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Causing Death and Saving Lives

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Causing Death and Saving Lives Journal of medical ethics, 1978, 4, 47-48 J Med Ethics: first published as 10.1136/jme.4.1.47 on 1 March 1978. Downloaded from Book reviews Causing Death and Saving Lives the effects on others of killing some- readers will remain unconvinced by Jonathan Glover one would be good, and there is then the book's basic assumptions, but I (Pp 327) £I.25) the problem of balancing direct and think that all doctors (and all moral Penguin Books, Harmondsworth, indirect considerations. philosophers) could gain much from Middlesex, I977. Glover then applies this general studying it with the care it deserves. theory to a series of controversies Jonathan Glover's book is an excel- about the morality of killing, of ELIZABETH TELFER lent example of the way in which which the most relevant to medicine moral philosophy can illuminate, and are those concerning abortion, in- La Responsibflite Medicale be illuminated by, practical prob- fanticide and euthanasia. It is (5th Edn) lems. After a brief introduction on difficult in this brief space to do Jean Penneau the scope and limits of moral argu- justice to the complexity and (Pp 342) ment, Glover examines the basic sensitivity of the discussions, especi- Sirey, Paris, I977. ideas to which appeal is often made ally as some of the most telling in discussions of the morality of material is in the quotations. I will This French book amines an killing. He begins his emination try to illustrate Glover's method important area of medical law, by making a distinction between with reference to the discussion of namely, medical liability. More direct objections to killing, which abortion, which is particularly full, specifically it provides an exposition relate to the person killed, and side- with two chapters discussing re- and discussion of some of the legal effects, relating to the effect on spectively the attempt to lay down a obligations and liabilities which copyright. others of killing him. Glover rejects boundary point at which a fetus attach to members of the medical the view that human life as such, or becomes a person and the attempt profession in carrying out their day- even human consciousness as such, to depict abortion as something to to-day work. It should be said that are sacred in themselves, and in- which women have some kind of the author, M Jean Penneau, is stead defends the theses that it is right. Glover's own view, based on ideally qualified to speak on the wrong to destroy worthwhile human his general principles, is that subject of medical liability: he has life and to go against the desire of abortion is in itself on a level with not only practised medicine for 20 particular individuals to go on living. contraception (the differences con- years; he also possesses a doctorate http://jme.bmj.com/ This view implies that consideration cem effects on people other than the in law. of the consequences should play a fetus or potential fetus). Since the The book is divided into two parts: dominant role in taking decisions fetus cannot be said to have a desire Part i deals with some of the about killing. Glover is happy with to go on living, the relevant principle traditionalaspects ofmedicalliability. this implication, and rejects two is that concerning worthwhile human Accordingly, as one would expect, doctrines, often invoked in these life. In terms of this principle both a fairly full discussion is given of the contexts, which would make the contraception and abortion are circumstances in which a doctor connexion between the morality of justifiable to avoid the consequence may find himself civilly liable in on September 26, 2021 by guest. Protected an act and its consequences more of producing a life which is not damages for acts of omission and indirect: 'double effect', which rests worthwhile either because the child commission resulting in harm to his on a distinction between intended is not wanted or because it will be patient. Here, and indeed through- and foreseen consequences, and the severely handicapped. In the latter out the book, the author makes excel- doctrine that acts with bad con- case it is argued that there may lent use of reported court cases (of sequences are always worse than indeed be a duty to have an abortion, which there seem to be not a few) to omissions with the same conse- though Glover does not crudely illustrate and support his statements. quences. The chapter against the equate physical handicap with lack Consideration is also given to a latter doctrine is especially powerful, of a worthwhile life, and includes a doctor's potential liabilities under concluding that if omission can be sensitive discussion of the relation- the criminal law. In this regard it is as blameworthy as actions, our ship between the two. interesting to note that under failure to save lives (for example by In all Glover's arguments there is Article 63 of the French Penal Code contributing to famine relief) may be considerable detail and complexity, it is a crime in certain circumstances in the same league as murder. Glover but he is always lucid and never (punishable by fine/imprisonment) ends this section by reminding us gives the feeling that he is embarking for any person to fail to give assist- that he has mainly been considering on logic-chopping unrelated to the ance to somebody in danger, pro- direct objections to killing. In most real moral issues. He also manages vided such assistance is possible and cases there would also be many ob- to be impassioned without ever 'sans risque pour lui ou pour les tiers'. jections resting on side-effects; but becoming strident - a rare feat in The relevance of this provision to a there are exceptional cases where this kind of sphere. I am sure many doctor who refused to go to a.
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