Euthanasia – defining the terms

Euthanasia – translated “a good death”

Definition “Euthanasia is the intentional killing by act or omission of a person whose life is not thought to be worth living. It is done for the patient’s own sake.

Make sure you are familiar with the following terms

Voluntary Euthanasia– when a terminally ill person requests death

Involuntary Euthanasia – when a person is killed or allowed to die to save them from more pain, even if they don’t request it.

Non-Voluntary Euthanasia – when a person is unable to make the request for himself or herself.

Active Euthanasia– to do – illegal in the UK. The killing of a person. In the UK the 1961 Suicide Act permits suicide but forbids it being assisted.

Passive Euthanasia – not to do- legal in the UK. Allow a person to die e.g. not feeding.

Where the Christians stand on this issue? Christians emphasise that life is sacred and a gift from God. Remember your Old Testament ideas from the creation narratives of Genesis, Psalm 139:13-16, Job 1:20-21 and in the New Testament Paul in 1 Corinthians 3:16-18. The body is the temple of the Holy Spirit. Roman Catholics and Orthodox Christians think that to end life prematurely is a mortal sin. (See Natural Law.) Anglicans pay lip-service to Natural Law but in reality tend more towards Situation Ethics. Non-Conformist Christians also defend the sanctity of life but in practical terms defend active euthanasia, arguing that in attempting to keep a patient alive rather than letting nature run its course, is to interfere with the will of God.

In some ways that is an oversimplification because there are many refinements of those opinions found in all branches of Christianity.

Natural Law This follows the ideas of Aquinas. Fundamental to this approach is the concept that life is sacred and should be preserved. To take a human life or to terminate a human life is against a fundamental principle of Natural Law. Remember thought the doctrine of double effect – the doctor’s duty is to cure or alleviate pain. If in doing so the high dose of the pain killer ends the patient’s life then no wrong has been committed. The doctor has been performing a good act but it has a secondary consequence. In practice a doctor may use ordinary means to keep a patient alive, but not extraordinary means. The problem these days for followers of Natural Law is the definition of ordinary and extraordinary.

Situation Ethics Situationists will ask the question “What is the most loving thing to do in this situation”. They may argue that in some circumstances to help someone to die is a more loving solution than to keep them alive and in great pain. This invokes the concept of Christian compassion but runs foul of the scriptures which talk about the will of God taking a backseat to the precepts of men! Small wonder that the Roman Catholic church condemned the philosophy from the outset. Even so Situation Ethics can appeal to the anti-nomian attitude of Jesus who spoke out against the law. Many feel it is a Christian common sense solution.

Kant Kant did not write about euthanasia, but he regarded suicide as wrong. Have a look at the first and second formulations of the categorical imperative. The willing that this should become a universal rule? Suicide is treating oneself as a means and not as an in one’s self.

Utilitarianism As always the consequentialist approach is a complex appoach and you must make sure that you examine all parties involved. The solution will of course consider the needs of the patient, but possibly the needs of others, friends, family and the hospital authorities. Make sure you look at the problem from all sides.

Bentham’s approach. Quantitative Utilitarianism may well agree to euthanasia in a particular instance. Consequentialist in its appraoch and it looks at all the consequences of (i) keeping a patient alive and (ii) allowing his or her life to be ended. You must not simply look for happiness here – and there isn’t a great deal of that – but the avoidance of pain. The Hedonic Calculus looks at the maximising of happiness and the avoidance of pain. It is the second part that might allow euthanasia to happen.

Mill – higher and lower pleasures don’t at first seem to yield a solution, but Mill would probably argue that the right to die with dignity and for an individual to retain a measure of autonomy over his own life and death, might be regarded as a higher pleasure.

Utilitarianism does not provide a one sided answer. Some utilitarian principles are in favour of euthanasia, while others would count against it. That is why this is a favourite choice for examiners. If you know your stuff there is plenty for you to get your teeth into.

Utilitarian pro euthanasia arguments

1. If the patient is in pain then the Hedonic Calculus might find there is no pleasure to balance against the pain. As might seem likely the patient’s condition deteriorates, then there will be more pain. In this case qualitative euthanasia might be justified.
2. If equipment used in a hospital to keep a patient alive could be used elsewhere to save lives, the hospital authorities may wish to rationalise use of their equipment. Similar arguments may surface over costs and hospital budgets.
3. Mill would argue that the right to die with dignity is a higher ideal if not actually a higher pleasure.
4. If the health and well-being of next of kin to the terminally ill person is being compromised eg those who visit a patient in pvs – see notes on Tony Bland.

Utilitarianism and arguments against euthanasia

1. When a patient is unable to communicate with family or medical staff, many utilitarians support anti-euthanasia legislation which safeguards human rights.
2. There is a fear that vulnerable elderly people might be co-erced into asking for euthanasia by family pressure.
3. Utilitarianism looks closely at the consequences of any decision. However there is a possibility that the diagnosis of a doctor could be wrong. A wrong decision could cause maximum pain and no happiness for the family.
4. There is a sense in which even utilitarians accept that one can only push these principles so far. Suppose one allowed euthanasia on demand. That might lead to an increase in calls for involuntary euthanasia of the terminally ill, the chronically sick, social outcasts, homosexuals, gypsies – is this starting to ring any bells?