Theory:
Is doing harm equal to allowing harm to be done? Are active and passive forms of euthanasia equally and morally justifiable? To understand the ethics behind euthanasia one must examine the issue through the theory of consequentialism and utilitarianism. Classic utilitarianism is the complex theory of many distinct claims. Listed below are the subcategories of claims that contribute to this theory.
Consequentialism = whether an act is morally right depends only on consequences (as opposed to circumstances or anything that happens before the act).
Actual Consequentialism = whether an act is morally right depends only on the actual consequences (as opposed to foreseen, foreseeable, intended, or likely consequences).
Direct Consequentialism = whether an act is morally right depends only on the consequences of that act itself (as opposed to the consequences of the agent's motive, of a rule or practice that covers other acts of the same kind, and so on).
Hedonism = the value of the consequences depends only on the pleasures and pains in the consequences (as opposed to other goods, such as freedom, knowledge, life, and so on).
Total Consequentialism = moral rightness depends only on the total net good in the consequences (as opposed to the average net good per person).
Universal Consequentialism = moral rightness depends on the consequences for all people or sentient beings (as opposed to only the individual agent, present people, or any other limited group).
Equal Consideration = in determining moral rightness, benefits to one person matter just as much as similar benefits to any other person (= all who count, count equally).
Agent-neutrality = whether some consequences are better than others does not depend on whether the consequences are evaluated from the perspective of the agent (as opposed to an observer).
(Stanford, 2003)
The issue of autonomy also plays a significant role in evaluating this issue. Autonomy is defined as the personal liberty of action in which the individual determines his or her own course of action in accordance with a plan chosen by him or herself. This self determination implies independence and self-reliance, freedom of choice, and the ability to make decisions. The social justice model points out that there are a number of criteria needed to be taken into account for the necessary conditions of autonomy: rationality, reasonableness, information and freedom from coercion (Schartz and Miculan, 2005).
Application:
The consequences of conducting euthanasia are extremely serious. Hence, consequences must be evaluated to assess the moral rightness of the act. Some may criticize euthanasia as a form of murder or suicide. If this was the case then euthanasia would immediately be deemed morally unacceptable. Conversely this view can be rebutted by stating that with our current state of medicinal knowledge, no one should die in pain and distress. Seeking euthanasia should not be dismissed as a method of avoiding physical or mental pain through murder or suicide, but to preserve dignity and exercise human endowment of autonomy (Telfer, 2004).
The principle of autonomy relates to euthanasia because a terminally ill patient should have the right to decide the conditions of their death. When a terminally ill patient has been given all the information needed to reach a rational and reasonable decision, they have the right to preserve their dignity and to determine the circumstances surrounding their death. Since some terminally ill patients cannot end their own lives, they depend on doctors who have the knowledge for the best way to carry out this decision. Here a doctor acts as an agent on behalf of the patient. In order to preserve the patient’s autonomy, the doctor must uphold agent neutrality. According to pro-euthanasia activists, voluntary active euthanasia is considered the “ultimate exercise of self-determination.” It will be the last decision ever made by a patient and in a sense is taking control of one’s entire self (Doerfligner, 1989).
Utilitarianism is a theory that allows one to advocate euthanasia. A hedonistic utilitarian would argue that voluntary euthanasia is acceptable. During a terminal patient’s remaining days the situation would arise in which the patient will feel more pain than pleasure. There comes a point in which medicine can do nothing more than delay death. If the terminal patient’s request is granted, resources that are keeping this patient alive will be freed to save others who stand a chance to survive their illness. Allowing a patient to be granted their dying wish will also bring happiness to a greater number of people through resource availability.
However, the theory of utilitarianism may not be an appropriate method to justify euthanasia. If a large majority of people agreed that they would all benefit from the death of one person, it seems to demean the value of life and justify murder. It provides no protection for the individual against the majority. On the other hand, universal consequentialism gives good reason for euthanasia, since according to the polls the majority of Americans find it reassuring to have the option of euthanasia regardless of whether they will proceed with this option. While satisfying the majority, once euthanasia is made legal it would reinforce the perception of this moral right (Pellergino, 1994).
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