Euthanasia

Euthanasia

1. From the Greek meaning 'good/easy death' - the deliberate ending of someone's life when they are in a condition when they cannot do so themselves

   • Can be passive (food/medicine denied/withheld) or active (lethal injection, drug etc)
   • Can be voluntary (the patient's choice) or involuntary (eg if the patient is in a coma and cannot make the choice themselves)

2. Issues

   • Sanctity of life vs quality of life
   • Is the act of killing always wrong?
   • Do the motives make a difference?
   • Is there a difference between killing and letting die?
   • What makes a person?

3. The sanctity of life

   • Idea that life comes from God, is sacred, is God's to take away
     • Differing views on what makes a person
       • Eg, maybe not still a person if in a persistent vegetative state
         • But this could be extended to the severely ill/mentally handicapped - not an appealing idea
       • Germain Grisez: When someone is alive, they're a person
     • Catholics: 'Suffering has a special place in God's creation.' Hebrews 13:5 'Never will I leave you.'
       • Intention is important - painkillers that kill as a side effect are OK, but actively killing is not.
       • Human dignity should be preserved - do not go to 'extraordinary measures' to keep someone alive.'
         • This is vague and hard to measure
         • Proportionalism: no unnecessary treatment past what would be given to an ordinary ill person
     • Daniel Maguire: Human life is a basic but not absolute good: respect it but do not prolong it
       • We are not God's property
         • Peter Singer: listen to a person's preference
     • More acceptable if the dying process has already started

4. The right to life

   • If we have this, we have a responsibility not to kill others
     • But we don't always take 'do not kill' as an absolute - eg in war
       • Capital punishment in some countries
     • Is there ever a duty to kill?
       • The Hippocratic Oath - non maleficence

5. Suicide

   • Thomas Aquinas said this was a rejection of God's gift of an eternal soul
     • Why is suicide condemned, but martyrdom and dying in war accepted?
     • Issue of a 'nanny state' trying to persuade people away from drugs, smoking, overeating etc. Does this go against autonomy?
     • Is there much difference between suicide and euthanasia?

6. Personal autonomy

   • JS Mill: in matters not concerning others, we should have free choice
     • Any competent adult has the right to decide and manner of their death
     • In some countries such as the Netherlands, if quality of life is poor, the patient capable of choice, and death imminent, euthanasia is accepted
       • Should palliative care be more important?

7. Killing/letting die

   • Many in a PVS are withdrawn from treatment
     • Painkillers are given in death-hastening doses
       • We do not have a right to have our lives saved
         • James Rachels: A passive euthanasia is worse because it's drawn out. Since the result is the same, active euthanasia should be accepted.
           • The 'slippery slope' argument

8. For and against

   • For
     • Values people's choice and dignity
     • Prevents suffering
     • It can be regulated
     • Spares healthcare resources
     • We allow death in war
   • Against
     • Sanctity of life
     • The elderly/ill could be pressured
     • Values sick people's lives less
     • Prevents search for treatments

9. Applying ethical theories

   • Utilitarianism
     • Would allow it to end suffering (pleasure over pain)
     • Examines effect on society - NHS resources vs 'slippery slope'
     • Singer: people in a PVS have no preference
     • Mill: preserve dignity
   • Natural Law
     • Preserving life is a primary precept
       • Treatment can be refused - proportion is important
   • Kant
     • Can it be universalised?
       • If what a person chooses is a law of nature it's OK - eg dying from 'losing the will to live.'
       • Is killing someone to end pain using them as means to an end?
       • Kant himself was opposed to it