Euthanasia

• Euthanasia

  'good death' - ending life to reduce pain and suffering
• Active euthanasia

  Direct deliberate killing of patient
• Passive euthanasia

  when life-sustaining treatment is withdrawn or withheld
• involuntary euthanasia

  Performed against the wishes of the patient. Widely opposed and illegal in the UK
• Non-voluntary euthanasia

  Done without the patient’s consent, because they are not competent or able to give the consent
• voluntary euthanasia

  When a patient’s death is caused by another person e.g. a doctor with the explicit consent of the patient. The patient request must be voluntary, enduring (lasting some time) and competent
• Goes against ‘Thou shalt not kill’ from the Bible
• The 1961 suicide act legalised suicide but made it illegal to assist
• •The Dignitas clinic in Switzerland has helped over 107 British people to die in 2010
• the debate comes down to issues around sanctity (preserving) of life versus quality of life
• Diane Pretty- diagnosed with motor neurone disease and argued under the Human Rights Act 1998 that she had the right to assister suicide this was rejected by British courts
• •Until 1961, suicide was illegal in the UK. The 1961 suicide act legalised suicide but made it illegal to assist
• A major problem to this argument is that it runs the risk of suffering from the slippery slope - runs the risk of euthanasia for non-lethal conditions
• Sanctity of Life can be applied with theist perspectives e.g natural law as life possesses a God-given soul
• Genesis 1:27 - "God created mankind in his own image"
• Genesis 1:28 - "Be fruitful and increase in number, fill the earth and subdue it"
• Exodus 20:13 - "You shall not murder"
• Weak sanctity of life - killing a persona out of love does not equal murder

  • no one has a duty to endure a life of extreme pain - Paul calls Christians to be a 'living sacrifice' (Romans 12:1), this doesn't mean a life of extraordinary suffering
  • Life is a gift not a burden - humans are owners of God's gift of life, as good stewards (Genesis 1:28) we can decide when to end it
• Strong sanctity of life

  life is sacred and a gift from God so we can't end it
• Applying natural law:

  • there is a primary precept to “preserve life” and views life as an intrinsic good
  • the Catholic Church forbids both active and passive euthanasia as “contrary to the dignity of the human person and the respect due to God, his creator”
  • the Doctrine of Double Effect might accept the shortening of human life as it is only a foreseen but unintended result
• Applying Roman Catholic Natural Law:

  "Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of “over-zealous” treatment"
• Applying Rule Utilitarianism:

  • A general rule should be in place for social happiness prohibiting euthanasia (so the elderly don’t feel under pressure or depressed people feel the temptation)
  • in specific cases near the end of life doctors using their discretion should hasten death. This is the present UK situation, which can be justified by rule utilitarian (non-Christian) arguments, giving a modified humanist sanctity of life view.
• Peter Singer (preference utilitarian) takes such a view and argues for replacing the traditional sanctity of life ethics with five quality of life commandments:


  1.      Recognise that the worth of human life varies

  2.      Take responsibility for the consequences of your decisions (to save or end life)

  3.      Respect a person’s desire to live or die

  4.      Bring children into the world only if they are wanted

  Do not discriminate on the basis of species
• James Rachels - cultural relativist - 'The Elements of Moral Philosophy'


  • the distinction between actively killing and passively letting someone die may not be helpful.
• The Hippocratic Oath

  it would be wrong for a doctor to do something that would cause the death of a person.
• John Glover


  • the distinction between acts and omissions may not be so clear cut, depending on whether the proposed treatment is something ordinary such as food and water, or whether it involves highly expensive medical technology which would be an extraordinary means.
  • we may debate what is or is not ‘extraordinary means’.
  • Peter Singer also questions the distinction between acts and omissions. Using the Tony Bland case, he asks us to consider whether the removal of the feeding tube was an ‘act’ that led to his death, or an ‘omission’
• Glover suggests that there are at least five options with regard to euthanasia:

  1.      Take all possible steps to preserve life

  2.      Take all ordinary steps to preserve life but not use extraordinary means

  3.      Not killing but taking no steps to preserve life

  4.      An act which, while not intending to kill, has death as a possible foreseen consequence

  5.      The deliberate act of killing
• Adam Maier-Clayton


  • he was diagnosed with a range of mental issues throughout his life including severe anxiety, obsessive-compulsive disorder, and dissociative disorder. He said all of this made him feel unbearable physical pain — although no doctor had been able to figure out the exact cause. He took at least 15 prescription pills every day and was relegated to bed most of the time.
  • “It just feels like I’m a 27-year-old physically fit male with the body of an 85-year-old. I can’t function,”
• Tony Bland

  • severely brain damaged at Hillsborough disaster and there was no "reasonable possibility" that after three years Mr Bland would emerge from a coma known as a "persistent vegetative state" 
  • The doctors performed non-voluntary euthanasia by removing the feeding tubes that were keeping him alive
• Jack Mahoney (Personhood) 'in Bioethics and Belief' - Personhood's criteria


  • rationality
  • sentience
  • emotions
  • free-will
  • continuity
• Dr Nigel Cox

  • doctor convicted of attempting to perform a mercy killing.
  • found guilty of attempted murder after injecting 70-year-old Lillian Boyes with a lethal drug.
  • discovered by a nurse who read Miss Boyes medical notes. She realised that the potassium chloride he had used would not alleviate pain, but instead stop Ms Boyes' heart.
  • it could not be proved conclusively that the injection had killed her.
  • Ms Boyes' family never wavered in their support for the doctor's actions.
• George and Betty Coumbias


  • wanted to die together
  • assisted suicide is illegal in Canada
  • they hoped to end their lives with the approval of the government of Switzerland.
  • George suffers from heart disease, Betty was reported to be in excellent health.
  • Director of the Swiss assisted-suicide group Dignitas, petitioned the Canton of Zurich to grant doctors the authority to issue lethal drugs to healthy people. The Coumbiases had their request turned down.
  • Betty developed cancer and died, while George continued to live with his heart condition.
• Tony Nicklinson

  • a man with locked-in syndrome who fought for the right to legally end his life
  • paralysed from the neck down after suffering a stroke - described his life as a "living nightmare"
  • "It cannot be acceptable in 21st Century Britain that I am denied the right to take my own life just because I am physically handicapped."
  • refused food and died after having contracted pneumonia
  • If Tony felt that he was forced to stop eating to protest against the court’s decision, this caused more accumulative pain and suffering, which the law is supposed to protect against
• Kant - *Groundworks...*


  "Always at the same time as an end and never merely as a means"

  Arguably any form of euthanasia is unethical as the person is being treated as a means to an end
• J. Bentham - *Utilitarianism*


  "The greatest happiness for the greatest number"

  Moralises voluntary euthanasia (e.g Mr and Mrs Coumbias) as it is their wish to die
• Kierkegaard - *Fear and Trembling*


  "Ethics is a question of an individual's relationship to God"

  NML would state that God's will is found within the Primary precepts and the precept to reproduce and preserve life still applies, so euthanasia is unethical
• Aquinas - *Summa Theologica*


  "The good is that which all things seek"

  Euthanasia would not be 'good' under Aquinas because not all beings are searching to die. In cases of non-treatment decisions (e.g Tony Bland), it can't be proved that the patient wished to die in the first place.
• E. Levinas - *Totality and Infinity*


  "The relationship with the other person...precedes all understanding and knowledge"

  Dr Nigel Cox allegedly had empathy for Lillian Boyes, so could be reflected as the relationship for her, so is the most loving action.
• J.S Mill - *On Liberty*


  "Our own good in our own way"

  Human autonomy must be valued. Rule utilitarianism would provide a flexible outlook- possibly viewing voluntary euthanasia as a higher pleasure and involuntary/non-treatment as a lower pleasure
• P. Singer - *Practical Ethics*


  [about the slippery slope argument] "once we allow doctors to kill patients, we will not be able to limit the killing to those who do not want to die"

  Preference utilitarians would prioritise what the patient would rationally prefer. Singer leans towards the quality of life argument, but has doubts about legalising voluntary euthanasia.