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Although Theravada Buddhism and Roman Catholicism agree on the moral justification for palliative sedation, they differ on the premises underlying the justification. While Catholicism justifies palliative sedation on the ground of the Principle of Double Effect, Buddhism does so on the basis of the Third Noble Truth. Despite their theological differences, Buddhism and Catholicism both value the moral significance of the physician’s intent to reduce suffering and both respect the sanctity of life. This blurs the demarcation line between Buddhism and Catholicism regarding the moral justification of palliative sedation.

The passage of time influences the content of the law and therefore also the validity of legal arguments. This is true even for charter-arguments, despite the widely held view that constitutional law is made to last. In this paper, I investigate the reason why the sanctity-of life argument against physician assisted suicide lost its validity between the Supreme Court decision in Rodriguez v. British Columbia in 1993 and Carter v. Canada in 2015. I suggest that a rhetorical approach to argument evaluation is the best basis for a satisfying explanation.

This paper analyzes the nature of the debate generated prior to the implementation of the Act Respecting End-of-Life Care in 2015 in Quebec (Canada). Including medical assistance in dying (MAID) along existing palliative care services, the act is an important policy change on a very sensitive issue. As such, MAID could be categorized as a morality policy issue, the latter being defined as a particular category of policy because of its specific features (issues of first principle, technical simplicity, high salience, public interest, and public participation). In line with Mucciaroni’s proposition, we rather analyze this issue by understanding morality policy as one of two framing strategies (moral and/or rational-instrumental frame). Our research reconstructs four public opinion framings as advanced and transmitted through the media between 2005 and 2015. It shows that although opponents to the bill unsurprisingly framed the debate in deontological terms, mostly referring to sanctity of life as one of the most important values in society, they also framed it on rational-instrumental grounds in a similar proportion, alleging the danger of a slippery slope and potential abuse. As well, if some of the proponents favored a moral framing centered on the argument that dignity and individual autonomy take precedence over all other values, others put forward a rational-instrumental one, where the slippery slope/abuse argument is used as a cautionary statement against the artificial prolongation of life. Our analysis reinforces Mucciaroni’s and Ferraiolo’s assertions that sensitive issues classified as morality policy cannot be apprehended solely through the unidimensional frame of morality.

Given the relationship between moral objections to suicide, physician-assisted suicide (PAS), and euthanasia and religion, it is important to understand under what conditions clergy have moral objections to suicide, ending futile medical treatment, PAS, and euthanasia. This study used thematic analysis to explore the moral deliberations of 15 clergy and the right- and wrong-making properties of nine death and dying scenarios. Fifteen Catholic, Jewish, and Protestant clergy completed semi-structured interviews. Data analysis generated eight themes: sanctity of life, preservation of the natural course of life, pastoral care, support of the faith community, referral to professional services, end-of-life decision in community, consultation with medical professionals, and a shift to a hopeful narrative. Respondents consistently endorsed the priority of pastoral care, demonstrating a deep concern for the well-being of suffering congregants. In conclusion, respondents were consistent in the application of eight themes to end-of-life scenarios but differed in their approach to the removal of a feeding tube and being present for a PAS death. Every respondent objected to suicide.

The determination of death by neurological criteria remains controversial scientifically, culturally, and legally, worldwide. In the United Kingdom, although the determination of death by neurological criteria is not legally codified, the Code of Practice of the Academy of Medical Royal Colleges is customarily used for neurological (brainstem) death determination and treatment withdrawal. Unlike some states in the US, however, there are no provisions under the law requiring accommodation of and respect for residents' religious rights and commitments when secular conceptions of death based on medical codes and practices conflict with a traditional concept well-grounded in religious and cultural values and practices. In this article, we analyse the medical, ethical, and legal issues that were generated by the recent judgement of the High Court of England and Wales in Re: A (A Child) [2015] EWHC 443 (Fam). Mechanical ventilation was withdrawn in this case despite parental religious objection to a determination of death based on the code of practice. We outline contemporary evidence that has refuted the reliability of tests of brainstem function to ascertain the two conjunctive clinical criteria for the determination of death that are stipulated in the code of practice: irreversible loss of capacity for consciousness and somatic integration of bodily biological functions. We argue that: (1) the tests of brainstem function were not properly undertaken in this case; (2) the two conjunctive clinical criteria set forth in the code of practice cannot be reliably confirmed by these tests in any event; and (3) absent authentication of the clinical criteria of death, the code of practice (in fact, although implicitly rather than explicitly) wrongly invokes a secular definition of death based on the loss of personhood. Consequently, the moral obligation of a pluralistic society to honor and respect diverse religious convictions to the greatest extent possible is being violated. Re A (A Child) is contrasted with the US case of Jahi McMath in which the court accommodated parental religious objection to the determination of neurological death codified in the Uniform Determination of Death Act. We conclude that the legal system in the United Kingdom should not favour a secular definition of death over a definition of death that is respectful of religious values about the inviolability and sanctity of life. We recommend the legal recognition of religious accommodation in death determination to facilitate cultural sensitivity and compassionate care to patients and families in a pluralistic society. Electronic supplementary material The online version of this article (doi:10.1007/s10730-016-9307-y) contains supplementary material, which is available to authorized users.

Embryonic Stem Cell Research (ESCR) raises ethical issues. In the process of research, embryos may be destroyed and, to some, such an act entails the 'killing of human life'. Past studies have sought the views of scientists and the general public on the ethics of ESCR. This study, however, explores multi-faith ethical viewpoints, in particular, those of Buddhists, Hindus and Catholics in Malaysia, on ESCR. Responses were gathered via semi-structured, face-to-face interviews. Three main ethical quandaries emerged from the data: (1) sanctity of life, (2) do no harm, and (3) 'intention' of the research. Concerns regarding the sanctity of life are directed at particular research protocols which interfere with religious notions of human ensoulment and early consciousness. The principle of 'do no harm' which is closely related to ahimsa prohibits all acts of violence. Responses obtained indicate that respondents either discourage research that inflicts harm on living entities or allow ESCR with reservations. 'Intention' of the research seems to be an interesting and viable rationale that would permit ESCR for the Buddhists and Hindus. Research that is intended for the purpose of alleviating human suffering is seen as being ethical. This study also notes that Catholics oppose ESCR on the basis of the inviolability of human life.

Whereas indirect euthanasia is a common clinical practice, active euthanasia remains forbidden in most countries. The reason for this differentiation is usually seen in the principle of double-effect (PDE). PDE states that there is a morally relevant difference between the intended consequences of an action and merely foreseen, unintended side-effects. This article discloses the fundamental assumptions presenting the basis for this application of the PDE and examines whether these assumptions are compatible with the PDE. It is shown that neither a liberal nor a utilitarian point of view makes the utilization of the PDE possible. In accordance with philosophical tradition, only within the doctrine of the sanctity of life does the PDE seem to be applicable. By analysing the premises of this doctrine, and comparing them with those of the PDE, the inconsistency of this idea is demonstrated. It is suggested that the role of the PDE in the current discussion on euthanasia is largely exaggerated.

What should Japanese doctors do when asked by a patient for active voluntary euthanasia (VE), when the family wants aggressive treatment to continue? In this paper, we present the results of a questionnaire survey of 366 Japanese doctors, who were asked how they would act in a hypothetical situation of this kind, and how they would justify their decision, 23% of respondents said they would act on the patient’s wishes, and provided reasons for their view; 54% said they would not practice VE, either because they were opposed to VE as such, or because they believed that the wishes of the patient’s family should be respected. Analysis of these responses yielded the following results: Doctors willing to respect the patient’s wishes defended their decision by highlighting the significance of patient autonomy and the patient’s exclusive ownership of his or her life; doctors unwilling to act on the patient’s wishes fell into two broad categories — those who based their reasoning on the family’s objections, and those who provided other reasons for refusing VE. Respondents who said they would not comply with the patient’s wishes because of family objections provided the following kinds of rationale: doctors have serious responsibilities not only to the patient, but also to the patient’s family; the importance of the family-doctor relationship; fear of lawsuits for murder and related criminal offences; the need for agreement among all those affected by the decision, and the belief that the patient’s life is not his or her own, but the family’s. Respondents who gave non-family centred reasons for not complying with the patient’s wishes pointed to values such as the sanctity of life, or the importance of a natural death In the remainder of this paper, we discuss the implications of a family-centred approach to VE.

Leon Kass's often-cited essay, “Death with Dignity and the Sanctity of Life,” provides the basis for a case study in the rhetorical function of definition in debates concerning bioethics. The study examines the way a particular definition of “human dignity” is used to maintain an advantage of power in the debate over the morality of physician-assisted suicide. It also considers sources of human dignity that are deflected from attention by the rhetoric of Kass's formulation.

In recent years there has been an increase in the number of requests for "mercy killings" by patients and their relatives. Under certain conditions, the patient may prefer death to a life devoid of quality. In contrast to those who uphold this "quality of life" approach, those who hold the "sanctity of life" approach claim that life has intrinsic value and must be preserved regardless of its quality. This essay describes these two approaches, examines their flaws, and offers a "golden path" between the two extreme positions. We discuss the halachic and the secular views, arguing for a balance between the sanctity of life and the quality of life. We argue that, indeed, such a balance exists in practice, and that life is important, but it is not sacred. Life can be evaluated, but quality of life is not the sole criterion.

The military might of the modern era poses devastating threats to humankind. Wars result from struggles for material or ideological power. In this context the probability of flouting agreements made during peaceful times is great. The rights of victims and the rights of medical personnel are vulnerable to State and military momentum in the quest for sovereignty. Scholars, scientists and physicians enjoy little enough influence during times of peace and we should be sanguine about their influence during war. But we also must avoid becoming co-opted by partisan political forces. The universal ideals for which we strive, need to be cherished and kept central in our field of vision if we are to rise above man's basest instincts and if we are to preserve professional integrity, individuality and humanitarian concern for the sanctity of life — even the lives of our foes who are engaged in battle against us. Such compassion also recognizes the coercion implicit in recruiting persons into wars they detest and which pits them against their own image. Man's inhumanity to man, most evident during war, must not be allowed to pervade the sanctuary of medical care. Health professionals must constantly be encouraged to serve humankind with empathy and compassion and great social effort needs to be expended to facilitate this role globally and under all conditions.

Human males are the cause of virtually all of our major problems on the Earth. Most past and present dictators, elected political officials, military officials and terrorists have been or are males who inflict immense human suffering by their actions. Rarely have females been responsible for comparable degrees of destruction. In fact, men have consistently cast tremendous suffering not only upon themselves, but also on women and children. Disregard for the sanctity of life – the lives of humans and other living organisms – seems to be a macho male thing. Males can also be considered responsible for our uncontrolled human population growth. Women empowerment and birth control availability always lead to greatly reduced fertility rates, regardless of the country, regardless of the poverty level. It’s men’s sex drive, not the desire for children, that has led to overpopulation and all of our current environmental problems. Men, often masquerading as local, national and world heroes, have been the causes of wars, war crimes, genocide and acts against humanity. They have implemented measures that have polluted and continue to pollute our biosphere for political and economic gain. They strive to achieve personal power and enhance acquisition. The political–military–industrial complex is dominated by men. Colonial and imperialistic doctrines and actions are and have always been male dominated. Recognizing these facts, we wonder if it isn’t the right time to consider a change, maybe an abrupt about face! Legal corruption is another immense international problem. Legal corruption can be considered as decisions and actions that are deemed legal only because the laws are inadequate, inappropriate or unjust. These laws have not evolved to protect world citizens and their common shared biosphere. Such laws do not actually prohibit actions damaging to major segments of society. They don’t ensure the welfare of the people because the lawmakers didn’t have the best intentions for humanity as a whole. Global warming, habitat destruction, and unintended species extinction provide examples. The universal legislation that should protect our planet simply doesn’t exist. One cannot break a legal law that, for whatever reasons, has not yet been formulated. Our common, shared biosphere is not sustainable with our current and future projections of population growth, pollution, energy usage, food consumption, frivolous product manufacture, and waste generation. The continuance of a world with billions of humans living in poverty under squalid conditions is not Water Air Soil Pollut (2009) 200:1–2 DOI 10.1007/s11270-006-9278-8

The biodiversity found in our biosphere is immense and still not fully identified. Given the likely millions of species of microorganisms and other unidentified eukaryotic species, we can conclude there is still a significant paucity of knowledge on the total biodiversity of our common biosphere. However, none of these diverse live forms are necessary. To the best of my knowledge, life is not necessary anywhere in the universe. The origin of life was not necessary, evolution and diversification of life was not necessary and humans are not necessary in the universe. In fact, the universe can carry on expanding and maybe even collapse at some time, all in the absence of any life forms. Our presence in the universe may therefore seems rather unimportant and insignificant. From a philosophical and scientific perspective this may be an accurate assessment, even though we do not know our future destiny and the life span of our emerging technological civilization. Some may disagree with me from a religious perspective. On a more practical level, humans do think they are necessary in the universe. We want to enjoy our lives, our loved ones, relatives and friends. And most people I know certainly want to better humanity on a global scale. As humans we are faced with the realization that the universe can exist without us, but our minds/consciousness and humanity tells us that we value the sanctity of life and our common biosphere on the Earth. Let us seek global solutions to infectious diseases and pollution that are so devastating to life. We can turn our focus to the health and well-being of life forms in our biosphere as it is all we have at this time in our civilization. Water Air Soil Pollut (2010) 205 (Suppl 1):S3 DOI 10.1007/s11270-006-9292-x

The birth of conjoined twins is extremely rare, and survival even rarer, but their neonatal management poses clinical and ethical issues of the greatest complexity for the patients, their surrogate decision makers, health care workers and society. The clinical issues are highly complex as the unique detailed anatomy has to be defined as an urgent priority for assessment of viability and planning future management including separation if possible at an appropriate time. As two individuals connected together who may be physiologically interdependent, the mode of separation raises burdensome conflicts for preserving the separate rights of the two individuals and their equal right to best treatment, and concerns for sanctity of life if one has to be ”sacrificed“ that the other may live. One may suffer treatment induced harms for the benefit of the other and risk becoming a ”means to an end“. In planning treatment the motivation to do good is confounded by the high risk of poor or unpredictable outcome and consequent difficulty in balancing harms and benefits for two interdependent individuals. When is further treatment merely prolonging the dying process?. There is an unclear boundary between clinical care and unlicensed human experimentation which is most acutely felt by the bedside nurses. Principal caregivers need to be certain they are not pursuing a path of aggressive treatment to satisfy a personal achievement goal; an unacceptable conflict of interest between themselves and the patients. Likewise the institution must ensure that there are not corporate reasons for involvement in such cases because of the positive media exposure they may bring. Media interest in conjoined twins knows almost no bounds. Yet in such an environment confidentiality must be carefully maintained and parents protected from the media if it is the family's wish that their most personal family catastrophe be kept completely confidential. Such a degree of confidentiality is a heavy burden for caregivers at all levels who require debriefing sessions to assist in coping with on-going stress. Appropriate care of these patients requires extreme clinical sensitivity and humanity, and repeated validation of ethical issues.