Active and passive euthanasia PDF

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Active and Passive Euthanasia

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Morality of Active and Passive Euthanasia Jennifer Delgado Drexel University

Active and Passive Euthanasia

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Many medical professional codes and moral ethics have historically prohibited and morally looked down upon a physician’s involvement in active euthanasia verses passive euthanasia. Moral ethics such as autonomy, beneficence/nonmaleficence, and utility contribute to the fight for both proponents and opponents for whether there is difference between active and passive euthanasia. James Rachels in his essay “Active and Passive Euthanasia” argues there is no moral difference between the two. Rachels makes this argument by outlining whether there is difference of action and intention between active and passive euthanasia which goes against the widely accepted belief of the American Medical Association. Rachels defends his rationale comparing active and passive euthanasia in different scenarios.

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The House of the Delegates of the America Medical Association on December 4, 1973 declared that “the intentional termination of the life of one human being by another – mercy killing – is contrary that for which the medical profession stands and is contrary to the policy of the American Medical Association (Vaughn, 2015, p. 649).The cessation of the employment of extrodinary means to prolong the life of the body when there is irrefutable evidence that biological death is imminent is the decision of the patient/ and or his immediate family.” James Rachels in his famous essay “Active and Passive Eunthansia”, claims that “the bare difference between killing and letting die does not, in itself, make a moral difference” (Rachels, 1975). Rachels makes a compelling argument for his case and if read thoroughly, it could easily persuade those interested or on the fence about this ethical issue to side with him, including myself. For a brief background, the main moral values believed to be attached with these ethical issues include autonomy, beneficence/nonmaleficence, and utility. Autonomy is expressed as the right of competent adults to make informed decisions about their own medical care (Snyder and Sulmasy, 2002). The principle underlies the requirement to seek the consent or informed agreement of the patient before any investigation or treatment takes place. For this reason, it would seem autonomy would play the biggest proponent for Rachel’s argument because the patient could choose the passive or active route of euthanasia and not a matter or morality for the physician. (Delgado, 2016). Beneficence and nonmaleficence is the principle where action can be taken to help prevent or remove harms or to simply improve the situation of others (Miller et al,.1996). Physicians and medical professionals purpose is to take pain away from their patients, to help them feel better to the best of their ability. However, the definition of removing harm can have

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two different meanings. Removing the harm could mean aiding them in their death to take away the harm, or it could mean taking away medical care to stop the prevention of the inevitable – death (Delgado 2016). The principle of utility is that physicians and health care providers should produce the most favorable balance of good over bad for all concerned (Emanuel et al., 1996). In laymen’s terms, a physician’s or a healthcare provider should be doing more good than harm to their patient. Is aiding someone in their death doing more good than harm for them? Is withdrawing all care from someone on their death bed doing more harm than good? Some will argue in the affirmative, and some in the negative. Providers make that decision every day on whether or not a risky surgery would benefit the patient even if the risk is death. (Delgado, 2016). Is a risky surgery that is likely to cause death anyway equivalent to taking “pain” away for a patient for good? The answer isn’t so clear cut for and for many physicians, is troubling. After lying out these the moral ethics, you can see that each one can make an argument for passive and active euthanasia. Therefore, it its appropriate to agree with Rachel’s rational stating there is no true moral difference between the active and passive euthanasia, even if there is a widespread negative connotation to one of the two. To further Rachels’ opinion, is the issue of performing an action. Active euthanasia is linked with the action of actively killing someone while passive euthanasia has no widely known association with performing an action. However, Rachel disproves this by giving an example of a patient with incurable cancer. He states “the first (point to be made) is that it is not exactly correct to say that in passive euthanasia the doctor does nothing, for he does do one thing that is very important: he lets the patient die” (Rachels, 1975). For the act of inaction is an action in and of itself.

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Lastly, an additional opponent for active euthanasia is that there is an intention of killing a patient and in passive there is no intention of terminating a patient’s life. Rachel concisely and intelligently disproves this. Rachel in his essay he says “the AMA policy statement isolates the crucial issue very well; the crucial issue is “the intentional termination of the life of one human being by another.” But after identifying this issue, and forbidding “mercy killing,” the statement goes to deny that cessation of treatment is the intentional termination of life. This is where the mistake comes in, for what is the cessation treatment, in these circumstances, if it is not “the intentional termination of life of one human being by another”? of course it is exactly that, and if it were not, there would be no point to it.” If you think about what he is saying, Rachels is assessing the situation accurately (Vaughn, 2015, p. 651). The reason for the cessation for treatment is to stop the prolongation of the patient’s life because they are in pain. This reasoning is what brought light to how I felt about the issue of passive and active euthanasia and is mainly why my opinion changed from concurring with AMA to that of Rachels. The future of the debate between whether there is a moral difference between active euthanasia and passive euthanasia is not an issue that is going away. “How to Die In Oregon” was released in 2012 and brought attention to the issues of active euthanasia and physician assisted suicide (PAS). This documentary directed by Peter Richardson dives into the lives of two individuals who have been diagnosed with a terminal illness (Delgado, 2016). One middle aged women with pancreatic cancer who decides to go through with PAS and another man who decides to suffer through his illness until his death (Richarson, 2012). This documentary got the nation talking about a topic that was relatively non-existent before its release. Due to law changes regarding PAS and active euthanasia in recent years, this issue is being talked about on a

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national level. Six states have made PAS legal with five out of six states passing the law within the last 8 years (Orentlicher, 1997). As a result of active and passive euthanasia being brought to the forefront in the news, there has been developed conversations about this topic. Both physicians and more of the general public will develop an opinion about it. I believe James Rachels makes one of the best arguments that there is no moral difference between active and passive euthanasia and it will be a vital piece of work in defending those who believe the same.

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Delgado, J. (2016). Legalization of Physician Assisted Suicide. Unpublished manuscript, Drexel University. Emanuel, E.j, E.r Daniels, D.l Fairclough, and B.r Clarridge. "Euthanasia and Physician-assisted Suicide: Attitudes and Experiences of Oncology Patients, Oncologists, and the Public." The Lancet 347.9018 (1996): 1805-810. Web. Miller, Franklin G., Howard Brody, and Timothy E. Quill. "Can Physician-Assisted Suicide Be Regulated Effectively?" The Journal of Law, Medicine & Ethics 24.3 (1996): 225-32. Web. Snyder, Lois, and Daniel Sulmasy. "Physician-Assisted Suicide." Annals of Internal Medicine137.3 (2002): 216. Web. Rachels, J. (1975). Active and passive euthanasia. Boston: Massachusetts Medical Society. Richardson, P., Korenbrot, M., In Snider, G., Richter, M., HBO Documentary Films,, Clearcut Productions,, New Video Group, Docurama (Firm),. (2012). How to Die in Oregon. Vaughn, L. (2015). Bioethics: principles, issues, and cases. New York: Oxford University Press....