Notes on Euthanasia: Active Voluntary Euthanasia — Premises, Arguments, and Non-Identity Problem

Euthanasia involves killing or allowing a patient to die when they believe they are better off dead. It distinguishes between active euthanasia (deliberate action to cause death) and passive euthanasia (withholding life support), and between voluntary (patient consent) and non-voluntary (decision by others) forms. Physician-assisted suicide, often permitted in some U.S. states like Oregon, allows a doctor to prescribe a lethal dose for patient self-administration, distinct from direct physician administration.

The Argument for Active Voluntary Euthanasia (AVE)

The discussion centers on the moral permissibility of active voluntary euthanasia under specific conditions, structured around three premises:

1. Premise 1: Death is in a person’s own best interest under certain circumstances, such as terminal illness with extreme suffering.

2. Premise 2a: The act does not violate anyone else’s rights (e.g., family dependents, future commitments).

3. Premise 2b: The act does not make the world a worse place (e.g., avoiding slippery-slope risks like eugenics or devaluation of lives).

Conclusion: If P1, P2a, and P2b hold, then active voluntary euthanasia is morally permissible in those circumstances. This is summarized as: $(\text{BestInterest(Death|C)} \land \text{NotViolatesRights(Suicide|C)} \land \text{NotMakeWorldWorse(Suicide|C)} ) \rightarrow \text{AVE(p|C)}$

The Non-Identity Problem

This concept is used to illustrate how an action can make the world worse in aggregate even if no currently existing person is directly wronged. It's relevant when considering 'making the world worse' (P2b), especially in scenarios involving reproduction and future persons who might not exist otherwise if different choices were made.

Critical Evaluations

Key challenges include:

• Determining Best Interest: Reliably assessing if death is truly in a patient's best interest can be highly subjective and complex.

• Rights Violations: Whether assisting suicide might violate existing duties or rights of others, such as family members or vulnerable groups.

• Slippery-Slope Concerns: The potential for unintended broader societal harms if active voluntary euthanasia becomes more widespread, leading to pressure on vulnerable individuals or a devaluation of certain lives.

The argument is grounded in ethical principles such as autonomy, beneficence/non-maleficence, justice, and rights theory.