Euthanasia Definitions

Euthanasia:

the intentional killing by act or omission of a dependent human being

for his or her alleged benefit. (The key word here is "intentional". If death is not intended, it is not an act of euthanasia)
Voluntary euthanasia: Non-voluntary:

When the person who is killed has requested to be killed.

When the person who is killed made no request and gave no

consent.
Involuntary euthanasia:

When the person who is killed made an expressed wish to the

contrary.
Assisted suicide: Someone

provides an individual with the information, guidance,

and means to take his or her own life with the intention that they will be used for this purpose. When it is a doctor who helps another person to kill themselves it is called "physician assisted suicide."
Euthanasia by Action:

Intentionally causing a person's death by performing an action

such as by giving a lethal injection.

Euthanasia by Omission:

Intentionally causing death by not providing necessary and

ordinary (usual and customary) care or food and water.

What Euthanasia is NOT: There is no euthanasia unless the death is intentionally caused by what was done or not done. Thus, some medical actions that are often labeled "passive euthanasia" are no form of euthanasia, since the intention to take life is lacking. These acts include not commencing treatment that would not provide a benefit to the patient, withdrawing treatment that has been shown to be ineffective, too burdensome or is unwanted, and the giving of high doses of pain-killers that may endanger life, when they have been shown to be necessary. All those are part of good medical practice, endorsed by law, when they are properly carried out. (Source: http://www.euthanasia.com/definitions.html)

Meaning and Cases of Euthanasia Etymologically, euthanasia means "easy death" (from the Greek word - "easy" and thanatos"death") (The Reader's Digest Great Encyclopedia Dictionary 1966). More strictly, it means painless, peaceful death; it is the deliberate putting to death, in an easy, painless way, of an individual suffering from an incurable and agonizing disease. It is popularly known as mercy killing, insofar as it is regarded as a merciful release from an incurable and prolonged suffering. Some call it the art or practice of painlessly putting to death a person suffering from a marked deformity or from an unbearable and distressing disease.(Bittle 1950: 369; Overduin and Fleming 1982: 150-151; Shannon and Digiacomo 1979: 59-65). Others consider it a theory that in* certain circumstances when owing, to disease, senility or the like, a person's life has permanently ceased to be either agreeable or useful, the sufferer should be painlessly killed, either by himself or another. Thus, by implication, euthanasia is a theory which affirms an individual's right to die in a painless and peaceful manner when he is confronted with a horrible disease and the quality of his life deteriorates. Cases of euthanasia may be grouped into self-administered and other-administered (Pahl 1981: 144-155; Beauchamp and Walters 1978: 286-290). The former may be either active (positive) euthanasia, in which a terminally ill patient will deliberately, directly terminate his life by employing painless methodsit is an act of commission insofar as it is voluntary and deliberate; or passive (negative) euthanasia, in which one allows oneself to die without taking any medicine or by refusing medical treatment it is an act of omission insofar as one simply refuses to take anything to sustain life. : The latter (other-administered) may be classified in four ways:

1. Active and voluntary euthanasia is one in which either a physician, spouse, or a friend of the patient will terminate the latter's life upon the latter's request. It is voluntary insofar as it is requested by the patient; it is active insofar as some positive means is used to terminate the patient's life.

2. Passive and voluntary euthanasia is one in which a terminally ill patient is simply allowed to die by the physician, spouse, or an immediate relative, upon the patient's request. It is passive insofar as no positive method is employed; the patient is merely permitted to pass away. It is voluntary insofar as this is done upon the patient's request. 3. Active and nonvoluntary euthanasia occurs when it is the physician, spouse, close friend, or relative who decides that the life of the terminally ill patient should be terminated. It is active insofar as some positive method is utilized to terminate the patient's life; it is nonvoluntary insofar as the termination of the patient's life is decided by an individual other than the patient. 4. Passive and nonvoluntary euthanasia is one in which a terminally ill patient is simply allowed to die, as requested by immediate family members, (spouse or parents) or the attending physician. It is passive inasmuch as no positive means is employed to end the patient's life; it is nonvoluntary insofar as other persons make the moral decision to terminate the patient's life.

Theorists Application Natural law ethics condemns mercy killing. Euthanasia is intrinsically wrong because it implies the direct, deliberate killing of an individualhence, it is murder (Bittle 1950: 370 371; Pahl 1081; 14(5-147). Even though the motive is good (e.g., the patient is better off dead than

suffering from prolonged agony), the good does not justify the evil means in this case. The principles of stewardship m and the inviolability of life may be appealed to in this connection.

Nevertheless, the principle of double effect may be legitimate under certain circumstances. To give medication for the relief of pain, for instance, even if the indirect outcome of the medication will be to shorten the patient's life, may be morally permitted. The primary and direct object of the initiated medication is the relief of pain, which is good in itself, and the patient's death following the medication is never intended directly; it becomes the secondary, indirect result of the act of medication. (Refer to the four conditions of the principle at issue supra). Furthermore, there is no moral obligation to continue medical treatment if and when a terminally ill patient becomes hopeless. Even if one's life might be lengthened through extraordinary measures which are already useless anyway, it is legitimate to allow the patient to die as a result of his/her own illness or injury as the case may be. The same moral reasoning and decision may be applied to us.

General Christian view

Christians are mostly against euthanasia. The arguments are usually based on the beliefs that life is given by God, and that human beings are made in God's image. Some churches also emphasise the importance of not interfering with the natural process of death. Life is a gift from God all life is God-given birth and death are part of the life processes which God has created, so we should respect them therefore no human being has the authority to take the life of any innocent person, even if that person wants to die

Human beings are valuable because they are made in God's image

human life possesses an intrinsic dignity and value because it is created by God in his own image for the distinctive destiny of sharing in God's own life
saying that God created humankind in his own image doesn't mean that people actually look like God, but that people have a unique capacity for rational existence that enables them to see what is good and to want what is good as people develop these abilities they live a life that is as close as possible to God's life of love this is a good thing, and life should be preserved so that people can go on doing this

to propose euthanasia for an individual is to judge that the current life of that individual is not worthwhile such a judgement is incompatible with recognising the worth and dignity of the person to be killed therefore arguements based on the quality of life are completely irrelevant

nor should anyone ask for euthanasia for themselves because no-one has the right to value anyone, even themselves, as worthless

The process of dying is spiritually important, and should not be disrupted Many churches believe that the period just before death is a profoundly spiritual time They think it is wrong to interfere with the process of dying, as this would interrupt the process of the spirit moving towards God

All human lives are equally valuable Christians believe that the intrinsic dignity and value of human lives means that the value of each human life is identical. They don't think that human dignity and value are measured by mobility, intelligence, or any achievements in life. Valuing human beings as equal just because they are human beings has clear implications for thinking about euthanasia: patients in a persistent vegetative state, although seriously damaged, remain living human beings, and so their intrinsic value remains the same as anyone else's so it would be wrong to treat their lives as worthless and to conclude that they 'would be better off dead' patients who are old or sick, and who are near the end of earthly life have the same value as any other human being people who have mental or physical handicaps have the same value as any other human being

Exceptions and omissions Some features of Christianity suggest that there are some obligations that go against the general view that euthanasia is a bad thing: Christianity requires us to respect every human being If we respect a person we should respect their decisions about the end of their life We should accept their rational decisions to refuse burdensome and futile treatment Perhaps we should accept their rational decision to refuse excessively burdensome treatment even if it may provide several weeks more of life

End of life care The Christian faith leads those who follow it to some clear-cut views about the way terminally ill patients should be treated: the community should care for people who are dying, and for those who are close to them the community should provide the best possible palliative care the community should face death and dying with honesty and support the community should recognise that when people suffer death on earth they entrust their future to the risen Christ religious people, both lay and professional, should help the terminally ill to prepare for death they should be open to their hopes and fears they should be open to discussion

KANT Kant's ethics speaks of the human dignity of an autonomous 1 rational being (Pahl 1981:147). As such, we have a bounden duty to preserve our life. But once a person becomes comatose and unknowing I because of illness and injury, this person loses his autonomous status, I and it is not clear whether there is still a duty to maintain one's life under such conditions. It seems that active and voluntary euthanasia may be compatible with, if not required by, Kant's ethics. It can also be argued that on Kant's ethical principles, active and nonvoluntary euthanasia may be regarded as our duty to comatose and hopeless patients as a way of recognizing the dignity which that person possess in his/her previous state.

Furthermore, a terminally ill patient in a vegetative state is no | longer an autonomous person with a self-regulating will. Hence, by | Kantian principles, our duty to preserve life no longer holds. Depending upon how one interprets the utilitarian principle of I utility, it seems that its formulation about the greatest happiness and benefits for the greatest number of persons may render euthanasia legitimate. One who is comatose and who has already become a financial liability and psychological burden to one's family may be put to painless death for one's own good, as well as that of anyone I who has witnessed such a patient bear great pain and agony for months or years. Others may interpret the utility principle, which argues that since life is a necessary condition for happiness, that it is morally wrong to destroy that condition, since by doing so the possibility of .promoting happiness is forever lost. Moreover, organ-transplant advocates may argue that a comatose patient is going to die anyway, and his transplantable organs (e.g. eyes, heart, or kidneys) will benefit those who are in need (upon informed consent or with the permission of his immediate relatives). In this way, promoting the greatest benefits for the greatest number of individuals to be benefited will make euthanasia morally acceptable. In the same light* the pragmatic theory of the good and truth seems to justify euthanasia in general. It can be argued that when an individual has been in agony for a long time, and it has become unbearable to go on living in misery and pain, the most pragmatic (i.e., realistic and

practical and beneficial) moral decision to make is to put such a useless life to an end. As in the utility principle, one can even opt for organic donations, once an individual has lapsed into irreversible unconsciousness for several hours without any sign of possible recovery. The pragmatic moralist may argue: "The bottom line is this: the most realistic, beneficial, and useful thing to do in a situation where recovery is nil, is to offer one's healthy organs to people who can still benefit from them. Why render them useless and allow them to die with the patient if others can still use them to continue living?" From the pragmatic point of view, reason seems to dictate (although it may sound unorthodox) that offering our "spare parts" to others for their own survival, if and when we no longer have use for them, appears to be legitimate and acceptable. Through similar reasoning, situation ethicians may justify and endorse euthanasia under certain conditions and situations. Active and voluntary euthanasia may be compatible with the principles of situation ethics. One (i.e., physicians and others) may employ some positive means to put a patient's life to a speedy end at his own request. This would be doing the patient more good than harm. To prolong the patient's agony and suffering, despite a request for a painless death, would be to do more harm than good. Thus, it can be argued that one is acting in the name of love by helping a terminally ill patient to die in a painless manner. In the light of Ross's ethical principles, under certain conditions or circumstances, one may find it a stringent prima facie duty to put a comatose patient to an easy death, depending upon a good motive e.g., to put an end, once and for all, to the prolonged suffering of the patient. It may be the most prudent thing to do under the prevailing circumstances. It may become one's prima facie duty which has the greatest balance of goodness over badness. On Rawls's concept of justice, which argues that no amount of social good or welfare can override the inviolability of the individual, it appears as if euthanasia would be illicit and unacceptable. However, a person's inviolability demands that his dignity be preserved and justice be served if and when his death would be as painless and nonviolent as possible. To let him live and suffer needless pain and agony would be doing him more injustice than justice, more harm than good.

One can perhaps argue that active and voluntary us well as active and nonvoluntary euthanasia would be in keeping with Rawls's concept of justice as fairness. To be fair and just to a terminally ill patient is to give and protect what is most essential. Nothing is more essential to an individual than one's dignity as a human being. That dignity, therefore, must be preserved and safeguarded by giving a hopeless and long-suffering patient a painless and honorable death.

Pro-choice arguments (for Euthanasia)

Can quickly and humanely end a patients suffering, allowing them to die with dignity. Can help to shorten the grief and suffering of the patients loved ones. Everyone has the right to decide how they should die. Death is a private matter, and if you are not hurting anyone else, the state should not interfere. Most people would have their pets put down if they were suffering this would be regarded as kindness. Why cant the same kindness be given to humans?

Illness can take away autonomy (the ability to make choices) and dignity, leaving you with no quality of life; euthanasia allows you to take back control in deciding to die

Keeping people alive costs a lot of money, which could be used to save other people's lives

Some Christians would support euthanasia. They might argue:

God is love. Christianity is love and compassion. Keeping someone in pain and suffering is not loving, it is evil. Euthanasia can be the most loving action, and the best way of putting agape love into practice.

Humans were given dominion over all living things by God (Genesis 1:28), i.e. we can choose for ourselves. Jesus came so that people could have life in all its fullness John 10:10: this means quality of life. If someone has no quality of life, then euthanasia could be good.

God gave humans free will. We should be allowed to use free will to decide when our lives end. Do to others as you would have them do to you. How would you want to be treated? There are examples of euthanasia in the Bible - in 2 Samuel 1:9-10 Then he begged me, Come over here and put me out of my misery, for I am in terrible pain and want to die. So I killed him.

Thomas More, a Roman Catholic saint, wrote a book about a perfect society ('Utopia'), which included euthanasia - people "

Pro-life arguments (against Euthanasia)

Many pain killing drugs can now help a patient die with dignity. A dying patient may not be able to make a rational decision. A patient may have said they want euthanasia when they were nowhere near death; however, when faced with death they may change their mind but be incapable of telling anyone.

Many people recover after being written off by doctors. Euthanasia makes life disposable it could be the first step on a slippery slope. Hippocratic Oath: doctors must try to preserve life. If euthanasia was legalised, the relationship of trust between doctors and patients can be destroyed. If there were better facilities for caring for dying, there would be less need for euthanasia. People might be pushed into saying they want euthanasia by relatives who do not want to look after them.

Many Christians are against euthanasia. They argue it is dangerous to make euthanasia legal.

Thou shall not kill. It is wrong to take away Gods sacred gift of human life. God made man in his own image Genesis 1:27 human life is a sacred gift from God. God gives and God takes away Job 1:21, not us! Dont you know that you are the temple of God? 1 Corinthians 3:16-17

Jesus healed the sick and dying, he did not kill them. Christians have a duty to help others who are suffering, not kill them. Humans have a responsibility to use Gods gifts to the full, not end it! Suicide denies our responsibilities to our neighbours, society, family, etc.. Everyone is created by God and offered salvation through Christ killing is always wrong. Killing a life opposes Gods love for that person

Justification and Unjustification of Euthanasia

Example Situations: Now that we have the basic idea of what euthanasia is and how the five theorists that we have learned in Bioethics, we may begin to deliberate an example situation regarding if euthanasia is acceptable in this condition or not.

When the condition is not terminal

Suppose now that we are dealing with a patient whose condition is not inevitably terminal, but rather such that it leads to severe impairment of function and involves a long period of intense and intractable pain, as well as other states of life regarded as intolerable by the patient. The story of a young man we call "Donald C.,"*who was severely burned, and wanted to die.

Two months after being discharged from three years of military service as a jet pilot, the world of Donald C. exploded in a flash of burning gas. He was then twenty-six years old, unmarried, and a college graduate. An athlete in high school, he loved sports and outdoors. Rodeos were his special interest, and he performed in them with skill Upon leaving the military in May 1973, Donald joined his father's successful real estate business. The two of them had always had a close and warm relationship. On July 25, 1973, they were together, appraising farm land. Without realizing it, they parked their car near a large propane gas transmission line; the line was leaking. Later, when they started their automobile, the ignition of the motor set off a severe and unexpected explosion. Donald, his father, and the surrounding countryside were enveloped in fire. The father died on the way to the hospital, and Donald was admitted in a critical but conscious state. He sustained second- and third-degree burns over 68 percent of his bodymostly third-degree burns. Both eyes were blinded by corneal damage, his ears were mostly destroyed, and he sustained severe burns to his face, upper extremities, body, and legs. During the next nine months, Donald underwent repeated skin grafting, enucleation of his right eye, and amputation of the distal parts of the fingers on both hands. The left eye was surgically closed in order to protect it from the danger of infection; the cornea was badly scarred and the retina was partially detached. His hands, deformed by contracture, were useless, unsightly stubs. When admitted to the University of Texas Medical Branch Hospitals in April 1974, the patient had many infected areas of his body and legs. He had to be bathed daily in the Hubbard tank to control infection. From the day of the accident onward, Donald persistently stated that he did not want to live. Nonetheless, he had continued to accept treatment. Two days after admission to the university hospital, however, he refused to give permission for further corrective surgery on his hands. He became adamant in his insistence that he be allowed to leave the hospital and return home to diea certain consequence of leaving since only daily tanking could prevent

overwhelming infection. The tankings were continued despite his protests. His mother, a thoughtful and courageous woman, was frantic; his surgeons were frustrated and perplexed. Although calm and rational most of the time, the patient had frequent periods of childlike rage, fear, and tearfulness. He engaged his mother by the hour in arguments regarding his demand to leave the hospital which, of course, he was physically incapable of doing unless she agreed to take him home by ambulance. At this juncture, Dr. Robert B. White was asked to see the patient as a psychiatric consultant. Prior to seeing the patient he was given the impression that Donald was irrationally depressed and probably needed to be declared mentally incompetent so that a legal guardian could be appointed to give the necessary permission for further surgery and other treatments. The patient's mother was understandably in favor of his remaining in the hospital. She was deeply concerned about her son's welfare, and the prospect of taking him home to die from pus-covered sores on his body was more than she could bear. She was a deeply religious woman and was also concerned lest her son die without reaccepting the church that he had left some time prior to his burns. Donald was the eldest of three children. By his family's account, he was an active, assertive, and determined person, who since childhood had tended to set his own course in life. What or whom he liked, he stuck to with loyalty and persistence; what or whom he disliked, he opposed with tenacity. His mother stated, "He always wanted to do things for himself and in his own way." Dr. White soon concluded that the mother's summary was apt. In the course of the first few interviews it was apparent that Donald was a very stubborn and determined man; he was also bright, articulate, logical, and coherent not by any criterion mentally incompetent. He summarized his position with the statement, "I do not want to go on as a blind and crippled person." Arguments that surgery could restore some degree of useful function to his hands, and perhaps some useful vision to his remaining eye, were of no avail. His determination to leave the hospital was unshakable, and he demanded to see his attorney in order to obtain his release by court order if necessary.
Donald has:
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11.

severe disability irreversible life expectancy shortened, but not greatly intractable pain patient requests to forego proposed treatment this request is based on a judgment that he would be "better off dead" the patient's request is coherent with his/her fundamental values ("in character") family and caregivers do not share these fundamental values these values are rationally defensible (?) continued treatment is a burden to others (family, significant others, caregivers) what is being requested is to withhold a treatment (i.e., another in a series of surgical procedures and/or another in a series of treatments to prevent infection)

12. 13.

what is to be done is an omission, not a positive action the treatment in question is regarded by the patient as an extraordinary measure (i.e., no reasonable hope of benefit, excessively painful, expensive, or otherwise burdensome); caregivers regard it as an ordinary measure

14.

the consequences of the proposed action (omission) would involve pain, suffering, indignity, or other burden for the patient

15.

the intention of the agent would be to honor the wishes of the patient, not directly to kill the patient

16. 17.

compassion is the predominant motive prompting everybody the underlying illness will be the cause of death