The subject of euthanasia a much-debated topic and the title suggests that often only passive euthanasia is morally justifiable while active euthanasia rarely ever is. I will motivate this claim with Foot’s arguments, and then seek to undermine and dismiss the claim with help from Rachels and Singer. Ultimately, I will conclude that medical killing in the form of active euthanasia is often morally permissible, and in some cases morally favourable compared ‘letting the patient die’ or passive euthanasia.
The title of this essay, I can assume, is based on the principle of killing and letting die which states that while it can be morally permissible to let someone die, it is not morally permissible to kill someone. Relating this to the medical case which the title specifies, we can apply this principle to argue that active euthanasia is never permissible, but passive euthanasia sometimes is. This is because active euthanasia involves the deliberate act of ending someone’s life (i.e. killing), whereas passive euthanasia could be described as not acting to prevent someone’s immanent death (i.e. letting them die). So, for example, it is never permissible, for a doctor to administer a lethal injection to hasten a patient’s death, but it might be morally permissible for a doctor to refrain from carrying out life-saving surgery without which a patient will die.
Before I discuss the relative moral permissibility of active and passive euthanasia I would first like to discuss the moral permissibility of killing itself, specifically in relation to people. I would consider that the intuition that killing is wrong is based on our particular reverence for the life of a person. I hereby adopt a definition of personhood based on Fletcher and Singer’s articulations as an entity that has a self-awareness of its identity with a past present and future, that is rationally conscious, and that can form preferences about itself and its future. Based on this definition I would also argue that each person possesses, as part of the social contract, a right to non-interference, that is to say that they have a right to act towards the preferences that they have about their future. The act of killing a person then is to violate their right of non-interference and obstruct the enactment of their preference and desire about their future which is morally impermissible. What then are we to conclude when it is the rationally chosen preference of a patient to die, and they are unable to carry out this preference without a doctor’s help? For this discussion of euthanasia, I will assume that the patient is in chronic pain or their immediate future involves insurmountable pain and suffering, and that they have decided for themselves that their life is no longer worth living. If our aim was to reduce harm, reduce pain, then helping the patient to carry out their preference would surely be the just thing to do. I have asserted however that it is contrary to our intuition to kill a person and this position may cause us to take a view that only passive euthanasia is permissible as in this case we aren’t killing the patient. For Foot, it is never permissible for us to be an originator of death. On this view, a person’s right to non-interference is related to their right to life, and it is therefore our negative duty, Foot would argue, not to cause their death. Foot also argues that person also has a right to the provision of goods and services, but that does not mean that we have a positive duty to provide those goods and services to that person. This is how we might morally justify passive euthanasia, since a doctor has a duty not to kill a patient, but they do not have a duty to provide a service (in this case medical aid). However, this view does stand up in related examples and appears counter to our intuition. In Rachels’ Smith and Jones example from ‘active and passive euthanasia’:
“In the first, Smith stands to gain a large inheritance if anything should happen to his six-year-old cousin. One evening while the child is taking his bath, Smith sneaks into the bathroom and drowns the child, and then arranges things so that it will look like an accident.
In the second, Jones also stands to gain if anything should happen to his six-year-old cousin.
Like Smith. Jones sneaks in planning to drown the child in his bath. However, just as he enters the bathroom Jones sees the child slip and hit his head, and fall face down in the water. Jones is delighted; he stands by, ready to push the child’s head back under if it is necessary, but it is not necessary. With only a little thrashing about, the child drowns all by himself, “accidentally,” as Jones watches and does nothing.”
2019-10-30-1572435864