Shiva

Ethical responses to euthanasia

Utilitarianism
Kant
Natural Law
Situation Ethics
Virtue Ethics

Utilitarianism
Bentham's Hedonic Calculus can be used to weigh up the pleasure

and pain caused by two courses of action - in this case, helping

someone to die, or not doing so. Bentham would consider
the Intensity of the pain and its Duration. The pain is
immediate, while possible future benefits are Remote.

In most cases, the degree of pain is so great that Bentham's theory

would support euthanasia. Mill would also have supported

euthanasia, as he believed in the sovereignty of the individual despite the principle of utility, if I'm harming no-one else, I can do
what I please.

Mill did make a distinction between higher and lower pleasures,

which can be shown effectively here. Thomas Hyde was 27 when

Dr. Kevorkian helped him to die. He had ALS - the same condition
that Stephen Hawking has. For Hyde, an athletic man, the
thought of never using his body again was too much. Mill would
argue that if his mind were still working, Hyde should have been
able to enjoy a happy life. Someone with Alzheimers would be a
different story, as Mill would see little benefit in continuing with
life if your mind wasn't working properly.

Kant's Ethical Theory

For Kant, the outcome of an action is not relevant to whether or

not it is ethical. This can easily be demonstrated - sometimes evil

actions lead to unintended good consequences. He also disagreed
with making moral choices out of compassion, kindness etc. It is
also easy to give an example of where kindness leads to doing the
wrong thing (the road to hell is paved with good intentions). The
only right thing is to do what reason dictates.

When considering euthanasia, then, Kant will not be interested in

the level of suffering of the patient or relatives. He would not agree

that we should do the loving thing. He would work out what the
right thing to do was.

The last statement of the Categorical Imperative says we should

not use people merely as a means to an end. Kant may have said
that killing someone to end their pain was using them to another
end. Other Kantians might argue the opposite - that a person's
ends are best served by ending their misery.

Kant himself was strongly against any form of suicide, and would

have argued against euthanasia. However, modern Kantians may

well disagree.

Natural Law
Natural Law theology has led to strong sanctity of life responses from the Catholic

church. Natural Law deals in moral absolutes - secondary precepts that cannot be
broken regardless of the situation, The end never justifies the means, so no amount
of suffering can justify an 'evil act' (Do good, avoid evil).

One of the primary precepts is to 'protect and preserve the innocent'. It is therefore a

secondary precept and an absolute moral rule that you should never kill an innocent
person. It would seem that euthanasia is always wrong. You couldn't argue for
assisted suicide, as the same principle would outlaw killing oneself even if you could
justify helping someone to die , which is unlikely.

However, we mustn't forget the principle of double effect. It is wrong to kill, but is it

wrong to give someone pain relief if a secondary effect is that they die? Once you
accept that death is merely a by-product of another action, you are asking a very
different question. You are asking 'Is death a proportionate outcome?' This brings in
a utilitarian type of consideration, which we would not expect from Natural Law!

In other words, while Natural Law clearly doesn't support active euthanasia, it may

well allow an action whose intention is merely to relieve pain, even if the action leads
to death. There are natural law thinkers who find the doctrine of double effect
difficult to reconcile with Natural Law thinking.

Situation Ethics
Situation Ethics is easy to apply here. Quite simply, you can dispense with

rules about killing, because the most loving thing to do may well be to give
someone a peaceful death. Situation Ethics is Personal - it puts people
before rules. It is also Pragmatic, allowing us to do whatever works best in
the circumstances. What is the use in keeping someone alive to suffer?
Relativism is at the heart of the theory. This means that in any situation,
when faced with a difficult decision about whether to help someone to die,
we need to act out of love, which means ignoring any hard and fast rule and
doing what the situation requires.
Situation Ethics isn't helpful when it comes to legislation, largely because
the situation ethicist would ignore any rules that were made anyway if the
situation demanded it. Situationists may well be worried that a law that
allowed euthanasia might put pressure on people who didn't want to die.
They might argue that there need to be great safeguards against the misuse
of any euthanasia rules. However, they are likely to argue in favour of
allowing euthanasia. A situation ethicist would probably say that, even if
euthanasia was not allowed, it may well be right to break the law and help
someone to die.

Virtue Ethics
Aristotle believed we should aim for eudaimonia happiness, but the sort of happiness resulting
from a life in perfect balance. Eudaimonia means we have developed habits of patience,
temperance, courage etc. These virtues are perfected so that we may be perfectly happy not in
order to benefit others. People suffering greatly from illness would not be living a eudaimon
life. If there was a way to improve their physical well-being, Aristotle would support
this. However, where someone is incurably and terminally ill, Aristotle might hope that they
would have the courage to accept their fortune. It is not clear whether he would expect someone
to have the patience to cope with their condition, or the courage to end their own life. He would
say that person achieving eudaimonia would have the wisdom and judgement to make the right
decision.
Aristotle was concerned with the good for society above the individual. In those cultures where
resources are scarce, euthanasia may well make a huge difference on the well-being of society as
a whole. Under these circumstances, it may be a courageous, noble act for someone to take their
own life when very ill. Even in our own society, where people are living longer and people with
illnesses are surviving when they wouldnt have before, there may be huge financial benefits to
society if those who are unproductive were euthanized. However, it doesnt seem in keeping with
Aristotles virtues of patience, modesty, temperance etc.
MacIntyre is a relativist virtue ethicist. He might argue that in Britain we are moving towards a
change in law regarding euthanasia. We are a more secular society than America, and America
found it difficult to imprison Jack Kevorkian who helped over 100 people to die. However,
MacIntyre might explain why other countries, particularly Roman Catholic and Muslim
countries, are likely to strongly resist any weakening of the law regarding the ending of human
life.
Macintyre will not say whether it is right to allow euthanasia - he will just explain the decisions
people make in terms of the context in which those decisions arise.

Conclusion
Many of the ethical disagreements about end-of-life

decisions can be seen as resulting from differing

ethical frameworks, esp. Kantian vs. utilitarian.
Use these models to understand where you stand,
where your patients stand, and where your
organization stands in regard to end-of-life issues.