There are 3 case study assignments, I have provided the required readings with each case study Case study and at the end we are suppose to answer the case study questions

READING

This forum is a continuation of a regular series of columns on engineering ethics based on the Applied Ethics Case of the Month program, sponsored by the National Institute for Engineering Ethics (NIEE), Texas Tech University. The Case-of-the-Month program consists of applied ethics cases taken from actual professional practice and presented in narrative format on the NIEE's interactive Web site, with the names of the participants and the locations altered to preserve anonymity. Each case is linked to a series of suggested solutions, not all of which are necessarily ethical but which represent reactions commonly found in professional practice. Web site visitors are given the opportunity to vote on their preferred course of action for the dilemma, as well as to offer commentary. Results are tabulated at the end of the voting period and the statistical responses are reported, along with commentary and in some cases, the actual solution for the case. Actual real-life situations are the central notion upon which the program is founded. Such ethics cases stimulate greater attention to ethical issues, and they allow readers the opportunity to avoid similar pitfalls in their own careers. In addition to individual review and reflection, the case histories may also provide a convenient focus for informal brown-bag discussions in forms and agencies. Those interested in the program are encouraged to visit the NIEE's Case-of-the-Month Web site at the following Internet address: http://www.niee.org/Case-of-the-Month/. Results and discussion appear on the Web site and also appear in this forum section of the Journal of Professional Issues in Engineering Education and Practice. A more detailed description of this program appeared in the January 1998 issue of this journal.

In the early 1980s, Fairview, a medium-sized city, established a Community Service Corporation (CSC) for the purpose of, among other things, revitalizing the city's downtown area. The Fairview CSC was envisioned as a catalytic, coordinating, and creative force to partner with national, state, and other local organizations that seek to solve problems through service by means of entrepreneurial, innovative, effective, and efficient utilization of its resources and influence. After doing an economic feasibility study and making a survey of Fairview's retailers, the CSC leadership concluded that a significant catalyst needed to be established in Fairview's downtown area. As an example, a consultant suggested an "off-price mall." Using the statistical data developed, the group put together a brochure to entice developers to undertake the project, and numerous brochures were sent out, but no one responded.So it went for several years, with nothing really going on in the way of downtown growth or revitalization. But things magically began to happen when Arthur, a principal in a local structural, environmental, and civil engineering firm, was elected president of the Fairview CSC. A long-time resident of Fairview, Arthur had the personal devotion, the vision, the political connections, and the effervescent energy needed to get the revitalization going. This was one of many volunteer positions Arthuran active citizen nearing retirement ageparticipated in, and he received no compensation for any of his services. Fairview's first revitalization success accomplished under Arthur's leadership was to persuade the state government to build a state office building in the downtown area and to concentrate a number of its offices in the building. Shortly after completion of that project, a second effort, to encourage the federal government to fund the construction of a federal courthouse and office building, was also successful. To add to these projects, a "capstone" development has just been announced. This new development includes a high-rise county office building with an underground connection to the federal building and a city building, along with a central fire station, police station, and city hall. The Fairview community is ecstatic. Arthur has enjoyed a high profile and has generally been acknowledged as a leader in these efforts, and his selfless service in these wonderful successes is being praised throughout the city. Selections are in the process of being made for the design work of the federal courthouse and office building project, and the Fairview CSCeven though they are not the "Owner"is one of the organizations that will directly participate in influencing the awarding of contracts. Larger design firms are beginning to contact smaller local consulting firms, including Arthur's firm, soliciting their participation. Actually, in the case of Arthur's firm, just one year ago Arthur transferred leadership to his son, David, who is now the president and chief executive officer. Arthur is the chairman and principal stockholder of the firm. A major design firm submitting a proposal to lead the design effort for the courthouse/office building project asks David and Arthur to partner with them by providing the production aspects of the civil/structural work. Arthur's firm was not involved in the previous (state office building) project, so this as a highly significant and appealing opportunity, all the sweeter when viewed as the well-deserved payoff for Arthur's years of volunteer service, local presence, and investment in the Fairview community. But therein lies the hitch. Monroe, a competitor engineer in Fairview, has become aware of the possible teaming of Arthur and David's firm with the other company (not him). Monroe realizes the connections and unique influence Arthur has had throughout the project development process in his role as president of the CSC, and even though Arthur has publicly gone on record that he will abstain from deliberations about the awarding of any engineering contracts, this does not satisfy Monroe. Monroe has written letters to the editor of the Fairview newspaper decrying any type of involvement in the project by Arthur and David's firm as a conflict of interest. Further, Monroe has started "discussions" of the issue in the State professional engineering community, couched in language about protecting the ethics of the profession.

How should Arthur and David respond?

Alternate Approaches and Survey Results

1. Pursue the opportunity, vigorously. There is nothing unethical about proactive business opportunity development. Arthur and David should accept partnership on the project. They were invited, and they have earned respect by their previous efforts on behalf of the community. While recusing himself from deliberations about consultant selection on the project, Arthur should stay involved with the Community Service Corporation and advise his son and the out-of-town firm how to best position themselves during proposing and negotiating. Percentage of votes agreeing: 12%

2. Check the law, carefully. Arthur and David should carefully review their State licensure law provisions having to do with conflicts of interest. Further, they should personally visit their State Engineering Licensure Board to explain their own position on what is happening with respect to the project and the safeguards that have been put in place to avoid the appearance of a conflict of interest, and they should request that the Engineering Licensure Board undertake a review and render an opinion. Percentage of votes agreeing: 31%

3. Invite third party opinion, publicly. Arthur and David should approach the State Society of Professional Engineers regarding their firm's intent to pursue the opportunity to participate in the design of the project and call for an open forum within the state professional community on the ethical issues. In so doing, Arthur should clearly and explicitly document how he will continue to abstain from assisting the Community Service Corporation in providing input to contract awards. Percentage of votes agreeing: 14%

4. Change the RFP, slightly. Arthur should use his influence with the Community Service Corporation to remove subconsultant services from consideration as part of the selection of the prime consultant. This diffuses the conflict-of-interest issue, and once the prime consultant is selected, that firm will be free to choose whichever subconsultants they need for the project on the basis of qualifications. Arthur's firm still stands in good stead to win the contract, but without the ethical complications. Percentage of votes agreeing: 6%

5. Share the wealth, generously. Realizing that there will be plenty of work to go around, Arthur should influence the Community Service Corporation to devise a system whereby project work can be shared on a rotation basis among local firms, including his firm, Monroe's firm, and other local design consultants. Percentage of votes agreeing: 2%

6. Create distance, deliberately. Given Arthur's history and success with the Community Service Corporation, the only way Arthur can ethically pursue the work with the out-of-town firm and avoid the conflict of interest is to create distance between himself and the project. Arthur must delegate all contact on this project to another senior manager in his firm and divorce himself and his son from the project. Also, Arthur must exclude himself physically from all deliberation by the Community Service Corporation related to the project. Percentage of votes agreeing: 4%

7. Curtail CSC activity, temporarily. Arthur realizes that if he remains as president of the Community Service Corporationand his firm pursues this project, there will be at least the appearance of a conflict of interest. Therefore, his firm should pursue the project but Arthur should take a sabbatical from the Community Service Corporation until the consultant is selected. Percentage of votes agreeing: 2%.

8. Curtail CSC activity, definitively. Arthur realizes that if he remains as president of the Community Service Corporation and his firm pursues this project, there will be at least the appearance of a conflict of interest. Therefore, his firm should pursue the project but Arthur should take a sabbatical from the Community Service Corporation until construction is completed. Percentage of votes agreeing: 2%

9. Curtail CSC activity, completely. Arthur realizes that if he remains as president of the Community Service Corporation and his firm pursues this project, there will be at least the appearance of a conflict of interest. Therefore, his firm should pursue the project but Arthur should resign from the Community Service Corporation. Percentage of votes agreeing: 8%

10. Walk away, happily. Arthur and David should decline involvement in the project, thus protecting their reputations and enhancing their high esteem in Fairview. Arthur should have realized when he accepted the presidency of the Community Service Corporation that his position would sooner or later place him and his firm in this predicament. If he truly intended that his work for the CSC be a service to the community, Arthur can rejoice at his success in that area and not allow short-term impact on his firm to dampen his civic enthusiasm. Percentage of votes agreeing: 18%

Forum Comments from Respondents

1. Only by walking away from the project and forsaking any chance of profit can Arthur dispel all appearance of conflict and leave everyone feeling assured of his sense of civic duty. Simply resigning from the CSC while still pursuing the project is insufficient sacrifice, because the CSC presidency is a volunteer position.

2. Arthur was a nonpaid executive so he did not benefit financially from his community service. In order not to have any potential conflict of interest issues he should resign his position completely before his firm seeks the job.

3. In the long run, refusing the contract will protect his firm and the legacy he has built in his community. Certainly, Arthur's work with the CSC was on a charity/volunteer basis, and his pay-off was building a city and better community. He has also built for himself a fine reputation and a new understanding of how civic projects get off the ground. This experience will become invaluable in other contracts in the future that have no conflict of interest and will grow his firm. Arthur's character appears to be honest; however, even an appearance of an ethical lapse can destroy a lifetime of building a reputation, years of work at the CSC, and make receiving future work from competing firms impossible. Arthur should leave this opportunity to others not associated with the CSC.

4. Arthur's obligations to act faithfully and avoid deceptive acts require that he make a decision about whether to remain on the CSC or continue his affiliation with the company he founded. Technically or not, Arthur is still seen as a principal figure within the company he foundedit is assumed that he is not yet ready to give up his stake. The greatest consequence would be realized if Arthur continued on his present course. Were he to and the CSC awarded the contract to the major design firm, Arthur would be ethically obligated to step down from the CSC, or, either vacate his position from his company or have his company withdraw from the design firm partnership. In so doing, Arthur puts his fellow CSC committee members in an awkward predicament and he may even cause them to arbitrarily select a different company. The end result is that the integrity of the CSC, the integrity of the design firm, and Arthur's own integrity might reasonably be challenged. The lesser consequence would be incurred should Arthur permanently resign his post from the CSC. Then, should Arthur's partnership get the contract, the integrity of the CSC might be brought into question but this issue would be entirely the responsibility of the CSC committee members. Should the contract go to another design firm, Arthur has simply to look for another challenge or seek reappointment to the CSC. In any event, Arthur would bear no responsibility or obligation for choices made by the CSC members.

Comments from Board of Review Members

1. Some observations on this case: (1) Each professional must have and trust his or her own "ethics compass," and follow its guidance; (2) it is very difficult to co-calibrate the ethical compasses of those holding different worldviews, even if they are from within a single profession; and (3) codified ethical standards are not clubs or wedges for forcing someone else to change their behaviorthey are the "the wicks of the candles" with which we should light our own way.

2. David and Arthur are in a pickle. No matter how "clean" the selection process actually is, there will be an unavoidable perception that the process has been influenced by Arthur's position and influence. Is it a "conflict of interests?" It doesn't matter; it will be perceived as one. Because the services Arthur and David's firm provide are "lower-tier" subconsulting services, one solution to the dilemma would be to remove subconsultant services from selection of the prime consultant-architecture based services. Once the architect is selected, he can be free to choose whichever subconsultants he needs for the project. Arthur's firm still stands in good stead to win that contract, but his influence over the selection process has been greatly diminished. Alternatively, Arthur's best choice is to remove his firm from the proposal process completely, so that the project can proceed without contestation. His new position within the firm is irrelevant as he is still the principal shareholder and so the one who stands to gain the most from this engagement. Arthur should have realized when he accepted the presidency of the organization that his position would sooner or later place him and his firm in this predicament. It's unfortunate that his great efforts are so poorly rewarded, but perhaps they'll at least name a building in his honor. Arthur's weakest choice is to go on the offensive and confront Monroe's allegations as ridiculous and unfounded. He will initially win the press war, but will ultimately tarnish the project, his tenure as president, and his firm. The project itself will overshadow all the good things he was able to accomplish for the community.

3. The conflict of interest is not the same in all states, at least from the perspective of engineering licensure law. Some state statutes are very specific and some are broad. Two examples:

South Carolina. "When in public service as a member, advisor, or employee of a government body or department, the Engineer or Land Surveyor shall not participate in considerations or actions with respect to services provided by him or his organization in private engineering or land surveying practices."

Georgia: Same as above, plus"...An engineer shall not solicit or accept an engineering contract from a governmental body on which a principal or officer of his organization serves as a member." Either of these can be interpreted to give Arthur some leeway. The first says that he must exclude himself from any activities during proposing and negotiating the work and maybe from the active participation in the project if his firm is awarded the contract. The second is similar but, since the Community Service Corporation is not the "Owner," Arthur may have a loophole as long as service on the Community Service Corporation is not interpreted as "advisory" to the "Owner."

4. David and Arthur should submit Monroe's letter to the State Board of Engineers (SBOE), together with the description of what is happening with respect to the "capstone" project and the safeguards that have been put in place to avoid the appearance of a conflict of interest, and request that the SBOE's Ethics Committee undertake a review and render an opinion. They should then write to the community service organization and the newspaper and inform both that if the SBOE's Ethics Committee rules against them, then their firm will not participate in the project. If they prevail, their competitor looks like a jerk. If not, then they've done the right thing.

5. All codes of ethics in the engineering profession prohibit "conflicts of interest." The case herein raises the possibility of a conflict of interest. It should be noted that (1) Arthur is involved in the Community Service Corporation, and the Community Service Corporation is not the owner of the project, and (2) Arthur has excused himself from participating in the selection of the consultant. There is no indication that the Community Service Corporation will be involved in the design phase of the project. There is therefore, no conflict of interest, and David's and Arthur's firm is free to pursue the assignment.

6. The case focuses on Arthur and David for good reason, but the situation can easily be looked at from other perspectives. For example, was Monroe's action ethical? Was Monroe's real concern protecting the integrity of the profession, or was he using an ethics smokescreen to get the work?

Case study question assignment

Resnik provides several examples of situations involving a conflict of interests, and although we may see how similar situations may arise within engineering research and practice, none of his examples pertain to engineers specifically. Lawson's case study "A Fair Deal in Fairview?" specifically deals with a situation faced by engineers.

The case is based on a situation reviewed by theNational Society of Professional Engineers Board of Ethical Review,^[26]and the issue question that Lawson poses in relation to it is "How should Arthur and David respond?" In the case, we see the alternative approaches (i.e., possible resolutions or options) that were considered by respondents and the percentage of respondents who favoured each approach, as well as the comments made by respondents and by Board of Review members.

One thing that this particular case makes clear is that problems concerning conflicts of interest arise in apparently innocent circumstances. This is most commonly the case. When we hear of a professional's conflict of interest situation in the news, it usually indicates some culpability on the part of the professional who behaved inappropriately or, perhaps, downright immorally and unprofessionally, and often intentionally. These factors are what make the story newsworthy, but these are the exceptions. One of the important things about conflicts of interest is that conscientious, upright, dedicated professionals encounter them, and not uncommonly. Professionals do not have complete control over all dimensions of their work and the ethical implications that may arise within their working relations; nonetheless, professionals must respond to such situations as they arise.

Questions for Case 4.1

1. For each of the ten approaches listed in the case study, briefly explain its main ethical advantage/s (pros) and its main ethical disadvantage/s (cons).
2. Which one of the ten approaches do you think is the best, all things considered, and why? If you think that two or more of the approaches are equally good, explain your reasoning.
3. Use your imagination and develop a different sort of case where a conflict of interests arises for an engineer in the course of her work. Describe the situation.

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CASE STUDY

READING 240-241

Built between 1968 and 1978, the West Gate Bridge in Melbourne, Australia was to be a among bridges."

"masterpiece" Original in design, it is a vital link between Melbourne's city district and the industrial suburbs in the west. The length of the bridge is over

2.5 kilometers (I.6 miles), with the height above the Yarra River being 58 meters (190 feet). It is the world's largest cable-stayed girder bridge. At the time of its construction, it was the longest bridge in Australia and carries eight lanes of traffic. The West Gate Bridge is also the site of Australias single worst workplace catastrophe.

Over 1,000 people were involved in the construction of the West Gate Bridge, including a host of notable designers, prime contractors, suppliers, and engineers. Two engineering firms, Maunsell and Freeman Fox Partners (FFP) were appointed as joint consultants for the design and preparation of tender documents. FFP was responsible for the structural design of the bridge. Two construction companies were awarded contracts, for building the foundations and concrete construction and steelwork construction respectively.

Unfortunately, relations between various groups soon began to deteriorate. The construction company responsible for steelwork claimed no responsibility for the joining of the bridge sections, and this role was transferred to FFP. Several work-delaying union strikes and poor on-site supervision meant that, in its first two years of construction, the building schedule fell seven months behind.

In June 1970, a counterpart of the West Gate Bridge in Wales also designed by FFP--collapsed during construction, killing several workmen. This news created more problems for the West Gate Bridge project. Unions demanded greater safety measures for workers, and a mass stop-work meeting was held until assurances were given by project management that what had happened in Wales would not happen on the West Gate Bridge. A senior engineer from FFP present at the meeting unhesitatingly gave the assurance and work resumed.

It was common practice for the different sections of the bridge to be assembled on the ground, hoisted into place with cranes and bolted together. However, in August 1970, when two particular sections were brought together, it was discovered that the north section was I14 millimeters (4.5 inches) higher than the south section. Rather than take the sections down for correction, engineers decided to put several 8-ton weights on the high section to bring it level with the lower.

In September 1970, there was a major buckle.

Work came to a halt, followed by a month of de- liberation. In October, the engineers decided to unbolt the two sections on each side of the buckle, theorizing that the weight of the higher section would cause it to lower and match the level of the lower section, and then it could be revolted. However, before the process could be completed, the buckle became greater and the 2000-ton span col- lapsed, killing 35 of the 68 workers and causing AUD sI0 million in damage. Several other workers were severely injured. The rebuilding cost AUD $31 million and the total cost of the bridge was three hundred million dollars, more than ten times the original estimated cost.

Ethical Analysis

A Royal Commission was established to investigate the cause of the collapse. It found that one of the main causes of the collapse was FF's structural de- sign. Other causes were "mistakes, miscalculations, errors of judgment, failure of communication and sheer inefficiency. In greater or less degree, the Authority itself, the designers, the contractors, even the labor engaged in the work, must all take some part of the blame."2 It is quite clear from the judgment that the Com- mission found various parties liable for the collapse.

However, perhaps it is not the case that FFP should have been the main cause. One morally relevant issue in this case is the fact that the different parties all contributed to the end result. For example, the designers of the bridge were particularly proud of their original "box-girder" design and insisted that the engineers adhere to it, despite the fact that such a design had not been tested before. Perhaps if they had gone with a more conventional design, the risk of collapse would have been reduced, but at the cost of originality.

Another related issue is how directly related to the collapse a party's action has to be for liability to attach. For example, the unions held up construction with protests and stop-work meetings. Being already seven months behind, such delays in the construction probably contributed to the decision by the engineers to weigh down the section of the bridge that was too high, instead of having to demolish it and rebuild it, to try and make up time.

Doing this would also be an extremely costly process for the client. How much weight should this be given?

Perhaps each party's actions were bound together in such a way that blame should not be attributed specifically to one group (such as FFP) it seems that But for the actions of each of the parties involved"a collapse could have been avoided. If only one party acted irresponsibly, it seems that blame would have been much easier to attribute. However, in this case where all the parties were connected in such a way What an action by one would irrevocably affect all the others, it may simply be the case that accountability could not be separated so simply.

It could also be a question of regulation. Engineers and builders, for instance, have different codes which govern the extent of their liability. However the code for one industry is often written in isolation from another industry. If the level of liability varies between different industries, perhaps this should be made uniform for all industries involved in a project.

However, the different roles that each party has initially may change as the project proceeds (as it did in this case) making it difficult to predetermine the extent of each party's liability.

The Royal Commission found that almost all the parties involved were liable. Only the suppliers were deemed to be blameless. The surviving designers, contractors, and engineers were dismissed. In 2004, on the thirty-fourth anniversary of the disaster, a memorial park was opened at the site of the collapse. 35 pillars were constructed, one for each worker who died.

Study Questions

I.

The Royal Commission summed up its investigation of the collapse as follows:"Error begat error ... and the events which led to the disaster moved with the inevitability of a Greek Tragedy.133

Is this a fair description of the events? Consider the role of the engineers, the construction team, the unions and the designers. How much blame should be attributed to each party?

2.

Suppose that the bridge had been completed without incident and opened to the public.

Two years later, the bridge collapses, killing 35 people on their way to work. Who do you think would be to blame in this case? Would your answer be different if the bridge had collapsed five years later? Ten years later? Fifty years later?

3.

Should there be different rules and regulations for the different groups involved in a large project like building a bridge? Why or why not?

4.

Imagine that you are a builder at the stop-work meeting following the collapse of the FFP-de- signed bridge in Wales. Would you have believed the engineer who made assurances that the West Gate Bridge was safe? Why or why not?

5.

In the engineering industry, originality and visual appeal in design is important, but having a structurally sound bridge is also crucial. How should the interests of originality and design be weighed against safety and social responsibility?

6.

Sometimes experts can do everything right, and something can still go wrong. In this case, engineers deliberated for at least a month to decide how to deal with the buckle, and yet dis- aster still ensued. Presumably they had all the best knowledge of engineering principles at the time. To what extent is the expert responsible when things go wrong?

Case study question assignment

As the title of this case study indicates, the first question at stake here is 1) "Who is responsible?" Answering it, however, as Lau makes clear in her discussion of the case and in the study questions she poses, requires some complex moral reasoning. A more specific way we might put the question to reflect the complexity of the case would be 2) "Given the various parties involved in the West Gate Bridge project, to what extent should each party be held responsible (or blamed) for the project's problems and disastrous outcomes?" Both questions are good ways of expressing the issue in that they direct us to focus on assigning responsibility. The second question, however, indicateshowwe should go about reasoning; for example, that we should first determine who the various parties are. One of the first things we would do in analyzing this case, then, is list all of the parties involved.

Question 2 also explicitly indicates that responsibility need not be "all or nothing," but could be conceptualized as a matter of degree. It is also useful to start with the idea that the total amount of responsibility involved in the case is represented by "100%," and then divide this total among all of the parties, according to the percentage we judge to be fitting. Admittedly, this proportion is not precise because it is based largely on our intuitive understanding or basic moral sense of how responsibility should be generally assigned; but it is a useful starting place, even if we find, as we analyze the case, that we need to adjust our initial attributions. We might initially think, for example, that one or more of the parties involved should bear no responsibility for the problems and outcomes. In her last paragraph, Lau mentions that the Royal Commission found all but one of the parties involved to be blameworthy. The suppliers were determined to be blameless; their part of the total amount of responsibility, according to the Royal Commission, was 0%. What is important here is that responsibility is often shared or spread out over a number of parties, which can make it difficult to assign responsibility and hold parties accountable. Thinking of responsibility as a matter of degree and using a heuristic to represent attributions of responsibility can help us determine more precisely how those attributions should be made.

The next very important step in analyzing the issue would be to provide justifications for how we have divvied up the responsibility. What, precisely, are the reasons for our assigning the suppliers no responsibility, for our assigning FFP its portion, for our assigning the unions their portion, and so on? In this step, we make clear to ourselves the reasoning behind our attributions of responsibility and aim to support those attributions and their comparative weightings. In doing so, we might find that our initial assignments should be adjusted. During this step of clarifying and supporting our reasons, we may well learn more about why the situation should be judged in certain ways and not others. We may learn, for example, that the reasons that initially lead us to assign a majority of the responsibility to a certain party are not as convincing as we thought, and we should adjust our view and our analysis accordingly. We would go back and revise our assignments in the ways indicated by the more careful and precise reasoning that we develop in this step.

Once our reasons are articulated and compared so that their relative weights allow us to provide an overall assignment of responsibility that we believe to be justified, we have reached our conclusion. This is a general strategy that may be used for questions of moral responsibility that involve multiple parties. It is little different than the reasoning strategy outlined in Unit 1, and simply shows in particular how we may argue for dividing responsibility in one way as opposed to others.

Questions for Case 4.2

1. Answer the six questions that Lau poses on pp. 240-241 of your textbook.
2. Consider what might have been done during the West Gate bridge project if a LeMessurier-type engineer had been involved. That is, is there a point in the case where you think a virtuous, imaginative, and insightful engineer might have acted so as to turn the situation around and guide it toward success instead of disaster? If not, why not? If so, what action do you think would have made the difference, and at what point should it have occurred?
3. Also, if an engineer had turned the situation around in such a way, would her action show exceptional professional dedication (of a LeMessurier variety) or would it show just a level of dedication that should be expected? Explain.

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Case study

Reading 515-517

Before examining the case of Terri Schiavo, it is useful to clarify some important concepts:

euthanasia	An act of bringing about a person's death that is motivated by the beliefs that (i) the person's suffering is so severe or quality of life is so poor that death is preferable to his or her continued existence, and (ii) it is in the interests of that person to not continue to exist. Euthanasia is often referred to as "mercy killing."
passive euthanasia	An act of euthanasia accomplished by some passive means such as not providing available treatment (e.g., antibiotics, resuscitation) or withdrawing life-sustaining measures (e.g.,ventilation, a feeding tube). This form of euthanasia is often conceived of as "letting die" as opposed to "killing."
active euthanasia	An act of euthanasia accomplished by some active means such as administering a lethal injection (e.g., potassium chloride). This form of euthanasia is often conceived of as "killing" the person, and sometimes the termmercy killingis reserved for active euthanasia rather than used to refer to euthanasia generally.
voluntary euthanasia	An act of euthanasia clearly and validly consented to by the person whose death is brought about or by a legitimate surrogate who relies on an advance directive or a substituted judgment standard. Clear and valid consent obtains when either (a) the person himself or herselfvoluntarilyandpersistentlyrequests to be helped to die or (b) there isconvincingevidence that the person would want to be euthanized under the circumstances, and a surrogate explicitly decides in favour of euthanasiaon the basis of that evidence.
involuntary euthanasia	An act of euthanasia to which the person whose death is brought about expresses opposition; the act is carried out even though the person expresses a wishnotto die. Some theorists contend, controversially, that onlycompetentpersons can provide valid opposition to euthanasia (just as only competent persons can provide valid consent to it) and so only competent persons can be involuntarily euthanized.[41]
Non-voluntary euthanasia	An act of euthanasia for which the person whose death is brought about has expressed neither favour nor opposition. The person is either able to express his or her view but doesn't or is unable to express a view. Some theorists, as mentioned just above, think that all acts of euthanasia involving non-competent persons are non-voluntary, since non-competent persons can neither validly consent to nor validly reject euthanasia.

Case Description

On February 25, 1990, Florida resident Theresa (Ter-

Mi) Schiavo, daughter of Robert and Mary Schindler, and wife of Michael Schiavo, suffered a cardiac ar- rest leading to brain damage from a lack of oxygen.

During the course of the immediately following hospitalization and attempts at rehabilitation Michael Schiavo was appointed as Ms. Schiavo's guardian and the Schindlers did not object. Over the next few years Ms. Schiavo received intensive therapy at various institutions, including experimental brain and thalamic stimulator treatments. In November of

1992 Ms. Schiavo was awarded over a million dollars in two malpractice suits against doctors involved in her treatment, $300,000 of which went to Michael Schiavo, and another $750,000 was placed in a trust tund tor Ms. Schiavo's medical care.

In 1993 Ms. Schiavos parents and Michael Schiavo had a disagreement over the course of Ms.

Schiavos therapy. As a result, on July 29th, the Schindlers petitioned the courts to have Mr. Schiavo removed as guardian for the first time. A guardian ad litem, who had no decision making power, but who was to represent Terri's best interests before the court was appointed. he guardians report stated that Michael Schiavo had acted appropriately and attentively towards Terri and the petition to remove Michael as guardian was later dismissed.

In May of 1998 Michael Schiavo petitioned the court for the first time to authorize the removal of Terris feeding tube (known as a PEG tube). His petition was opposed by the Schindlers, who maintain that Terri would have wanted to stay alive. A second guardian ad litem was appointed. He agreed that Ms.

Schiavo was in a persistent vegetative state without possibility of improvement, but stated that Michael Schiavos decision making may be influenced by his prospective inheritance of her estate.

On February 11, 2000, Pinellas-Pasco County Circuit Court Judge George Greer ruled that Ms.

Schiavo would have chosen not to live in such a condition and ordered the PEG tube removed. On April 24, 200I, upon the denial of several appeals, the PEG tube was removed for the first time. Two days later the Schindlers filed a new civil suit against Michael Schiavo, and the tube was re-inserted.

During the ensuing court battle the Schindlers alleged that Ms. Schiavo was abused by her husband, leading to her condition, an attempt at mediation between the Schindlers and Michael Schiavo failed, and Governor Jeb Bush filed a federal court brief in support of the Schindler's efforts. On October IS,

2003 the PEG tube was removed once again on the court's orders. On October 20th and 2Ist respectively, the Florida House of Representatives and Senate passed "Terri's Law," allowing the governor to issue a onetime stay in certain cases. As a result, Governor Bush issued an executive order and the PEG tube was reinserted for the second time. By this time, in addition to a maze of court proceedings, the case had become a national media event. Pres- ident Bush publicly praised his brother Jeb Bush's handling of the case. Pope John Paul Il spoke out on "Life Sustaining Treatments and Vegetative state,"defending the obligation to keep Ms. Schiavo alive.

And Randall Terry, the founder of the nationally recognized pro-life group Operation Rescue, made media appearances with the Schindlers. In both the Florida and the US congresses bills were introduced which would, to varying degrees, limit the right of legal guardians in such cases to remove sustenance without the express written consent of the patient themselves.

On September 23, 2004 the Florida Supreme Court declared Terri's Law unconstitutional, and on March 18th of the following year Ms. Schiavo's PEG tube was removed for the third and final time. In the resulting scramble to have the tube re-inserted Governor Jeb Bush reported that a neurologist, Dr. William Cheshire, claimed that Ms. Schiavo was not, after all, in a persistent vegetative state. Despite this, several federal and state appeals failed and on March 3Ist at 9:05 a.m. Terri Schiavo died. A post-mortem revealed that she was indeed in an irreversible vegetative state. Ethical Analysts There are three primary areas of ethical concern in- volved in the Terri Schiavo case. First is the question of decision-making procedures at the end of life. The initial consideration in such cases is always the autonomous will of the patient herself. The right of Ms. Schiavo to request the removal of her PEG tube had been established by the Nancy Cruzan case. Ms.

Cruzan's feeding tube was removed and she died in December 1990, after her family presented what was considered clear and convincing evidence that this would have accorded with her wishes. Since Ms.

Schiavo left no written evidence of her preferences regarding continued treatment, or the abrogation thereof, the decision was left entirely up to her legal guardian. Michael Schiavo was Terris legal guardian during the entire period from her cardiac arrest to her death. He maintained consistently that the removal of the PEG tube was what Terri herself would have wanted. The court's acceptance of his decisions regarding Ms. Schiavo's treatment was blocked, however, by the legal actions of her parents. Robert and Mary Schindler repeatedly claimed themselves as the rightful legal guardians, and the courts were obligated to hear their case before acceding to Mr.

Schiavo's requests for euthanasia. The Schindlers also claimed that, contrary to Mr. Schiavos testimony, their daughter would have preferred to stay alive.

The court's discretion in deciding whose legal guardianship is in the best interests of an incapacitated patient placed it in a very difficult position.

The second area of ethical concern involved in the Terri Schiavo case is the question of the scope of the right to privacy. The courts were petitioned by the litigants in the case, Robert and Mary Schindler and Michael Schiavo. They were therefore rightful participants in the dispute. Governor Jeb Bush, the Florida Congress, and the US Congress were not petitioned as such and had, by some accounts, no business inserting themselves into what should have been a private decision. Others claim that the removal of the PEG tube and Terri Schiavo's subsequent death was an act against moral law, and there- fore the activities of said politicians, as well as other public personalities such as Pope John Paul I and Randall Terry, were justified.

Finally we must consider the status of Terri's "right to die.

" While precedent has established such

a right under certain circumstances, its implementation is still limited to the removal or withholding of treatment. The removal of a PEG tube commences the slow and painful process of starvation. While it is unclear if Terri could do so, it is clear that some patients who ask to die in this manner can feel this pain. Terri began this process and was abruptly renourished twice. If what patients in these situations seek is a "good death" (the very definition of euthanasia) would a less painful and quicker injection be preferable?

Study Questions

I.

Given clear testimonial evidence that the removal of the PEG tube is what the patient would have wanted, but lacking a written statement by the patient to that effect, should the courts and/or medical establishment allow the removal of PEG tubes, or euthanasia of any kind? What guidelines could you recommend to make such decisions easier in the future?

2.

Regardless of the outcome, should end-of-life decisions be private? Does the fact that the decision involves the intentional, though presumably voluntary, ending of a life justify the involvement of politicians? Why or why not?

3.

It you were in a persistent vegetative state, would you want to be unplugged? Would you perhaps prefer an injection? Why or why not? Since we are afforded a right to die, should this right be extended to the right to die in the most humane way possible?

Case study question assignment

It follows from these definitions that there are six types of euthanasia that could be carried out. Since no one disputes the judgment thatinvoluntaryeuthanasia is always unethical, we will discuss neither involuntary passive euthanasia nor involuntary active euthanasia.

In Canada, voluntary active euthanasia, or medically assisted dying as it is referred to in Bill C-14, became legal on June 17, 2016, but is still illegal in much of the United States. The debate surrounding the legalization of euthanasia is highly controversial as is the complexity of how to implement it where it is legal. There have been controversial cases of non-voluntary active euthanasia that have tested aspects of the legal system. Considering voluntary euthanasia, the ethical question, which logically precedes any questions about legalization, is "Are there conditions under which it is ethically permissible to carry out an act of voluntary active euthanasia?" Society remains divided about whether there are such justifying conditions. Likewise, considering non-voluntary euthanasia, we may ask: "Are there conditions under which it is ethically permissible to carry out an act of non-voluntary active euthanasia?" Voluntariness is ethically significant especially because, in relation to euthanasia, it includes (by definition) competence and autonomous decision making, which permit some assurance that death is desired by the patient whose death is to be brought about. In cases where non-voluntary euthanasia is considered, there is not this assurance. For at least this reason, and although the two sets of conditions overlap, any set of conditions that aims to justify voluntary active euthanasia will be different than a set that aims to justify the more problematic case of non-voluntary euthanasia.

Passive euthanasia,so long as it is limited to situations that meet certain conditions, is generally accepted as morally permissible in North American societies and in many other societies throughout the world. Acts of passive euthanasia take place daily in our hospitals and sometimes in our homes. Sometimes we permit people to die, even when we could do something to keep them alive. We do so, usually, when we judge or when they themselves judge that their suffering is too great or their quality of life is too poor to warrant measures that would sustain their lives (as with the terminally ill and with some very old persons). Even though there are some people who oppose all forms of euthanasia, voluntary and non-voluntary passive euthanasiaagain, so long as certain conditions are metare both widely accepted and commonly practised.

Nevertheless, even these seemingly less problematic types of euthanasia involve, in some instances, difficult ethical issues. Terri Schiavo's is a case in point. The type of euthanasia in question in this case is both non-voluntary and passive. If Terri Schiavo had prepared a valid and applicable advance directive, or if there was convincing evidence that she would have wanted to have her feeding tube removedorkept in place, then this case, in itself, would hardly have been controversial. The relevance of the Schiavo case issues from the fact that Schiavo's husband and parentsdisagreedabout what she would have wanted and what was in her best interests. Since both parties claimed to be her rightful surrogate, the matter ended up in the courts. Additionally, once high-powered political and religious leaders became involved in the case, what might have been a private matter settled by the disputants in court became a public matter, subject to public influences and scrutiny. It is debatable whether the involvement of public figures was ethically justified, but those who think it was claim that the public has a legitimate interest in seeing the moral law upheld.

Another important ethical issue involved in not only Terri Schiavo's case but in many cases where passive euthanasia is considered pertains to the means by which death is (or would be) brought about: either withholding or removing life-sustaining measures.Do Not Resuscitateorders (DNRs) are common in the event of respiratory and cardiac arrest. Whether issued by patients or surrogates, DNRs are regularly honoured (with conditions) in health care and long-term care facilities. Not infrequently, however, it is a matter of not treating patients with common interventions such as antibiotics and nourishment. When this is the case, death comes slowly and sometimes painfully. We simply do not know whether death by dehydration and starvation is painful forallpatients or, at least, whether it is any more painful than their death would be otherwise. We do know, however, that death by these means is painful for otherwise healthy people and can be a long process, so we may safely assert that it involves considerable pain for some.

This raises the issue of whether, in certain kinds of cases, passive euthanasia is morally preferable to active euthanasia or vice versa. The arguments for both points of view are complex. Those who contend that active euthanasia is the more ethically justifiable of the two in some situations is the argument that the quick (and, therefore, comparatively less painful) death brought about by active means such as lethal injection is more humane and better realizes our duties to be merciful, to prevent harm, and to respect a person's right to die with dignity. Those who contend that passive euthanasia is the more ethically justifiable option (in any case where euthanasia is justified) argue that passive euthanasia allows the body to die naturally. For all we know, there could be a greater purpose to our dying in which humans should not interfere.

Although active euthanasia was not a consideration in the Schiavo case, we may ask whether doing so would have been ethically preferable to malnourishment. Her husband, so far as we know, had no wish for her to be actively euthanized, and her parents, undoubtedly, would have strongly opposed such action. For various reasons, it is morally important to consider the judgments of those who are closest to the patient, know her best, and are most intimately concerned for her well-being. Schiavo's family did not want active euthanasia, and this alone may be enough to conclude that active euthanasia is not morally preferable to passive euthanasia, in this and similar cases. In other cases, however, patients and their families express clear and competent judgments in favour of active euthanasia, but current laws forbid it.

Questions for Case 5.1

1. Answer question 3 that Siewert poses on p. 517 of our textbook.
2. Supposing that voluntary and/or non-voluntary euthanasia is justified in some situations, do you think that passive euthanasia is morally preferable to active euthanasia or vice versa? Explain your answer.
3. Compared to involuntary and non-voluntary euthanasia, voluntary euthanasia is the least ethically problematic. Leaving aside, for now, considerations of active versus passive euthanasia, list the conditions that you think should be satisfied for any act of voluntary euthanasia to be ethically justified. Two conditions that many people insist upon, for example, are that the patient is suffering and that there is little to no chance that his suffering can be alleviated. What justificatory conditions do you think should be minimally required?
4. Consider reasons for opposing voluntary euthanasia and list them. Do you think these reasons show that, even where the conditions you list above are satisfied, we should oppose voluntary euthanasia? Why or why not?