Euthanasia happens anyway

Euthanasia happens - better to make it legal and regulate it properly

Sounds a bit like "murder happens - better to make it legal and regulate it properly".

When you put it like that, the argument sounds very feeble indeed.

But it is one that is used a lot in discussion, and particularly in politics or round the table in the pub or the canteen.

People say things like "we can't control drugs so we'd better legalise them", or "if we don't make abortion legal so that people can have it done in hospital, people will die from backstreet abortions".

What lies behind it is Utilitarianism: the belief that moral rules should be designed to produce the greatest happiness of the greatest number of people.

If you accept this as the basis for your ethical code (and it's the basis of many people's ethics), then the arguments above are perfectly sensible.

If you don't accept this principle, but believe that certain things are wrong regardless of what effect they have on total human happiness, then you will probably regard this argument as cynical and wrong.

A utilitarian argument for euthanasia

From a utilitarian viewpoint, justifying euthanasia is a question of showing that allowing people to have a good death, at a time of their own choosing, will make them happier than the pain from their illness, the loss of dignity and the distress of anticipating a slow, painful death. Someone who wants euthanasia will have already made this comparison for themselves.

But utilitarianism deals with the total human happiness, not just that of the patient, so that even euthanasia opponents who agree with utilitarianism in principle can claim that the negative effects on those around the patient - family, friends and medical staff - would outweigh the benefit to the patient.

It is hard to measure happiness objectively, but one way to test this argument would be to speak to the families and carers of people who had committed assisted suicide.

Opponents can also argue that the net effect on the whole of society will be a decrease in happiness. The only way to approach this would be to look at countries where euthanasia is legal. However, as no two countries are alike, it seems impossible to extricate the happiness or unhappiness resulting from legal assisted suicide, from any happiness or unhappiness from other sources.

Even if you agree with the utilitarian argument, you then have to deal with the arguments that suggest that euthanasia can't be properly regulated.

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Is death a bad thing?

Why ask this question?

If death is not a bad thing then many of the objections to euthanasia vanish.

If we put aside the idea that death is always a bad thing, we are able to consider whether death may actually sometimes be a good thing.

This makes it much easier to consider the issue of euthanasia from the viewpoint of someone who wants euthanasia.

Why is death a bad thing?

We tend to regard death as a bad thing for one or more of these reasons:

· because human life is intrinsically valuable

· because life and death are God's business with which we shouldn't interfere

· because most people don't want to die

· because it violates our autonomy in a drastic way

The first two reasons form key points in the arguments against euthanasia, but only if you accept that they are true.

The last two reasons why death is a bad thing are not absolute; if a person wants to die, then neither of those reasons can be used to say that they would be wrong to undergo euthanasia.

People don't usually want to die

People are usually eager to avoid death because they value being alive, because they have many things they wish to do, and experiences they wish to have.

Obviously, this is not the case with a patient who wishes to die - and proper regulation will weed out people who do not really want to die, but are asking for other reasons.

Violation of autonomy

Another reason why death is seen as a bad thing is that it's the worst possible violation of the the wishes of the person who does not want to die (or, to use philosophical language, a violation of their autonomy).

In the case of someone who does want to die, this objection disappears.

Being dead, versus not having been born

Some people say that being dead is no different from not having been born yet, and nobody makes a fuss about the bad time they had before they were born.

There is a big difference - even though being dead will be no different as an experience from the experience of not having yet been born.

The idea is that death hurts people because it stops them having more of the things that they want, and could have if they continued to live.

Someone who makes a request for euthanasia is likely to have a bad quality of life (or a bad prognosis, even if they are not yet suffering much) and the knowledge that this will only get worse. If that is the case, death will not deprive them of an otherwise pleasant existence.

Of course, most patients will still be leaving behind some things that are good: for example, loved ones and things they enjoy. Asking for death does not necessarily mean that they have nothing to live for: only that the patient has decided that after a certain point, the pain outweighs the good things.

Overview of anti-euthanasia arguments

It's possible to argue about the way we've divided up the arguments, and many arguments could fall into more categories than we've used.

Ethical arguments

· Euthanasia weakens society's respect for the sanctity of life

· Accepting euthanasia accepts that some lives (those of the disabled or sick) are worth less than others

· Voluntary euthanasia is the start of a slippery slope that leads to involuntary euthanasia and the killing of people who are thought undesirable

· Euthanasia might not be in a person's best interests

· Euthanasia affects other people's rights, not just those of the patient

Practical arguments

· Proper palliative care makes euthanasia unnecessary

· There's no way of properly regulating euthanasia

· Allowing euthanasia will lead to less good care for the terminally ill

· Allowing euthanasia undermines the committment of doctors and nurses to saving lives

· Euthanasia may become a cost-effective way to treat the terminally ill

· Allowing euthanasia will discourage the search for new cures and treatments for the terminally ill

· Euthanasia undermines the motivation to provide good care for the dying, and good pain relief

· Euthanasia gives too much power to doctors

· Euthanasia exposes vulnerable people to pressure to end their lives

· Moral pressure on elderly relatives by selfish families

· Moral pressure to free up medical resources

· Patients who are abandoned by their families may feel euthanasia is the only solution

Historical arguments

· Voluntary euthanasia is the start of a slippery slope that leads to involuntary euthanasia and the killing of people who are thought undesirable

Religious arguments

· Euthanasia is against the word and will of God

· Euthanasia weakens society's respect for the sanctity of life

· Suffering may have value

· Voluntary euthanasia is the start of a slippery slope that leads to involuntary euthanasia and the killing of people who are thought undesirable

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Against the will of God

Religious people don't argue that we can't kill ourselves, or get others to do it. They know that we can do it because God has given us free will. Their argument is that it would be wrong for us to do so.

They believe that every human being is the creation of God, and that this imposes certain limits on us. Our lives are not only our lives for us to do with as we see fit.

To kill oneself, or to get someone else to do it for us, is to deny God, and to deny God's rights over our lives and his right to choose the length of our lives and the way our lives end.

The value of suffering

Religious people sometimes argue against euthanasia because they see positive value in suffering.

Down through the centuries and generations it has been seen that in suffering there is concealed a particular power that draws a person interiorly close to Christ, a special grace.

Pope John Paul II: Salvifici Doloris, 1984

The religious attitude to suffering

Most religions would say something like this:

We should relieve suffering when we can, and be with those who suffer, helping them to bear their suffering, when we can't. We should never deal with the problem of suffering by eliminating those who suffer.

The nature of suffering

Christianity teaches that suffering can have a place in God's plan, in that it allows the sufferer to share in Christ's agonyand his redeeming sacrifice. They believe that Christ will be present to share in the suffering of the believer.

Pope John Paul II wrote that "It is suffering, more than anything else, which clears the way for the grace which transforms human souls."

However while the churches acknowledge that some Christians will want to accept some suffering for this reason, most Christians are not so heroic.

So there is nothing wrong in trying to relieve someone's suffering. In fact, Christians believe that it is a good to do so, as long as one does not intentionally cause death.

Dying is good for us

Some people think that dying is just one of the tests that God sets for human beings, and that the way we react to it shows the sort of person we are, and how deep our faith and trust in God is.

Others, while acknowledging that a loving God doesn't set his creations such a horrible test, say that the process of dying is the ultimate opportunity for human beings to develop their souls.

When people are dying they may be able, more than at any time in their life, to concentrate on the important things in life, and to set aside the present-day 'consumer culture', and their own ego and desire to control the world. Curtailing the process of dying would deny them this opportunity.

Eastern religions

Several Eastern religions believe that we live many lives and the quality of each life is set by the way we lived our previous lives.

Those who believe this think that suffering is part of the moral force of the universe, and that by cutting it short a person interferes with their progress towards ultimate liberation.

A non-religious view

Some non-religious people also believe that suffering has value. They think it provides an opportunity to grow in wisdom, character, and compassion.

Suffering is something which draws upon all the resources of a human being and enables them to reach the highest and noblest points of what they really are.

Suffering allows a person to be a good example to others by showing how to behave when things are bad.

M Scott Peck, author of The Road Less Travelled, has written that in a few weeks at the end of life, with pain properly controlled a person might learn

how to negotiate a middle path between control and total passivity, about how to welcome the responsible care of strangers, about how to be dependent once again ... about how to trust and maybe even, out of existential suffering, at least a little bit about how to pray or talk with God.

M Scott Peck

The nature of suffering

It isn't easy to define suffering - most of us can decide when we are suffering but what is suffering for one person may not be suffering for another.

It's also impossible to measure suffering in any useful way, and it's particularly hard to come up with any objective idea of what constitutes unbearable suffering, since each individual will react to the same physical and mental conditions in a different way.

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Sanctity of life

This argument says that euthanasia is bad because of the sanctity of human life.

There are four main reasons why people think we shouldn't kill human beings:

· All human beings are to be valued, irrespective of age, sex, race, religion, social status or their potential for achievement

· Human life is a basic good as opposed to an instrumental good, a good in itself rather than as a means to an end

· Human life is sacred because it's a gift from God

· Therefore the deliberate taking of human life should be prohibited except in self-defence or the legitimate defence of others

We are valuable for ourselves

The philosopher Immanuel Kant said that rational human beings should be treated as an end in themselves and not as a means to something else. The fact that we are human has value in itself.

Our inherent value doesn't depend on anything else - it doesn't depend on whether we are having a good life that we enjoy, or whether we are making other people's lives better. We exist, so we have value.

Most of us agree with that - though we don't put it in philosopher-speak. We say that we don't think that we should use other people - which is a plain English way of saying that we shouldn't treat other people as a means to our own ends.

We must respect our own value

It applies to us too. We shouldn't treat ourselves as a means to our own ends.

And this means that we shouldn't end our lives just because it seems the most effective way of putting an end to our suffering. To do that is not to respect our inherent worth.

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The slippery slope

Many people worry that if voluntary euthanasia were to become legal, it would not be long before involuntary euthanasia would start to happen.

We concluded that it was virtually impossible to ensure that all acts of euthanasia were truly voluntary and that any liberalisation of the law in the United Kingdom could not be abused.

We were also concerned that vulnerable people - the elderly, lonely, sick or distressed - would feel pressure, whether real or imagined, to request early death.

Lord Walton, Chairman, House of Lords Select Committee on Medical Ethics looking into euthanasia, 1993

This is called the slippery slope argument. In general form it says that if we allow something relatively harmless today, we may start a trend that results in something currently unthinkable becoming accepted.

Those who oppose this argument say that properly drafted legislation can draw a firm barrier across the slippery slope.

Various forms of the slippery slope argument

If we change the law and accept voluntary euthanasia, we will not be able to keep it under control.

· Proponents of euthanasia say: Euthanasia would never be legalised without proper regulation and control mechanisms in place

Doctors may soon start killing people without bothering with their permission.

· Proponents say: There is a huge difference between killing people who ask for death under appropriate circumstances, and killing people without their permission

· Very few people are so lacking in moral understanding that they would ignore this distinction

· Very few people are so lacking in intellect that they can't make the distinction above

· Any doctor who would ignore this distinction probably wouldn't worry about the law anyway

Health care costs will lead to doctors killing patients to save money or free up beds:

· Proponents say: The main reason some doctors support voluntary euthanasia is because they believe that they should respect their patients' right to be treated as autonomous human beings

· That is, when doctors are in favour of euthanasia it's because they want to respect the wishes of their patients

· So doctors are unlikely to kill people without their permission because that contradicts the whole motivation for allowing voluntary euthanasia

· But cost-conscious doctors are more likely to honour their patients' requests for death

· A 1998 study found that doctors who are cost-conscious and 'practice resource-conserving medicine' are significantly more likely to write a lethal prescription for terminally-ill patients [Arch. Intern. Med., 5/11/98, p. 974]

· This suggests that medical costs do influence doctors' opinions in this area of medical ethics

The Nazis engaged in massive programmes of involuntary euthanasia, so we shouldn't place our trust in the good moral sense of doctors.

· Proponents say: The Nazis are not a useful moral example, because their actions are almost universally regarded as both criminal and morally wrong

· The Nazis embarked on invountary euthanasia as a deliberate political act - they didn't slip into it from voluntary euthanasia (although at first they did pretend it was for the benefit of the patient)

· What the Nazis did wasn't euthanasia by even the widest definition, it was the use of murder to get rid of people they disapproved of

· The universal horror at Nazi euthanasia demonstrates that almost everyone can make the distinction between voluntary and involuntary euthanasia

· The example of the Nazis has made people more sensitive to the dangers of involuntary euthanasia

Allowing voluntary euthanasia makes it easier to commit murder, since the perpetrators can disguise it as active voluntary euthanasia.

· Proponents say: The law is able to deal with the possibility of self-defence or suicide being used as disguises for murder. It will thus be able to deal with this case equally well

· To dress murder up as euthanasia will involve medical co-operation. The need for a conspiracy will make it an unattractive option

Many are needlessly condemned to suffering by the chief anti-euthanasia argument: that murder might lurk under the cloak of kindness.

A C Grayling, Guardian 2001

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Devalues some lives

Some people fear that allowing euthanasia sends the message, "it's better to be dead than sick or disabled".

The subtext is that some lives are not worth living. Not only does this put the sick or disabled at risk, it also downgrades their status as human beings while they are alive.

The disabled person's perspective

Part of the problem is that able-bodied people look at things from their own perspective and see life with a disability as a disaster, filled with suffering and frustration.

Some societies have regarded people with disabilities as inferior, or as a burden on society. Those in favour of eugenics go further, and say that society should prevent 'defective' people from having children. Others go further still and say that those who are a burden on society should be eliminated.

People with disabilities don't agree. They say:

· All people should have equal rights and opportunities to live good lives

· Many individuals with disabilities enjoy living

· Many individuals without disabilities don't enjoy living, and no-one is threatening them

· The proper approach to people with disabilities is to provide them with appropriate support, not to kill them

· The quality of a person's life should not be assessed by other people

· The quality of life of a person with disabilities should not be assessed without providing proper support first

Opposition to this argument

Supporters of euthanasia would respond that this argument includes a number of completely misleading suggestions, and refute them:

· Dying is not the same as never having been born

· The debate is nothing to do with preventing disabled babies being born, or preventing people with disabilities from becoming parents

· Nobody is asking for patients to be killed against their wishes - whether or not those patients are disabled

· The euthanasia procedure is intended for use by patients who are dying, or in a condition that will get worse - most disabilities don't come under that category

· The normal procedure for euthanasia would have to be initiated at the patient's request

· Disabled people who are not mentally impaired are just as capable as able-bodied people of deciding what they want

· Protections will be in place for patients who are mentally impaired, whether through disability or some other reason

· It is possible that someone who has just become disabled may feel depressed enough to ask for death, which is why any proposed system of euthanasia must include psychological support and assessment before the patient's wish is granted

· All people should have equal rights and opportunities to live, or to choose not to go on living

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Date: 2015-01-02; view: 6067