Active and Passive Euthanasia

                In Active and Passive Euthanasia (pg. 641-645 of our text), James Rachels argues that passive and negative euthanasia are morally equivalent actions. He begins with a simple statement that physicians, and most people, in most cases find nothing morally reprehensible in allowing a suffering patient to die. However, as decreed by the House of Delegates of the American Medical Association, “the intentional termination of the life of one human being by another – mercy killing – is contrary to that for which the medical profession stands...” It is against this claim that Rachels argues.

                One of the simplest situations where this topic would find relevance is in the case of a terminally ill patient with merely days left to live but whose pain cannot be alleviated. The patient does not want continue living through those days in intense agony, so he asks the doctor to end his life. The doctor can make one of two choices: euthanize the patient (active), or cease treatment and allow him to die (passive). If the doctor euthanizes the patient, then the patient’s suffering ends immediately. If the doctor chooses the latter option, then the patient will day perhaps a few days earlier than if the ineffective treatment had been continued. If these two options are all that remain, then the doctor has already decided that alleviating the patients suffering has surpassed in importance even the patient’s life. With this in mind, isn’t merely ceasing to treat the patient contrary to this other choice the doctor has already made? Rachel thinks so, as do I.

                One reason many people are opposed to active euthanasia is the bias that people have towards killing. Rachels brings up that this is mostly attributable to the situations in which killing and allowing to die are commonly compared. People find it very easy to imagine terrible situations involving killing; murders and wars surround us continually. But outside of the medical field being discussed here, people rarely hear of others being allowed to die. However, it is the nature of these acts that differentiates them morally, not how often they occur. A serial killer is motivated by greed, or anger or one of many other self-serving negative emotions and desires. The doctor, on the other hand, is understood to be acting with humanitarian goals in mind. Because we are so focused on the context of the acts, we forget that it is really the motivations behind them that we are judging. And if motivation and purpose are how the morality of acts can be distinguished, then active euthanasia is equivalent to passive euthanasia.

Some might wrongly try to attribute the cause of death to the disease itself, saying that if the cancer was the cause of sickness, then cancer is what caused the patient to die, not the inaction of the doctor. Therefor the doctor is not morally responsible. This can be tackled in many ways. Rachels uses the argument that when morally speaking, one cannot not act. Even choosing to do nothing is a moral action. Therefor you are responsible for whatever happens after the doctor’s ceased treatment. With this in mind, I would go back to a previous argument as further evidence. In this case the doctor is still making the same decision as before, that allowing suffering to end is more morally noble than prolonging a life of pain. If both these arguments are true, then not wanting to be the cause of someone’s death is not a valid standpoint.

                From the arguments presented, I can see no convincing argument morally differentiating active and passive euthanasia. So the real discussion then becomes whether or not euthanasia of any form is just, be it by suicide, doctor’s assistance, etc. The choice is truly about the value of life. In any relevant circumstance, continuing treatment in an attempt to preserve life and active euthanasia in order to immediately end suffering are the only valid options. Passive euthanasia is in fact the worst possible choice because not only does it allow suffering to exist, but it is also dishonest.