Passive Euthanasia: Jewish and Catholic Perspectives Compared

Introduction

Euthanasia is essentially the practice of "mercifully ending a person's life in order to release the person from an incurable disease, intolerable suffering, or undignified death" (Euthanasia). The term is derived from the Greek words eu and thanatos, meaning "good death." It has most commonly been used in relation to intentional mercy killings — that is, cases in which the life of a terminally ill or severely suffering person is ended with the assistance of another. In short, this means that person "A" ends the life of person "B" for the sake of "B" (Kuhse, 1992).

Fully comprehending the implications of the term euthanasia requires an understanding of two important aspects: first, that it involves the taking of a life, and second, that this life-taking is intended to be for the sake of the person who is dying or suffering. This correlation separates euthanasia from other forms of life-taking. Advances in medical science have made it possible to artificially prolong life, which has complicated the ethical and moral issues surrounding euthanasia and has further problematized the moral feasibility of non-interactive, or passive, euthanasia.

There are four types of euthanasia generally recognized. Active euthanasia, the most contentious form, is when a patient's life is ended in a direct and intentional way, usually to reduce suffering or to terminate what the medical practitioner may regard as a hopeless case. Passive euthanasia, by contrast, involves taking no direct action to end life while also refraining from steps that would artificially extend it: "It is when a doctor withholds any means in order to prolong the life of a patient" (Ibrahim, 2002). Voluntary euthanasia refers to a patient's personal decision to end his or her own life. Involuntary euthanasia refers to cases in which the patient cannot participate in the decision — for example, when the patient is mentally ill or in a coma (ibid).

The euthanasia debate, which is often heated and controversial, is part of the larger "right to die" debate and touches on questions of civil liberty and personal freedom. From a purely secular standpoint, euthanasia relates specifically to individual freedom and is argued, in those terms, to be morally and legally permissible in cases where the patient is terminally ill or suffering without medical hope of relief. In the religious and non-secular context, however, active and passive euthanasia become severely problematic. The dominant world religions do not treat euthanasia as separate from the larger spiritual dimension. Consequently, the theological and moral implications of any form of life-taking are weighed against religious teachings that emphasize the sanctity of life and the relationship between the individual and God.

According to both Judaic and Catholic perspectives, the patient does not have sole ownership of his or her life; that life is, in a religious sense, an integral part of the theological context from which it came. Any decision pertaining to euthanasia must therefore be considered within the broader ambit of theological issues, perceptions, and laws. Whereas in secular terms euthanasia is a matter of personal liberty, in a theological context the debate takes place against the background of a much broader ethical and spiritual framework. From both the Judaic and Christian points of view, euthanasia can only be considered in light of the sanctity of life and the importance of the dying process within a theological context — a crucial point on which there are broad similarities but also subtle differences between the Catholic and Jewish traditions.

The scientific and medical advances that have characterized the past century have expanded the range of euthanasia-related situations that these religious groups must address. This is particularly true with regard to artificial life-support systems.

Historical Background

Every society has certain principles aimed at prohibiting the taking of life, though there are differences and variations across tradition and culture. In Western history, approaches to both active and passive euthanasia have varied considerably. In Greek and Roman times, for example, "practices such as infanticide, suicide, and euthanasia were widely accepted" (Tait). A notable exception was the Greek physician Hippocrates (460–370 BCE), who famously stated: "I will not prescribe a deadly drug to please someone, nor give advice that may cause his death" (Euthanasia: Internet Encyclopedia of Philosophy). This oath emphasized the preservation of life, a value that would later come to characterize both Judaic and Christian theology.

Throughout history there have been various secular and theological approaches to euthanasia. The humanist Thomas More (1478–1535), for example, defended euthanasia in the context of compassion and care for those in pain — arguably a necessary humane position in an age without modern medicine (ibid).

In general, the rise of Judaism and Christianity intensified the view that all human life was sacred and that taking life was irreligious. Western historians claim that "Judaism and the rise of Christianity contributed greatly to the general feeling that human life has sanctity and must not deliberately be taken" (Kuhse, 1992). These religions not only emphasized the moral importance of life but also situated the taking of life within a specific theological context: "To take an innocent human life is, in these traditions, to usurp the right of God to give and take life. It has also been seen by influential Christian writers as a violation of natural law" (ibid). The long history of the euthanasia debate has therefore been characterized by its express condemnation under Judaism, Christianity, and Islam, and by the implementation of this view into social law (Tait).

Active and Passive Euthanasia Distinguished

Active euthanasia refers to the taking of life by performing a specific act — such as administering a lethal dose of medication — with the explicit intention of ending a life deemed terminal or otherwise beyond relief. Passive euthanasia, by contrast, is non-active: "Passive euthanasia involves not doing something to prevent death, as when doctors refrain from using an artificial respirator to keep alive a terminally ill patient" (Kuhse, 1992).

While passive and active euthanasia may seem similar in ethical terms — both involve the termination of life — there are essential differences. In passive euthanasia the patient is killed by the disease itself and therefore dies of natural causes, whereas in active euthanasia it is the physician who directly terminates the patient's life. Ethicists describe this distinction as follows: "When the physician withholds or withdraws treatment, the patient is killed by the disease, whereas when the physician gives a lethal injection, the patient is killed by the physician" (Gordon, 1998).

There is, however, a counter-argument that regards both active and passive euthanasia as morally culpable. As one study poses the question: "Is killing, in itself, worse than letting die?" (Baird & Rosenbaum, 1989, p. 47). Baird and Rosenbaum argue that the cessation of treatment, if it is "the intentional termination of the life of one human being by another," is morally equivalent to active killing: "Of course it is exactly that, and if it were not, there would be no point to it" (ibid). Nevertheless, numerous counter-arguments have been advanced in favor of the moral superiority of passive over active euthanasia, and this distinction remains central to both religious traditions examined here.