Death Within Morality: Ethics of Euthanasia in Medicine

Introduction

Medical professionals are guided by a set of moral and ethical standards centered on the principle of doing no harm. However, the medical world is faced with questions and controversies surrounding the issue of death. Generally, life and death are complex subjects in the field of medical practice. Controversies exist over whether keeping someone alive can actually be harmful and whether death can be a more ethical choice than continued life. These debates are fueled by the widespread view that living long, happy lives is the highest good. For medical professionals, determining when to keep someone alive or allow them to die remains deeply debatable — a dilemma intensified by the philosophical premise that the heart and function of philosophy is to prepare humans to die (Wassmer, p. 759). While death is at the center of the human experience, this paper argues that death within morality is an impossibility.

Overview of the Issue

Life and death are two difficult subjects that have attracted the attention of medical professionals and philosophers alike. Life and death decisions are primarily moral issues at the core of ethical theory. According to Wassmer, philosophers have always been interested in public discourse on death, particularly its implications for both the deceased and the living (p. 759). Philosophers' interest in death is fueled by the idea that the heart and function of their discipline is to prepare humans for it. When considering death, philosophers often attempt to apply mysticism or metaphysical reasoning. From a philosophical perspective, views of death are primarily contradictory: on one hand, many people try to push death out of their daily consciousness; on the other hand, some people are constantly preoccupied with it, which is itself considered a normal human experience. This suggests that death is simultaneously viewed as larger than life and as something life transcends.

Philosophical arguments on death are based on the concern of whether death annihilates life altogether or is in some sense larger than life (Kokosalakis, p. 402). These contradictory views have contributed to problematic arguments about the concept of death within an existential and philosophical context. Even though death is deemed ordinary and inevitable, its occurrence generates profound questions about what it means within the human existential condition. As a result, philosophical debates have emerged over how humans should cope with death and whether moral justifications can negate the existential experience of dying. From a philosophical perspective, the issue of death involves more than the complex question of biological life — it encompasses human consciousness, existence, and transcendence.

From a medical perspective, death primarily means the cessation of all bodily organ functions. Kokosalakis notes that human death essentially entails the cessation of an individual's consciousness (p. 403). The intersection between medicine and philosophy on this concept is evident in their shared concern with human existence and consciousness. Medicine seemingly utilizes philosophical ideas to define death by viewing it through the lens of human existence, while also grounding that definition in biological life as the premise for consciousness. Therefore, medicine considers death in terms of its precedence over biological life. Death is not only a threat but also an eliminating force upon human life — a force that medicine regards as something sacred and worthy of protection.

Medical professionals face moral dilemmas about death because of their duty to patients, including those at the end-of-life stage. That moral duty is centered on the principle of doing no harm, one of the fundamental ethical tenets governing medical practice. When medical professionals encounter patients who seek voluntary euthanasia, they face dilemmas about whether their actions would violate this principle and whether such actions could ever be morally justified. The dilemma is further complicated by the fact that modern medicine sometimes treats terminal illness as a de facto justification for death, since the condition cannot be cured regardless. Consequently, the issue of death remains an ethical and controversial problem in medicine, compounded by the underlying philosophical arguments and moral views at stake.

Arguments in Favor of Death

Eribo and Izibili contend that the concept of death has been the subject of philosophical debate for centuries (p. 373). These debates exist because human death has constituted basic mythological problems that philosophers have found difficult to navigate and resolve. These mythological problems have found their way into medicine. Since both medicine and philosophy incorporate ideas of human existence and consciousness, debates surrounding the concept of death have become integral to medical practice.

With the advent of modern medical advances, medical professionals do their best to prolong the lives of patients, including those with terminal illnesses. However, there are ethical concerns about whether prolonging the lives of suffering patients is the right course of action. This has fueled debates about whether death within morality is achievable in the medical field. Can death be morally justified, particularly in situations where patients cannot withstand the pain that accompanies deteriorating conditions? Is it ethically right to keep terminally ill patients permanently sedated when there is no chance of recovery? Could ending a patient's life to prevent worsening suffering be the more humane and ethical choice?

These questions have been central to philosophical and medical debates on death. The issue has attracted contradictory viewpoints between those who view death as morally justifiable in certain medical scenarios and those who oppose it.

One prominent argument advanced by proponents is the view that it is better for an individual to die than to suffer every day (Papadimitriou et al., p. 25). This view has its origins in Greek tragedians such as Aeschylus, who believed it was better for a person to die than to drag out an existence of suffering and anguish. This view contradicts long-standing ethical perspectives on the sanctity of life. The idea that death is preferable to suffering also draws on the philosophy of Socrates, who defined death as a release to the world of the gods (Eribo & Izibili, p. 373). Based on Socrates' view, death is not necessarily an evil — it should be understood as a migration to a higher existence. Socrates' position was supported by Lucretius, who argued that since death is inevitable, it should not trouble either the living or the dead: for the living, death has not yet come; for the dead, they no longer exist.

These philosophical views have informed the position that death is preferable to suffering, and consequently that medical professionals should practice voluntary euthanasia — particularly for terminally ill patients or by mutual consent. From this perspective, it is right for a physician to participate in terminating a patient's life rather than allowing them to suffer (Gupta, Sharma & Sharma, p. 185). From a consequentialist standpoint, there is no meaningful moral difference between letting a person die and actively ending their life, since the outcome is identical (Fisher, par. 7). Efforts to distinguish between the two morally would, in this view, amount to hypocrisy — and could even produce harm by forcing individuals who would be better off dead to endure prolonged suffering or an undignified existence at others' expense.

Drawing further on Socrates and Lucretius, proponents also contend that voluntary euthanasia differs from murder because it involves the patient's consent. While physicians do not have the sole discretion to evaluate euthanasia requests, their role in care delivery requires them to make serious judgments about such requests — judgments that must weigh the severity and intensity of a patient's condition against the intrinsic value and sanctity of life (Gupta, Sharma & Sharma, p. 185). Proponents further argue that medically assisted euthanasia is ethically justifiable because death is, in any case, guaranteed. No human being can escape death despite medicine's best efforts to prolong life. Therefore, people should not only adjust to the reality of death but submit to it. Administering treatment to individuals at the end-of-life stage purely to prolong their lives, proponents argue, confers no genuine benefit on either the patient or society.

Conclusion

Life and death decisions have been at the center of philosophical debates and controversies in the medical profession. The long-standing philosophical debate on the concept of death has found its way into medicine, where it continues to generate controversy. Current philosophical and medical debates on death are fundamentally concerned with whether it is ever morally justifiable. On one hand, some argue that death within morality is justifiable on grounds of an individual's suffering or pain. On the other hand, others argue that death is never morally justifiable, as it infringes upon an individual's right to life. Following an assessment of the arguments and counter-arguments on this issue, this paper concludes that death within morality is not justifiable and remains an impossibility.

Works Cited

Eribo, NM, and MA Izibili. "Religion and Philosophy: The Value of Human Death: The Moral Perspective." Lwati: A Journal of Contemporary Research, vol. 6, no. 1, 7 Oct. 2009, pp. 372–380.

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Gupta, Kshitiz, et al. "The Notion of Morality of Death and Human Behaviour." Journal of Statistics Applications & Probability, vol. 7, no. 1, 1 Mar. 2018, pp. 183–187.

Kokosalakis, Nikos. "Reflections on Death in Philosophical/Existential Context." Society, vol. 57, no. 4, 2020, pp. 402–409.

Papadimitriou, John D, et al. "Euthanasia and Suicide in Antiquity: Viewpoint of the Dramatists and Philosophers." Journal of the Royal Society of Medicine, vol. 100, no. 1, 2007, pp. 25–28.

Svenaeus, Fredrik. "To Die Well: The Phenomenology of Suffering and End of Life Ethics." Medicine, Health Care and Philosophy, vol. 23, no. 3, 2019, pp. 335–342.

Wassmer, Thomas A. "Between Life and Death: Ethical and Moral Issues Involved in Recent Medical Advances." Villanova Law Review, vol. 13, no. 4, 2010, pp. 759–783.