The new eugenics and the newborn: the cousinage of eugenics and infanticide.
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According to the Roman Catholic perspective, we are not obliged to ward off death at all costs, but we should not deliberately intervene to bring death about. The "sanctity of life" principle, which rests on the human person's unique relationship with God, is the basis of the Church's honoring of human life as a basic value. Under this principle, direct intervention to end the life of a patient in a terminal condition would not be condoned. This negative position also follows from the religious principle of divine sovereignty--the idea that God alone is Lord over life and death, and the end of human life is not subject to a person's free judgment. Catholic moral tradition distinguishes between actions, on the one hand, or omissions that constitute intervention to put the patient to death and, on the other hand, the withholding of useless treatment that could not significantly reverse or prolong the progressive deterioration of life. The distinction rests on the difference between ordinary and extraordinary means. Also to be considered is the intention--the physician's goals versus the foreseeable yet unintended results. Thus death may not be directly sought, but it may be tolerated as an inevitable side effect of one's goal (such as the relief of suffering). These moral principles need to be rooted in the specific ways a moral community cares for its sick and dying. The religious convictions of grace and covenant and corresponding virtues of gratitude and fidelity enable the community to uphold its convictions about euthanasia.
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Advance directives have been criticized as impractical and/or ineffective, but very little of the criticism differentiates among diverse types of advance directives. The thesis of this article is that carefully drawn documents can be effective. The inadequacy of the advance directive mechanism to date flows in part from documents that are too vague and uninformative. People preparing advance directives are usually seeking to define a level of intolerable indignity at which death becomes preferable. By focusing on the elements of indignity that commonly trouble dying persons, drafters of advance directives can prepare forms that are relevant and meaningful to most people. The author examines the efforts of some existing forms to define intolerable indignity and suggests a different approach. That approach is a unique values profile geared to helping people describe what is, for them, an intolerably deteriorated status.
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