A Case for Active Euthanasia

Death is deeply personal, generally feared, and wholly inescapable, but medical technology now can prolong our biological existence virtually indefinitely, and, with these advances, comes the question of whether we should pursue the extension of life in all cases. Most people would agree that, under certain circumstances, it would be preferable to cease our hold on life. Nearly everyone can agree that there are situations when terminally ill patients have the right to call for a halt to life-extending treatments, and that their physicians will have the moral obligation to comply.

What appears to be quite difficult for us as a society to come to terms with is the thought that someone would actively intervene in the "natural" process of the death of another human being. Why is it tolerable, even desirable, to intervene in the "natural" process of death when it results in extending life, but intolerable and morally abhorrent when we act to speed the patient to his or her unavoidable death? In this paper I am going to argue that active euthanasia should become legal in certain circumstances.

To do this I will argue that, in the situation of terminal illness, active euthanasia allows for the patient to end the suffering and should therefore be permissible. Secondly, I will examine a case where someone has survived a life-changing accident and wishes they had given a choice to live or die. Perhaps the most important issue at hand is the patient's right, willingness, and desire to die. For the most part, any random, healthy individual would most likely be unable to imagine or comprehend the type of pain and anguish that a terminal illness will cause.

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Therefore, the decision to live or die under the presence of certain, and probably painful, death should be left in the hands of the individual that is suffering. Taking its name from a Greek term meaning "the good or easy death," euthanasia should represent exactly that. The decision to live or die does not belong to anyone but to the person whose life it is. According to Kantian ethics, autonomy is based on the human capacity to direct one’s life according to rational principles. Autonomy is where people are considered as being ends in themselves in that they have the capacity to determine their own destiny and must be respected.

Having one's entire life slowly drained from oneself is frequently considered the most excruciating of tortures. Yet somehow the right to bring peace to oneself through a slightly unconventional method is repeatedly denied. It has been assumed since the dawn of the medical profession that the doctor's place is a healer, as the ones to cure all illnesses. A physician is seen as the one who is supposed to maintain and prolong ones health, as best as they can until no more can be done. This means that, if all treatment fails, the physician should be allowed to assist in avoiding the unnecessary agony.

James Rachels’ article, called “Active and Passive Euthanasia,” uses the equivalence thesis. He believes that killing and letting die are equally as bad, that there is no real moral difference in certain circumstances. He distinguishes killing as active euthanasia and letting die as passive. I am going to argue that, in most cases, passive and active euthanasia are equally as “bad,” and sometimes passive is more morally wrong than active euthanasia. Rachels argues that there may be times when active euthanasia is more merciful than passive.

This is often in cases with incurable cancer or disease that, if you were to stop the treatment, the patient would die within a few days. I am going to argue that active euthanasia can be more merciful by giving an example of an incurable disease. Imagine that an elderly woman is diagnosed with Parkinson’s disease. The doctor tells her that although it is incurable, there is medicine that can help lessen the symptoms. Imagine that when it is first starts, things like relaxing, reading a book, and sitting still are no longer relaxing, as a tremor that has started in her hand, arm, or leg.

Soon her muscles become rigid and what used to seem like an easy task is no longer so. As the disease progresses, the medicine required to keep the muscles from going rigid has a side effect of dyskinesia (involuntary movement of the body). This becomes a balancing act – she must be able to tolerate the dyskinesia in order to be able to still move her muscles. As the disease advances more, she has spouts of dementia that will soon take over completely; trouble swallowing (often choking on food) and talking, and she can no longer stand or walk on her own.

She needs help going to the bathroom and is often humiliated by the need to depend on someone else entirely. As the dementia comes and goes, she able to tell her family how unhappy she is and that she no longer wants to live. The family understands and wishes for her to no longer suffer, however, for this to happen, she must suffer without medicine with no promise to immediate death, just complete rigidity of her muscles. All of these symptoms seem horrifying to those not experiencing it, and humiliating and frustrating for those that are.

The life she used to live is completely gone and she rarely remembers what her family members do as a living and is stuck remembering the past. Would it not be torture to put her through staying alive, realizing that every time she becomes lucid she hates her life and realizes she has no control over it? However, stopping medicine in this case will not kill the patient, and will only result in rigidity of the muscles and inability to move. What choice is she left with? In this situation active euthanasia should be permissible. Often in times like these the family is also suffering due to the pain of their family member.

When the person has an incurable disease, knows that they are not happy and that things will get worse, it would be unfair to keep them alive due to selfishness and what we believe is “right. ” It is ultimately the person’s choice and should be kept this way, as it is their life. One might argue that in this case the dementia prevents the patient from being fully reasonable and therefore autonomy cannot be used in this situation. I argue that when she lets her family know she is unhappy and does not want to live this way, she is coherent.

Shouldn’t this person be given the right to make this choice when they are still capable, before people start speaking and making choices for their life? Furthermore, it is often argued that the side effects (such as how it will effect the family and friends, Glover) of death are what really influence a decision. In John Hardwig’s article “Duty to Die,” Hardwig argues that there are times when a person has a duty to die. His argument covers what many of us believe to be a reason for someone to stay alive- for our own well-being.

A duty to die is permissible when the burden of caring for someone seriously compromises the lives of those that love us (Hardwig). In the Parkinson’s situation, the family will need to help the woman often and if not themselves, will need to hire someone to care for her all the time as the disease progresses. This can be a large financial burden on the family. There are many cases out there where autonomy was not respected. One great example is the Dax Cowart case. Dax was involved in a terrible accident in 1973 when he was twenty-five years old.

He was critically injured in a propane gas explosion that killed his father and left Dax with burns to over sixty-five percent of his body including both eyes, ears and hands, which were damaged beyond repair. Large doses of narcotics were required for minimal pain relief. For more than a year, he underwent extraordinarily painful treatments. From the day of his accident, Dax expressed a desire to die, to leave the hospital and to end his suffering. He pleaded with his caregivers to be allowed to die, and also stated several times that he wanted to kill himself.

The physicians turned to his mother to obtain consent for all his treatments, even though she was not appointed his legal guardian and Dax was determined by psychiatric evaluation to have full decision-making capacity. Ultimately, he recovered from the burns, although severely mutilated. He successfully sued the oil company responsible for his burns, which left him financially secure. He eventually finished law school and married. He says he is now relatively happy, but still believes the doctors were wrong to follow his mother’s wishes over his. The case advanced respect for patient autonomy all around the country.

The case of Dax Cowart illustrates the complexity of issues such as autonomy, paternalism, and quality of life. In an interview of Dax twenty-five years after his accident, Dax is absolute that he would still want the same choice if he were to be put in the same situation he was in. He stated, "Another individual may well make a different decision. That’s the beauty of freedom; that’s his or her choice to do so" ("Please Let Me Die"). Unfortunately, while the attitude remains the same about active and passive euthanasia, nothing will change for those who are fighting for the right to end their lives.

One should have the right to autonomy without being violated and should be allowed to decide when it is their time to go in cases that include terminal illness. How is it morally just to make someone suffer a disease that is killing them just because we may not think it’s right to die? I hope that throughout this paper you have been able to see a different side to what active euthanasia can bring (peace to those suffering). Glover, Johnathan. "Sanctity of Life. " Bioethics: An Anthology. By Helga Kuhse and Peter Singer. Oxford, UK: Blackwell, 1999. 66-75. Print. Hardwig, John. "Duty to Die? " Duty to Die? Hastings Center Report, n. d. Web. 07 Oct. 2012. ;http://web. utk. edu/~jhardwig/dutydie. htm;. "Please Let Me Die. " Interview by Robert White. Literature, Arts, and Medicine Database. NYU School of Medicine, n. d. Web. 3 Oct. 2012. ;http://litmed. med. nyu. edu/Annotation? action=view;annid=10105;. Rachels, James. "Active and Passive Euthanasia. " Bioethics: An Anthology. Ed. Helga Kuhse. By Peter Singer. 2nd ed. Oxford, UK: Blackwell, 1999. 288-91. Print.

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