Active And Passive Euthanasia
Euthanasia is the act of ending another person’s life, either with or without their consent or assistance, performed generally in order to end one’s suffering. It manifests in two main forms; “active euthanasia” is the act of directly causing someone’s death, either with or without their permission, while “passive euthanasia” relies on inaction rather than action – usually ending treatment that could prolong a patient’s life and allowing death to occur naturally. The former is basically “mercy killing,” while the latter can be considered “letting nature take its course.”
Physician-assisted suicide differs from active euthanasia because the former gives patients control of the process that results in their death. With physician-assisted suicide, the choice rests with the patient, who voluntarily commits suicide and enlists a doctor’s help only to provide the means without performing the act. Euthanasia is different because the patients do not actually kill themselves, but are allowed to die (in the passive case) or put to death by others (in the active variety).
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Two schools of thought exist on the moral differences between active and passive euthanasia. Conventional morality tolerates some degree of the latter, while the former is considered unconditionally wrong, little better than murder itself. The American legal and medical professions tend to agree and enforce this doctrine; according to the AMA, “Whether a specific case of euthanasia is ‘active’ or ‘passive’ has nothing to do with whether or not the patient consented to it,” which seems to make a case against euthanasia in general because patients’ consent has no bearing (AMA). Also, the United States Supreme Court makes no distinctions between the types.
However, advocates of euthanasia, like James Rachels, claim that active euthanasia is acceptable, even desirable; he writes that “active euthanasia is in many cases more humane than passive euthanasia” (Rachels). Instead, he claims that passive euthanasia is morally the same as watching someone die in an accident while refusing to save them, and that withholding life-sustaining treatment only prolongs the patient’s agony, so actively ending that person’s life is actually morally more acceptable.
Rachels also argues that the grounds for such arguments are themselves outmoded and inherently incorrect. This view assumes that one agrees that the best action causes the greatest benefit (or, if nothing else, the least unhappiness for patients and relatives alike).
Between the two, I find active euthanasia more morally acceptable, since it is often quick and painless. Simply ceasing treatment and allowing a patient to die naturally can be callous because, in many cases, the patient will continue to suffer until death. I do not necessarily agree with Rachels’ notion that passive euthanasia is the same as watching someone drown and refusing to assist, though, since the former act is generally not done out of cruelty or indifference. However, I agree with Rachels’ point of view, which argues that active euthanasia is at times more favorable and even more humane than the passive type (which can prolong a patient’s suffering).
In cases of permanently comatose or brain-dead patients, it seems more humane to allow them to die with dignity than to live artificially However, I am ambivalent about the issue because I am aware that many consider any for of euthanasia little more than murder.
I believe my reasons for advocating active euthanasia are consequential, since they center on the most relevant concern – the patient’s welfare and dignity. A brain-dead patient has no quality of life to speak of, while the terminally ill generally suffer greatly. Keeping them alive with no legitimate hope of recovery, as James Rachels claims, does seem cruel because it prolongs their suffering. Allowing their lives to end quickly and painlessly appears more humane. However, I am aware of the law’s position on euthanasia, as well as the religious considerations. Also, there is the possibility of euthanasia being applied unnecessarily or against the patient’s will, or in cases where the patient is not as ill as initially thought.
Permanently comatose (or “brain-dead”) patients pose another dilemma, because they are unable to actively participate in the act of euthanasia. They cannot issue orders or make decisions, leaving them wholly at the mercy of physicians or family members who consider death a more dignified state than being a vegetable. (In this case, euthanasia can be only active, and places much more responsibility for the death in the caregivers’ hands.)
This was the case in the Terri Schiavo controversy, in which the permanently brain-damaged patient’s family and husband took opposite stances on whether her life should be ended. Her devoutly Catholic relatives objected on primarily religious grounds and did not concede that she was as brain-damaged as some experts maintained, and the matter became a sort of national referendum on euthanasia itself, with right-to-die advocates siding against the religious right and briefly involving Congress.
Anonymous. “Active and Passive Euthanasia.” BBC – Religion and Ethics. 2005. <http://www.bbc.co.uk/religion/ethics/euthanasia/active_passive.shtml>.
Anonymous. “Euthanasia & Assisted Suicide.” Constance Perry. Ph.D. <http://www.pages.drexel.edu/~cp28/euth1.htm>.
Rachels, James. “Active and Passive Euthanasia.” 2002. Perspectives on Death and Dying. <http://www2.sunysuffolk.edu/pecorip/SCCCWEB/ETEXTS/DeathandDying_TEXT/Rachels_Active_Passive.htm>.