Euthanasia: Opposing Viewpoints by David L. Bender and Bruno Book review by Joseph Uphoff One of a series that discuss controversial issues, this work presents different perspectives on euthanasia. Structurally, it is an anthology organized around five aspects of the issue. Preceding each article and ending each aspect is a list of points and questions the editors ask the reader to consider as well as encapsulated biographies of the authors. Section 1 discusses the ethics of euthanasia. Margaret Pabst Battin maintains euthanasia is indeed ethical and moral, within guidelines she proposes, so as to alleviate the pain of the patient. Joyce Ann Schofield argues that life is sacred, and if we allow euthanasia for the terminally ill, what is to stop us from applying it to the disabled or minorities? She suggests hospices as an alternative. E. Fritz Schmerl discusses legal aspects of euthanasia and advocates legislative and societal changes, including living wills, toward a more favorable position. He mentions that some clergy see passive euthanasia as indeed ethical. Charlotte Low argues that courts are overstepping their authority in granting euthanasia petitions. She maintains that the "quality of life" argument is invalid, as courts are vague as to its meaning and application. James Rachels suggests that there should be no moral distinction between passive and active euthanasia. Rather, he believes we should consider euthanasia a single issue rather than yes for passive, but no for active. However, Robert Campbell and Diane Collinson maintain that such a distinction can and should be made, and they directly address Rachels' article. Section 2 discusses what policies American society should consider toward euthanasia. Elizabeth Ogg argues that euthanasia should be legal. She cites several cases in which the family or person directly involved had requested that the hospital staff discontinue treatment, or had signed a previous declaration to that effect, and the staff did not comply. She concludes with the status of euthanasia laws in various states. While Stephen G. Potts supports euthanasia on an individualized basis, he is opposed to governments legislating in favor of it. One of his primary concerns is where it will stop. Fred Rosner differentiates medical treatment such as surgery from supportive treatment such as providing nourishment, and argues the latter should not be denied terminally ill patients. He maintains that, according to Judaeo-Christian morality, we have an obligation to live rather than a right. Dan W. Brock suggests that there is no actual difference between allowing a person to die by removing a respirator and killing him by denying nourishment, but asks: can either approach be morally justified? Howard Caplan advocates legislation allowing doctors to employ euthanasia upon receiving consent from the family and an independent medical panel. Nat Hentoff believes that doctors should honor the Hippocratic Oath and reject euthanasia. He uses the Nazis as an example of what might happen if it becomes legal. Section 3 discusses what factors should be used in deciding whether euthanasia is appropriate. Quality of life is discussed favorably by Norman L. Cantor. He does advise caution when this criterion is used. Sheryl A. Ross argues that only in extreme cases should euthanasia enter the picture. Otherwise the physician should do what he can to treat his patient, including surgery and administering drugs to alleviate pain. Believing that families are not objective, she rejects their involvement in the process. Daniel Callahan suggests that because health care is getting expensive, especially for the elderly, society needs to rethink its outlook on death and accept it rather than try to prolong its inevitability. Roy A. Fox believes there is discrimination against the elderly regarding the treatment they receive. He advocates a system in which age is irrelevant to the quality of care one receives. Richard D. Lamm advocates rationing health care to cut costs which he believes are too great a burden for America to handle. Dana E. Johnson warns that, due to rising costs and fear of litigation, doctors might take those factors into consideration while treating patients. Instead, a system of patient advocacy that would represent the needs of those who could not otherwise afford health care is proposed. Section 4 addresses the issue of who should decide; several alternatives are presented. Gerald Larue believes the final decision is the patient's. He has no problem with a doctor actively assisting should the need arise. Christaan Barnard favors legislation whereby doctors make the final decision, as they are best qualified to determine when a condition is actually terminal. Susan M. Wolf discusses a case in which the doctor did not trust the patient's judgment from prior experience and suggests that, because close family members usually know the patient's wishes, they should be consulted. Ezekial J. Emanuel advocates a plan whereby community standards should be employed rather than individual. While he believes this would allow greater freedom, it raises the question (which he does not address): what if the people involved do not agree with the community standard? Judith Areen discusses living wills and other documents that should guide doctors in what they can do in situations where the patient is no longer capable of making decisions. George A. Kendall believes terms such as "extraordinary care" and other terms used in living wills are difficult to define and subject to potential abuse. Thus he is opposed to their use. Section 5 focuses on infants. Earl A. Shelp maintains that there is no moral distinction between killing and letting die. Thus he suggests that active euthanasia should be used in cases where it would cause less suffering than passive. Arthur Caplan, et al. oppose active euthanasia for infants as errors can be made, abuses possible, or a perceived failure of technology to "fix" the problem. David Andrusko is a pro-lifer who believes disabled infants should be treated. He continues with a speech in support of his movement. Rasa Gusaitis argues that intensive care technology should not be used if it no longer assists the patient. David G. McLone uses spina bifida to discuss issues regarding infant euthanasia and believes treatment should be discussed between the parents and doctor. Ruth Macklin believes that in cases where there is doubt whether treatment would benefit an infant, a hospital committee should arbitrate and have the final say. While most of the authors use logic and examples to support their views, a few nay-sayers use the Bible or the slippery slope to strengthen their case. This leaves open the possibility of editorial bias. These concerns aside, I would recommend reading this anthology. Euthanasia: Opposing Viewpoints. Greenhaven Press, P.O. Box 289009, San Diego, CA 92198-9009. ISBN 0-89908-417-6 paperback ©1989, 235 p. David L. Bender & Bruno Leone, Series Editors; Neal Bernards, Book Editor.