Lesson 10 – Euthanasia defined
Define euthanasia
Distinguish 6 different kinds of
euthanasia
An intentional act, or omission, that brings about the death of another individual for
that individual’s own health-related good.
Voluntary active (VAE)
Non-voluntary active (NAE)
Involuntary active (IAE)
Voluntary passive (VPE)
Non-voluntary passive (NPE)
Involuntary passive (IPE)
Active euthanasia is when one directly causes another individual’s death. Passive
euthanasia occurs when one allows another individual to die.
Voluntary euthanasia occurs when a competent person consents to his death. Nonvoluntary euthanasia occurs when it involves mentally incompetent individuals who
lack the decision-making capacity to express a preference to live or die. Involuntary
euthanasia occurs when a competent individual does not consent to his death.
Lesson 11 – Arguments against
the Moral Permissibility of
Active Euthanasia
Explain the Sanctity of Life
Argument against active
euthanasia
Explain the Playing God
Argument in support of the
Sanctity of Human Life Principle
Explain the Kantian argument in
support of the Sanctity of
Human Life Principle
1. Active euthanasia is the intentional killing of an innocent human being.
2. It is wrong to intentionally kill an innocent human being.
-3. Active euthanasia is wrong.
Premise 2 contains the principle that is known as the Sanctity of (Innocent) Human
Life.
Our life belongs to God, only God should be able to make life and death decisions.
Active euthanasia makes a life and death decision, so active euthanasia is wrong.
In response, there are counterexamples such as saving a person’s life being an act
that plays God but isn’t wrong. Also, sacrificing your life to save others.
Rational nature, or the ability to make one’s own decisions, is of ultimate value and
must always be respected. Kant opposed suicide on the grounds that the person who
commits suicide treats himself merely as a means, and does not respect his own
rational nature. When one kills another person (euthanasia), one destroys that
person’s rational nature, which is forbidden.
Evaluation: Even if it is always wrong to treat rational beings merely as a means, this
would not rule out all cases of active euthanasia, since some cases of active
euthanasia are not performed on rational beings, e.g. young, disabled children.
Explain the cases of the
incompetent plague victim and
Also, why is it always wrong to destroy rational nature? The passengers of United #93
treated themselves merely as a means but it was not wrong for them to do so, and
they saved many lives.
Lorry driver is driving his truck, gets into an accident and gets trapped in his truck as
flames begin to engulf him. He screams for someone to kill him so that he does not
the petrol lorry driver and how
have to roast to death.
they are used as
counterexamples to the Sanctity Plague: Suppose that a totally incompetent patient has been infected with an
of Human Life Principle
incurable and highly contagious disease, and the patient has escaped custody and is
running toward a crowd. A police officer shoots and kills the patient to avert a global
disaster, a plague.
Lesson 12 – Active vs Passive
euthanasia
Give the argument against AE
1. AE involves intentionally killing while PE merely involves intending to let die.
that is based on the claim that
2. It is always much worse to intentionally kill than to intentionally let die.
intentional killing is worse than -intentional letting die
3. AE is always much worse than letting die.
Explain the case of Smith and
Jones that Rachels uses to
refute the claim that intentional
killing is, in itself, worse than
intentional letting die
Is Premise 2 true? Going to a refugee camp that is famine stricken and shooting
everyone is obviously worse than having people die in the camp because of lack of
famine relief. However, letting die can be a slow, undignified and painful process and
active killing can be quick and merciful.
He creates 2 cases – 1 case is intentional killing and the other is intentional letting die.
Case 1. Smith stands to gain a large inheritance if anything should happen to his 6
year old cousin. While his cousin is taking a bath, Smith enters to drown his cousin
intentionally.
Case 2. Same thing for Jones, except before he does anything his cousins slips and
drowns and Jones does not do anything to save him. He intentionally allowed his
cousin to die.
Morally speaking, Smith’s behaviour is not morally worse than Jones’ so Premise 2
above must be false.
Evaluate the effectiveness of
Rachels controlled experiment
Lesson 13 – An Argument for
the Moral Permissibility of
Voluntary Active Euthanasia
(VAE)
Present the autonomy/best
interest argument for VAE
Give examples
Consider and evaluate possible
1. Acts that are freely chosen by a competent person and that are in the person’s best
interest, and do not violate rights or set back important interests of others are morally
permissible to perform.
2. In some cases, VAE is freely chosen by a competent person, is in that person’s besti
interest, and does not set back the important interests of others.
-3. In these cases, VAE is morally permissible.
This argument involves the moral importance of respecting a person’s autonomy.
e.g. Maggie’s decision
e.g. truck driver
Identify a faulty premise:
objections to argument
One may be able to reasonably deny that euthanasia was in Maggie’s best interest
(premise 2).
It is vague when it mentions “important interests.”
Lesson 14 – An argument for
moral permissibility of nonvoluntary active euthanasia
(NAE)
Present the best interest
argument for NAE.
The VAE argument cannot be applied to NAE because VAE involves a person’s
autonomy.
1. When dealing with individuals who are not and will never be competent to make
their own health care decisions, it is morally permissible to act in that non-competent
individual’s best interest provided that no one’s rights are violated.
2. In some cases (like Tracy’s below), NAE is in the best interest of the individual who
is to die, and can be done without violating anyone else’s rights.
-3. Therefore, in these cases, NAE is morally permissible.
Illustrate this argument with
examples
Consider and evaluate possible
objections to this argument
Lesson 15 – Legalizing Active
Euthanasia
Explain the main arguments for
legalizing active euthanasia
Explain the various kinds of
slippery slope arguments
against legalizing active
euthanasia
Trace Latimer: euthanized by her father at twelve, suffered from cerebral palsy and
severe mental and physical disabilities caused by oxygen deprivation at birth. In
constant pain, was required to have several surgeries. Not wanting Tracy to go
through more pain and another surgery to repair a dislocated hip, Robert killed her by
placing her in his truck and connecting a hose from the truck’s exhaust pipe to the
cab. He described the medical treatments Tracy had undergone to be “mutilation and
torture.”
Perhaps the most controversial premise is premise 2. Some deny that NAE can be
done without violating someone’s rights, because some may maintain that NAE
always violates the right to life of the person who is to be killed.
Slippery slope argument:
1. X may be permissible
2. If X is permitted, then Y is likely to occur.
3. Y is objectionable.
-4. Therefore, X should not be practiced.
VAE may lead to the wrongful killing of patients who either do not really (freely) agree
to being killed, or who agree to it, but who in fact could have lived and had lives worth
living. There are three possible sources of abuse or misuse: institutional abuse,
professional abuse and interpersonal abuse.
Institutional abuse: The way medical care is delivered, the way society is organized,
will lead to wrongful killings in the name of VAE. A shortage of beds, equipment, and
staffing, for example will cause doctors to be pressured to encourage patients to opt
for euthanasia. A lack of adequate support systems, or the lack of health insurance,
may pressure patients to opt for euthanasia.
Professional abuse: Doctors who are unable to care for all their patients may pressure
sicker or older patients to request euthanasia when they are actually just concerned
with caring for other patients rather than that particular patient’s best interests.
Additionally, these pressures could lead to a relaxation in the standards of what could
count as a life not worth living, and so people could end up being killed whose lives
are well worth living.
Interpersonal abuse: This, like professional abuse, is in part because of institutional
abuse. A family member may pressure an ailing relative to request euthanasia, only
because that family member lacks the resources to properly care for their relative.
Or, someone may request it because they do not want to be a financial burden to
their family, even though it is not their interest to die.
There are other concerns with legalizing VAE, but the main point here is that VAE is a
bad social policy because it is too likely to be abused, and mistakes are too likely to
happen. Patients should be given good comfort care instead so that the number of
people needing/wanting euthanasia is kept to a minimum.
Explain how defenders of
legalization counter the slope
arguments
The most promising line of defense to these concerns of abuse is to say that these
serious concerns can be greatly avoided by introducing carefully targeted safeguards.
For example, to protect patient autonomy, and to reduce the likelihood of undue
pressures (be they professional, institutional or interpersonal), supporters of legalized
VAE could require at least two medical opinions, strict documentation, institutional
review of all euthanasia requests, and psychological counselling, prior to carrying out
VAE. Such safeguards as well as others could help ensure that the patient is both
choosing autonomously and expected to have a life that is not worth living.
Even though safeguards are never perfect and mistakes/abuse will still happen, this is
not enough to say that VAE should be prohibited. After all, virtually all social policies
have mistakes – like automobiles causing thousands of needless deaths each year in
Canada but it is still prohibited. Instead, we think that we should regulate the use of
automobiles and then allow them because their benefit outweighs their cost.
Finally, supporters of legalized VAE will also point out that there are dangers in not
legalizing the practice. Even it is illegal, euthanasia still happens, especially since
many of the institutional, professional and interpersonal pressures still exist
regardless of the legal status of active euthanasia. Wrongful or mistaken killing in the
name of euthanasia might actually be reduced if it were legalized and carefully
regulated.
Defend your own views on
whether active euthanasia
ought to be legalized