Active and Passive Euthanasia

1 Active and Passive Euthanasia 1. Active vs. Passive Euthanasia : Imagine two cases: Peggy is suffering from terminal, untreatable cancer. She has a month to live, but in the meantime is in extreme, incurable pain. She spends her days screaming and unable to sleep, asking for death. The doctor inserts a lethal injection into her Minutes later, she dies. Sue is suffering from terminal, untreatable cancer. She has a month before the cancer kills her, but in the meantime is in extreme, incurable pain. She has degenerated to the point that she is being kept alive with a respirator and a feeding tube. She spends her days in agony, asking to die. The doctor turns off the respirator. Minutes later, she dies. Most people think it would be WRONG to administer lethal injection in the first case, but PERMISSIBLE to essentially withdraw treatment in the second case.

2 The difference is that the first is Active Euthanasia , while the second is Passive Euthanasia . Euthanasia : Literally, in ancient Greek, good death . The act of bringing about someone's death (directly or indirectly) for their own good. There are 2 kinds of Euthanasia : Active Euthanasia : Directly bringing about someone's death for their own good. Passive Euthanasia : Indirectly bringing about someone's death ( , by withholding or withdrawing treatment) for their own good. Passive Euthanasia is currently legal in the , while Active Euthanasia is illegal. But, is there really a moral difference between Active and Passive Euthanasia ? 2. Physician-Assisted Suicide: First, a related note: Closely related to Active Euthanasia is physician-assisted suicide.

3 The crucial difference is that, instead of the DOCTOR. administering the lethal injection, the injection is instead placed in the hands of the patient, who then administers the dose to himself. The idea here is that, by merely ASSISTING the death, the moral blame is transferred from the physician to the patient. In other words, the doctor is morally blameless if she merely PRESCRIBES a lethal dose to the patient. Some suggest that, while Active Euthanasia is wrong, assisted suicide is not. This is reflected in the legal code to some degree as well, since Active Euthanasia is banned across the , while physician- assisted suicide is legal in Washington, Oregon, Montana, and Vermont. 1. But, is this correct? Imagine that you have a gun collection, and a friend asks, Friend: Hey, can I have one of those guns?

4 You: What do you want with it? . Friend: I'm going to put it in my mouth and pull the trigger.. You: Look, I'll give you the gun, but I can't be held responsible for whatever you do with it.. Friend: No, I PROMISE you. I am DEFINITELY going to use it to kill myself.. You: Ok, here you go. But, remember, I'm still not responsible.. Friend: Ok, bye! I'm off to kill myself now! Thanks! . Are you not responsible for your friend's death? It seems that you are, in this case, an accomplice. Similarly, then, it seems that, if Active Euthanasia is morally wrong, then a physician who assists suicide is still blameworthy. If that's correct, then the REAL. question is simply whether or not Active Euthanasia is in fact wrong.

5 [Do you agree? Is blameworthiness preserved if you merely FACILITATE a death? Even if murder is not permissible, is suicide morally permissible? If so, does the doctor do anything wrong by helping someone else carry it out?]. 4. Killing vs. Letting Die: Most people think it is much worse to DO harm (or KILL) than to merely ALLOW harm (or LET DIE). When the physician administers a lethal injection, she is KILLING the patient. On the other hand, when the physician withholds treatment, she is merely LETTING the patient die (and the former is MUCH worse, morally, than the latter). Why? (1) In Passive Euthanasia , the disease is responsible for the death of the patient, while in Active Euthanasia , the physician is responsible.

6 This is expressed by statements like, Just let nature run its course or Stop prolonging death . (2) Killing an innocent human being is always wrong. (3) There are cases where killing is clearly morally worse than letting die (for instance, recall the Crowded Cliff scenario). 5. The Definition of Death: So long as we're talking about KILLING someone, we had better get clear on what death IS. There are three views on this: (1) Death occurs when respiration and circulation ceases. (2) Death occurs when all brain activity ceases. (3) Death occurs when higher brain activity ceases. 2. Which of these views is correct? Though (1) used to be the universal view, many have since rejected it, since the body can be artificially kept alive (respiration and circulation) indefinitely, long after someone has clearly died.

7 So, (2) became the new paradigm. But, (2) would classify what we call human vegetables either someone who is in a persistent comatose state, or even someone who appears awake, but has not capacity for consciousness or awareness as alive. Their lower brain functions continue to keep their heart and lungs operating, but there is no one home . So, some have suggested a move to (3). Higher brain functions are responsible for consciousness, and THAT is who we really are. If consciousness disappears forever, we are, for all intents and purposes, already dead, even if our body continues to function on its own. If (3) is correct, then administering a lethal injection to someone in a persistent vegetative state is not a killing at all.

8 For, the person is already dead (though their body still functions). Here, we will focus on the more controversial cases: Is it morally permissible to euthanize someone who is fully aware; that is, fully conscious? (not to say that euthanizing human vegetables is not controversial it is just LESS controversial). 6. Killing is No Worse Than Letting Die: James Rachels believes that there is no morally relevant difference between doing harm and allowing it. In order to defend this stance, he asks us to consider the following two cases: Smith: Smith stands to gain a large inheritance if anything should happen to his six-year-old cousin. One evening while the child is taking a bath, Smith sneaks into the bathroom and drowns the child.

9 Jones: Jones also stands to gain if anything should happen to his six-year-old cousin. One evening while the child is taking a bath, Jones sneaks into the bathroom to drown the child. However, just as he enters, the child slips and hits his head, falling face down in the water. Jones is delighted. He stands by, ready to push the child's head back under if necessary, but it is not necessary. The child drowns. Smith is doing harm, or killing the child. Meanwhile, Jones is merely allowing harm, or letting the child die. If there were a morally relevant distinction here, we ought to think that what Smith does is far worse than what Jones does. But, we do not. What Smith and Jones do seem to be equally wrong. (Do you agree?)

10 Therefore, Rachels argues, the do- allow distinction is not a morally relevant one. 3. Rachels' argument might be stated as follows: 1. If killing were morally much worse than letting die, then what Smith does to the child would be morally much worse than what Jones does to the child. 2. What Smith does is NOT morally much worse than what Jones does. 3. Therefore, killing is not morally much worse than letting die. Therefore, Rachels concludes, Active Euthanasia is NOT morally much worse than Passive Euthanasia . So, if we think that withholding treatment is permissible, then we should think that lethal injection is also permissible. 3. Objection to Rachels: Judith Thomson thinks this sort of argument is a bad one.