mostly, it is still cancer patients who are living longer. Medicine keeps changing the
pattern of disease and the pattern of dying. I think in America you have such an
enormous belief in medical science that you look upon it and say, 'Isn't it wonderful, it
can do anything.' That's one reason why there is so much aggressive effort in the
system....We, in the Netherlands, look at medical science and say, 'It is indeed
wonderful, but it has its limits.' If you always vote for life, you never accept death, and
of course we all must."8
b. Soviet Views on Euthanasia. In 1989, six American philosophers
specializing in medical ethics met with fifty Soviet professionals (physicians,
philosophers, and others) working on issues relevant to medical ethics. They met under
the auspices of the International Research and Exchanges Board and the Institute of
Philosophy of the Soviet Academy of Science. While Soviet medical ethics cannot be
interpreted entirely on the basis of this series of encounters, it does suggest the
direction of Soviet thinking in this area.
(1) A strongly anti-euthanasia posture. For the Soviets in this group, active
killing and withholding or withdrawing treatment were the same. They felt strongly
about the absolute moral prohibition against euthanasia. For them, life is has intrinsic
and absolute value, an end in itself. Thus, the one Moral principle that is without
exception is not to kill.
(a) Even passive euthanasia is wrong from an ethical standpoint.
According to these Soviets, if a person comes to a physician, everything should be
done. He or she has come for the physician's advice and unconsciously wants to be
treated, even if not treatment were requested. Use should be sustained until there is full
confirmation of death from a physiological point of view.9
(b) Numerous anecdotes were related about patients who had not
wanted to be treated, who were, nevertheless, treated successfully. One patient, for
example, was saved after 40 resuscitation attempts. A well-known person with
Parkinson's disease who, over a 3-year period, repeatedly asked to be allowed to die,
remained mentally coherent. The family objected to halting treatment, and his life was
maintained. As a result, he was able to dictate important scholarly contributions.11
These writings, to the Soviet mind, provided justification for keeping him alive, despite
the patient's debilitating pain.
(2) Culturally based ethics. Why should Soviet and Dutch ethical positions
on euthanasia be so opposite? It is because ethics is culturally based. Events unique
to Soviet history helped shape the strongly pro-life stance. The 1922 Penal Code of the
Russian Federation, which permitted the mercy killing of patients, was abolished after
only 6 months. In addition, the Soviet experience of the war with Nazi Germany was
much more immediate than that of the Dutch, and the Soviet remembrances of it are
much more acute. Systematic extermination under Stalin is another important part of
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