Ethical Perspectives on Physician Assisted Suicide

Euthanasia

Euthanasia can be defined as the process of helping a person end his own life. It can be desired by a person who is perhaps in pain already or expects to be in pain in the coming future due to some terminal illness. It is a concept that goes against the traditional Western code of medicine based on the Hippocratic Oath and Christian ethics, which shaped Western society sine the time of the Middle Ages. In today’s post-Christian culture, there is more debate about the ethics of euthanasia. Physician-assisted suicide has actually been legalized in several states, such as Oregon and California (ProCon, 2022). The primary reason for social support for euthanasia today in some states is that voters see it as a way to end the suffering of an individual who is resigned to dying and wants to die as peacefully as possible on his or her own terms (Buiting et al., 2009). Thus, euthanasia can be seen in negative terms by those who oppose it for ethical reasons, and it can be seen in positive terms by those who support for different ethical reasons. It is ultimately a controversial and divisive topic.

The difference between passive and active euthanasia is that the former involves taking life-support away from an individual while the latter involves giving the individual a life-ending intervention, such as a chemical that will kill. Passive euthanasia has more support among physicians than active euthanasia, which some still associate with Dr. Kevorkian, aka Dr. Death (Vaughn, 2012). The reason more physicians tend to support passive euthanasia than active euthanasia is that there is more ethical justification for passive euthanasia within the Western tradition of ethics. There is no moral obligation, for instance, in Christian ethics to provide life support that is viewed as extraordinary or overly burdensome (Holmes, 2007). Physicians therefore tend to see passive euthanasia as more acceptable within the context of the Hippocratic Oath, as death is a natural and inevitable phenomenon and the purpose of medicine is not to delay the inevitable but rather to help the person return to health when possible. However, some physicians do support active euthanasia, as they see it from a different ethical perspective, namely the perspective of Ethical Egoism in which a person’s autonomy is seen as the most important factor in making decisions (Holmes, 2007).

My beliefs regarding euthanasia are that it should not be pursued actively but that passively it can be accepted. I believe that we have traditional standards and principles that we should follow and that when we do not follow them our society becomes chaotic and unstable. The issue of suicide is one that our standards and principles have traditionally viewed as immoral because there was the notion that life was not one’s to start or stop but rather belonged to God. Obviously, the culture of the Age of Faith supported this principle more than the post-modern, post-Christian culture of today supports the principle. Yet today’s culture also sees far more random acts of violence, such as mass murder, than former epochs saw. So I believe that by moving away from the Old World principles and standards, our culture has lost something valuable and has become desensitized to the preciousness of life. No one likes to suffer, obviously, but it is on us as human beings to help ease the suffering of others. A person with a terminal illness should not be made to feel that he is a burden on everyone. There is the example of St. Catherine of Sienna, who took care of many terminal patients with great care and devotion. There is nothing really preventing anyone from following in her example other than a lack of virtue.

At the same time I see passive euthanasia as acceptable because keeping a person alive through artificial means seems contrary to nature. Just because the technology exists to prolong life for a person who cannot breathe on his own or feed himself does not mean it must necessarily be used in all cases. This type of situation to me represents a gray zone where there is no standard or principle that necessarily applies; the most ethical approach to addressing the matter would be to take it case by case. I would say that if caretakers are available who can provide and want to provide care for the invalid then it would be acceptable. However, I am also torn on this matter because it seems at times selfish to try to keep a person alive through artificial means when it appears that God is calling the person back to Him. If I were in that situation I do not know what I would do if it meant making a decision on keeping a loved one alive or letting a loved one die. It is a difficult matter even to speculate about.

Vulnerable populations that might be affected by euthanasia would be those special populations like the elderly or the handicapped, who cannot make decisions on their own very well or who cannot look after themselves very well. Euthanasia programs were used in the 20th century against populations like this, and the program that is particularly infamous is the one used in Nazi Germany, which applied euthanasia on the handicapped population. Regardless of whether it is the elderly population, the handicapped population, or even the unborn population, euthanasia seems immoral in each case because it is not suicide per se but rather murder. Euthanasia is when the person makes the choice to die and wants help doing it; murder is when someone else decides to take the life of another person. When a euthanasia program is applied to a population that did not ask for it, it should not be called a euthanasia program but rather genocide. Indeed, that is one of the main beliefs of the pro-life population that opposes abortion: they see it as the murder of an infant; but the pro-choice population sees it as a free choice issue or as a woman’s rights issue, completely side-stepping the fact that it is a human life that is being taken. At the very least, active euthanasia thus can be said to facilitate the devaluation of life and dehumanizing.

Laws concerning physician-assisted suicide in my home state are that it is not permitted. Euthanasia is not legal in my state of Kentucky, which prohibits what are called mercy-killings and any other attempt to end a person’s life other than to allow the natural progression of things to take place. This can be contrasted with Oregon’s Death with Dignity Act, which permits active euthanasia. In Oregon’s state law, the requirements that must be met for euthanasia to take place are these: The person must be: 1) 18 years of age or older, 2) capable of making and communicating health care decisions for him or herself, and 3) must be diagnosed with a terminal illness that will lead to death within six months. So it cannot be a case of a person who is 18 walking in and saying that he wants to die because he is depressed. There has to be a terminal condition with a prognosis of six months. No such requirements exist in my home state because in my state euthanasia is not permitted, period.