Is there a moral difference between active and passive euthanasia? The philosopher James Rachels contends that there is no significant moral difference between the two, while Philippa Foot believes there is a crucial moral distinction. This essay will explore the arguments put forth by Rachels and Foot, using illustrative examples and academic theories to deepen the analysis.
Rachels’ Argument: No Moral Difference
Rachels argues that active euthanasia (directly causing a patient’s death) and passive euthanasia (withdrawing or withholding treatment, allowing the patient to die) are morally equivalent. He supports this claim with several examples and reasoning.
The Cancer Patient Example
Rachels provides a scenario involving a terminally ill cancer patient. Suppose this patient, suffering immensely, decides they no longer wish to endure the pain and opts to discontinue treatment. According to a certain medical doctrine, it is permissible to withhold treatment, thus allowing the patient to die naturally, but it is considered morally wrong to actively induce death through euthanasia.
However, if the treatment is withheld, the patient might linger in pain for a prolonged period before dying. In contrast, active euthanasia would end the suffering immediately. Rachels argues that, in such cases, active euthanasia could be seen as more humane and morally preferable, since it minimizes suffering. The intention behind both actions is the same: to relieve the patient’s unbearable pain. Hence, Rachels suggests that distinguishing between the two methods on moral grounds is arbitrary when the outcome and intention are aligned with the patient’s best interest.
The Smith and Jones Example
To further illustrate his point, Rachels presents the famous Smith and Jones scenario. Both Smith and Jones stand to gain a large inheritance if their respective children with Down syndrome die. In the first case, Smith drowns the child in the bath, directly causing the child’s death. In the second case, Jones finds the child has accidentally fallen into the bath and is drowning, but chooses not to intervene, allowing the child to die. Rachels argues that morally, there is no significant difference between Smith’s active killing and Jones’s passive allowance of death. Both actions are driven by the same selfish motive and result in the same outcome: the death of the child.
Rachels’ main argument is that the moral distinction between active and passive euthanasia is flawed. Both forms of euthanasia aim to alleviate suffering and prevent the patient from becoming a burden. Therefore, if the intention and outcome are humane, the method—whether active or passive—should not matter morally.
Foot’s Counterargument: The Moral Difference
Contrary to Rachels, Philippa Foot argues that there is a significant moral difference between active and passive euthanasia. She bases her argument on the distinction between killing and letting die and the concept of being an agent of death.
The Agent of Death
Foot asserts that actively causing someone’s death makes one the agent responsible for that death. This responsibility carries moral weight. In contrast, allowing someone to die without intervening means the death is due to natural causes, and the agent is not directly responsible. Foot illustrates this with an example involving a famine-stricken third world country.
The Poisoned Food Example
Suppose a third world country is suffering from starvation and disease. A first world country decides to send poisoned food to the starving nation. The inhabitants of the third world country would have died from starvation, but now they will die from the poison instead. In this case, the first world country becomes the agent of death, responsible for the fatalities due to their active intervention. The moral difference lies in the fact that the inhabitants were initially dying from natural causes, but the introduction of poisoned food by the first world country created a new, fatal sequence.
Foot’s Analysis of Rights
Foot also discusses the importance of respecting individuals’ rights, particularly the right to non-interference. This right implies that individuals should not be subject to active interventions that result in their death. While people also have the right to goods and services, including medical treatment, these rights should not infringe upon the right to non-interference. When a doctor performs active euthanasia, they initiate a new causal sequence leading to death, thereby violating this fundamental right.
In the context of euthanasia, if a doctor administers a lethal injection (active euthanasia), they are directly responsible for the patient’s death, infringing upon the patient’s right to non-interference. Conversely, if the doctor withholds treatment, the disease is the cause of death, and the doctor is not morally accountable in the same way.
Academic Theories and Ethical Frameworks
To further analyze the moral differences between active and passive euthanasia, we can turn to various ethical theories and frameworks.
Utilitarian Perspective
From a utilitarian perspective, which focuses on the consequences of actions and aims to maximize overall happiness and minimize suffering, Rachels’ argument might hold significant weight. Active euthanasia, in cases where it alleviates more suffering, could be considered morally preferable. The utilitarian approach emphasizes the outcome—reduction of pain and suffering—rather than the means by which it is achieved.
Deontological Ethics
On the other hand, deontological ethics, particularly the Kantian framework, which focuses on the adherence to moral rules and duties, may align more closely with Foot’s view. Deontologists argue that certain actions, like killing, are inherently wrong regardless of the consequences. Thus, even if active euthanasia reduces suffering, it might still be morally impermissible because it involves directly causing death, which violates a moral duty to respect life.
Virtue Ethics
Virtue ethics, which emphasizes the character and intentions of the moral agent, can offer insights into both perspectives. A virtuous doctor, according to virtue ethics, would act with compassion and seek to alleviate suffering. If both active and passive euthanasia arise from a place of compassion and a desire to reduce suffering, virtue ethics might suggest that there is little moral difference between the two. However, it would also consider the broader implications of each action on the character and moral development of the individuals involved.
Conclusion
In conclusion, the debate over the moral difference between active and passive euthanasia is complex and multifaceted. Rachels argues that there is no moral difference, as both methods aim to alleviate suffering and prevent the patient from being a burden. Foot, however, contends that actively causing death makes one morally responsible in a way that letting someone die does not, emphasizing the importance of respecting the right to non-interference.
By examining these arguments through various ethical frameworks—utilitarianism, deontology, and virtue ethics—we gain a deeper understanding of the moral intricacies involved. While utilitarianism may support Rachels’ view due to the emphasis on outcomes, deontological ethics would likely align with Foot’s perspective on the inherent wrongness of killing. Virtue ethics, meanwhile, offers a nuanced approach that considers the intentions and character of the moral agents involved.
Ultimately, the moral distinction between active and passive euthanasia remains a contentious issue, reflecting broader debates in ethics about the nature of moral responsibility, the importance of intentions versus outcomes, and the rights of individuals in medical contexts.