Euthanasia "good death"

famous cases

-- Nancy Cruzan

-- Karen Anne Quinlan

-- Jack Kevorkian

Different types of euthanasia

active -- killing -- take action that causes death

passive -- letting die -- take no steps to prolong life when they might be called for

Voluntary -- at the patient's request.

patient refuses life-sustaining treatment, or seeks life-ending treatment

non-voluntary -- patient neither explicitly consents nor refuses

usually non-communicative -- in persistent vegetative state

involuntary -- against persons explicit wishes, murder

(Hitler's euthanasia program in Nazi Germany)

self-administered

other-administered

How can we define euthanasia so it captures all these variations?

Causing or allowing a person to die for reasons of compassion for that person.

Some forms of active euthanasia are legal in some countries, and Oregon.

Has to meet certain conditions

-- patient initiated request

-- competence

-- informed

-- enduring decision

-- unbearable suffering

-- second opinion

-- gov't report

Gay-Williams "The Wrongfulness of Euthanasia"

Argues that Euthanasia is wrong

defines euthanasia

"intentionally taking the life of a presumably hopeless person" (3^rd 453/ 4^th 366)

-- deliberate intentional action

-- taking a human life (another or one's own)

-- subject is believed to be suffering from disease or illness from which recovery cannot be reasonably expected.

G-W: In cases of withholding treatment, the aim is not death of the patient. That is merely a foreseen but unintended side effect.

Goal: avoiding needless manipulation, pain, suffering expense on procedures that have no foreseeable benefit.

So called "passive euthanasia" not euthanasia at all.

Verbal dispute

We can understand G-W as saying: "Active euthanasia is wrong"

Arguments against AE

1. Nature

Every human being has a natural goal to survive. Almost everything about our physiology is geared to this goal, as well as our natural psychological responses.

AE is contrary to this goal, against nature, against human nature.

That which is contrary to nature is wrong.

2. Self-interest

AE is contrary to the interest of the patient.

Doctors make mistakes.

New cures are discovered.

Doctors should always act in the best interest of the patient.

3. Practical Effects

Allowing AE could have corrupting influences -- lessen perceived value of life.

Slippery slope

1. Event A will lead to event B.

2. Event B will lead to event C.

...

5. Event E will lead to event F.

6. Event F is clearly undesirable.

AE

self-administered

other-administered voluntary

other-administered non-voluntary

other-administered involuntary

Killing of those deemed abnormal by those making decisions

James Rachels

"The Morality of Euthanasia"

Absolute rule: Do not give a deadly drug -- No AE

Is this a good rule?

Considering "standard case" of euthanasia:

-- suffering terminal patient who, while rational, requests to be killed as an alternative to a slow, lingering death. (3^rd 456/ 4^th 369)

Is euthanasia in the standard case right or wrong?

(Not asking -- good or bad social policy?

-- legal or illegal?

Moral question is different from legal question.)

Arguments in favor of AE

I. Mercy

We should be merciful.

AE is merciful in certain situations.

II. Utilitarianism (3^rd 458/ 4^th 371)

1. Principle of utility: Any action is morally right if it serves to increase the amount of happiness in the world or to decrease the amount of misery. Conversely, an action is morally wrong if it serves to decrease happiness or to increase misery.

2. Killing a hopelessly ill patient, who is suffering great pain, at his own request, would decrease the amount of misery in the world.

Objections:

Contest the principle of utility.

-- Happiness and misery are not the only morally important things.

(freedom of religion, brainwashing)

-- Counterexample: Killing a miserable person against his will would still be wrong.

Replies:

1. Even if other things are important, happiness and misery still very important.

If an act would decrease suffering and increase happiness,

that is a strong reason in its favor.

2. Broaden conception of good and evil, beyond happiness and misery -- "interests" (welfare, well being...)

New version of argument

1. If an action promotes the best interests of everyone concerned, then that action is morally acceptable.

2. In at least some cases, euthanasia promotes the best interests of everyone concerned.

Defense of premise 2

euthanasia in best interest of

-- patient

-- family, friends, witnesses

-- hospital staff

-- other patients

III. Golden Rule

"Do unto others as you would have done unto you"

inadequate formulation

masochist, sexual pervert

General idea: Moral rules apply to everyone alike.

Kant -- categorical imperative

Act only according to the maxim which you can at the same time will to become a universal law

When we are trying to decide whether to do a certain action, we must first ask what general rule we would be following if we did it. Then, we ask whether we would be willing for everyone to follow that rule, in similar circumstances.... if we would not be willing for the rule to be followed universally, then we should not follow it ourselves. (3^rd 460/ 4^th 373)

1. Categorical imperative: Act only according to rules that you would be willing to have everyone follow.

2. If everyone followed a rule forbidding AE, then I might be forced to suffer a slow, painful death instead of a quick, painless one.

3. I am not willing to suffer a slow painful death instead of a quick painless one.

5. Therefore, I should not act according to rules that forbid AE.

6. Therefore, I should allow AE.

What about the possibility of unexpected cures?

1. Doctors make mistakes.

2. Medical research is advancing.

3. No matter the diagnosis, a cure is always possible.

4. If a cure is possible, euthanasia is wrong.

Rachels admits 1 &2, denies 3.