One argument for voluntary euthanasia is the idea of personal autonomy. People may believe that ending someone’s life who no longer is able to make these decisions for themselves, is wrong. This is probably because these people lack personal autonomy. It seems sensible to say that a doctor should however, allow someone to die if they do have personal autonomy, especially if the patient has good reasons for wanting to die. An example of this would be if they suffered from a painful illness, and one which they stood no chance of recovering from.
Personal autonomy cannot always act in favour of voluntary euthanasia. For example, if a person is feeling very suicidal it does not mean that the doctor should just agree with the patient that helping them to would be the best decision. Often when a patient comes to the doctor and tells themh that they have these feelings it is a sub-conscious cry for help. In these cases it is obviously very un-ethical for the doctor to assist them in suicide instead of trying to help them. It may also be the case that the person is wrongly fearful of the future, and what they may think will happen actually will not. There is a possibility of misinformation or a failure to understand the situation, these things could lead to tragic consequences if they are not resolved.
‘Locked in syndrome’ is a condition whereby a person lacks the ability to perform any kind of movement other than the upward movement of they eyes. This does not mean that they are brain dead as they are totally aware of their surroundings. Jean-Dominique Bauby gave proof for this by writing a book dictated entirely by eye movements.
Some people suffer from the condition called ‘Persistent Vegetative State’, or ‘PVS’. This is classified as being brain dead. There are several criteria which contribute to the definition of this condition. The key criteria I feel are these; no evidence of awareness of self or environment and an inability to interact with others, no responses to any kind of stimuli and no evidence of language comprehension or expression. Even though PVS patients sometimes may move in meaningless ways, smile or shed tears, it is believed that there is no psychological awareness behind these actions. Many reflex actions are also maintained throughout and some patients survive for ten or even twenty years. Most people would accept that those who suffer with this condition have lost all remnants of themselves as human beings and are now merely shadows of their former selves and lack any feelings or character. In this situation most people would say keeping them alive in hope that they may some day recover is futile. There are others however, who do not take this view.
The Roman Catholic Church for example teaches that killing, in any situation, is always a sin. That includes not only murder but also genocide, abortion, euthanasia, or wilful suicide. They take the commandment ‘though shall not kill’ as an absolute statement. One of the arguments put forward by Roman Catholics is that life has core value and is sacred whether or not it is a ‘good’ or a ‘bad’ life. Therefore a crippling illness is not enough to take away the intrinsic value of life. They say that ending our own life is rejecting Gods sovereignty over our lives, and the freedom that God gives us should not stretch as far as being able to end our own lives. We do not have the right to die. This does not mean that we cannot allow ourselves to die by refusing harsh and unattractive medical treatment as it is seen as accepting one’s fate. Roman Catholics believe that we do not have the kind of freedom necessary to take someone’s life as we are made by God for the purpose of loving him.
John Stuart Mill has views which are strongly against those of the Catholic Church. In his book ‘On Liberty’ he said that if someone is faced with a decision which does not directly affect others then the person should be given total autonomy.
Another reason for Catholics to believe that euthanasia is wrong is because of the fact that it is believed that suffering has a special place in God’s plan. This is backed up by the idea that Jesus died on the cross and so if we suffer at the end of life, we are being connected to the suffering that Jesus felt. This doesn’t mean that people should go out of their way to seek pain, but it does mean that a positive effect can be had on the individual. It allows someone to get closer to God.
There is a principle which allows one to morally ‘get around’ the problem of euthanasia. This is called the principle of double effect (PDE). There are four factors which must be true in order for this to be morally acceptable. The first is that the action itself must be a good one. Only the good effect must be intended. The good effect must not be achieved by way of the bad effect, and the good result must outweigh the bad. An example of this could be if a doctor gave a patient who was in severe pain enough morphine so that their death was foreseen. This would be okay as the intended effect was to get rid of the pain, and as a result they died. Also the death is only foreseen and not intended in order to stop the pain. This would be unacceptable according to PDE, as the good effect would be achieved by way of the bad.
The Buddhists view on euthanasia is not as clear as the Roman Catholic view, the teachings of the Buddha do not specify very certainly as to whether it is acceptable or not. Some Buddhists who believe that euthanasia is wrong do so because Buddhists believe that someone of a good mind is able to block out physical pain and not allow it to affect them mentally. Someone who is able to do this would not normally want to be killed even if they were suffering from a terminal illness. Buddhism also teaches that harm and the ending of life is wrong, this points away from the idea of euthanasia being an acceptable practise
Buddhists also believe in people possessing a karma which determines the quality of the next life. In terms of euthanasia, it is impossible to tell whether the person’s next life will be better their present life, therefore they cannot tell whether ending their life prematurely is a good thing. They also believe that the shortening of a life may interfere with the karma.
It has been seen as acceptable in cases when Buddhist monks have taken their own lives in a form of protest, however it is very important the state of mind at the end of one life in terms of impacting the next. Because of this only those who have achieved enlightenment should ever commit suicide. It was also however, tradition for samurai to kill themselves either having lost a battle, so that their enemy could not kill them, or if they were so crippled that they could no longer benefit society. This can be compared to euthanasia in the sense that a patient has lost the battle with the disease killing them, and the idea of being extremely crippled is the exact same thing.
One particular organisation called ‘No less Human’ believes strongly that euthanasia is wrong. Their argument is based around the fact that legalising euthanasia would be saying that the lives of some lack the value that other lives have; it would decrease the value of the sick and those with disabilities. The doctor is meant to have the final judgement over the treatment of a patient, so a patient who believes that it would be the best decision if they were to die does not have to be agreed with by their doctor. A doctor always has the final say. Just like when prescribing treatment, the doctor does not have to do what the patient believes would have the best outcome.
There are also several arguments put forward by the ‘Voluntary Euthanasia Society’ in favour of voluntary euthanasia. The first and most blunt argument is the fact that it fails to protect the vulnerable. Also it makes no distinction between murder and assisted suicide which seems very unreasonable. Britain and Wales have the harshest laws on prevention of assisted suicide, yet it still goes on. The laws also deny the right for those in extreme pain to choose to die with medical assistance under proper legal safeguards. The VES believe that their should be no ethical distinction between withdrawing treatment and giving a lethal injection. Some people who disagree with the VES say that palliative care takes away the need for euthanasia as people are relieved of their suffering.
There are times when it is necessary to make a moral distinction between acts and omissions. The act-omissions distinction goes by the idea that, ‘in certain contexts, failure to perform an act, with certain foreseen bad consequences of that failure, is morally less bad than to perform a different act which has the identical foreseen bad consequences. It is worse to kill someone than to let them die.’ This can be related to medical terms as it is legally accepted for a doctor to withdraw treatment of a person in some conditions. However it is always illegal for a doctor to actually take someone’s life.
There are several other arguments against voluntary euthanasia. There is a chance that mistakes could have been made in the diagnosis of the patient. The patient could either not have the illness at all, or the time estimated for it to develop. However, some people may argue that this is a very minute possibility and not worth putting many through the suffering of their particular illness.
People would also be given the chance to abuse the system. Elderly relatives may feel that they are a burden on their family and so ask to be killed, and also people who have ulterior motives may try to pressurise these people into asking to die. The recent incidents involving Dr Harold Shipman could also be repeated if voluntary euthanasia were legalised. He managed to kill dozens of elderly people and got away with it even under the current regulations.
Some people believe that voluntary euthanasia may lead to other schemes carried out by the Nazis which involved the involuntary euthanasia of the sick, disabled and the elderly. When the constraints on killing are loosened, undesirable effects must occur. This is called the slippery slope argument. However this is fairly unconvincing as that situation has not occurred in Holland.
The final argument against voluntary euthanasia is the idea that it is totally contrary to the initial aim of medicine, to promote the health and life of people. The opposite act is being carried out and medical practitioners are failing at their jobs. These people should not be put in the position where society expects them to take a persons life.
‘Collins Pocket English Dictionary’.
Withdrawal is to stop treatment, withholding is to never give it and both are seen as legally equal.
Tony Hope, Julian Savulescu, Judith Hendrick. ‘Medical Ethics and Law’. pp157.
Campbell, Alistair. Gillet, Grant. Jones, Gareth. ‘Medical Ethics-Third Edition’. pp200
Alison Davies. ‘Briefing notes on voluntary euthanasia/assisted dying.’
In fact, the term ‘best interest’ is easily miss understood as meaning the patients ‘wishes’. What it really means is what will preserve their health or prevent them from dying.
Robert A Bowie, ‘Ethical Studies’. pp190.
‘Declaration on Euthanasia’ 1980.
