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"mercy Killing": What Should Be Done

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The applied moral issue of euthanasia, or mercy killing, concerns whether it is morally acceptable for a third party, such as a physician, to end the life of a terminally ill patient who is in intense pain. I will go further into the facts of this in my paper.

The euthanasia controversy is part of a larger issue concerning the right to die.

Staunch defenders of personal liberty argue that all of us are morally entitled to end our

lives when we see fit. Thus, according to these people, suicide is in principle morally

permissible. For health care workers, the issue of the right to die is most prominent when a patient in their care is terminally ill, is in intense pain, and voluntarily chooses

to end their life to escape prolonged suffering. In these cases, there are several theoretical

options open to the health care worker. First, the worker can ignore the patient's request

and care can continue as usual. Second, the worker can discontinue providing

life-sustaining treatment to the patient, and thus allow him to die more quickly. This

option is called passive euthanasia since it brings on death through nonintervention. Third, the health care worker can provide the patient with the means of taking his own life, such as a lethal dose of a drug. This practice is called assisted suicide, since it is the patient, and not technically the health care worker, who administers the drug. Finally, the health care worker can take active measures to end the patient's life, such as by directly administering a lethal dose of a drug. This practice is called active euthanasia since the health care worker's action is the direct cause of the patient's death. Active euthanasia is the most controversial of the four options and is currently illegal in the United States. However, several right to die organizations are lobbying for the laws against active euthanasia to change.

Two additional concepts are relevant to the discussion of euthanasia. First,

voluntary euthanasia refers to mercy killing that takes place with the explicit and voluntary consent of the patient, either verbally or in a written document such as a living will. Second, nonvoluntary euthanasia refers to the mercy killing of a patient who is

unconscious, or otherwise unable to explicitly make their intentions known. In

these cases it is often family members who make the request. This would be done against the wishes of the patient and would clearly count as murder. It is important not to confuse nonvoluntary mercy killing with involuntary mercy killing.

During the Renaissance, English humanist Thomas More defended Euthanasia in book Utopia. More describes in idealic terms the function of hospitals. Hospital workers watch after patients with tender care and do everything in their power to cure illnesses. However, when a patient has a torturous and incurable illness, the patient has the option to die, either through starvation or opium. In New Atlantis, British philosopher Francis Bacon writes that physicians are "not only to restore the health, but to ease pain and dolours; and not only when such mitigation may conduce to recovery, but when it may serve to make a fair and easy passage."

One of the most cited contemporarily discussions on the subject of euthanasia is

"Active and Passive Euthanasia", by University of Alabama philosophy professor

James Rachels. Rachels argues that there is no moral difference between actively killing a

patient and passively allowing the patient to die. Thus, it is less cruel for physicians to use active procedures of mercy killing. Rachels argues that, from a strictly moral standpoint, there is no difference between passive and active euthanasia. He begins by noting that the AMA (American Medical Association) prohibits active euthanasia, yet allows passive euthanasia. He offers two arguments for why physicians should place passive euthanasia in the same category as active euthanasia. First, techniques of passive euthanasia prolong the suffering of the patient, for it takes longer to passively allow the patient to die than it would if active measures were taken. In the mean time, the patient is in unbearable pain. Since in either case the decision has been made to bring on an early death, it is cruel to adopt the longer procedure. Second, Rachel argues that the passive euthanasia distinction encourages physicians to make life and death decisions on irrelevant grounds. For example, Down's syndrome infants often have correctable congenital defects; but decisions are made to decline corrective surgery (and thus let the infant die) because the parents do not want a child with Down's syndrome. The active-passive euthanasia distinction simply encourages these groundless decisions.

Rachels observes that people think that actively killing someone is morally worse

than passively letting someone die. However, they do not differ since both have the same

outcome: the death of the patient on civilized grounds. The difference between the

two is accentuated because we frequently hear of terrible cases of active killings, but not

of passive killings. Rachels anticipates two criticisms to his argument. First, it may be

objected that, with passive euthanasia techniques, the physician does not have to do

anything to bring on the patient's death. Rachels replies that letting the patient die involves performing an action by not performing other actions (similar to the act of insulting someone by not shaking their hand). Second, it may be objected that Rachels's point is only of academic interest since, in point of fact, active euthanasia is illegal. Rachels replies that physicians should nevertheless be aware that the law is forcing on them an indefensible moral policy.

In "Active and Passive Euthanasia: An Impertinent Distinction?", Thomas

Sullivan argues that no intentional mercy killing (active or passive) is morally



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