogate decisions take place. This case is similar to Stephen Dawson. In both cases I think the parents should have the right to decide the treatment for their child. I think the father acted appropriately under the principle of non-maleficence. In this case, non-maleficence has two rules that compete, do not kill and do not cause pain and suffering. Here, although we are violating the rule of do not kill, we are minimizing pain and suffering in doing so. The father stated he killed his daughter “to put her out of her pain” (p. 224). I think this situation is justified as for the past 12 years he has watched his daughter suffer immensely with little hope. The case states that the father “finally settled on putting her to sleep with carbon-monoxide gas” (p. 225). This act was thought through and the most gentle measures were taken.