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25. Social Practice / F. Life Issues / 2. Euthanasia

[attitudes to mercy-killing for the very ill]

11 ideas
In Utopia, legal euthanasia is considered honourable [More,T]
     Full Idea: In Utopia, officially sanctioned euthanasia is regarded as an honourable death.
     From: Thomas More (Utopia [1516], Bk 2)
     A reaction: A bit surprising coming from a writer who is now a Catholic martyr and saint.
We only allow voluntary euthanasia to someone who is both sane and crazed by pain [Kamisar]
     Full Idea: It seems that voluntary euthanasia can only be carried out by someone who is both sane, and crazed by pain.
     From: Yale Kamisar (Against Euthanasia [1958], p.77)
     A reaction: A fair point, despite its obvious exaggeration. How much pain must someone experience before we permit them to choose euthanasia?
People will volunteer for euthanasia because they think other people want them dead [Kamisar]
     Full Idea: In the process of voluntary euthanasia we will sweep up some who are not really tired of life, but think others are tired of them.
     From: Yale Kamisar (Against Euthanasia [1958], p.78)
     A reaction: We could permit such choices. Or set up systems to eliminate such cases.
The Nazi mass murders seem to have originated in their euthanasia programme [Glover]
     Full Idea: It is argued that the mass murders of the Nazi period had their small beginnings in the Nazi euthanasia programme.
     From: Jonathan Glover (Causing Death and Saving Lives [1977], §14.2)
     A reaction: This is the 'slippery slope' problem, and it seems undeniable that killing gets easier as you do more of it (e.g. on a farm). But not all slopes are slippery, if the focus is retained on reasons and justifications.
Euthanasia is voluntary (patient's wish), or involuntary (ignore wish), or non-voluntary (no wish possible) [Glover]
     Full Idea: Voluntary euthanasia is done at the request of the person themselves. Involuntary euthanasia is killing someone in their own interests, but disregarding views they could express. Non-voluntary euthanasia is killing someone who cannot express any views.
     From: Jonathan Glover (Causing Death and Saving Lives [1977], §15.1)
     A reaction: Seems a clear and satisfactory distinction, despite the possibility of borderline cases. A look of pain on a face? An inarticulate person? Deliberate ambiguity? Misunderstanding?
Involuntary euthanasia is wrong because it violates autonomy, and it has appalling side-effects [Glover]
     Full Idea: Involuntary euthanasia can normally be ruled out, because it falls foul of the autonomy objection, and it is likely to have appalling side-effects.
     From: Jonathan Glover (Causing Death and Saving Lives [1977], §15.1)
     A reaction: The only defence of it is if the prospects are utterly horrible and the subject cannot grasp them. However, is this true of children or the very old. Paternalism may be appropriate, if the decider has reliably depressing knowledge?
Maybe extreme treatment is not saving life, but prolonging the act of dying [Glover]
     Full Idea: It is often suggested that medical intervention which goes beyond easing pain or distress is not saving life but 'prolonging the act of dying'.
     From: Jonathan Glover (Causing Death and Saving Lives [1977], §15.6)
     A reaction: This is an important idea to keep in mind, but still a very difficult call to make. It needs to be presented to those who fight for life, at any cost in money, time, medical resources, or suffering. May people probably give up unnecessarily.
If it is desirable that a given patient die, then moral objections to killing them do not apply [Rachels]
     Full Idea: The cause of death (injection or disease) is important from the legal point of view, but not morally. If euthanasia is desirable in a given case then the patient's death is not an evil, so the usual objections to killing do not apply.
     From: James Rachels (No Moral Difference [1975], p.102)
     A reaction: Seems reasonable, but a very consequentialist view. Is it good that small children should clean public toilets?
It has become normal to consider passive euthanasia while condemning active euthanasia [Rachels]
     Full Idea: It seems to have become accepted that passive euthanasia (by withholding treatment and allowing a patient to die) may be acceptable, whereas active euthanasia (direct action to kill the patient) is never acceptable.
     From: James Rachels (No Moral Difference [1975], p.97)
     A reaction: He goes on to attack the distinction. It is hard to distinguish the two cases, as well as being hard to judge them.
Euthanasia may not involve killing, so it is 'killing or not saving, out of concern for that person' [Hooker,B]
     Full Idea: Passive euthanasia is arguably not killing, and the death involved is often painful, so let us take the term 'euthanasia' to mean 'either killing or passing up opportunities to save someone, out of concern for that person'.
     From: Brad W. Hooker (Rule Utilitarianism and Euthanasia [1997], 1)
     A reaction: This sounds good, and easily settled, until you think concern for that person could have two different outcomes, depending on whether the criteria are those of the decider or of the patient. Think of religious decider and atheist patient, or vice versa.
Euthanasia is active or passive, and voluntary, non-voluntary or involuntary [Hooker,B]
     Full Idea: Six types of euthanasia: 1) Active voluntary (knowing my wishes), 2) Active non-voluntary (not knowing my wishes), 3) Active involuntary (against my wishes), 4) Passive voluntary, 5) Passive non-voluntary, 6) Passive involuntary.
     From: Brad W. Hooker (Rule Utilitarianism and Euthanasia [1997], 5)
     A reaction: 'Active' is intervening, and 'passive' is not intervening. A helpful framework.