★★Euthanasia

sanctity of life

the idea that life is intrinsically sacred or has such worth that it is not considered within the power of a human being

quality of life

a way of judging the extrinsic experience of life, that affects or justifies whether or not it is worth continuing life

personhood

the quality of human life that makes it worthy - usually linked to certain higher capacities

voluntary euthanasia

when a person’s life is ended painlessly by a third party at the person’s own request

non-voluntary euthanasia

when a person is unable to express their wish to die but there are reasonable grounds for ending their life painlessly, for example, if a person is in extreme pain

involuntary euthanasia

where a person is killed against their wishes, for example when disabled people were killed by Nazi doctors

active euthanasia

a deliberate action performed by a third party to kill a person, for example by lethal injection - active euthanasia is illegal in the UK

non-treatment decision/passive euthanasia

the decision medical professionals make to uphold or withdraw medical treatment or life support that is keeping the person alive because they are not going to get better, or because the person asks them to

euthanasia

euthanasia comes from the Greek words for a ‘good death’. it is a controversial issue raising questions of whether people should have the right to end their own lives or the lives of others at a time of their own choosing

overview of the sanctity of life

• people who believe in the sanctity of life believe that life is special, scared and holy, and that it has an intrinsic worth

• often people who believe in the sanctity of life do so for religious reasons. they might believe that life is sacred because it is a gift from God and/or because of imago Dei

• “so God created mankind in his own image” (Genesis 1:27)

• non-religious people might believe that human life is sacred because people have reason and free will

• some people believe that all life is sacred, not only human life

• the idea that life is sacred can be used as an argument against euthanasia, on the grounds that no one has the right to take away human life

slippery slope argument

the ‘slippery slope’ argument can be used in the context of the sanctity of life, saying that once life is considered to be less than sacred in some cases, it undermines all human dignity and allows people to be treated as disposable

arguments against the sanctity of life

• the Bible can be used to question ideas about the sanctity of life, for example on different occasions when God commands war

• it can be argued that the sanctity of life is not an unbreakable moral rule but that it can sometimes be moral to take life, for example killing someone who is murderously aggressive in order to save many lives, or sacrificing one’s own life in order to save others

overview of quality of life

• ideas about quality of life are often introduced into debates about euthanasia, sometimes as a counter-argument to ‘sanctity of life’ beliefs

• the concept if quality of life involves considering how much enjoyment and fulfilment a person is getting, given their state of physical and mental health. it includes looking to the future and the prognosis for their condition

• discussions about the quality of life consider whether the life is worth living, or whether bringing about death would be preferable

• some people argue that if someone has a debilitating or painful terminal condition then they should not be compelled to live until they die naturally

• quality of life is commonly considered in cases of animal welfare, where it is considered by many to be cruel not to euthanise a suffering animal

overview of personhood

• issues of personhood involve the question of what makes a living thing a ‘person’. this issue is important because if a living thing is not a person, perhaps it does not have the same rights, including the right to life, as persons do

• some argue that in order to be a person, there must be awareness of self and others, and ability to interact with the world

• others argue that in order to be a person, the only thing necessary is to be human

• others argue that other species as well as human beings should be considered as persons, or that personhood is a spectrum

• personhood is usually linked to capacities and functions. this raises issues about whether a foetus is a person, whether animals with high brain function such as primates might be persons

• the question of potential is also an issue of personhood, raising discussion of whether a living thing should be accorded dignity and rights because of potential for higher-level function

overview of voluntary euthanasia

• the ancient Greek Hippocratic oath, which still informs medical standards for today, obliges doctors to do good and avoid evil

• voluntary euthanasia is when a patient’s life is ended at their own request. it is illegal in the UK but legal in some other countries

• it is often the focus for legal challenges when people in very difficult circumstances challenge the law and ask that someone should be allowed to help them die without fer of prosecution

• a key argument in favour of voluntary euthanasia is that people should have the right to avoid pain and choose a gentle, painless death as long as the decision is made rationally

• some people argue in favour of voluntary euthanasia because suicide is an option for able-bodied people and it is discriminatory not to allow it for disabled people

• some argue against voluntary euthanasia because the person might change their mind when they are no longer able to communicate

• some people argue tat allowing voluntary euthanasia will encourage unscrupulous people to put pressure on sick relatives to end their lives when this was not what they wanted

overview of non-voluntary euthanasia

• this is when there is euthanasia without the request of the patient

• it could happen in cases of severe brain damage, or when a baby is born with multiple problems, or when someone is incapable of communication

• debates arise when there are cases of people who cannot communicate and who seem to be permanently incapable of functioning in ways that might give them an acceptable quality of life

• medical science has progressed to the extent that people with severe loss of brain function can be kept alive artificially for a long time

• some people write ‘living wills’ to clarify their wishes if they should become brain-damaged and incapable of communicating

• some argue that non-voluntary euthanasia is the most compassionate course of action when there is no prospect of the patient having an acceptable standard of brain function

• others argue that it is not for us to decide what is an acceptance that there is never a point where medical professionals can be totally certain that there is no hope of improvement

• a distinction is often made between deliberate active euthanasia and a non-treatment decision i.e. the removal of ‘extraordinary treatment’. however, people do not agree about what kinds of treatment might be considered ‘extraordinary’

natural law response to euthanasia

• in natural law, an action is morally good if it accords with eternal law, divine law, natural law and human law

• there is a primary precept to do good and avoid evil, and a primary precept to preserve life

• human life is considered to be a sacred gift from God. divine law teaches in the Bible that God creates each individual person in his own image

• natural law ethics have been very influential on Catholic teaching, which says that euthanasia is wrong. it contradicts the precept of preserving life

• euthanasia is an apparent good - it seems to offer a good outcome, but it is not a real good

• natural law ethics are absolutist; they do not make exceptions for different circumstances or likely outcomes

• there is no obligation under natural law for people to go to great lengths to keep someone alive when the treatment offered is ‘burdensome’

• the doctrine of double effect could be used in end-of-life-care, where the treatment offered to relieve someone’s pain might have the double effect of shortening life. the intention would not be to kill, but to relieve pain, and therefore this would not be wrong

• it could be argued that if the patient is so debilitated that they lack all the higher functions, such as reason, associated with personhood, then the rules about how persons should be treated might not apply

advantages of a natural law approach to euthanasia

• it gives clear guidance, there is no doubt about what to do and what not to do

• it respects religious beliefs about the sanctity of life

• it does not leave people vulnerable to unscrupulous relatives who might wish to benefit from their deaths

• it avoids a ‘slippery slope’ where human dignity becomes less important over time

disadvantages of a natural law approach to euthanasia

• it could be seen as unsympathetic to people in great pain or with no quality in life

• medical advantages make it difficult to judge whether some kind of treatment should be regarded as burdensome or extraordinary. life support, for example, is both common and extraordinary, as are many resuscitation techniques

situation ethics response to euthanasia

• Fletcher, the leading advocate of situation ethics, who wrote the book ‘Situation Ethics’, was in favour of legalising euthanasia and he became president of the Euthanasia Society of America

• situation ethics rejects absolute rules, and so it rejects an absolute ban on euthanasia

• Fletcher thought that the ethical thing to do was to take account of each individual’s personal situation

• agape love

• situation ethics advocates applying the ‘rule of love’. the ethical thing to do is whatever will bring about the most loving consequences. euthanasia can be justified if it will bring about the most loving outcome for the patient and their friends and family

• Fletcher thought the quality of life was more important than the sanctity of life. he thought life was not worth living if the patient did not have some basic functions, such as minimal intelligence, self-awareness and ability to judge the passage of time

advantages of a situation ethics approach to euthanasia

• it could be seen as far more compassionate in individual situations than a blanket ban on euthanasia, recognising that many people would like to have this option available to them

• it could be seen as less discriminatory towards disabled people

• it places greater emphasis on human autonomy and dignity

disadvantages of a situation ethics approach to euthanasia

• it could be criticised as not giving recognition to the sacred nature of human life

• the most loving course of action is not always easy to identify

• allowing euthanasia on a case-by-case basis makes legislation difficult

• legalising euthanasia might create a ‘slippery slope’ where people are euthanised when it might not be what they really wanted or they might have had a chance of recovery

‘Natural law provides excellent moral guidance for people making decisions about euthanasia’ Discuss

How convincing is the claim that decisions about euthanasia should be made according to the principles of situation ethics?