Ethical Stance On Euthanasia Research Paper

Ethical Stance on Euthanasia

Abstract
Euthanasia is one of the most talked about issues related to biomedical ethics today. This paper will discuss the ethical findings on the topic of euthanasia from a philosophical point of view. The paper examines the moral views of philosophers and then will end with an argument as to why euthanasia should be allowed in United States.
Ethical Stance on Euthanasia
There are many people that have their opinion on whether one should be able to end their own life when they are suffering from a terminal illness. Some believe that they should have the right to end their own life when they are terminal or that their quality of life will never be the same. Others
feel it is unjust to take your own life. There are many ethical positions on the topic of euthanasia that philosophers have been arguing about for many centuries. With all the moral and ethical positions, the question still remains, is euthanasia morally justified?
Euthanasia Defined
There are different forms of euthanasia that we must define before we can answer the question of whether these methods are justifiable means to end of life treatment. Active, passive, voluntary, involuntary, and non-voluntary are all methods of euthanasia.
Active Euthanasia
When most people think of euthanasia they are referring to active euthanasia. Most people are also referring to voluntary euthanasia as well which we’ll define later. Active euthanasia is the practice of ending the life by the deliberate administration of drugs. Injecting a patient, with patient’s consent, with a lethal dose of medication would be an example of euthanasia. Other examples of treatments that could be used to deliberately terminate a patient’s life could by the use of lethal gas or the use of prescription medication.
Passive Euthanasia
Passive euthanasia is the withholding or withdrawing of medication or treatment what could prolong life. This form of euthanasia implies the intent of allowing a natural death to occur without the health care provider’s interference. In most of passive euthanasia cases, the patient is simply not given any form of treatment that would extend his or her life. An example of this would be radiation treatment for terminal cancer.
Voluntary Euthanasia When a patient personally requests that euthanasia takes place, either by active or passive forms, they are fully aware of the consequences from their actions. Again, when most people refer to euthanasia it is this type of request of end of time means.
Involuntary Euthanasia Roy et al. (1994) states that involuntary euthanasia is carried out against the wishes of the patient. Another way of saying this is the person who is killed, expressed an exact wish to the contrary. Because this is basically carrying out a murder, involuntary euthanasia will never be accepted as a morally justifiable means of terminating a life.
Non-voluntary Euthanasia
When the patient is killed made no request and when consent of the patient is unavailable, usually due to the person being comatose, this is referred to as non-voluntary euthanasia. The end of life decision is usually made through the consent of loved ones.
A Question of Ethics
A being that is capable of acting with reference to right and wrong is defined as a moral agent (“Ethics in PR,” n.d.). Ethics in PR (n.d.) goes on to say, when something or someone is deemed a moral agent, it does not necessarily mean that they are successfully making moral decisions. It means that they are in a category that enables them to be blamed. If someone is unable to be blamed, then they do not have rights. Being a moral agent means that they can be held responsible for their decisions and behaviors, whether they are good or bad. Halliday (2000) states that:
A moral agent must be a living creature, as they must be able to comprehend abstract moral principles and apply them to decision making. They must have “self-consciousness, memory, moral principles, other values, and the reasoning faculty, which allows him to devise plans for achieving his objectives, to weigh alternatives, and so on”. Also, in order to weigh the options in decision making, a moral agent must “attach a positive value to acts that conform to his moral principles and a positive value to some of the results that he can achieve by violating his moral principles.” This means that in order to be a moral agent “you must live in a world of scarcity rather than paradise.” If all of your values could be easily and immediately be achieved, you wouldn’t have to pick between your moral and non-moral goals, and you couldn’t practice moral agency. When discussing euthanasia who then are the moral agents? Certainly the patient that is competent would be a moral agent and the health care provider would qualify as a moral agent. If the patient were not competent, as would be the case in a non-voluntary euthanasia, the surrogate would be a moral agent. Surrogates could be family members, a friend with power of attorney, or a court appointed representative.

Philosophical Theories Telfer (2004) explains that there are mainly two traditional philosophical theories regarding morality that have often been aimed to find a criterion of morally right action that can be broken into two groups. Those two groups are: those which hold that the right action is always that which produces the best consequences, and those which hold that the right action is not always that which produces the best consequences. The first kind of theories are Consequentialist and the theories of the second kind are called Deontological theories.
John Stuart Mill In his famous essay, Utilitarianism, Mill states that Utilitarianism good consequences are simply happiness, and happiness is pleasure and freedom from pain-not only physical pain but also distress of other kinds. Mill goes on to state that in his view, the right action is that which produces the most pleasure and the least pain for all those affected. Mill’s second view of good consequences is that of the right action is that which promotes in oneself and other what we may call a higher happiness, one which stresses self-development and the fostering of the distinctively rational nature of human beings.
Immanuel Kant The second theory we will discuss is Deontology. Deontology is an alternative ethical system that is usually attributed to the philosophical tradition of Immanuel Kant. Deontologists argue that there are transcendent ethical norms and truths that are universally applicable to all people. Deontology holds that some actions are immoral regardless of their outcomes; these actions are wrong in and of themselves. Kant writes a categorical imperative that tells us to act morally at all times. The categorical imperative, in its most widely used formulation, demands that humans act as though their actions would be universalized into a general rule of nature. Kant believes that all people come to moral conclusions about right and wrong based on rational thought. Deontology is roughly associated with the maxim the means must justify the ends. Whereas utilitarianism focuses on the outcomes, or ends, of actions, deontology demands that the actions, or means, themselves must be ethical.
Pro-Euthanasia Arguments The first argument for euthanasia will be that of a utilitarian one. As stated above in his argument for utilitarianism, the right action, according to Mill, are right as they tend to promote happiness, wrong as they tend to produce pain or the reverse of happiness. In the argument for a terminally ill patient suffering from a disease that causes severe, untreatable pain, we would see that the happiness is maximized and the pain would thus be minimized by euthanasia. If the same person were living an enjoyable life prior to the disease and now unable to enjoy the activities that made life worth living, there would be no higher intellectual or emotional pleasures to balance the physical pain. Euthanasia would also allow this patient’s family and friends to be spared the pain of watching him suffer. This would also be considered an action to promote happiness. By allowing this patient to suffer, it would produce pain, or the reverse of happiness, thus agreeing with both arguments in Mills utilitarian theory. To use a utilitarian stance, we must consider what is good for all. In taking this stance, using euthanasia would also allow for other patients that are sick to be allowed to use hospital resources with more treatable conditions. Again, this would contribute to everyone’s happiness by allowing a person who needs a hospital bed to be admitted to the hospital for treatment. There are two forms of Utilitarianism that you could argue for euthanasia. Those are Hedonistic (pleasure based) and Ideal Utilitarianism (Telfer, 2004). Telfer goes on to write that the Hedonistic Utilitarian would say that situations often arise in which a person’s continued existence brings more pain than pleasure both to them and to all those who are distressed by their suffering-not to speak of the resources which are being spent on keeping them alive and which would produce more happiness if used in other ways. She goes on to say, the Ideal Utilitarianism version is the views of those who advocate the possibility of death with dignity through voluntary euthanasia. Ideal Utilitarians can argue that no one who receives proper expert care need die in pain and distress by stating that the good they seek is not mere absence of pain, physical or mental, but the preservation of dignity and the exercise of the human endowment of autonomy. The pro-euthanasia deontology argument brought up by Immanuel Kant is that the intent of an action rather than its effect is what determines morality. According to Kant, omissions are subject to the same moral rules acts. So, according to Kant the intentions of an act are more important than the act itself. In using this argument for euthanasia, one can feel it is acceptable to end the life of a competent terminally ill patient; it is the intention that you are doing a good act by alleviating the pain or ending the suffering of the patient is more meaningful than the act of euthanasia itself. Rationality can be defined as, “the capability of following rules, drawing inferences, generalizing, making free choices, and altering conduct when the truth of a proposition and interconnections between conduct and the proposition is recognized” (Homes, 2003). According to Gunderson (2004), Kant does not rule out euthanasia for people who have permanently lost their rational agency. Once someone has irretrievably lost rational agency, that person no longer has the sort of Kantian dignity that would justify a duty not to perform euthanasia. Gunderson goes on to say, in Kantian ethics, it would be permissible to write an advanced directive refusing life-saving treatment, and even requesting euthanasia, in the event that one were to suffer a permanent loss of rational agency. Euthanasia would not go against the Kantian duty to seek one’s perfection, because the person who has permanently lost the ability to function rationally is unable to seek perfection. Even for people who have not made an advanced directive, the Kantian argument still applies so long as there is no reason to believe that euthanasia would thwart what the person willed as a rational agent. If a person were to express a desire not to be killed in the event that he or she suffers a permanent loss of rationality, then there is reason to respect that desire, just as there is reason to respect the directives of the deceased regarding property distribution. Respect for rational agency requires both sustaining the conditions of rational agency and respecting decisions made by rational agents. It would be less respectful of humanity and therefore not a genuine kingdom of ends if the rational decisions were not respected after the loss of competence or death (Gunderson, 2004). A person that becomes incompetent and has lost his or her moral life becomes relegated to the status of an animal, or even to that of an object. Rational individuals who foresee the full onset of a mental debilitating disease, such as dementia, must choose between preserving the physical or moral life. Kant and others agree the moral life has greater value than the physical life. Therefore, a rational person has the moral duty to commit suicide, thereby sacrificing the physical life, in order to preserve his moral life (Cooley, 2007). According to Kant, dementia is a brain disorder that leads to the loss of rationality, and thus, humanity. Kant argues that irrational agents have physical lives, but no moral lives. A physical life is the biological life of a body that is physically living. Although this is shared with animals, a moral life involves reason, autonomy, and rationality and that, a moral life, is what separates persons from animals. Kant also argues of the duty of beneficence, which is the moral obligation to act in the best interest of others.
This argument could then be used to say that dementia-related diseases cause an emotional burden on the family. Family members interact with someone that is only a shell of the person they once were. This results in emotional strains on the family as they care for the person with dementia, but cannot be loved or even recognized by those they love. Therefore, for those who foresee dementia have the moral right to commit suicide so they do not force their family to care for them in their non-human state. If the patient does not carry out this duty to die, one could easily infer that some sort of mercy killing would be permissible (Sharp,
2012). Sharp (2012) goes on to say that patients with severe dementia have lost all moral status, thus equating them to an object. As a result, others may act toward the patient as they would towards an object. If a demented patient becomes a burden, it should be abandoned in the same way as any other useless object. Another argument is that from Brassington (2006).
He believes that if suicide is permissible, it should also be acceptable to respond to a call for assistance by assisting. Although there is no reason to suppose that it may be obligatory actually to help someone die, neither is there any basis for a refusal to do so in the wrongness of a proposed suicide, because there is no wrongness. Brassington goes on to state that the use of Kant’s Categorical Imperative second formulation argues that if we are using euthanasia, we are treating a person wholly as a means to an end; we have desired that we want to minimize suffering, and we have chose to kill as a means to that. If we are to accept this argument for euthanasia, it only works if our actions are motivated by something such as a desire to reduce the net level of suffering in the world and if the euthanasia and the person euthanized are thereby treated as a means to an end. In cases where a person wants us to kill him and when that desire is what motivates us to kill that person, and where we have no other desires that motivates us to kill that person, it would be difficult to sustain the charge that we are acting in such a way to make a person a means to our end (Brassington,
2006). In conclusion, I believe that with terminal diseases and mental diseases that destroy our functional being and thought process, euthanasia should be allowed. I do however, strongly only advocate for the option of voluntary euthanasia. I believe that either the use of active or passive euthanasia should be used. If all forms of euthanasia were to be allowed, society would abuse the privilege. Others may accept that there are circumstances where it is morally permissible to end a life intentionally, but that a change in the law would result in the very potential for abuse and coercion of the people that are vulnerable (Begley, 2008). While both active and passive euthanasia allows the person to exercise their own autonomy and preserve their dignity even in death, active differs from passive in the fact that it also has equal consideration for the doctor’s freedom of conscience and autonomy. I have a hard time agreeing with the fact that doctors should be involved in taking specific steps towards ending a patient’s life because their main objective is to heal/do no harm. Begley (2008) states that doctors, who believe that a patient’s partner can carry out voluntary euthanasia, believe that they (the doctors) should not be involved. The law states as of now that euthanasia is not legal. It is suggested then that doctors and nurses develop empathy and compassion when caring for the patient, but to lay that aside when the patient has asked to end their suffering, because it goes against the law. Begley (2008) writes that this “pushes a square into a round hole” and encourages the feeling that good doctors and nurses are those who can walk away from situations calling for a compassionate response. It is my opinion that when a patient it known to be competent and knows what decisions they are making, that euthanasia should be a valid alternative. My strongest argument for allowing patients to seek euthanasia is that they must be competent to make the decision. Active or passive euthanasia would allow the patient to be making a rational, competent decision. Again, with the action being voluntary, a patient personally requests that euthanasia takes place, either by active or passive forms, they are fully aware of the consequences from their actions. Being fully aware of the consequences means they have made a rational decision. Kant would argue that suicide is irrational because of “self-love.” (Matthews, 1998). However, Matthews goes on to say that the contradiction about which Kant speaks arises, however, only if loving oneself always and necessarily implies wanting to stay alive, that is, if going on living, even in conditions of misery, pain, dishonor and so on, is inherently and self-evidently preferable to ceasing to exist. But, one must ask, is life always preferable to non-existence (Matthews, 1998)? If one can make a rational determination that life is not worth living when one must have to go through pain and misery, then one must conclude that euthanasia is an ethical and rational means. References

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