http://www.units.it/etica/2004_2/DELBO.htm
Assisted Suicide and Euthanasia: Arguing for a Distinction
Dipartimento
di Studi Politici e Sociali
Abstract
In this essay, I
will try to analyze the problems of assisted suicide and euthanasia by using
the Joel Feinberg’s analysis of the so-called ‘right to life’ and the Wesley
Hohfeld’s legal terminology. Through Feinberg’s analysis I will trace a
conceptual and normative distinction between assisted suicide and euthanasia;
through the Wesley Hohfeld’s legal terminology I will develop this distinction
to show where the distinction precisely arises. My conclusion will be that the
problem of permissibility of assisted suicide is conceptually and normatively
different from the problem of permissibility of euthanasia. |
In bioethics it is quite usual to consider assisted
suicide and euthanasia as connected issues and think that permissibility for
the former imply permissibility for (or a prima facie presumption in
favour of) the latter. I think this view is incorrect. I believe that there is
an important conceptual difference that marks an important normative
difference. In this paper I will try to show what is this difference and where
the distinction between assisted suicide and euthanasia arises. An implication
of my argument is that a justification (or a refusal) of the former does not
imply a justification (or a refusal) of the latter; that is, the problem of
permissibility of assisted suicide is conceptually and normatively different
from the problem of permissibility of euthanasia.
I will proceed as follows. In section 1, I will try to
frame these problems (assisted suicide and euthanasia) by offering some
preliminary definitions and delimiting their area of application. In section 2
I will use the Joel Feinberg’s analysis of the so-called ‘right to life’. Feinberg’s
analysis provides us the elements required to trace a conceptual and normative
distinction between assisted suicide and euthanasia. I will develop this
distinction in a more detailed way in section 4, using Wesley Hohfeld’s legal
terminology (which I will present in section 3). My idea is that the
application of the Hohfeldian scheme to Feinberg’s concept of right to life
enables us to find the distinctive feature between assisted suicide and
euthanasia, and this allow us to set up the issues involved in these practices
in a particular way.
1. Preliminary definitions
In this section I will start with some preliminary
definitions, that will be modified later in this paper. At a very general
level, we say that assisted suicide is the act through which a person
takes his/her life through means furnished by another person (whereas the
suicide tout court is the act of killing oneself without others’
help). The classic example is someone who swallows a lethal pill another person
has provided him with. The provider is not necessarily a physician (for
example, he/she could be a relative). Therefore assisted suicide is a wider
concept than physician-assisted suicide; however, in this paper I will ignore
the difference and I will use assisted suicide, without any other
specifications, to refer to physician-assisted suicide. Again, at a very
general level, we say that euthanasia is the act of killing someone for
his good. In this case, the classic example is someone, typically a physician,
who gives a lethal injection to another person (from now on, I will also
consider euthanasia as a problem located in the physician/patient therapeutic
relation).
There are at least three possible cases of euthanasia:
voluntary euthanasia, when the lethal injection is given according to
the patient’s genuine, explicit, constant and well-considered request; non-voluntary
euthanasia, when the lethal injection is given without the patient’s
consent (because he is not able to express it; for example, when he is in
permanent vegetative state); involuntary euthanasia, when the lethal
injection is made against the patient’s will. It is worth noting that
considerations about the patient’s good determine the conceptual difference
between euthanasia and murder: although both acts cause the patient’s
death, euthanasia is made for the patient’s good, whereas murder is made
without any consideration of it. In order to complete the picture, we finally
say that withdrawing life-sustaining
treatment is the act of letting the patient die by stopping a
particular medical treatment. An example of withdrawing life-sustaining treatment is the
interruption of a pharmacological therapy that allows the disease to go on and,
therefore, lead the patient to death more quickly. Another example is the
interruption of hydration and feeding in permanent vegetative state patients,
who will consequently die of starvation.
Therefore, at a conceptual level, we have five
possible situations connected with dying (suicide, assisted suicide, withdrawing life-sustaining treatment,
euthanasia, murder); and one of them (euthanasia), as we have seen, can be
voluntary, involuntary and not-voluntary. Let us omit murder, which does not
regard directly the topic of this paper and focus on the other four situations.
Before proceeding, it is however useful to point out two specifications (I will
refer to the case of euthanasia, but the same can also be said for suicide –
assisted or not –, and withdrawing
life-sustaining treatment). First specification: it is
necessary to keep in mind that the legal issue (i.e., if the legal system
foresees or should foresee, and under which conditions, euthanasia) and the
moral issue (i.e., whether there could be or not a moral justification for
euthanasia, whatever the legal system provides) are two distinct issues. This
specification, very obvious indeed, is useful when we consider that in several
countries, judges have been often pronunciate sentences about the
permissibility of euthanasia and related practices. Their sentences on specific
cases and in specific contexts have circulated in the bioethical debate and
this has in fact contributed to mix moral reasoning and legal reasoning,
whereas the limits of what is morally permissible are clearly different from
the limits of what is legally permissible. Second specification: assuming that
the moral permissibility of euthanasia, if any, should be translated (according
to appropriate procedures) into a legally recognized permissibility, it is
necessary to consider four different ways in which this translation could be
made. First, we could consider euthanasia as a crime but at the same time
encourage judges not to prosecute it; or, we could consider euthanasia as a
crime but admit that it is not punishable in some circumstances (for example,
when euthanasia concerns seriously suffering and terminally ill patients);
still, we could maintain the crime but make extenuating some reasons and/or
circumstances (for example, serious suffering and terminal illness); finally,
we could, abolish the crime and legalize euthanasia, perhaps (and favourably)
conditioning the way of its application .
In this paper, I am not interested, if not
incidentally, in the legal aspects of the problem, nor I will inquire what is
the more correct way to translate moral permissibility into legal
permissibility. I will focus my attention on moral permissibility, without
considering its actual or potential legal implementation.
2. Suicide, euthanasia and right to life
In order to discuss the issue on euthanasia I think it
is useful to analyze what Joel Feinberg has said about the so-called ‘right to
life’.(1) Feinberg shows that the complex and
controversial concept of ‘right to life’ involves at least two ideas: first,
people have a right not to be killed (call this D1); second, people
have a right to be rescued from impending death (call this D2). If
we summarize our preliminary definitions, we can see that euthanasia, withdrawing life-sustaining treatment
and assisted suicide violate (D1+D2): more specifically,
euthanasia violates D1, withdrawing
life-sustaining treatment and the assisted suicide violate D2.
However, the issue is a little more complex. Intuitively, it seems to me
implausible to think that withdrawing
life-sustaining treatment or attending the suicide of a
terminally ill patient can be easily put on the same side, for example, of
refusing to throw a life belt to a person who is drowning; in fact, the
violation of D2 seems morally important only in the latter case,
whereas it seems implausible this violation will morally interest us in the
case of withdrawing life-sustaining
treatment or attendance to a suicide of a terminally ill
patient (arguments against these practices are others than the violation
of the right to life). Therefore, it can be assumed that the right of being
rescued from impending death is to be better specified, as a right to be
rescued from starting an irreversible process of death (call this right D3),
and therefore the interpretation of the right to life must be corrected as (D1+D3).
Withdrawing life-sustaining treatment
and attending the suicide of a terminally ill patient clearly do not violate D3,
because the irreversible process of death is not started (although it is
accelerated) by withdrawing or attendance; and given that withdrawing life-sustaining treatment
and attending the suicide do not violat D1, we can assert that both
are coherent with (D1+D3).
In what follows I would like to examine the
implications that the idea of a right to life may have for the issues of assisted
suicide and euthanasia (hereafter I will consider only D1, assuming
that there are no conflicts between D1 and D3, or, if
there are, they can be solved). In order to do this, we have to go back to
Feinberg and his argument of the alienability of the right to life.
According to Feinberg we usually think that a right is alienable if the holder
can (not in an empirical but in a normative sense) resign it; if not, we
characterize the right as an inalienable right.(2) The interesting point is that it is not always clear, when
people discuss about euthanasia or assisted suicide, if the alienability (or
the inalienability) in question concerns life or the right to life.(3) These are two different questions: if life
is alienable, I am allowed to kill myself, but other people are not allowed to
do it; if the right to life is alienable (under particular
circumstances), others are allowed (if the particular circumstances occur and I
alienate the right effectively and correctly) to kill me. In the same way, if
life is not alienable, I am not allowed to kill myself; if the right to life is
not alienable, others are not allowed to kill me.
From these considerations we can begin to see the
feature that generates conceptual discontinuity between assisted suicide and
euthanasia: if the alienability of the right to life is a different issue from
the alienability of life, then euthanasia must be distinguished from suicide,
being the former a matter of alienability of the right to life, and the latter
a matter of the alienability of life. However, to completely identify this
feature we have to address Wesley Hohfeld’s analysis on legal concepts and
consider the issues of the alienability of life and the alienability of the
right to life using his terminology.(4)
3. Hohfeld and fundamental legal concepts
According to Wesley Hohfeld, for a proper
representation of the legal space, it is enough to use eight concepts: right
(or claim), privilege (or liberty), power, immunity, duty, no-right,
liability,(5) inability. Among these concepts there are
relations of correlation (which reproduce the legal relation between two
subjects)(6) and opposition (which are merely
semantic). The following table shows these relationships.
|
1 |
2 |
3 |
4 |
Types |
Claim-Right |
Privilege (liberty) |
Power |
Immunity |
Correlatives |
Duty |
No-right |
Liability |
Disability |
Opposites |
No-right |
Duty |
Disability |
Liability |
According to Hohfeld, the concepts inserted into the
row ‘types’ express, four different types of legal advantage that are usually
summarised under the generic expression right; using them in an
appropriate way (i.e., respecting the logical relations of correlation and
opposition existing among them), we can achieve an analytical purification
that, according to Hohfeld, will allow us to avoid terminological confusions in
the realm of legal language. In what follows we will analyse these concepts and
their respective relations of correlation and opposition (numbers correspond to
the columns of the table).
1) Rights in the strict sense are claims
against other people concerning some actions or some states of affairs. Having
a claim-right means that others have a correlative duty. So,
If Adam has a claim-right that Barbara do x, Barbara
has a duty to make x.
Example:
if Adam has a claim-right to have money from Barbara, Barbara has a duty to
give money to him.
If Adam has a claim-right to x, any other people have
a correlative duty towards Adam on x.
Example: if
Adam has a claim-right not to be killed, any other people have the duty not to
kill Barbara.
Hohfeld defines no-right the absence of a
claim-right: therefore no-right is, the opposite of a claim-right. In this
category, we can distinguish positive rights (which impose positive
actions upon the other party, as, for example, the right of citizens to be
protected from violence by the State) and negative rights (which demand
only non-interference, as the right not to be assaulted), or rights in
personam (which are held against a specific person or group), and rights in
rem (which are held against people at large).
2) Privileges are liberties. If I have a
liberty-right, I have no constraint set up by other people's rights. So,
If Barbara has a liberty-right towards Adam not to do
x, Adam has a no-right that Barbara does x.
Example:
if Barbara has a liberty-right not to give money to Adam, Adam does not have
any right to have money from her.
If Barbara has a liberty-right to do x, any other
people do not have any right that Barbara does not do x.
Example:
if Barbara has a liberty to kill any other people, none has any right that
Barbara does not kill them.
However, as we have seen at 1, if there is a claim-right,
Barbara has a duty to give money to Adam and has a duty not to
kill anybody. Moreover, as the table above shows, the opposite of a claim-right
is a no-right and the opposite of a liberty-right is a duty. So, it is not true
that liberty-rights require correlative duties: if I have a liberty-right to do
something, it does not follow that other people have a duty not to prevent me
from doing it. Duty is the opposite of liberty, not its correlative
(which is no-right). Therefore, if a soccer player has the liberty to score a
goal, it does not follow that the players of the opponent team have a
duty to allow him to do it; rather, they have an analogous liberty to prevent
him from scoring, respecting the rules of the game (not, for example, tripping
up).(7)
Confusion arises because people usually hold liberty-rights
within a context of claim-rights; the latter, as Hart famously said,
constitute the “protective perimeter” of the formers (this is the reason why
Hart speaks of vested liberties).(8)
Therefore, in the example above, the liberty of the player to score a goal is
protected by a perimeter of claim-rights that prohibits other people to
prevent him in not prescribed ways to score. This coexistence of claim-rights
and liberty-rights is not necessary from a pure logical point of
view, because we can imagine situations where there are liberties without any
protection provided by claim-rights (in this case Hart speaks of naked
liberties).(9) Take, for example, the Hobbesian state of
nature: all liberties are naked, because no duty to others exists (neither,
obviously, some correlative claim-right), and people have the liberty to
do all what they judge useful for the preservation of their life, and resources
(and others’ bodies too) belong to those that can get them, and for so long as
they can keep them.(10) The conceptual
separation between liberty-rights and claim-rights can be
illustrated more clearly by making reference to freedom of expression: it is a
liberty-right insofar as it attributes the liberty to express his or her
ideas to his/her holder; it is, instead, a claim-right insofar as it
states what others have the duty to do or not to do towards him or her (for
example, not to gag him or her, not to do noise while he or she speaks, to
allow him or her to have access to the media etc). As Jones says, we can affirm
that “from the perspective of the right-holder, liberty-rights are ‘active’ in
that they concern what the right-holder is himself entitled to do or not to do,
[... ] claim-rights are ‘passive’ in that they concern what others are
obliged to do or not to do in respect of the right-holder”.(11)
3) Power is the legal ability to change a legal
relation. From this point of view,
If Adam has a power to force Barbara to change from
legal relation r1 to legal relation r2, Barbara is
subjected to that change.
Example: if
Adam has a power to exempt Barbara from the duty to give him money, Barbara is
subjected to this power of exemption held by Adam à if Adam exercises it, Barbara has no duty to give
money to Adam anymore, and Adam has no claim-right to Barbara’s money anymore.
If Adam has a power to force any other people to
change from legal relation r1 to legal relation r2
concerning x, everyone are subjected to this change to r2 concerning
x.
Example: if
Adam has the power to extinguish his right not to be killed, any other people
are subjected to this extinction à if Adam exercises it, he has no claim-right not to be
killed anymore and any other people have no correlative duty not to kill him
anymore.
In the Hohfeldian scheme, therefore liability is
correlative of power. Lack of power constitutes disability, which is opposite
of power.
4) Immunity is not being subjected to another’s power
to change a legal relation. So,
If Barbara has an immunity concerning the Adam’s power
to change from legal relation r1 to legal relation r2,
Adam has the disability to change from r1 to r2.
Example: if
Barbara has an immunity from Adam concerning her claim-right of having money,
Adam does not have the power to deprive Barbara of this right à Barbara continues to have the right to receive money
and Adam the duty to give money to her.
If Barbara has an immunity concerning legal relation r1,
any other people do not have the power to oblige Barbara to change to r2.
Example: if
Barbara has an immunity about the extinction of the claim-right not to be
killed, any other people have the power to extinguish it à Barbara continues to have the right not to be killed
and any other people their correlative duties.
Therefore the correlative of immunity is disability.
On the contrary, if Adam has this ability, then Barbara is subjected to Adam’s
power; therefore, being subjected to someone is the opposite of immunity.
Examples of immunity-rights are civil rights (freedom of expression,
press, religion etc.) normally protected in liberal democracies from the
interference of political power. However, we have to distinguish between immunity-rights
and liberty-rights: having an immunity regarding x means that other
people have no power over x, while having a liberty-right on x means that other
people cannot advance any claim on x.(12)
Hohfeld’s classification would deserve many
considerations, but only two are interesting for us.(13) First, it should be clear that the Hohfeldian scheme is
purely formal, so it works independently from the content of the single
concepts constituting it, that is to say it works independently from what particular
claims, liberties, powers, immunities, duties, no-rights, liabilities and
disabilities are recognised by a legal system. Let us consider, for example, claim-rights:
someone might believe that only civil and political rights are rights in a
proper sense, while another might believe that “social rights” ahould be
included in this category (the right to a job, to a pension, to free health
care); and some other people think that group rights (right of self
determination, for example) should be recognized. The Hohfeldian scheme is
indifferent about these issues: in fact, it limits itself to assume that the
acknowledgment of a right implies the imposition of a correlative duty, but it
does not say anything about the problem of establishing whether such a
right is morally justified. From Hohfeld we can gather, for example, that
Andrew has the duty to give a job to Barbara if she has the right to have a job
from Andrew, but we cannot deduce anything about the moral foundation of her right.
Secondly, it is virtually possible to extend (and it
is, indeed, what I am doing in this paper) the Hohfeldian concepts from the
legal to the moral sphere, insofar as these concepts would not simply serve to
describe a series of actual legal relations, but, rather, they would define the
moral permissibility of the actions of individuals and the constraints posed on
them by other individuals or the State.(14)
4. Assisted suicide and euthanasia: a conceptual
distinction
Let us go back to the concept of the right to life and
Feinberg’s distinction between the renunciation of life and the renunciation of
the right to life, and restate all this in the Hohfeldian terminology. To
affirm that I have a right to life, i.e. I have a right not to be
killed, is equivalent, by correlation, to affirm that other people have a duty
not to kill me (that is, by opposition, they do not have the liberty to kill
me). If my right to life is alienable, then I have the power to modify
the relation that exists between me and other people, i.e. I have the power to
resign my right not to be killed. In that case, if I exercise my power, other
people, by correlation, are subject to my renunciation; moreover, I do not
have the right not to be killed anymore and other people, again by
correlation, do not have the duty not to kill me (that is, by opposition, they
have the freedom to kill me). Vice versa, if my right to life is not alienable,
I do not have the power to resign my right not to be killed: therefore, I still
have my right not to be killed and other people, by correlation, have
the duty not to kill me (that is, by opposition, they still do not have
the liberty to kill me). Voluntary euthanasia is a case of renunciation of the
right to life (indeed, I resign the right not to be killed), so it is permitted
in circumstances in which this renunciation is allowed.
The case of renunciation of life is different. If my
life is alienable, I have the liberty to renounce life, but I do not
have the power to resign the right not to be killed; and other people, by
correlation, do not have rights against my renunciation of life, even if they
still have the duty not to kill me (that is, by opposition, they do not have
the liberty to kill me). Vice versa, if my life is not alienable, then I do not
have the liberty to renounce life, but, by opposition, I have the duty not to
do it. (Assisted) suicide is a case of renunciation of life (I do not resign
the right not to be killed), so it is allowed in circumstances in which this
renunciation is permitted.
At this point we can modify the preliminary
definitions from which we started. Notice that we do this not because those
definitions were wrong, but only because they did not identify the difference
between assisted suicide and euthanasia that is instead essential for our aim.
From the list of modified definitions that I am going to provide, the following
difference would emerge.
1.
Suicide = renunciation of
life made without anybody’s help.
2.
Withdrawing life-sustaining treatment = renunciation of life made though renouncing some
specific medical treatment.(15)
3.
(Physician-)assisted suicide
= renunciation of life made with somebody’s help.
4. Euthanasia
4.1
Voluntary = renunciation of the right to life.
4.2
Non-voluntary = violation of the right to life in the interest of the
victim, who is in the condition neither for renouncing it nor for not
renouncing it.
4.3
Involuntary = violation of
the right to life in the interest of the victim, who does not want to renounce
it.
5. Murder
= violation of the right to life against, or without considering, the interest
of the victim.
The important difference existing between cases 1-3 on
one hand and 4-5 on the other one is the following: cases 1-3 concern the
liberty to renounce life, whereas cases 4-5 concern the power to renounce the
right to life. Note that this is a conceptual difference and not a moral
difference, although, as I will try to prove, this conceptual difference is
important for the elaboration of a moral argument.
We omit 4.2, 4.3 and 5 (all they deal with the
violation of the right to life), and we focus on cases 1-3 from one part
and 4.1 from the other. At least two points are made clear by the conceptual
difference above. First, suicide, withdrawing
life-sustaining treatment and assisted suicide are on the same
side of the dividing line that we traced; therefore, the possible
permissibility of one of these, at least prima facie, would involve the
permissibility of the other two. From this point of view, admitting the
permissibility of suicide (without any other argument) implies to admit also
the permissibility of assisted suicide. Second, assisted suicide and euthanasia
are not on the same side of the line; therefore the possible permissibility of
one of them does not have consequences for the permissibility of the other.
Admitting the permissibility of assisted suicide does not force us to admit the
permissibility of voluntary euthanasia as a logical consequence; then, you can
argue that voluntary euthanasia should be permitted only using a different argument
from that you would have possibly used in order to admit the permissibility of
assisted suicide.(16) The same applies to withdrawing life-sustaining treatment.
People thinking euthanasia should be permitted and
recognized by law will find this a discouraging outcome. To put euthanasia on
the same side of suicide seems to confer normative force to euthanasia, since
we usually think that nothing is morally wrong in suicide itself (although
there are certain situations in which it should be considered morally wrong,
for example if we have an obligation or responsibility for someone); it is not
without reason, it seems to me, that we usually reserve mercy, not
blame, to the suicides. From this point of view, then, separating suicide and
euthanasia seems to be, at best, a way for ‘saving’ assisted suicide and
renouncing the fight for the more difficult battle in favour of euthanasia. But
it could also introduce an argument to distinguish between suicide tout
court and assisted suicide, excluding therefore also assisted suicide from
the list of legitimate practices after having previously discarded euthanasia.
For example, it could be objected that suicide is lawful, but the attendance
to suicide is not. Therefore, when the physician supplies the patient with
the lethal pill, it could be asserted that the patient is allowed to take the
pill, but that the physician is not allowed to give it to him.
I do not want to insist on this point, but I think it
is possible here to suggest a couple of shortcomings. In the first place, it is
not clear why, if suicide is not morally wrong (at least under some
specific conditions), to help someone to do it (at least under some specific
conditions) should be morally wrong. Second, the physician participating in the
killing plan is not the causal factor of the patient’s death, but he/she is
only part of the causal process that brings about the patient’s renunciation of
life, like the producer of the lethal pill or the supplier that brought it into
the hospital (if nobody had produced the pill or had transported it into the
hospital, the patient’s renunciation of life would not have been possible, at
least with these modalities).
Obviously, this does not exhaust the argument in
favour of assisted suicide; I do not deny, of course, that other arguments are
available to people who want to contrast this practice.(17) However, my aim here was to focus on the separation between
the issue of assisted suicide and the issue of euthanasia.
5. Conclusions
In this paper I have tried to show that there is an important conceptual difference between assisted suicide and euthanasia. This means that the justification (or the refusal) of the former does not imply the justification (or the refusal) of the latter. From this point of view, therefore, the problem of the permissibility of assisted suicide is a different conceptual and normative problem from the one of the permissibility of euthanasia. In this paper I was not arguing for or against assisted suicide and euthanasia. Rather I was trying to offer a possible (and, I hope, original) guideline useful to explore a very controversial topic.
(1) Joel Feinberg, Voluntary
Euthanasia and the Inalienable Right to Life, «Philosophy and Public
Affairs», 7 (1978), 2, pp. 93-123, 94.
(2) Feinberg, Voluntary
Euthanasia and the Inalienable Right to Life cit., pp. 112-4.
(3) Feinberg, Voluntary
Euthanasia and the Inalienable Right to Life cit., pp. 114-5. Following
raws make explicit and partially restate Feinberg’s reasoning.
(4)
Hereafter, I will use ‘renunciation’ instead of alienability, being
alienability an option open to the agent and renunciation the realization of
this option.
(5) Wesley
N. Hohfeld, Some Fundamental Legal Conceptions as Applied in Legal
Reasoning. I, «Yale Law Journal», 23 (1913), 1, pp. 16-59, edited by W.
Cook in Id., Fundamental Legal Conceptions as Applied in Legal Reasoning and
other Legal Essays, New Haven, Yale University Press, 1923, pp. 3-64. See
also Wesley N. Hohfeld, Fundamental Legal Conceptions as Applied in Legal
Reasoning. II, «Yale Law Journal», 26 (1917), 8, pp. 710-70, edited by W.
Cook in Id., Fundamental Legal Conceptions as Applied in Legal Reasoning and
other Legal Essays, cit., pp. 65-114.
(6) The
Hohfeldian scheme states that every jural position is necessarely relational
and this relation is necessarely dual.
(7) Peter
Jones, Rights, Basingstoke, MacMillan, 1994, pp. 19-20.
(8) Herbert L.A. Hart, Essays on Bentham,
Oxford, Clarendon Press, 1982, pp. 171-3.
(9) Ibidem.
(10) Thomas
Hobbes, Leviathan, or the Matter, Form and Power of a Commonwealth
Ecclesiasticall and Civill, edited by C.B. Mac Pherson, Harmonsworth, 1968.
Notice that Hobbes says ‘right of nature’ to indicate an Hohfeldian liberty and
not a claim-right.
(11)
Jones, Rights, cit., p. 21.
(12) I
assume it is clear that a distinction exists between concepts of columns 1 and
2 and 3 and 4. This distinction depends on the fact that power and immunity
(and their correlatives) describe procedural or second-order
relations, that is they state wheter it is (legally) possibile or not to
change first-order relations (as those identified by claim-rights and
liberty-rights, and their correlatives) and/or other second-order relations.
(13) The
most recent and systematic analysis of the Hohfeldian scheme can be found in
Matthew H. Kramer, ‘Rights Without Trimmings’, in Id. e altri, A
Debate over Rights, Oxford, Clarendon Press, 1998, pp. 7-111, 7-60.
(14) See,
for example, David Miller Social Justice, Oxford, Clarendon Press, 1976,
pp. 52-82 and Hillel Steiner, An Essay on Rights, Oxford, Blackwell, 1994, pp.
59-108. A discussion of this problem can be found also in Jones, Rights,
cit., pp. 12-25.
(15)
This is true assuming that the right to life is (D1+D3).
Instead, if we define the right to life (D1+D2), withdrawing life-sustaining treatment
would be a case of renunciation of the right to life.
(16) From
now, without any other specification, I will use ‘euthanasia’, but I will refer
to‘voluntary euthanasia’.
(17) These
are basically consequentialist objections regarding the negative effects that
the permissibility of assisted suicide might cause.