However there are problems in following the sanctity of life view. It has been suggested that to respect the sanctity of life means that all treatments must be provided for all people, however sick they are. It has been suggested that the aim is to make life last as long as possible. This is not so. Treatments, which are burdensome or likely to be ineffectual or of no benefit should not be provided and cannot be justified under arguments about the sanctity of life.
The church of England would go by the Bible’s view for Euthanasia whereas the Roman Catholics would follow Natural law, which is seen as part of God, the creator’s purpose, in addition to the bible but both think life is sacred and it comes from God, so in both denominations, Euthanasia would be forbidden generally. There would however be exceptions. Many people within these denominations accept passive euthanasia. Passive euthanasia is allowing someone to die by withdrawing their treatment; they may allow this such as turning a life support machine off when someone is still connected after being advised by the medical profession.
The Natural Law view holds an absolute view, which is a deontological theory, it believes in our duty and what we ‘ought’ to do. St. Thomas Aquinas developed a full account of natural law in the thirteenth century emphasising the belief that life is sacred. Aquinas held five primary precepts, the most important being ‘self preservation and the preservation of the innocent’ so this would be to ‘preserve life at all costs.’ A secondary precept to this was ‘Do not murder- Commit Suicide’ and to ‘defend the defenceless’. So there would be no allowances made for Euthanasia under this theory. The view comes from God because God is seen as a creator and there is believed to be a plan/purpose for us all and therefore we must do what is natural, It should be left for matters to reach there purpose. Euthanasia is clearly going against this plan and not letting things reach their purpose. An advantage of the natural law view is that we can have confidence that everyone should have access to some basic moral principles, which they known deep down are true.
The Bible has no universal prohibition against killing, for it endorses war and provides for capital punishment. It does not condemn even the cases of suicide recorded: Saul (1 Sam 31:4); Anthithopel (2 Sam 17:23); Samuel (Judges 16:30); Judas (Matt 27:5)
Certain Issues are central to the Euthanasia debate. These being Does God exist? Do human beings have a duty to God in considering how to behave? If they do, then it may be held that it is not permissible to take life, as this is God’s prerogative. If there isn’t a God, an individual should be allowed to make the final decision in whether to live or die.
It is important to distinguish between acts whose direct aim and intention is the bringing about of death and acts such as providing pain relief whose main purpose is not to bring about death, but death may be caused as a side effect.
There is no moral problem with the second of these positions for Christians.
Acts of omission and commission, where the former involves not doing something for example not giving a blood transfusion. The latter is a positive action. Leaving someone to die would be classified as an act of omission and would be Euthanasia. In the 1988 British Medical Association’s statement it maintained that ‘deliberate bringing to an end of life should remain a crime’.
A distinction needs to be drawn between ‘ordinary’ means and ‘extraordinary means’. Extraordinary means are disproportionate means- means of attempting to save life, which are out of proportion in terms of the pain suffered. One of the major problems is what is to be decided as ‘extraordinary’ means and what it is to be measured to, for example length of life, quality of life or the pain received during the procedure. Treatment is therefore not easy to determine. Christians would most probably say that extraordinary means to keep people alive might be as immoral as active euthanasia (something done actively to end a persons life). An example of this would be killing a healthy person to donate a liver that an ill person required. It would be immoral to kill a healthy person to save another person.
Christianity teaches that all life comes from God; ‘be fruitful and increase in number, fill the earth and subdued it. Rule over the fish of the sea, and the birds of the air, and every other living creature that moves on the ground.’ (Genesis 1:26-28). In other words the number of people should be increasing so why should people be killed. Christianity also teaches that life is sacred; ‘Your body is a temple of the Holy Spirit’ (1 Corinthians 6:19). For this reason it would be against Christian teaching to take life of another person or to commit suicide. From the bible it is clear that human beings are not to choose whether to live or die; ‘For everything there is a reason, and a time for every matter under heaven, a time to be born, a time to die, a time to plant and a time to pluck up what is planted’ (Ecclesiastes 1-4). Another point is that God sends us only experience that we can handle. He does not send us any experience we cannot handle. He supports people in suffering. To actively seek an end to ones life would represent a lack of trust in God’s promise.
The Roman Catholic Church is opposed to Euthanasia because in their eyes it is seen as murder. The Pope Paul VI in Humanae Vitae said that all human life is sacred and that all men must recognise that fact.
The Church’s concern is to bring light and life of Christ to everyone who needs it; it teaches clearly that those whose lives are weakened or diminished in anyway should be treated with the special care that they deserve. This includes the handicapped and elderly who should be helped to live as normal life as possible.
The Catholic’s declaration on Euthanasia in 1980 considered ethically relevant both Christian religious convictions as well as the accumulated human wisdom on death, pain and suffering.
It considers the value of human life seeing it as ‘sacred’ and a gift from God’s love. Catholics believe in three norms: Universal prohibitions against attempts on the life of an innocent person; universal duty to live one’s life in accord with God’s plan, that human life be fruitful; Prohibits suicide on the grounds that suicide rejects God’s sovereignty and plan, refuses to love self, denies the natural instinct to love and avoids the duties of justice and charity. It seems impermissible in catholic religion to kill someone else. The Catholics state that ‘suffering has a special place in God’s plan of salvation’. Death is thought to be unavoidable and we should be ready to accept it with full responsibility as the end of an earthy existence and as the opening to immortal life.
Christian views on Euthanasia aren’t so black and white. This can be seen in the exceptions to euthanasia that they believe in, for instance the double effect, somebody dying from the administration of drugs to help relieve pain, many Christians would have no problem accepting this.
People who don’t agree with Voluntary Euthanasia argue that if it was legalised it would damage moral and social foundations of society by removing traditional principles such as men should not kill. This would reduce the respect for human life. However the idea we should not kill is not an absolute view, even for those with religious beliefs for example self defence or killing in war, is justified by most. Currently in society we let people die because they’re allowed to refuse treatment, which could save their lives. This has not damaged anyone’s respect for the worth of human life.
The Christian protestant view of euthanasia tends to be slightly more relaxed. A much lower percentage of Protestants disagree with euthanasia because putting a person through unnecessary pain is sometimes deemed wrong. This is the theory that ‘the end justifies the means’. In Diane Pretty’s case0 that she would die certainly, the outcome was certain so the means, the way in which she died should be as dignified as possible.
There is a significant and growing percentage of agnostics, atheists, humanists, secularists and ethical philosophers that do not accept the theologically based arguments. Such groups argue that each person has autonomy over his or her own life, those who have poor quality of life should be allowed to right to seek assistance if necessary. Sometimes a terminal illness is so painful it causes life to be an unbearable burden; death can represent a relief of this intolerable pain.
Peter Singer4 wrote about the dilemma of life and death. He stated that the collapse of the traditional ethic is about to happen in many countries across the world.
The Philosopher, Kant believed that there is an objective moral law that we know through reason. The moral laws that exist are binding. According to Kant we are rational beings who base moral laws on one fundamental principle, ‘The Categorical Imperative’. Moral statements are categorical in that they prescribe actions irrespective of results. This is deontological. Kant identified three principles in the categorical imperative. Two of these are of relevance to the euthanasia debate. Kant would argue if we are obliged to alleviate suffering by destroying the sufferer, it would be hard to imagine how human life could exist for so long.
Euthanasia is not an option, as you can’t universalise the action of Euthanasia, Kant stated. He believed humans were the highest part of creation and should receive moral protection; ‘Man cannot have power to dispose of life’. However he also believed in human autonomy and that people were free to make rational choices.
The libertarian view is a minority position among current philosophers. James Rachels5 points out that if a person has biographical life (the sum of aspirations, decisions and activities) then that person should be able to live at all costs, but if that person doesn’t hold this and only has biological life then euthanasia should be able to take place (this concerns comatose patients etc). The problem is there may be mentally ill patients with little biographical life but there body is intact in the biological sense. Just because someone can’t make decisions, doesn’t want to participate and activities and doesn’t have any aspirations, doesn’t mean they are worthless.
Citing those countries and states where some form of euthanasia is permitted further enhances the argument.
British Law states that a person has the right to refuse treatment as long as he/she is fully competent to make such a decision. However, if a person is not in a position to ask or refuse treatment a doctor is allowed to decide to withhold treatment. However law contradicts itself6and this has already given rise to court cases.
In the Netherlands Euthanasia is widely practised although not strictly legal. It accounts for 8 percent of deaths. In the United States of America a patient can make a ‘living will’, which sets out the conditions under which he or she wished to die.
In 1995 the Northern Territory of Australia legalised voluntary euthanasia and under this legislation the first person died in 1996. The federal government overturned the legislation and debates are now underway in Australia and other countries.
However the Dutch experience has demonstrated the truth of what critics said about any legal accommodation of voluntary euthanasia namely that it would lead to the extensive practice of non-voluntary euthanasia. The Dutch are critical of their own system and are continually refining and testing it. Data7 shows that about 1 in 12 deaths in Holland in 1990 were euthanasia (10,558) cases and more than half of these were without explicit request.
A survey8 carried out in 1994 showed that there were over 10 percent of doctors already helping patients die, despite the prosecution risk. Nearly half of all doctors would be willing to help patients die if it were made legal. 79 percent of British people think that Euthanasia should be a legal choice. It is true that medical advances are causing people to live longer but people are also dying of incurable diseases. About 5 percent of terminal pain is incontrollable even in equipped hospices, which shows not everyone dies well. For some people these facts and figures support the argument that everyone should have the choice of a peaceful and dignified death. The problem is that even doctors who want to make euthanasia legal often say they would not want to participate. The response to surveys also depends to a large extent on question phrasing and emotive responses are often evoked. Therefore surveys could prove unreliable as a case for euthanasia. As the pope illustrated also, morality cannot be based upon majority but grounded on an objective moral law, which is written in the human heart.9
The essence of the Hippocratic oath was to establish the right kind of doctor-patient relationship. In the past the role of the doctor tended to be paternalistic. The doctor was the professional upholder of the sanctity of life and told the patient what to do. The shift in emphasis in recent years has been to acknowledge the rights and autonomy of the patient. The doctor’s role has developed accordingly to guide and inform the patient and, in the final instance, to comply with the patient’s wishes. The issue of euthanasia in this area is complicated because it is a decision, which can’t be reversed and may either depend on a confused or frightened patient, or a patient who is unable to express their wishes. In these cases a doctor or physician has to make hard choices. It is hard for a doctor to comply with patient’s wishes and decide if they should live or die because he is not experiencing what the patient is going through.
Dr Jack Kevorkian10 built a suicide machine to help people die. He stated that people have a right to avoid a lingering death. In 1999 he was found guilty of giving a man a lethal injection and sentenced to prison. People argue that he is hopelessly unqualified to assess his patients medical and psychological needs. He could be providing people with the means to die when they may just be having a bad day.
The voluntary Euthanasia society argues that ‘physician aid in dying’ enables a person to have a ‘good death’ with dignity rather than a degraded one. Once a person has the knowledge that they can die when they wish, it is believed to give them courage to live fuller and longer lives. The society also argues that many doctors feel that assisted suicide at the request of their patients is good medicine. The society however doesn’t take into account the fact that many may abuse the system and the drawbacks that this causes.
There are many people who disagree with groups such as the voluntary Euthanasia society and believe that euthanasia is clearly wrong. They believe that assisted suicide is the ‘ultimate abrogation of personal responsibility’ on the part of the patient. Real care for the sick and dying is apparently found in a caring environment. People believe that old people might worry and indeed fear that their doctor will want to suggest euthanasia as a good medicine. They might feel it is their duty to request euthanasia as they are a burden to others. People have also suggested that the inclusion of the possibility of euthanasia puts an intolerable burden on the doctor patient relationship. However is it fair to satisfy those that fear and not help the people that are actually in pain. Surely the pain endured by people in their final stages of life is greater than the fear endured by those worrying about their doctors choices.
A survey11 carried out highlighted the problems for euthanasia. There were high scores of patients wanting to die for reasons such as control over their death and readiness to die, and low scores for depression, and perception of self as a burden. This questions whether people desiring euthanasia are dying for the right reasons, whether they are actually in incontrollable pain or whether they just feel the urge to die.
Supporters of the pro-euthanasia movement have challenged the position of the churches and some ethicists.
A case of debated euthanasia can be seen in the Anthony Bland case12. Although he was not ‘dead’ his lungs were crushed and his brain was deprived of oxygen. In 1993, the decision to withdraw the feeding tubes from Anthony was passed at the High Court. Although Bland had never expressed any wishes for this to happen, if he was ever in this state, his family agreed it was for the best. The court threw out years of traditional laws to consider the quality of the patient’s life when making the final decision.
One of the primary objections to legalising Euthanasia has been the slippery slope or wedge argument. The wedge argument is based on a form of logic, which argues that what may be permitted initially as an exception becomes the rule. There are always those who exploit a weaker rule and what begins with the best of intentions results in undesirable ends. Those who wish to uphold the sanctity of life argument support the wedge argument. The active non-voluntary euthanasia practised by the Nazi’s during the holocaust years as a form of eugenics causes problems because the deaths of millions were justified as part of the improvement of society. However some people may do well from euthanasia and do it for the right reasons. Is it really fair to punish those in time of aid in suffering for past events in history? Not all people will abuse the system. Laws could be made to allow the practice of euthanasia but provisions made for it not to happen again on a large scale.
The problems and issues raised are if Euthanasia is the start of a ‘slippery slope’ that may justify the killing of handicapped people and the elderly. The question is whether to adopt a natural law approach, a situation ethics approach or favour proportionalism. Each of these positions is likely to result in different approaches to the problem of Euthanasia.
In conclusion, it is down to the government, on whether euthanasia should be legal. We live in a democratic society however and due to surveys there have been proved to be the majority wanting voluntary euthanasia legalised. However majorities can often be wrong. States all over the world are turning to voluntary euthanasia as a medical practice such as Netherlands allowing ‘Physician Assisted Suicide’. The problems have arisen from this and now people are turning against the euthanasia law. In the future the United Kingdom will most probably listen to the majority and turn also to this form of medical practice. Provisions should be made though to make sure that the country doesn’t suffer from the same problems that the Netherlands has encountered. It is hard to decide whom we follow in judging euthanasia. Many philosophers hold different views, some academic ones arguing for changes in the law whilst others expressing deep concerns. Doctors are also the same in deciding euthanasia in that many hold different views. Every Christian denomination has their own opinion on the subject of euthanasia but the Roman Catholic opinion stands out more strongly than the rest. They believe that euthanasia is totally wrong and any act that deliberately brings death is seen as murder whether or not it was done for kindness. They believe that it is sometimes acceptable to give drugs to relieve pain, which may end up shortening the life of a person. They also strongly emphasise the fact sick people do need and deserve special care while they are ill and so shouldn’t be discarded of just because some may die. Values of patient well-being and self determination that support a patients right to refuse any life sustaining treatment appear to support active voluntary euthanasia.13 The problem is whether the government will choose to listen to the standing traditional churches, or the people of the country. And if they do listen to the people of the country whether or not they will make sure people don’t abuse Euthanasia. It seems however though that, as with most things, people will find a way to get around the law to satisfy their sometimes-selfish needs.
4 Singer, P, Practical Ethics: Cambridge University Press 1979
11 New England Journal of Medicine: Ganzini et al, N Engl J Med, Vol.37, No.8, 582-588
12 1989 when he was crushed at the Hillsborough Disaster. He was in a persistent vegetative state (PVS) for four years
13 D.Brock, ‘Death and Dying’, in Medical Ethics, edited by R. Veatch (Boston: Jones and Bartlett, 1989), 347-348
