Mercy Killing Physician Assisted Suicide Euthanasia

Euthanasia remains one of the most contentious issues in bioethics, with implications for healthcare practice, law, and public policy. Even when religious arguments are excluded from the debate, it is difficult to determine how healthcare workers and policymakers should consider the complex issues surrounding how a person dies and what situational variables to take into account. Complicating the issue is how to define euthanasia, differentiate between active and passive types of euthanasia, and distinguish it from physician-assisted suicide. When considered from a utilitarian perspective, euthanasia can be considered an ethical practice under certain circumstances but not others. Unlike deontological or duty-based ethical theories, utilitarianism allows for flexibility in making decisions related to the right to die with dignity. Utilitarianism generally supports euthanasia for three main reasons. The first is the principle of patient autonomy. The second is the principle of harm reduction. The third is the healthcare principle of beneficence, the obligation to maximize patient wellbeing.
Utilitarianism is an ethical framework highly relevant to a secular society. Although not comprehensive in scope, utilitarianism is nevertheless flexible enough to offer intelligent insight into how to resolve the euthanasia debate. Rule-based utilitarianism can either support or refute the morality of euthanasia, either by showing that euthanasia could lead to a slippery slope in which physicians have too much power over the lives of others; or by showing that legal euthanasia is the only means to preserve autonomy and individual rights (Hooker). When considering how to frame euthanasia using utilitarianism, it is critical to differentiate between the types of euthanasia and to also resist the temptation to oversimplify the issue by resorting to universalities. No two people and no two situations are equal, which is why it would be unfair to claim that euthanasia is always right or always wrong. However, utilitarian approaches do tend to favor a view that values the reduction of suffering both for the individual and for society as a whole (Vaughn 604). Some, if not most, types of euthanasia clearly do alleviate pain and suffering. In fact, the text defines euthanasia as facilitated death “for that person’s sake,” (Vaughn 604). Therefore, utilitarianism does generally support the moral efficacy of euthanasia.
As convenient as it may be to apply utilitarianism to resolving the bioethical problem of euthanasia, utilitarianism can lead to abuses of power and other types of injustice. If euthanasia is deemed categorically acceptable under the tenets of utilitarianism, then it would be possible to argue that any individual who is being financially or emotionally burdensome to family members would lack utility. That person can also be framed as a burden to society. A central tenet of utilitarianism is doing the greatest good for the greatest number of people. Therefore, euthanasia would be used far too often to end the lives of those who are believed to be less useful than other people.
Rule-based utilitarianism switches the focus of utility away from the utility of the person and towards the utility of the act itself. In other words, rule-based utilitarianism stresses the utility of euthanasia itself as a rule, act, or principle. In the case of euthanasia, the morality of the act must be proven useful in some way. In the simplest and most straightforward of cases, euthanasia is relatively simple to defend from a rule-based utilitarian perspective. If the practice alleviates suffering, then it is morally permissible. For example, a person who has undergone years of chemotherapy and radiation treatment continues to suffer. Doctors determine that the cancer has spread throughout the lymph nodes and is far too aggressive for any existing medical treatments. The person is in pain every day, dependent on life support systems and pharmaceutical pain relief. In these situations, euthanasia is an act of compassion and care. The person’s death is immanent, and prolonging their suffering is not only unnecessary but also cruel.
However, for euthanasia to be considered moral, it must in some way be a voluntary act that promotes the individual’s autonomy. Utilitarianism is an ethical philosophy that is grounded in personal autonomy, precluding a paternalistic or overly moralizing medical system. In some situations, autonomy and conscious choice are clearly determined. Yet in many cases involving euthanasia, it is difficult if not impossible to determine whether a person is acting independently and autonomously. The ambiguity of personal choice is magnified under enormous pain and suffering. Many people will beg to die if they are in a lot of pain for a long period of time; if euthanasia rules were too liberal then it would be too easy to resort to mercy killing in haste, unnecessarily and prematurely ending a life. For this reason, proponents of euthanasia rely on the professional discretion of healthcare workers and physicians who would determine whether a person’s suffering is inevitable, prolonged, and severe. The problem with euthanasia is that even an expert physician opinion is subjective.
Euthanasia does fulfill the main parameters of utilitarianism including patient autonomy, general harm reduction, and beneficence. Yet there is a tremendous risk in resorting to a utilitarian value system in law, governance, and healthcare. Without needing to revert to medical paternalism or restrict patient rights, it is still possible to prohibit any form of euthanasia such as physician-assisted suicide but not necessarily within a utilitarian framework. To prohibit euthanasia requires a categorical denunciation of the practice, which by definition suggests a deontological ethical framework. Utilitarianism permits greater nuance and flexibility, showing that each patient’s situation requires a unique outlook that might in some cases reveal the ethical benefits of euthanasia. Those potential benefits need to be squarely considered in light of the potential harm that a pro-euthanasia healthcare policy might entail. To best ensure that no patient dies prematurely, in haste, or unnecessarily, it is still best even within a utilitarian framework to prohibit any type of mercy killing.



Works Cited

Hooker, Brad. “Rule-utilitarianism and euthanasia.” Retrieved online: http://www.blackwellpublishing.com/content/BPL_Images/Content_store/Sample_chapter/0631228330%5Clafollette.pdf
Vaughan, Lewis. Bioethics. Oxford: Oxford University Press, 2012