The empathic genesis of the Right to Euthanasia

Luís FONSECA; Guilhermina RÊGO; Rui NUNES

doi:10.34625/issn.2183-2705(34)2023.ic-06

Authors

Luís FONSECA Faculty of Medicine University of Porto https://orcid.org/0000-0001-6984-0612
Guilhermina RÊGO Faculty of Medicine University of Porto https://orcid.org/0000-0002-8590-9832
Rui NUNES Universidade do Porto Faculdade de Medicina, Portugal https://orcid.org/0000-0002-1377-9899

DOI:

https://doi.org/10.34625/issn.2183-2705(34)2023.ic-06

Keywords:

Constitution, empathy, ethics, euthanasia, Law, morality.

Abstract

Euthanasia is an ancient theme that, especially since individual autonomy became the health paradigm in contemporary societies, has aroused deep reflections and declared dissensions between socio-ideological quadrants. The relationship between Empathy and Morality has been addressed several times over recent centuries. Studies and opinion articles present disparate conclusions regarding this relation, mainly because a heterogeneous, nebulous and somewhat maladjusted conceptual approach to human nature has prevailed. In this article, we argue that considering diversity as the fundamental axiological axis of a democratic rule of Law, Empathy is essential to respond appropriately to the most diverse circumstances in which an ethical-legal decision is pending, as in Euthanasia.

Author Biographies

Luís FONSECA, Faculty of Medicine University of Porto

- M.D, Psychiatry Consultant, Senhora da Oliveira Hospital (SOH), Guimarães, Portugal.

- Head of the Psychogeriatrics Unity of the Department of Psychiatry of SOH.

- Pre and post graduate training coordinator of the Department of Psychiatry of SOH.

- Supervisor and Clinical Tutor of the School of Medicine of University of Minho, Portugal;

- PhD. Student, Department of Bioethics, Faculty of Medicine of University of Porto (FMUP), Portugal.

Guilhermina RÊGO, Faculty of Medicine University of Porto

- PhD in Business Sciences from the Faculty of Economics of the University of Porto in the area of hospital management.

- Assistant Professor with Aggregation (in Bioethics) of the Faculty of FMUP, being regent of the Discipline of Hospital Administration of the Integrated Master in Medicine of this Faculty.

- Member of the Scientific Committee of the Doctorate in Bioethics (FMUP) and of the Doctorate in Palliative Care (FMUP).

Rui NUNES, Universidade do Porto Faculdade de Medicina, Portugal

- M.D, PhD. Otorhinolaryngology Consultant.

- Full Professor at FMUP.

- Coordinator of the Advisory Committee of the Disaster Section of the World Psychiatric

Association.

- Secretary General of the International Chair in Bioethics.

- Member of the Council National Ethics Committee for the Life Sciences.

References

ACÓRDÃO nº 123/2021. Processo nº 173/2021. Tribunal Constitucional Português.

BEAUCHAMP, T., CHILDRESS, J.; Principles of Biomedical Ethics, New York: Oxford University Press, 8th edition.

BLOOM, P. Empathy and Its Discontents. Trends Cogn Sci. 2017 Jan;21(1):24-31. doi: 10.1016/j.tics.2016.11.004. Epub 2016 Dec 2. PMID: 27916513.

CARTA enviada ao Presidente da Assembleia da República: “Palácio de Belém, 29 de novembro de 2021. https://www.presidencia.pt/media/uhjckew3/carta_ar_20211129.pdfCUFF, B., et al. (2016). Empathy: A Review of the Concept. Emotion Review. 8. 144-153.

CHOLBI, M., VARELIUS, J. New Directions in the ethics of Assisted Suicide and Euthanasia. Springer International Publishing Switzerland 2015

DECETY, J., Cowell, J. “Friends or Foes: Is Empathy Necessary for Moral Behavior?.” Perspectives on psychological science: a journal of the Association for Psychological Science vol. 9,5 (2014): 525-37.

DECETY, J., COWELL, JM. The complex relation between morality and empathy. Trends Cogn Sci. 2014 Jul;18(7):337-9. doi: 10.1016/j.tics.2014.04.008. PMID: 24972506.

DECRETO de 10 de abril de 1976. 8ª versão (Lei 1/2005, de 08/12). Constituição da República Portuguesa.

DECRETO N.º 199/XIV. Regula as condições em que a morte medicamente assistida não é punível e altera o Código Penal.

DIERICKX et al. Drugs used for Euthanasia: repeated population-based mortality follow-back study in Flanders, Belgium, 1998-2013. Journal of pain and symptom management. Vol.56 No. 4 October 2018.

FAIRCHILD, G., et al. Mapping the structural organization of the brain in conduct disorder: replication of findings in two independent samples. Journal of Child Psychology and Psychiatry; 16 June 2016.

FERNANDES, R. (1971), A Pena de Morte em Portugal, Lisboa, Ordem dos Advogados.

GANCZAREK, J., et al. From "Einfühlung" to empathy: exploring the relationship between aesthetic and interpersonal experience. Cogn Process. 2018 May;19(2):141-145.

GONÇALVES, F. Attitudes toward assisted death amongst Portuguese oncologists. Support Care Cancer, v. 18, p. 359-366, 2010.

GOUVEIA, A. (1863), Eliminação do salário do carrasco, Lisboa, Assembleia da República.

ISERN-MAS C., GOMILA, A. (2019). Why Does Empathy Matter for Morality?. Análisis Filosófico. 39. 5-26.

JASPERS, K. (1913). General Psychopathology. Johns Hopkins. University Press.

JONES, D., GASTMANS, C., MACHELLAR, C. Euthanasia and Assisted Suicide: Lessons from Belgium. Cambridge University Press. 2017.

KAPLAN, A., ARP, R. Contemporary debates in Bioethics. John Wiley & Sons. 2014.

LENZEN, LM., et al. Exploring the neural correlates of (altered) moral cognition in psychopaths. Behav Sci Law. 2021 Dec;39(6):731-740.

MAIBOM, H., ed. Empathy and Morality. New York: Oxford University Press, 2014. Oxford Scholarship Online, 2014.

MASTO, M. (2015), Empathy and Its Role in Morality. South J Philos, 53: 74-96.

NUNES, R. Diretivas antecipadas de vontade. 1ª ed. Conselho Federal de Medicina / Faculdade de Medicina da Universidade do Porto. Quality Gráfica e Editora, 2016. ISBN 978-85-87077-44-8.

NUNES, R. Ensaios em Bioética. 1ª ed. Conselho Federal de Medicina / Faculdade de Medicina da Universidade do Porto. Tikinet Edição Ltda, 2017. ISBN 978-85-87077-47-9.

NUNES, R. Testamento Vital. 1ª ed. Coimbra: Almedina, 2011.

OXLEY, J. (2011). The Moral Dimensions of Empathy, Limits and Applications in Ethical Theory and Practice.

PASCAL E. Being similar while judging right and wrong: The effects of personal and situational similarity on moral judgements. Int J Psychol. 2019 Apr;54(2):188-196.

PASSOS-FERREIRA, C. (2015). In Defense of Empathy: A response to Prinz. Abstracta_ 8 (2):31- 51.

PRINZ, J. (2011), Against Empathy. The Southern Journal of Philosophy, 49: 214-233. https://doi.org/10.1111/j.2041-6962.2011.00069.x

RACHELS, J. The Elements of Moral Philosophy 7th Edition. McGraw-Hill Education. 2011.

RICCELLI, R., et al. Surface-based morphometry reveals the neuroanatomical basis of the five-factor model. Social Cognitive and Affective Neuroscience; 25 Jan 2016;

ROPPER, AH., et al. (2005). Adams and Victor's principles of neurology. New York: McGraw-Hill Medical Pub. Division.

SAHOO, S., PEARL, PL. Locked-In Syndrome. NORD Guide to Rare Disorders. Lippincott Williams & Wilkins. Philadelphia, PA. 2003:554.

SAMIA, A., HURST, AM. Assisted Suicide and euthanasia in Switzerland: Allowing a role for non-physicians. BMJ Volume 326. 1 February 2003.

SIMMONS, A. In Defense of the Moral Significance of Empathy. Ethic Theory Moral Prac 17, 97–111 (2014).

SLOTE, M. (2010). The Mandate of Empathy. Dao. 9. 303-307.

SLOTE, M. (2017). The Many Faces of Empathy. _Philosophia_ 45 (3):843-855.

THIBAUT, F. The mind-body Cartesian dualism and psychiatry. Dialogues Clin Neurosci. 2018 Mar;20(1):3. doi: 10.31887/DCNS.2018.20.1/fthibaut.

TOST, H., CHAMPAGNE, F., MEYSER-LINDENGERG, A. Environmental influence in the brain, human welfare and mental health. Nat Neurosci 18, 1421–1431 (2015).

VAN HOOF, A. “Ancient euthanasia: 'good death' and the doctor in the Greco-Roman world.” Social science & medicine (1982) vol. 58,5 (2004): 975-85.

VAUGHN, L. Bioethics: principles, issues and cases. Oxford University Press. 4th Edition.

WILLE, N., et al. Risk and protective factors for children’s and adolescents’ mental health: results of the BELLA study. Eur Child Adolesc Psychiatry 17, 133–147 (2008).

WOITHA, K., et al. “Ranking of Palliative Care Development in the Countries of the European Union.” Journal of Pain and Symptom Management vol. 52,3 (2016): 370-7.