Ethics – Euthanasia

Once again, this is a very delicate topic today, but it is an interesting and necessary topic for AS Ethics, so I hope you can get something out of it whether you are a student or not. Enjoy 🙂


Euthanasia

What is euthanasia?

Euthanasia is the ending of life because a person is in pain and suffering.

  • Voluntary euthanasia is when a person’s death happens with their consent without any coercion. Physician -assisted suicide is similar in that the doctor helps the patient but the final act is done by the patient themselves.
  • Non-voluntary euthanasia is done without the consent of the patient, for example, if the patient is in a coma. There must be a medical/family and sometimes legal agreement.
  • Involuntary euthanasia is done against the wishes of the patient (sort of like a mercy kill).

Killing or allowed to die?

  • Active euthanasia is doing something to deliberate end a patient’s life.
  • Passive euthanasia is stopping doing something (such as when food/water is withdrawn) so the person eventually dies.

James Rachels says there is no difference between the two and passive euthanasia, although it is practised, is worse as death takes longer and there is more suffering.

Ethical issues surrounding euthanasia

  • Sanctity of life – Christianity holds that all life is sacred which implies reverence and respect. However, there is a strong week’s entity of life – what part does compassion play was the dying process has begun? Sanctity of life applies to humans – is someone in the permanent vegetative state a human?
  • Personhood – is someone in PVS still a person? How do we decide? If you are an incomplete person, for example, you cannot move or talk does that mean euthanasia is acceptable?
  • Many consider the Quality of Life argument to apply to euthanasia but who decides what this is or should be – the doctor/s, patient, the family or a court?
  • Autonomy – if people have the right to life, do we also have a right to death? Does right to life mean that others do not have a right to kill? But this does seem to be absolute – what about wars, self-defense and capital punishment? It seems easier to justify killing someone who wants to die than killing someone in war who does not desire to die.

Sanctity of life applied to euthanasia

According to the Bible, life is a gift from God and only he should take it away: ‘the Lord gave them the Lord has taken away’ (Job 1:21). This means that human life should always be protected.

The Sanctity of Life has been particularly important for Catholic ethical thinking about euthanasia. The problem today is that modern technology means that people can be kept physically alive, so Catholics now accept that there is no need to use extraordinary means to keep someone alive and the patient can refuse treatment when death is imminent – this approach sees the Quality of Life is as important and take a more proportionalist approach as people should not always be obliged to prolong life in every situation and is that it is better to achieve a good death.

Euthanasia is seen as possible once the dying process has begun and life has in fact reached its end. The doctrine of double effect also follows this view as it allows the increase of pain relief knowing that a by-product of this will be to hasten death.

Personhood apply to euthanasia

The problem with personhood and euthanasia occurs when a patient is in PVS. How do we decide how much consciousness they have? Many argue that using euthanasia on those in PVS, or those who cannot give consent will lead to a slippery slope and more patients would be killed, as what begins as perfectly legitimate reason to assist a person’s death will lead to killing people because someone else decided their Quality of Life justifies ending it. They use the example of Hitler’s rule to euthanise certain new-born babies because their Quality of Life will be short and unpleasant. Helge Kuhse objected to this as she said it was an argument from extremes.

Grisez and Boyle emphasise the importance of personhood and rejects the view that someone can be bodily alive and yet not be person – euthanasia they say is against the basic good of life.

Quality of Life apply to euthanasia

Peter Singer argues that the worth of human life varies and depends on its quality. If the patient considers they now have a low Quality of Life this justifies them taking their life or getting someone else to do it for them.

However, this again raises problems over who makes the decision if the patient is not able to and if this became commonplace in may harm the doctor/patient relationship. Is it allowing the doctor to ‘play God’ such as when they put ‘do not resuscitate’ orders on patient’s files without their express consent? This led to the guidelines on ‘do not resuscitate’ orders being clearly restated in 2000 after a number of seemingly healthy patients discovered that they had ‘do not resuscitate’ orders written in their medical notes without consultation with them or their relatives. Additionally, the Quality of Life is subjective and very hard to judge so some patients may want to end their lives as they see themselves as a burden on others.

Autonomy applied to euthanasia

According to John Locke a person has absolute rights over his or her body. John Stuart Mill says that people should have full autonomy as long as it does not harm others. Many of those who support euthanasia believe that this personal autonomy is vital.

However, there is also the side of the coin that autonomy gives people the right to life and so the rights not to be killed: personal autonomy often conflicts with other values.

Useful case studies

Quality of Life:

  • Daniel James was a young rugby player who was paralysed in a rugby scrum. He chose to die did Natasha rather than lead a life as paraplegic. Matt Hampson had the same injury and decided not to end his life – he is now said to be getting feeling back to some of his limbs, which throws whether euthanasia for people who are paralysed should happen.
  • Diane Pretty had motor neurone disease and wanted to die in the comfort of her own home but it is illegal to have euthanasia in England so she campaigned to the courts. She was unsuccessful and died in her own home. She focused on the right to live, saying that this meant she also had a right to die.
  • Tony Nicklinson had locked-in syndrome after a stroke. He died after refusing food or treatment for pneumonia for a week following a rejection by the High Court for his case that doctors should be allowed to assist his death without facing prosecution.

Autonomy:

  • Nan Maitland aged 84 chose to die rather than suffer a ‘dwindling old age’.

Application of ethical theories to euthanasia

Christian ethics

  • Christian views on euthanasia are linked to those on suicide – it is intrinsically wrong and rejecting God’s gift of life.
  • Euthanasia is against God’s will and plan.
  • The Sanctity of Life should be preserved.
  • Situation ethics may consider euthanasia to be the most loving thing in the circumstances. This does not consider the Quality of Life but stresses the need for agape.
  • Is it Christian? Fletcher changed religion later in life and it’s only on one teaching from the Bible that would get the same conclusion if a different teaching was used.

Natural law

  • Euthanasia goes against the primary precepts of the preservation of life.
  • Taking life is intrinsically wrong.
  • Nature should be allowed its own course without human intervention.
  • Natural law does allow a patient to refuse treatment.
  • Extraordinary means.
  • Doctrine of double effect can be applied.

Utilitarianism

  • Utilitarianism would look for the best consequence the greatest number.
  • It rejects the Sanctity of Life argument.
  • Focuses on the Quality of Life argument – pleasure versus pain.
  • Patient’s interests are a minority and this means no protection against the majority.
  • Mill would stress autonomy.

Kantian ethics

  • People should be treated as ends not means. You can kill to stop suffering, but not the money. Need to value the life.
  • The person has a moral duty to others such as family and doctors. Doctors have a duty of care to the patient which means that euthanasia is wrong as it would go against these duties.
  • Categorical Imperative – wouldn’t pass. There is also a contradiction in will because we can’t all want to die.
  • Any decisions would be made using reason and should be objective, and unemotional decisions.
  • Euthanasia is difficult to universalise, as Kant also thought personal autonomy and freedom were important.

Done again! There’s only one more post for Ethics and then AS Ethics is done, although Philosophy has a few more I believe. Please comment any information I missed and any debate points you can think of, and give this a like if you thought it was interesting 🙂

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