EUTHANASIA, ETHICS AND PUBLIC POLICY
An Argument Against Legalisation
John Keown
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Cambridge University Press, 2002
318 pp
ISBN 0-521-00933-2
RRP $A59.95 $US 25 £17
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As indicated by the subtitle, this book is unashamedly against the legalization of euthanasia and physician-assisted suicide, but
it is written in a moderate and reasoned tone and in a manner easily understood whether you are a health care professional, lawyer, politician or just an interested member of the public.
Keown first explores the inexactitudes and ambiguities that abound in the euthanasia debate, and then dissects the arguments for
and against. This includes a description of the doctrine of double effects, although more recently published information suggests that it may not need to be invoked; Sykes et al (Lancet Oncology
2003; 4:312) found no evidence that initiation of opioid or sedative therapy is associated with the precipitation of death.
The second pat of the book is an in-depth assessment of the practices in The Netherlands, the Northern Territory of Australia, and
the U.S. State of Oregon, and includes a clear illumination of the inadequacy of the much-vaunted legal safeguards against abuse. Despite all their talk, the most recent data published by the
Dutch (Onwuteaka-Philipsen et al. Lancet 2003; 362: 395) shows no sign of any reduction in the incidence of non-voluntary euthanasia or euthanasia without request. It is to be hoped that Cambridge
University Press will invite Keown to prepare an up-dated edition as more information and data becomes available from The Netherlands and Oregon. The third part of the book critically reviews
the findings of various expert committees, associations and the courts.
By no means everyone will agree with the conclusions and opinions expressed in this book, but it should be required reading for anyone
who intends to make a public statement in the euthanasia debate.
Roger Woodruff
Director of Palliative Care, Austin Health, Melbourne, Australia
(May 2004)
Author Information
John Keown is Senior Lecturer in The Law and Ethics of Medicine, Faculty of Law, University of Cambridge, UK
Table of Contents
Part I. Definitions
1. 'Voluntary euthanasia'
2. Intended v. foreseen life-shortening
3. 'Physician-assisted suicide'
Part II. The Ethical Debate
4. The value of human life
5. Respecting the good of autonomy
6. Legal hypocrisy?
7. The 'slippery slope' argument
Part III. The Dutch Experience
8. The guidelines
9. The first survey: the incidence of euthanasia
10. Breach of the guidelines
11. The shift toward condonation of NVE
12. The second survey
13. The Dutch in denial?
Part IV. Australia and the United States
14. The Northern Territory: ROTTI;
15. Oregon: The Death with Dignity Act
Part V. Expert Opinion
16. Expert committees
17. Supreme Courts
18. Medical Associations
Part VI. Euthanasia by Omission
19. The Tony Bland case
20. The BMA guidance
21. The Winterton Bill
Part VII. Conclusions
22. Conclusions
Afterword: the Diane Pretty case.
Bibliography
Index
